florid adnexal polypoid endometriosis associated with very high serum ca - 125 levels mimicking ovarian malignancy

we report a case of florid polypoid endometriosis presenting with advanced bulky disease in pelvis with serum ca – 125 levels of 7844u/ml. the extent of tumor, ct scan findings, elevated serum ca – 125 levels were suggestive of ovarian malignancy. histopathology demonstrated endometrial glands and stroma. glands were neither crowded nor complex and were separated by a fibromatous stroma that contained endometrial stromal cells. these features were consistent with diagnosis of polypoid endometriosis, a recently described entity with a clinical presentation completely different from conventional endometriosis. our case emphasizes the association of high levels of ca – 125 with benign gynaecologic conditions.