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Case Reports in Obstetrics and Gynecology
Volume 2013, Article ID 728291, 4 pages
http://dx.doi.org/10.1155/2013/728291
Case Report

A Case Presentation: Decidualized Endometrioma Mimicking Ovarian Cancer during Pregnancy

Department of Obstetrics and Gynecology, Faculty of Medicine, Selcuk University, Selcuklu, Konya 42250, Turkey

Received 5 February 2013; Accepted 7 March 2013

Academic Editors: B. Reime and R. Shaco-Levy

Copyright © 2013 Aybike Tazegül et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

During pregnancy, masses that are larger than 5 cm and appearing in the Doppler ultrasonography as having increased blood flow, echoes of heterogeneous density, and containing solid components are suspicious for malignancy; however, differential diagnosis of decidualized endometriomas should also be considered. The patient was an 8 weeks pregnant primigravida. The ultrasonographic evaluation showed a cystic mass of size 65 × 57 mm in the left ovary that was well circumscribed, heterogeneous, with highly dense internal echo, and containing a solid component of size 8 × 14 mm. In the 12th week, the ultrasonographic examination revealed an increase in the size of the mass and increased arterial blood flow in the mass. The patient underwent surgery. It was observed that both ovaries were adherent in the Douglas pouch and that the left ovary contained an endometrioma of size 8cm. While the capsule was being peeled, lesions of soft density, with irregular surfaces, and with adhesion in the Douglas pouch were observed. The results of the frozen section revealed decidualized endometrioma and decidual structures. Even in pregnant women when adnexal masses are encountered and the ultrasonography, Doppler, MRI, and CA 125 level analysis still do not favor endometriosis, decidualized endometrioma should be considered in the differential diagnosis.