Deep infiltrating endometriosis with mucinous metaplasia of mullerian origin

Christopher Ke Arkfeld, Julia Gelissen, Animesh Upadhyay, Gary Altwerger
In: Journal of Endometriosis and Pelvic Pain Disorders · 2023 · vol. 15(2) , pp. 91–94 · doi:10.1177/22840265231178332 · W4382584753
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This case report describes a 49-year-old woman whose endometriosis with mucinous metaplasia was initially misdiagnosed as malignancy due to elevated tumor markers and a large adnexal mass.

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Abstract

Background: Endometriosis is a common gynecological condition that often presents with pelvic pain and infertility, but in rare cases may masquerade as a gastrointestinal or gynecologic malignancy. Case: A 49-year-old G0 presented with abdominal pain, fevers, elevated tumor markers, and a large adnexal mass concerning for malignancy. Intra-operatively, mucinous lesions diffusely involved abdominopelvic structures. Intra-operative frozen section (IOFS) revealed invasive cancer and full cytoreductive surgery was completed. Final pathology was downgraded to atypical cystic endometriosis with mucinous metaplasia. Conclusion: Endometriosis, a nonmalignant condition, can present as pelvic masses associated with elevated tumor markers. The case presented here depicts a confounding preoperative and intraoperative picture where endometriosis was falsely identified as malignancy. Endometriosis should always remain a part of the differential diagnosis in a premenopausal patient with presumed gastrointestinal or gynecologic malignancies.

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Condition tags

endometriosisdie_deep_infiltratinginfertility

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