Huge endometrioma and ovarian mucinous cyst causing LUTS

Brief History 

 A 57- year-old woman complaining of frequency and nocturia since 3-4 months ago.

Nulliparous (infertility)

Menopause

Chronic nonspecific abdominal and pelvic pain from 6 years ago.

Pervious laparotomy and bowel repair (bowel trauma during diagnostic colonoscopy) → 10 years ago

Diagnostic Evaluation

Normal laboratory Data : U/A, U/C, CBC, Tumor Markers

Abdominopelvic ultrasonography:

Normal kidneys and bladder

Abdominopelvic hemorrhagic ascites.

Normal uterus and left ovary

In right adnexa a multiloculated cyst with internal echo and internal vascularity measuring

about 108* 88 mm was noted.

Another ground glass mass suggestive of  endometrioma in right adnexa was noted

measuring about 65*51 mm.

Abdominopelvic MRI

Pre operation Evaluation

General surgery consult: Diagnostic colonoscopy → small bowel polyp

Gynecology consult

Bowel prep. And prophylactic antibiotic

Frozen section pathology report:

Ovarian mucinous cyst and Endometrioma

Benign appearance with small foci of border line cells.

Final Plan 

Complete cyst resection

Hysterectomy and bilateral oophorectomy

omentectomy