Polypoid Endometriosis Of The Ovary Mimicking Advanced Ovarian Carcinoma With Extensive Peritoneal Metastases

Polypoid endometriosis of the ovary is a rare type of endometriosis and its imaging findings and clinical features may simulate malignancy. This report presents the medical history and clinical details of a 32-year-old woman with bilateral ovarian masses, a highly elevated serum CA-125 level, ascites, peritoneal dissemination, and rectosigmoid involvement. Computed tomography and magnetic resonance images showed bilateral complex cystic masses with large amounts of ascites, and multiple omental and peritoneal nodules, suspicious of ovarian malignancy. Widespread polypoid lesions were noted on bilateral ovaries, omentum, cul de sac, peritoneum, and rectosigmoid colon. Final pathologic findings led to a diagnosis of polypoid endometriosis. The patient was treated with gonadotropin-releasing hormone agonist and then with dienogest. The authors report a rare case of polypoid endometriosis of the ovary which appears very much alike to advanced ovarian carcinoma with extensive peritoneal metastases.