Ruptured endometrioma mimicking ovarian malignancy: a case report and literature review

Radha Rani Seelam, Neha Varun, Jyoti Meena, Rajesh Kumari, Vatsla Dadhwal
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2025 · vol. 14(5) , pp. 1660–1664 · doi:10.18203/2320-1770.ijrcog20251263 · W4409877545
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⚙ AI-generated summary by claude@2026-06, 2026-06-06 ⓘ

This case report describes a ruptured endometrioma that mimicked ovarian malignancy in a perimenopausal female, emphasizing the need for a high index of suspicion given common presenting symptoms.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-06 · read from full text ⓘ

This paper presents a case report and literature review of a perimenopausal female with an adnexal mass who developed a ruptured endometrioma that mimicked ovarian malignancy. It describes the clinical concern in this setting, emphasizing peritonitis features with rising serum CA-125 and CA19.9 levels, and the authors’ high “index of suspicion” for ruptured endometrioma when these findings co-occur. A limitation is that, as a single case with a literature review, the report cannot establish diagnostic accuracy or quantify how often ruptured endometrioma truly presents like cancer. This paper is centrally about endometriosis — it focuses on a ruptured endometrioma presenting with imaging and tumor-marker features that mimic ovarian malignancy.

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Abstract

In current practice endometriosis is a rising concern, involving all age groups and relatively less prevalent in perimenopausal age groups. It has a variety of presenting symptoms in perimenopausal age group including severe dysmenorrhoea, dyspareunia, infertility, chronic pelvic pain, abdominopelvic mass, acute abdomen with peritonitis and non-specific symptoms like gastritis, diarrhoea, rectal bleeding. High index of suspicion should be there to diagnose a ruptured endometrioma in a perimenopausal female with adnexal mass, peritonitis features and rising serum CA-125 and CA19.9 levels. Here we present a case of ruptured endometrioma mimicking ovarian malignancy in a perimenopausal female.
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Ruptured endometrioma mimicking ovarian malignancy: a case report and literature review DOI: https://doi.org/10.18203/2320-1770.ijrcog20251263Keywords: Endometrioma, Ruptured endometrioma, Ovarian malignancyAbstract In current practice endometriosis is a rising concern, involving all age groups and relatively less prevalent in perimenopausal age groups. It has a variety of presenting symptoms in perimenopausal age group including severe dysmenorrhoea, dyspareunia, infertility, chronic pelvic pain, abdominopelvic mass, acute abdomen with peritonitis and non-specific symptoms like gastritis, diarrhoea, rectal bleeding. High index of suspicion should be there to diagnose a ruptured endometrioma in a perimenopausal female with adnexal mass, peritonitis features and rising serum CA-125 and CA19.9 levels. Here we present a case of ruptured endometrioma mimicking ovarian malignancy in a perimenopausal female. Metrics References Endometriosis-World Health Organization-Fact Sheets, 2024. Available at: https://www.who.int/newsroom/factsheets/detail/endometriosis. Accessed on 10 March 2025. Petruškevičiūtė E, Bužinskienė D. Acute Diffuse Peritonitis Due to Spontaneous Rupture of an Infected Endometrioma: A Case Report. Acta Med Litu. 2021;28(2):360-6. DOI: https://doi.org/10.15388/Amed.2021.28.2.20 Missmer SA, Hankinson SE, Spiegelman D, Barbieri RL, Marshall LM, Hunter DJ. Incidence of laparoscopically confirmed endometriosis by demographic, anthropometric, and lifestyle factors. Am J Epidemiol. 2004;160(8):784-96. DOI: https://doi.org/10.1093/aje/kwh275 Hoyle AT, Puckett Y. Endometrioma. In: Stat Pearls. Treasure Island (FL): StatPearls Publishing. 2024. Foote C, Smith AD, Milward A, Mojica WD, Bailey H, Muscarella P. Spontaneously ruptured endometriomas presenting with symptoms and imaging findings worrisome for carcinomatosis: A case report. Int J Surg Case Rep. 2023;105:108078. DOI: https://doi.org/10.1016/j.ijscr.2023.108078 Kvaskoff M, Mahamat-Saleh Y, Farland LV, Shigesi N, Terry KL, Harris HR. Endometriosis and cancer: a systematic review and meta-analysis. Hum Reprod Update. 2021;27(2):393-420. DOI: https://doi.org/10.1093/humupd/dmaa045 Evangelinakis N, Grammatikakis I, Salamalekis G, Tziortzioti V, Samaras C, Chrelias C, et al. Prevalence of acute hemoperitoneum in patients with endometriotic ovarian cysts: a 7-year retrospective study. Clin Exp Obstet Gynecol. 2009;36(4):254-5. Young H, Bui TL, Cramer SE, O'Connell R, Houshyar R. Ruptured endometrioma in a nonpregnant patient: a case report. J Med Case Rep. 2022;16(1):161. DOI: https://doi.org/10.1186/s13256-022-03361-3

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endometriosisendometriomachronic_pelvic_paindysmenorrheadyspareuniainfertility

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