Case study of a pregnant woman with decidualized ovarian endometriosis whose preoperative findings suggested malignant transformation
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This case study describes a pregnant woman whose ovarian endometriosis with decidual changes mimicked malignancy on imaging, leading to surgery but revealing benign decidualization upon pathology.
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Abstract
BACKGROUND: Because both decidualization and malignant transformation of endometriosis are characterized by mural nodules on the wall of the cyst, the preoperative differential diagnosis is reportedly difficult.
CASE: A 31-year-old woman was referred to our hospital at ten weeks of gestation. Sonographic examination revealed an intrauterine gestational sac and ovarian endometrial cyst. At 21 weeks of gestation, characteristic findings associated with malignant transformation of ovarian endometriosis were seen on color-flow Doppler sonography and contrast magnetic resonance imaging. Under the diagnosis of malignant transformation of ovarian endometriosis, right salpingo-oophorectomy was performed at 22 weeks' gestation. However, histopathologic examination revealed ovarian endometriosis with marked decidual changes but no evidence of malignancy.
CONCLUSION: During pregnancy, intracystic vascularized excrescences of an endometrial cyst indicate not only malignant transformation but also decidualization. Thus, the preoperative differential diagnosis is reportedly difficult. However, the present findings of decidualization on magnetic resonance imaging seemed to be slightly different from those of malignant transformation, and therefore, might help distinguish decidualized endometriosis from malignant transformation preoperatively.
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Cited by (19)
- Decidualized endometrioma mimicking malignancy: A case report and literature review of magnetic resonance imaging findings 2023
- Decidualized ovarian endometrioma mimicking malignancy in pregnancy: a case report and literature review 2022
- The effect of pregnancy on endometriosis-facts or fiction? 2018
- Computed diffusion-weighted imaging for differentiating decidualized endometrioma from ovarian cancer 2016
- A systematic review on endometriosis during pregnancy: diagnosis, misdiagnosis, complications and outcomes 2015
- A Case of Bilateral Decidualized Endometriomas during Pregnancy: Radiologic-pathologic Correlation 2015
- Decidualized Ovarian Endometrioma in a Pregnant Woman Mimicking Ovarian Malignancy: Magnetic Resonance Imaging and Ultrasonographic Findings 2015
- Natural history of ovarian endometrioma in pregnancy 2014
- Magnetic resonance imaging manifestations of decidualized endometriotic cysts: comparative study with ovarian cancers associated with endometriotic cysts 2014
- Decidualisation of ovarian endometriomas in pregnancy: a management dilemma. A case report and review of the literature 2014
- MR imaging of endometriosis: ten imaging pearls 2012
- MR Imaging : Ten Imaging Pearls 1 2012
- Polypoid endometriosis of the bladder during pregnancy mimicking urachal carcinoma 2011
- Decidualized endometrioma 2010
- A retrospective analysis of ovarian endometriosis during pregnancy 2009
- Decidualized endometrioma during pregnancy: recognizing an imaging mimic of ovarian malignancy 2008
- Two cases of pregnant women with ovarian endometrioma mimicking a malignant ovarian tumor 2008
- Magnetic resonance manifestations of decidualized endometriomas during pregnancy 2008
- Decidualization of ovarian endometriosis during pregnancy mimicking malignancy: report of three cases with a literature review 2008
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