| Author: Eva Račanská
Description:
34 year old 0 gravida referred by gynecologist for a persisting ovarian cyst and sterility (trying time - 2 years) and complains of pelvic pain during the sexual intercourse. Bimanual pelvic examination: anteverted uterus of normal size, palpable cystic formation behind the uterus, 10 cm in diameter. Ultrasound examination described uterus of normal size, endometrium 10 mm, trilocular hypoechogenic cyst of the right ovary 10 by 7 cm in size. Tumor markers (Ca 125) - negative. Laparoscopy with dye instillation was performed with the following findings: uterus of normal size, both ovaries enlarged with endometrial cysts (Sampson cysts) 50 and 60 mm in diameter. Ovaries in adhesions in the pouch of Douglas and joint to each other. Right uterine tube is patent for the dye but with delay, left uterine tube is occluded. Both ovaries were released form adhesions and cysts with chocolate-like content were exstirpated. Histology confirmed endometrial cyst of both ovaries. According to the laparoscopy, patient sufferes from the severe form of endometriosis (grade III, IV) with occluded left uterine tube. She is scheduled for GnRH analogue treatment for 6 months, IVF (in vitro fetilization) with embryotransfer should be considered.
Categorization:
Endometrioma - Sampson cyst
Attachments:
Description: Uterus and both ovaries joint together filling the pouch of Douglas. Ovaries are enlarged with the brownish colour on the surface which is typical for endometriosis.
Description: Uterus and both enlarged ovaries. Brown endometrial implants are visible.
Description: Uterus, both enlarged ovaries behind the uterus, brown endometrial implants.
Description: Uterus, right ovary with endometrial cyst and dilated ampullar part of the right uterine tube after dye instillation.
Description: Both ovaries after cyst exstirpation.
Description: Both ovaries and uterine tubes after cyst exstirpation.