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 Table of Contents  
LETTER TO EDITOR
Year : 2015  |  Volume : 3  |  Issue : 2  |  Page : 356

Heterotopic chondroid tissue in the endometrium


Department of Pathology, IGMC, Shimla, Himachal Pradesh, India

Date of Web Publication16-Dec-2015

Correspondence Address:
Sarita Asotra
Flat No. 5, Block No. 5, Phase-3, New Shimla - 171 009, Himachal Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2321-4848.171950

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How to cite this article:
Asotra S. Heterotopic chondroid tissue in the endometrium. Arch Med Health Sci 2015;3:356

How to cite this URL:
Asotra S. Heterotopic chondroid tissue in the endometrium. Arch Med Health Sci [serial online] 2015 [cited 2019 Aug 25];3:356. Available from: http://www.amhsjournal.org/text.asp?2015/3/2/356/171950

Sir,

The occurrence of heterotopic cartilage in the endometrium is a rare event.

We report a case of hererotopic cartilage in the endometrium. A 40-year-old female with para three underwent hysterectomy for complaints of menorrhagia. On gross examination there was white transluscent nodule in the endometrium. Microscopic examination showed lobules of benign hyline cartilage lining the endometrial cavity. There was a cleavage plane between the cartilage and the endometrium. No other tissue was identified, and there was no associated inflammation or tumor [Figure 1].
Figure 1: Photomicrograph showing mature cartilage surrounded by normal endometrium (H and E, ×400)

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A diagnosis of benign heterotopic uterine cartilage was made.

Heterotopia means the occurrence of mature tissues at an abnormal location. Heterologous tissues including bone, cartilage, smooth muscle and glial tissue have been reported in the endometrium. [1] Two theories that account for the presence of these tissues include metaplastic transformation of the endometrial stromal cells and implantation of fetal tissue after abortion and instrumentation with the fetal tissue persisting and growing as a homograft. Other mechanism for uterine cartilage formation includes hypercalcemia and hyperestrenism. Another mechanism is iatrogenic implantation of fetal tissues including the cartilage into uterine wall following dilatation and curettage. [2] Fadare et al. have reported two cases of cartilaginous differentiation in peritoneal tissue, which may represent metaplastic lesions of the secondary mullerian system or a unique peritoneal response to previous surgical response to previous surgical manipulation. Cartilage may be seen in uterine neoplasm such as malignant mixed mullerian tumor. [3] In addition to cartilage areas in high-grade tumor, the epithelial and other stromal components are seen. Heterotopic uterine cartilage of metaplastic origin may occur as solitary or multiple foci. The patient may be asymptomatic or may present with menorrhagia if cartilage is located in the endometrial surface as was seen in our case. [4]

Before classifying heterologous tissue as benign, we should exclude the possibility of bland appearing component of malignant mixed mesodermal tumor or an adenosarcoma. And careful clinical examination and histopathological correlation is required to reach correct diagnosis.

 
  References Top

1.
Madiwale C, Dahanuka S. Heterotopic uterine cartilage. J Postgrad Med 2001;47:281.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.
Sethi S, Bhatnagar S, Sethi S. Heterotopic chondroid tissue in the uterus. Indian J Pathol Microbiol 2008;51:568-9.  Back to cited text no. 2
[PUBMED]  Medknow Journal  
3.
Kurman RJ. Blaustein Pathology of the Female Genital Tract. 5 th ed. USA. Springer-Verlag; 2002. p. 455-6.  Back to cited text no. 3
    
4.
Jashnani KD, Baviskar RR. Chondroid heterotopia in the fallopian tube. Indian J Pathol Microbiol 2009;52:577.  Back to cited text no. 4
[PUBMED]  Medknow Journal  


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