A unique pathology associated with pelvic pain and adnexal mass

OBJECTIVE: To present a unique case of pelvic pain. DESIGN: Case report. SETTING: Academic institution. PATIENT(S): Thirty-nine year-old with history of endometriosis presented with pelvic pain and possible adnexal mass. INTERVENTION(S): Imaging results were not consistent and suggested possible adnexal mass and hydrosalpinx in different studies. Physical exam was concerning for a vaginal mass that was felt not to be contiguous with the adnexa. At laparoscopy, a 3 cm pararectal mass was identified immediately lateral to the uterosacral ligament and medial to the ureter. This mass was completely resected laparoscopically. MAIN OUTCOME MEASURE(S): Resolution of pelvic pain. RESULT(S): Pathologic diagnosis was ganglioneuroma. Postoperatively, the patient had resolution of her pelvic pain. CONCLUSION(S): Pelvic ganglioneuromas are a very rare entity but emphasize the importance of a broad differential for pelvic pain.