Giant Endometrioma of the Ovarian Mimicking Malignant Tumor

Rong Wang, Ziyi Yang, Shaoli Song
In: Clinical Nuclear Medicine · 2026 · doi:10.1097/rlu.0000000000006748 · W7225911504
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⚙ AI-generated summary by qwen3.7-flash, 2026-11-14 ⓘ

This case report describes a 27-year-old woman with a giant bilateral ovarian endometrioma mimicking malignancy on 18F-FDG PET/CT, despite elevated tumor markers and weight loss.

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This case report details the clinical presentation and imaging characteristics of a 27-year-old woman with a giant pelvic cystic mass. Initial evaluation via 18F-FDG PET/CT showed mild internal septations and FDG uptake, while elevated tumor markers and weight loss raised strong suspicion for ovarian malignancy. However, histopathologic examination confirmed the diagnosis as bilateral ovarian endometriomas rather than cancer. This paper is centrally about endometriosis — specifically describing the atypical radiological mimicry of malignant tumors by large endometriomas.

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Abstract

18 F-FDG PET/CT findings of a giant ovarian endometrioma are exceedingly rare. We present a case of a 27-year-old woman with a giant pelvic cystic mass mimicking malignancy. 18 F-FDG PET/CT revealed a massive cystic lesion occupying the entire abdominopelvic cavity, with mild internal septations and mild FDG uptake. Despite elevated tumor marker levels, weight loss, and suspicious imaging findings, the final histopathologic diagnosis was bilateral ovarian endometriomas.
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Interesting Image Giant Endometrioma of the Ovarian Mimicking Malignant Tumor - Rong Wang* - Ziyi Yang†,‡,§,∥ - Shaoli Song†,‡,§,∥ Clinical Nuclear Medicine Publish Ahead of Print, November 11, 2026. | DOI: 10.1097/RLU.0000000000006748 18F-FDG PET/CT findings of a giant ovarian endometrioma are exceedingly rare. We present a case of a 27-year-old woman with a giant pelvic cystic mass mimicking malignancy. 18F-FDG PET/CT revealed a massive cystic lesion occupying the entire abdominopelvic cavity, with mild internal septations and mild FDG uptake. Despite elevated tumor marker levels, weight loss, and suspicious imaging findings, the final histopathologic diagnosis was bilateral ovarian endometriomas. This case report describes a rare 18F-FDG PET/CT finding of a giant ovarian endometrioma in a 27-year-old woman. She presented with a massive cystic lesion filling the entire abdominopelvic cavity, showing mild internal septations and mild FDG uptake. Clinical suspicion of malignancy was high because of elevated tumor marker levels, weight loss, and suspicious imaging features. However, histopathologic examination ultimately revealed bilateral ovarian endometriomas. This case highlights that large endometriomas can mimic ovarian cancer on imaging and underscores the importance of considering benign etiologies, even when tumor markers and imaging findings appear worrisome. Text is machine generated and may contain inaccuracies. FAQ Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved.

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