Massive ascites as a presentation in a young woman with endometriosis: a case report
Received 1 March 2008; received in revised form 21 May 2008; accepted 9 July 2008. published online 09 September 2008.
Objective
To report a case of endometriosis associated with massive ascites and an elevated CA-125 level.
Design
Case report.
Setting
Tertiary care center.
Patient(s)
A 26-year-old woman presented with massive ascites and an increased CA-125 level suggestive of ovarian cancer.
Intervention(s)
Ultrasonography, laparotomy, and bilateral ovarian cystectomy and reconstruction. Endometriosis was diagnosed postoperatively on the basis of histopathology. The patient received 6 months of treatment with a GnRH analogue.
Main Outcome Measure(s)
Ultrasound examination 6 months after surgery to evaluate for ascites or recurrent ovarian cysts.
Result(s)
Frozen sections obtained at laparotomy and ovarian cystectomy ruled out a malignancy. The final histologic report was compatible with a diagnosis of endometriosis. After 6 months of treatment with the GnRH analogue, the patient experienced a progressive reduction of the ascitic fluid and full remission after 2 years.
Conclusion(s)
Endometriosis associated with massive bloody ascites is an unusual occurrence. This report draws attention to this condition as a complication of endometriosis. For this reason, endometriosis should be included in the differential diagnosis of reproductive-age women presenting with an apparent ovarian malignancy.
Department of Obstetrics and Gynecology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
Reprint requests: Khalid Sait, M.Bch.B., F.R.C.S.C., Consultant, Gynecologic Oncology, Department of Obstetrics and Gynecology, King Abd Alaziz University Hospital, Jeddah 21589, PO Box 80215, Saudi Arabia (FAX: 026408316).
ABSTRACT