Decidualization of ovarian endometriosis during pregnancy mimicking malignancy

Rami Sammour, Rami N Sammour, Sammour RN, Zvi Leibovitz, Z. Leibovitz, Leibovitz Z, Israel Shapiro, Shapiro I, I. Shapiro, Degani S, Shimon Degani, Levitan Z, Z. Levitan, Zohar Levitan, Aharoni A, Ariel Aharoni, Joseph Tal, Tal J, J. Tal, M. Lurie, Michael Lurie, Lurie M, G. Ohel, Gonen Ohel, Ohel G
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine · 2005 · vol. 24(9) , pp. 1289–1294 · doi:10.7863/jum.2005.24.9.1289 · PMID:16123189 · W2140060378
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This case series describes two pregnant patients with ovarian masses showing a sonographic appearance of malignancy that histologically proved to be markedly decidualized endometriotic cysts.

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Abstract

OBJECTIVE: The purpose of this series is to present deciduosis (the formation of extrauterine decidua) as one of the differential diagnoses of a malignant tumor during pregnancy. METHODS: Two cases are described in which pregnant patients had a pelvic tumor. The lesions, which were diagnosed in the early second trimester, consisted of complex masses with an extensive blood supply and had a sonographic appearance of a malignant tumor. The high suspicion for malignancy necessitated surgical intervention. RESULTS: During surgery, the lesions were observed to be of an ovarian origin with papillary excrescences covering their exterior. The lesions were excised and sent for histologic examination. The results showed a markedly decidualized endometriotic cyst in both cases. CONCLUSIONS: This phenomenon is a diagnostic challenge and should be considered in the differential diagnosis of a malignant mass during pregnancy.

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Condition tags

endometriosis

MeSH descriptors

Decidua Endometriosis Ovarian Neoplasms Adult Adult Decidua Decidua Decidua Decidua Diagnosis, Differential Diagnosis, Differential Endometriosis Endometriosis Endometriosis Endometriosis Female Female Humans Humans Laparoscopy

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