Endometriosis Mimicking Ovarian Cancer in the Setting of Acquired Immune Deficiency Syndrome

Haeri S, Sina Haeri, Cosin JA, Jonathan A. Cosin
Obstetrics and gynecology · 2009 · vol. 114(2) , pp. 425–426 · doi:10.1097/aog.0b013e318198a429 · PMID:19622948 · W1995567715
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-07-09 ⓘ

This case report details endometriosis mimicking ovarian cancer in an AIDS patient, highlighting the need to consider endometriosis in HIV/AIDS patients presenting with carcinomatosis.

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This case report describes a woman with acquired immunodeficiency syndrome who presented with abdominal pain, weight loss, and a Sister Mary Joseph’s nodule. Clinical findings included ascites, lymphadenopathy, elevated CA 125 levels, and peritoneal seeding that initially suggested ovarian malignancy. Surgical intervention revealed chocolate-colored ascites and widespread disease, which pathology confirmed as endometriosis rather than cancer. The authors note that AIDS-related immunosuppression may alter endometriosis progression to mimic carcinomatosis. This paper is centrally about endometriosis — specifically its atypical presentation mimicking ovarian cancer in an immunocompromised patient.

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Abstract

In Brief BACKGROUND: With rising rates of human immunodeficiency virus (HIV) among women and resultant immunosuppression, clinicians face varying presentations of gynecologic pathologies. We report a case of endometriosis in a patient with acquired immunodeficiency syndrome (AIDS) presenting with a Sister Mary Joseph’s nodule and mimicking carcinomatosis. CASE: A woman with AIDS and 2-month history of abdominal pain, distention, and weight loss was found to have periumbilical and pelvic masses, ascites, lymphadenopathy, and an elevated CA 125 level. Operative findings included chocolate-colored ascites and peritoneal seeding involving the ovaries, uterus, appendix, bowel, umbilicus, and omentum. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy and resection of all gross disease. Pathologic diagnosis was endometriosis and AIDS-associated adenopathy. COMMENT: Immunodeficiency from AIDS can affect the progression of endometriosis to the point of mimicking ovarian malignancy. Endometriosis should be considered in the differential diagnosis for patients with human immunodeficiency virus/acquired immunodeficiency syndrome presenting with a pelvic mass, ascites, lymphadenopathy, and carcinomatosis.
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Endometriosis Mimicking Ovarian Cancer in the Setting of Acquired Immune Deficiency Syndrome - Sina Haeri - Jonathan A. Cosin BACKGROUND: With rising rates of human immunodeficiency virus (HIV) among women and resultant immunosuppression, clinicians face varying presentations of gynecologic pathologies. We report a case of endometriosis in a patient with acquired immunodeficiency syndrome (AIDS) presenting with a Sister Mary Joseph’s nodule and mimicking carcinomatosis. CASE: A woman with AIDS and 2-month history of abdominal pain, distention, and weight loss was found to have periumbilical and pelvic masses, ascites, lymphadenopathy, and an elevated CA 125 level. Operative findings included chocolate-colored ascites and peritoneal seeding involving the ovaries, uterus, appendix, bowel, umbilicus, and omentum. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy and resection of all gross disease. Pathologic diagnosis was endometriosis and AIDS-associated adenopathy. COMMENT: Immunodeficiency from AIDS can affect the progression of endometriosis to the point of mimicking ovarian malignancy.

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Condition tags

endometriosis

MeSH descriptors

Acquired Immunodeficiency Syndrome Carcinoma Endometriosis Endometriosis Ovarian Neoplasms Acquired Immunodeficiency Syndrome Adult Carcinoma Diagnosis, Differential Endometriosis Endometriosis Female Humans Ovarian Neoplasms

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