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29 August 2014 : Case report  USA

Endosalpingiosis in Conjunction with Ovarian Serous Cystadenoma Mimicking Metastatic Ovarian Malignancy

Unusual clinical course, Challenging differential diagnosis

Namrata SinghaniaABCDEFG, Neha JanakiramanABCDEFG, Douglas CoslettBDE, Navid AhmadBD

DOI: 10.12659/AJCR.890921

Am J Case Rep 2014; 15:361-363

Abstract

BACKGROUND: Interesting and unusual case of endosalpingiosis mimicking ovarian malignancy presentation.

CASE REPORT: A 26-year-old G0P0 white female presented to our office with chronic pelvic pain. On vaginal examination, a nontender mass in left the adnexal region was palpable. Transvaginal ultrasound showed a left ovarian cyst. Laparoscopy was performed, which revealed diffuse bilateral ovarian excrescences with unusual multiple studdings throughout the peritoneum and abdominal cavity. Due to a suspicion of malignancy, a biopsy specimen was obtained for frozen sectioning. The specimen proved to be consistent with benign papillary serous cystadenofibroma. Gross appearance was still suspicious for malignancy and therefore left paraovarian cystectomy was performed. Additional specimens showed ovarian adenofibroma and endosalpingiosis. The patient’s complaint of pelvic pain improved after laparoscopy. Due to diffuse presentation of endosalpingiosis in the peritoneum, serial CT scan of abdomen and pelvis at 6-month intervals was recommended.

CONCLUSIONS: To our knowledge, this is an unusual case of a young, nulliparous female presenting with diffuse-presentation endosalpingiosis in the abdomen and peritoneum, which on gross examination was suspicious for malignancy. By following a conservative approach and performing serial CT scans, the patient will be clinically monitored.

Keywords: Cystadenoma, Serous - surgery, Diagnosis, Differential, Endosonography, Follow-Up Studies, Laparoscopy, Ovarian Neoplasms - secondary, Ovariectomy - methods, Precancerous Conditions, Salpingitis - surgery, Tomography, X-Ray Computed, Vagina

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923