Necrotic pseudoxanthomatous nodules of the omentum and peritoneum: A peculiar reaction to endometriotic cyst contents

Carey M, Mark Carey, M. Carey, Kirk ME, Megan Kirk, M. E. Kirk
Obstetrics and gynecology · 1993 · vol. 82(4) , pp. 650–652 · doi:10.1097/00006250-199310000-00035 · PMID:8377999 · W2047018465
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Necrotic pseudoxanthomatous nodules of the omentum and peritoneum are a peculiar reaction to endometriotic cyst contents that can mimic metastatic ovarian carcinoma.

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This case report describes a 39-year-old woman who presented with acute abdominal pain due to a ruptured ovarian endometrioma associated with endometrioid adenocarcinoma. Following surgical intervention, subsequent exploration revealed multiple necrotic pseudoxanthomatous nodules on the peritoneum and omentum, which were identified as a reaction to the spillage of endometriotic cyst contents. The authors note that these nodules can clinically mimic metastatic ovarian carcinoma, highlighting their potential for diagnostic confusion. This paper is centrally about endometriosis — specifically describing a rare pathological reaction involving pseudoxanthomatous nodules triggered by endometriotic cyst rupture.

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Abstract

BACKGROUND: Necrotic pseudoxanthomatous nodules of the ovary, omentum, and peritoneum are rare, and have been described as a late manifestation of endometriosis. CASE: A 39-year-old woman presented with acute abdominal pain and an abdominopelvic mass. Emergency laparotomy revealed a ruptured ovarian neoplasm with several liters of old blood in the abdominal cavity. Left adnexectomy was performed, and exploration of the abdominal cavity revealed no other lesions. Pathologic examination of the neoplasm showed a large endometrioma with an associated endometrioid adenocarcinoma. At surgery 7 weeks later, multiple pseudoxanthomatous peritoneal and omental nodules were found. CONCLUSION: This case suggests that pseudoxanthomatous nodules of the peritoneum and omentum may arise from a peculiar reaction to endometriotic cyst contents and clinically can mimic metastatic ovarian carcinoma.
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Background

Necrotic pseudoxanthomatous nodules of the ovary, omentum, and peritoneum are rare, and have been described as a late manifestation of endometriosis. Case: A 39-year-old woman presented with acute abdominal pain and an abdominopelvic mass. Emergency laparotomy revealed a ruptured ovarian neoplasm with several liters of old blood in the abdominal cavity. Left adnexectomy was performed, and exploration of the abdominal cavity revealed no other lesions. Pathologic examination of the neoplasm showed a large endometrioma with an associated endometrioid adenocarcinoma. At surgery 7 weeks later, multiple pseudoxanthomatous peritoneal and omental nodules were found.

Conclusion

This case suggests that pseudoxanthomatous nodules of the peritoneum and omentum may arise from a peculiar reaction to endometriotic cyst contents and clinically can mimic metastatic ovarian carcinoma.(Obstet Gynecol 1993;82:650-2)

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Condition tags

endometriosisendometrioma

MeSH descriptors

Adenocarcinoma Endometriosis Neoplasms, Multiple Primary Omentum Ovarian Neoplasms Peritoneal Diseases Peritoneum Postoperative Complications Xanthomatosis Adenocarcinoma Adenocarcinoma Adult Endometriosis Endometriosis Female Humans Necrosis Necrosis Necrosis Neoplasms, Multiple Primary

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