Endometriosis of para-aortic node masquerading a malignancy: a rare occurrence

Area of Science:

• Gynecology
• Oncology
• Pathology

Background:

• Endometriosis is a common benign estrogen-dependent disorder characterized by endometrial tissue outside the uterus.
• The pathogenesis of endometriosis involves multiple theories, including Halban's 'Benign Metastasis' theory.
• This theory suggests the potential for endometriotic cell spread via lymphatic vessels.

Observation:

• A case of a 26-year-old nulliparous woman with endometriosis is presented.
• The patient exhibited significantly elevated cancer antigen 125 (CA 125) levels.
• Endometriosis was identified in the para-aortic lymph nodes.

Findings:

• The para-aortic lymph node endometriosis mimicked advanced ovarian cancer.
• Elevated CA 125 levels in this context can be misleading.
• Halban's theory provides a plausible explanation for lymphatic spread in this case.

Implications:

• This case highlights the importance of considering endometriosis in the differential diagnosis of suspected ovarian cancer, especially in younger women.
• Accurate diagnosis is crucial to avoid misclassification and ensure appropriate management.
• Understanding lymphatic spread mechanisms is vital for comprehending endometriosis progression.