Endosalpingiosis in Conjunction with Ovarian Serous Cystadenoma Mimicking Metastatic Ovarian Malignancy

PATIENT Female, 26. FINAL DIAGNOSIS Endosalpingiosis. SYMPTOMS Chronic pelvic pain. MEDICATION -. CLINICAL PROCEDURE Diagnostic laproscopy (conservative management). SPECIALTY Obstetrics and Gynecology. 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 studdings 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 cystadenofibroma. Gross appearance was still suspicious for malignancy and therefore left paraovarian cystectomy was performed. Additional specimens showed ovarian adenofibroma and endosalpingiosis. The patient's complaint of pelvic pain improved after laparoscopy. Due to diffuse presentation of endosalpingiosis in the peritoneum, 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. By following a conservative approach and performing serial CT scans, the patient will be clinically monitored.