Polypoid endometriosis in a young woman: a case report and review of literature

The authors report a case of polypoid endometriosis (PE) in a young woman. In addition, they review the PE cases in patients under 40 years of age. A 34-year-old null iparous presented with a vaginal polyp protruding from the posterior vaginal fornix and a boundary ambiguous mass located at Douglas' pouch from the vaginal wall to the rectum, suggesting advanced malignancy. Because an intraoperative frozen section examination showed no evidence of malignancy, the authors opted for conservative management with administration of GnRH agonist once a month for six months followed by dienogest. MRI revealed marked improvement after the third administration of GnRH agonist. Including the present case, the authors identified 13 patients under 40 years old with PE. The notable macroscopic finding of PE was vaginal polyp formed by a protruded pelvic mass. The immunohistochetnistry findings and a marked effect of GnRH agonist in the present case suggest the etiology of PE was related to estrogen stimulation.