Endometrioma Coexisting with Dermoid Tumor in a Single Ovary Presenting as Atypical Endometrioma

Huseyin Kiyak, MD, Pınar Kadirogullari, MD, Tolga Karacan, MD, Doga Kerem Seckin, MD, Suat Karatas, MD

Department of Obstetrics and Gynecology, Bagcilar Research and Education Hospital, University of Health Sciences, Istanbul, Turkey (Dr. Tolga)
Department of Obstetrics and Gynecology, Sisli Research and Education Hospital, University of Health Sciences, Istanbul, Turkey (Dr. Karatas)


Introduction: Ovarian endometrioma, the clinical phenotype of endometriosis, is found in 17% to 44% of patients with endometriosis and is related to the severe form of the condition. The observation of endometrioma and dermoid tumor in the same ovary can be evaluated as atypical endometrioma or ovarian cancer in ultrasound findings.

Case Description: The objective of this report is to present two cases in which an endometrioma and a dermoid tumor are present in the same ovary and to review the subject together with the results of 10 previously reported cases in the literature.

Discussion: The ultrasound findings in atypical endometriomas and endometriomas that mimic ovarian tumors are combinations of papillary projections, hyperechoic irregular walls, a distinct solid mass, and calcifications. Magnetic resonance imaging is the second option for patients who are ultrasonographically identified as having an indeter- minate adnexal mass, and it can provide additional information in distinguishing between the two pathologies within the same ovary. Due to suspected malignancy, unnecessary tests and gynecologic oncology consultations are recommended in cases of atypical endometrioma. This may lead to an increase in the frequency of unnecessary midline laparotomy.

Key Words: Endometrioma; Dermoid cyst; Ultrasonography.

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