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LETTER TO EDITOR Table of Contents   
Year : 2009  |  Volume : 52  |  Issue : 4  |  Page : 577
Chondroid heterotopia in the Fallopian tube


Department of Pathology, TN Medical College and BYL Nair Charitable Hospital, Mumbai, India

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Date of Web Publication1-Oct-2009
 

How to cite this article:
Jashnani KD, Baviskar RR. Chondroid heterotopia in the Fallopian tube. Indian J Pathol Microbiol 2009;52:577

How to cite this URL:
Jashnani KD, Baviskar RR. Chondroid heterotopia in the Fallopian tube. Indian J Pathol Microbiol [serial online] 2009 [cited 2014 Nov 27];52:577. Available from: http://www.ijpmonline.org/text.asp?2009/52/4/577/56120


Sir,

Cartilage heterotopia is a rare but well-recognized phenomenon in the uterus and cervix. Though cartilage islands can occur in the  Fallopian tube More Details in association with ectopic tubal pregnancy, mature cystic teratoma and extraskeletal chondroma, heterotopic cartilage has not been reported as yet in the literature. We present the first reported case of heterotopic fallopian tubal cartilage in a 48-year-old multiparous woman.

Total abdominal hysterectomy with bilateral salpingo-oophorectomy was carried out in a 48-year-old female who presented with menorrhagia of two years duration. Ultrasonography of the pelvis revealed uterine fibroid. Preoperative hematological and biochemical investigations were within normal limits. Gross morphology revealed a 5-cm-diameter anterior fundal intramural leiomyoma and adherent right ovary and fallopian tube to the posterior uterine wall. The uterus, cervix, left adnexae and right ovary were unremarkable on histopathologic examination. The right fallopian tube though unremarkable on gross, showed fusion of tubal plicae with chronic inflammatory cells in the lamina propria and the lumen. In addition, small plates of mature hyaline cartilage were seen in the lamina propria, extending into the underlying muscular wall [Figure 1]

Heterotopia means the occurrence of mature tissue at an abnormal location. Cartilaginous heterotopia has been reported in several organs, including such unlikely sites as the prostate, tonsil and thyroid gland. In the uterus [1],[2] and cervix, these lesions may represent metaplasia or organized products of conception showing cartilaginous differentiation. Fadare et al. [3] 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 manipulation. In the fallopian tube, Spanta and Lawrence [4] have suggested mesenchyme of the myosalpinx or subcoelomic mesenchyme of the tubal serosa as the origin of tubal chondroma. Similarly, tubal subepithelial mesenchyme can be the origin of chondroid metaplasia in the present case.

The differential diagnosis for the presence of cartilage in this case includes extraskeletal chondroma, mature cystic teratoma as well as fetal tissue remnants. The first two conditions would present as a tumor nodule grossly as well as microscopically with no normal fallopian tubal structure intermingled with the islands of chondrocytes in a chondroma. Teratoma, in addition would show evidence of other germ cell elements. [5] Fetal tissue remnants are ruled out by the absence of any other stigma of ectopic pregnancy like decidua or chorionic villi. The present case illustrates the first reported case of fallopian tube chondroid heterotopia.

 
   References Top

1.Roth E, Taylor HB. Heterotopic cartilage in the uterus. Obstet Gynecol 1966;28:834-44.   Back to cited text no. 1      
2.Madiwale C, Dahanuka S. Heterotopic uterine cartilage. J Postgrad Med 2001;47:281.  Back to cited text no. 2  [PUBMED]  Medknow Journal  
3.Fadare O,Bitulco C, Cart D, Prakash V. Cartilagenous differentiation in peritoneal tissues. A report of two cases and a review of literature. Mod Pathol 2002;15:777-80.   Back to cited text no. 3      
4.Spanta R, Lawrence WD. Soft tissue chondroma of the fallopian tube. Differential diagnosis and histogenetic consideration. Pathol Res Pract 1995;191:174-6.  Back to cited text no. 4      
5.Massouda D, Wortham GF 3rd, Oakley JL. Tubal pregnancy associated with a benign cystic teratoma of the fallopian tube: A case report. J Reprod Med 1988;33:563-4.  Back to cited text no. 5      

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Correspondence Address:
Kusum D Jashnani
8, Aashirwad, First floor, Opposite Kakad Industrial Estate, Lady Jamshedji Cross road-3, Mahim, Mumbai 400 016
India
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DOI: 10.4103/0377-4929.56120

PMID: 19805982

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