Endometrioma mimicking ovarian malignancy in a post-menopausal woman

Vijay Zutshi, Shreshtha Gupta, Charanjeet Ahluwalia, R. Gadelha Mônica
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2021 · vol. 10(8) , pp. 3226 · doi:10.18203/2320-1770.ijrcog20212986 · W3186251122
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⚙ AI-generated summary by claude@2026-06, 2026-06-12 ⓘ

This case report details a post-menopausal woman whose adnexal mass, initially suspected as ovarian malignancy, was ultimately diagnosed as ovarian endometriosis through histopathology.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-12 · read from full text ⓘ

This paper reports a case of a 68-year-old post-menopausal woman with an adnexal mass that imaging suggested was a malignant ovarian tumor despite normal serum CA-125 levels. She underwent total hysterectomy with bilateral salpingo-oophorectomy, and final histopathology identified ovarian endometriosis/endometrioma. The authors note that endometriosis is uncommon after menopause but may occur due to peripheral estrogen production and that ovarian endometrioma can rarely mimic malignancy in post-menopausal patients, as highlighted by this case. This paper is centrally about endometriosis — it describes a post-menopausal ovarian endometrioma mimicking ovarian malignancy.

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Abstract

Endometriosis is an estrogen dependant disorder of reproductive-age women. It is uncommon after menopause, however, peripheral estrogen production may account for endometriosis in post-menopausal women. We reported a case of a 68 year old post-menopausal woman with an adnexal mass suspected malignant ovarian tumor on imaging and normal serum CA 125 levels. Total hysterectomy with bilateral salpingo-oophorectomy was done. The final histopathology revealed the diagnosis of ovarian endometriosis. Rarely, ovarian endometrioma can mimic ovarian malignancy in a post-menopausal woman.
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Endometrioma mimicking ovarian malignancy in a post-menopausal woman DOI: https://doi.org/10.18203/2320-1770.ijrcog20212986Keywords: Post-menopausal endometriosis, Ovarian masses, Endometrioma, Ovarian malignancy, Estradiol, CA 125Abstract Endometriosis is an estrogen dependant disorder of reproductive-age women. It is uncommon after menopause, however, peripheral estrogen production may account for endometriosis in post-menopausal women. We reported a case of a 68 year old post-menopausal woman with an adnexal mass suspected malignant ovarian tumor on imaging and normal serum CA 125 levels. Total hysterectomy with bilateral salpingo-oophorectomy was done. The final histopathology revealed the diagnosis of ovarian endometriosis. Rarely, ovarian endometrioma can mimic ovarian malignancy in a post-menopausal woman. Metrics References Punnonen R, Klemi PJ, Nikkanen V. Postmenopausal endometriosis. Eur J Obstet Gynecol Reprod Biol. 1980;11(3):195-200. Matsushima T, Asakura H. Huge ovarian endometrioma that grew after menopause: case report. J Obstet Gynaecol Res. 2016;42(3):350-2. Ness RB. Endometriosis and ovarian cancer: thoughts on shared pathophysiology. Am J Obstet Gynecol. 2003;189(1):280-94. Oral E, Sozen I, Uludag S, Demirkiran F, Ilvan S, Oncul M, et al. The prevalence of endometrioma and associated malignant transformation in women over 40 years of age. J Gynecol Obstet Hum Reprod. 2020;49(5):101725. Attar E, Bulun SE. Aromatase and other steroidogenic genes in endometriosis: translational aspects. Hum Reprod Update. 2006;12(1):49-56. Noble LS, Takayama K, Zeitoun KM, Putman JM, Johns DA, Hinshelwood MM, et al. Prostaglandin E2 stimulates aromatase expression in endometriosis derived stromal cells. J Clin Endocrinol Metab. 1997;82(2):600-6. Tuncay G, Kilic S, Yuksel B, Elmas C, Lortlar N, Erdogan D, et al. Heterogeneous appearance of VEGF (vascular endothelial growth factor) immunopositivity in cyst capsules of endometrioma. Acta Histochem. 2009;111(1):61-7. Magtibay PM, Heppell J, Leslie KO. Endometriosis-associated invasive adenocarcinoma involving the rectum in a postmenopausal female. Dis Colon Rectum. 2001;44(10):1530-3. Oral E, Ilvan S, Tustas E, Korbeyli B, Bese T, Demirkiran F, et al. Prevalence of endometriosis in malignant epithelial ovary tumours. Eur J Obstet Gynecol Reprod Biol. 2003;109(1):97-101. Gordts S, Koninckx P, Brosens I. Pathogenesis of deep endometriosis. Fertil Steril. 2017;108(6):872-85.

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