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  • Title: Massive ascites as a presentation in a young woman with endometriosis: a case report.
    Author: Sait KH.
    Journal: Fertil Steril; 2008 Nov; 90(5):2015.e17-9. PubMed ID: 18778818.
    Abstract:
    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.
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