Final Diagnosis: Endosalpingiosis Symptoms: Chronic pelvic pain

Objective: Challenging differential diagnosis Background: Interesting and unusual case of endosalpingiosis mimicking ovarian malignancy presentation. Case Report: A 26-year-old G0P0 white female presented to our office with chronic pelvic pain. On vaginal examination, a nontender mass in left the adnexal region was palpable. Transvaginal ultrasound showed a left ovarian cyst. Laparoscopy was performed, which revealed diffuse bilateral ovarian excrescences with unusual multiple stud-dings throughout the peritoneum and abdominal cavity. Due to a suspicion of malignancy, a biopsy specimen was obtained for frozen sectioning. The specimen proved to be consistent with benign papillary serous cystad-enofibroma. Gross appearance was still suspicious for malignancy and therefore left paraovarian cystectomy was performed. Additional specimens showed ovarian adenofibroma and endosalpingiosis. The patient’s com-plaint of pelvic pain improved after laparoscopy. Due to diffuse presentation of endosalpingiosis in the perito-neum, serial CT scan of abdomen and pelvis at 6-month intervals was recommended. Conclusions: To our knowledge, this is an unusual case of a young, nulliparous female presenting with diffuse-presentation endosalpingiosis in the abdomen and peritoneum, which on gross examination was suspicious for malignancy.