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Archives of Gynecology and Obstetrics

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01-03-2009 | Case Report

Recurrent endometriosis following total hysterectomy with oophorectomy mimicking a malignant neoplastic lesion: a diagnostic and therapeutic challenge

Authors: I. Giarenis, P. Giamougiannis, C. T. M. Speakman, J. J. Nieto, S. G. Crocker

Published in: Archives of Gynecology and Obstetrics | Issue 3/2009

Abstract

Case report

A woman with a previous hysterectomy and bilateral salpingo-oophorectomy for endometriosis presented with painless vaginal bleeding. Imaging revealed a heterogeneous soft tissue pelvic mass suggestive of a malignant neoplastic lesion. Radical surgery was performed including excision of the pelvic mass and anterior resection of the sigmoid colon. Histopathology revealed endometriosis.

Conclusion

The risk of malignant transformation and the difficulty in achieving a preoperative diagnosis make radical surgery inevitable in the management of recurrent endometriosis. The use of hormone replacement therapy after bilateral salpingo-oophorectomy for endometriosis remains controversial and requires careful counseling about recurrence and close follow-up.

Olive DL, Schwartz LB (1993) Endometriosis. N Engl J Med 328:1759–1769. doi:10.1056/NEJM199306173282407 PubMedCrossRef

Dmowski WP, Radwanska E, Rana N (1988) Recurrent endometriosis following hysterectomy and oophorectomy: the role of residual ovarian fragments. Int J Gynaecol Obstet 26:93–103. doi:10.1016/0020-7292(88)90202-0 PubMedCrossRef

Metzger DA, Haney AF (1989) Etiology of endometriosis. Obstet Gynecol Clin North Am 16:1–14PubMed

Matorras R, Elorriaga MA, Pijoan JI, Ramon O, Rodriguez-Escudero FJ (2002) Recurrence of endometriosis in women with bilateral adnexectomy (with or without total hysterectomy) who received hormone replacement therapy. Fertil Steril 77:303–308. doi:10.1016/S0015-0282(01)02981-8 PubMedCrossRef

Fedele L, Bianci S, Raffaeli R, Zanconato G (1999) Comparison of transdermal estradiol and tibolone for the treatment of oophorectomized women with deep residual endometriosis. Maturitas 32:189–193. doi:10.1016/S0378-5122(99)00032-8 PubMedCrossRef

Magos A (1993) Endometriosis: radical surgery. Baillieres Clin Obstet Gynaecol 7:849–864. doi:10.1016/S0950-3552(05)80467-5 PubMedCrossRef

Hickman TN, Namnoum AB, Hinton EL, Zacur HA, Rock JA (1998) Timing of estrogen replacement therapy following hysterectomy with oophorectomy for endometriosis. Obstet Gynecol 91:673–677. doi:10.1016/S0029-7844(98)00071-4 PubMedCrossRef

Van Gorp T, Amant F, Neven P, Vergote I, Moerman P (2004) Endometriosis and the development of malignant tumours of the pelvis: a review of literature. Best Pract Res Clin Obstet Gynaecol 18:349–371. doi:10.1016/j.bpobgyn.2003.03.001 PubMedCrossRef

Sampson JA (1925) Endometrial carcinoma of the ovary arising in endometrial tissue in that organ. Arch Surg 10:1–72

10.

Reimnitz C, Brand E, Nieberg RK, Hacker NF (1988) Malignancy arising in endometriosis associated with unopposed estrogen replacement. Obstet Gynecol 71:444–447PubMed

11.

Belchetz PE (1994) Hormonal treatment of postmenopausal women. N Engl J Med 330:1062–1071. doi:10.1056/NEJM199404143301508 PubMedCrossRef

12.

Heaps JM, Nieberg RK, Berek JS (1990) Malignant neoplasms arising in endometriosis. Obstet Gynecol 75:1023–1028PubMed

13.

Powell JL, Connor GP, Henderson GS (2001) Androgen-producing, atypically proliferating endometrioid tumor arising in endometriosis. South Med J 94:450–453PubMed

14.

Asch E, Levine D (2007) Variations in appearance of endometrioma. J Ultrasound Med 26:993–1002PubMed

15.

Vignali M (1998) Molecular action of GnRH analogues on ectopic endometrial cells. Gynecol Obstet Invest 45(Suppl 1):2–5. doi:10.1159/000052845 PubMedCrossRef

16.

Coronado C, Franklin RR, Lotze EC et al (1990) Surgical treatment of symptomatic colorectal endometriosis. Fertil Steril 53:411–416PubMed

17.

Kim KS, Moon WS, Song HW, Kim JH, Cho SN (2001) A case of persistent endometriosis after total hysterectomy with both salpingo-oophorectomy managed by radiation therapy. Arch Gynecol Obstet 265:225–227. doi:10.1007/s004040000167 PubMedCrossRef

Title: Recurrent endometriosis following total hysterectomy with oophorectomy mimicking a malignant neoplastic lesion: a diagnostic and therapeutic challenge
Authors: I. Giarenis
P. Giamougiannis
C. T. M. Speakman
J. J. Nieto
S. G. Crocker
Publication date: 01-03-2009
Publisher: Springer-Verlag
Published in: Archives of Gynecology and Obstetrics / Issue 3/2009
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-008-0723-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Recurrent endometriosis following total hysterectomy with oophorectomy mimicking a malignant neoplastic lesion: a diagnostic and therapeutic challenge

Abstract

Case report

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Case report

Conclusion

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