Expecting Endometriosis: An Unexpected Diagnosis of Adenomyomatous Cysts

A 25 year-old G0 female presented with pelvic pain and suspected endometriosis. A diagnostic laparoscopy with excision of endometriosis was planned. Intraoperatively, there were no obvious endometriotic implants identified; however, there were two retroperitoneal cysts that were noted (Fig. 1). One was on the right broad ligament, and the second one was overlying the external iliac artery. The cysts measured approximately 5–7 mm, and were excised intact. Pathology noted the presence of nodular proliferation of delicate smooth muscle bundles mixed with endometrial type glands indicative of adenomyomatous nodules (Fig.