Huge endometrioma mimicking ovarian malignancy : a case report

Abstract

Abstract Background Endometriosis is a very common disease, yet sometimes it is hard to be diagnosed. Typical symptoms include pelvic pain and infertility. However, it could present with a variety of symptoms depending on different type of endometriosis. There are also a variety of imaging findings indicative of endometriosis with varying sizes and locations. Huge ovarian mass accompanied with mass-effect symptoms was not usual in typical endometriosis, and may be considered as ovarian malignancy at initial diagnosis. Case presentation A middle-aged woman presented with dyspnea, lower leg edema, and abdominal dullness for 2-3 years. Laboratory exam showed severe anemia, severe hypokalemia, impaired renal function, and metabolic acidosis. Abdominal sonography and computed tomography (CT) showed huge pelvic mass 35x33x28cm with solid part. Exploratory laparotomy revealed right ovarian endometrioma and endometriosis of sigmoid colon. After operation, she had much less dyspnea and abdominal dullness, while renal function was only partially improved with bilateral ureteral stents remained in place. Conclusion We presented a case report of huge endometrioma mimicking ovarian malignancy. The atypical symptoms and image findings were uncommon for endometriosis. We thus shared this case for help further differential diagnosis of huge pelvic mass.