OBJECTIVE: To report a case of endometriosis associated with massive ascites, pleural effusion, and extremely elevated Ca-125. DESIGN: Case report. SETTING: University hospital. PATIENT(S): A 46-year-old, white nulligravida with bilateral adnexal masses, Ca-125 of 3,504 U/mL, abdominal pain, ascites, and a pleural effusion. INTERVENTION(S): Chemotherapy followed by exploratory laparotomy for suspected ovarian cancer. MAIN OUTCOME MEASURE(S): Surgical findings and histopathology. RESULT(S): Intraoperative examination and histology ruled out malignancy but found stage IV endometriosis. CONCLUSION(S): In rare instances advanced endometriosis may be associated with ascites, pleural effusions, and large pelvic masses. For this reason endometriosis should be included in the differential diagnosis of reproductive-age women presenting with apparent ovarian malignancy.
OBJECTIVE: To report a case of endometriosis associated with massive ascites, pleural effusion, and extremely elevated Ca-125. DESIGN: Case report. SETTING: University hospital. PATIENT(S): A 46-year-old, white nulligravida with bilateral adnexal masses, Ca-125 of 3,504 U/mL, abdominal pain, ascites, and a pleural effusion. INTERVENTION(S): Chemotherapy followed by exploratory laparotomy for suspected ovarian cancer. MAIN OUTCOME MEASURE(S): Surgical findings and histopathology. RESULT(S): Intraoperative examination and histology ruled out malignancy but found stage IV endometriosis. CONCLUSION(S): In rare instances advanced endometriosis may be associated with ascites, pleural effusions, and large pelvic masses. For this reason endometriosis should be included in the differential diagnosis of reproductive-age women presenting with apparent ovarian malignancy.