Polypoid endometrioma mimicking malignant transformation: a case report and systematic review
Guillaume Parpex1,2,3, Louis Marcellin1,2,3, Joëlle Uzan-Augui4
1Department of Gynecology, Obstetrics II, and Reproductive Medicine, Centre Hospitalier Universitaire (CHU) Cochin, Hôpital Universitaire Paris Centre (HUPC), Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
Objective:
To report a case of polypoid ovarian endometrioma mimicking malignant transformation, review the literature on this rare entity, and highlight its implications for surgical management and fertility preservation.
Design:
Case report and literature review.
Subject:
One reproductive-age woman with suspected malignant transformation of an ovarian endometrioma.
Exposure:
Laparoscopic adnexectomy.
Main Outcome Measure:
Histopathologic confirmation of nonmalignant disease and review of surgical management in previously reported cases.
Results:
A 38-year-old woman desiring fertility preservation presented with a complex ovarian mass classified as O-RADS 4 on magnetic resonance imaging. Laparoscopic adnexectomy was performed for suspected malignancy. Final histopathologic examination confirmed a benign polypoid endometrioma. Review of the literature identified 22 reported cases, all managed surgically for presumed malignancy, with hysterectomy performed upfront in ten cases despite benign histology.
Conclusion:
Polypoid ovarian endometrioma is a rare mimic of ovarian malignancy that may lead to extensive surgery before histologic confirmation. Awareness of this entity is essential to reduce overtreatment and to support fertility-preserving management when appropriate.
