Endometriosis Mimicking Ovarian Cancer in the Setting of Acquired Immune Deficiency Syndrome

Abstract

BACKGROUND: 

With rising rates of human immunodeficiency virus (HIV) among women and resultant immunosuppression, clinicians face varying presentations of gynecologic pathologies. We report a case of endometriosis in a patient with acquired immunodeficiency syndrome (AIDS) presenting with a Sister Mary Joseph’s nodule and mimicking carcinomatosis.

CASE: 

A woman with AIDS and 2-month history of abdominal pain, distention, and weight loss was found to have periumbilical and pelvic masses, ascites, lymphadenopathy, and an elevated CA 125 level. Operative findings included chocolate-colored ascites and peritoneal seeding involving the ovaries, uterus, appendix, bowel, umbilicus, and omentum. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy and resection of all gross disease. Pathologic diagnosis was endometriosis and AIDS-associated adenopathy.

COMMENT: 

Immunodeficiency from AIDS can affect the progression of endometriosis to the point of mimicking ovarian malignancy.

In Brief

Endometriosis should be considered in the differential diagnosis for patients with human immunodeficiency virus/acquired immunodeficiency syndrome presenting with a pelvic mass, ascites, lymphadenopathy, and carcinomatosis.