Aggressive endometriosis: report of a case
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This case report describes a patient with aggressive endometriosis, detailing their presentation and management.
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Abstract
A 54-year-old premenopausal woman presented with abdominal pain, constipation, and raised serum CA-125 levels during routine follow-up of a low-grade endometrial stromal sarcoma with prominent sex cord-like features, which had been treated by vaginal hysterectomy 4 years previously. The findings at laparotomy included: a 100-mm unilocular thick-walled right ovarian cyst, a solid 25-mm nodule in the left meso-ovarium, and a phlegmonous mass in the wall of the sigmoid colon, which proved to be a pericolic abscess due to diverticular disease. The ovarian cyst was a histologically benign endometrioid cystadenoma with stromal luteinization in the wall. Small islands of morphologically benign endometrial tissue were present in vessels of the meso-ovarium. The left adnexal nodule exhibited florid morphologically benign endometriosis, much of which was within and occluding large vascular spaces, and of apparently recent onset. No lesions resembled, in any way, the original stromal sarcoma. There was no evidence of endometriosis elsewhere in the pelvis or abdomen. The patient has made an uneventful recovery and is being monitored, as before, by tumor markers only. The discordance in morphology between the uterine sarcoma and the subsequent pelvic lesions was so complete as to raise doubts about any pathogenetic relationship between them. We propose the use of the term aggressive endometriosis to describe the changes observed.
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References (12)
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Cited by (9)
- The many faces of endometriosis 2022
- Endometrial polyp and endometriosis with atypical stromal cells 2012
- Pitfalls in the diagnosis of endometriosis: a condition characterized by a plethora of unusual histological features 2011
- Deeply infiltrating endometriosis of the sigmoid and lymph nodes simulating obstructive neoplasm 2010
- Endometrial stromal sarcomas with extensive endometrioid glandular differentiation: report of a series with emphasis on the potential for misdiagnosis and discussion of the differential diagnosis 2009
- Aggressive endometriosis with focal change suggesting early neoplastic transformation 2007
- Endometrial stromal sarcoma resembling adenomyosis and menstrual-phase endometrium 2004
- REVIEW: Evidence for asymmetric distribution of lower intestinal tract endometriosis 2004
- Letter to the Editor 2003
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- europepmc
- last seen: 2026-08-22T06:09:51.966504+00:00
- openalex
- last seen: 2026-06-10T17:14:06.276822+00:00
- pubmed
- last seen: 2026-05-13T22:13:30.513821+00:00
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