OVARIAN ENDOMETRIOSIS MIMICKING HYDROSALPINX Both 2 Sides, Dr PHẠM THỊ THANH XUÂN, MEDIC MEDICAL CENTER, VIETNAM

35yo female patient, PARA: 1011, suffered from a hypogastric pain for a long time with menorrhagia and slight fever. Her history included a cesarian section 2003, and a curettage 2005. Lab data : Beta HCG (-).CA 125: 110 U/ml.

Ultrasound detected a tubular structure 6x3cm on the right side of her uterus and a cystic duct on the left side of the uterus, 7x3cm, with septa filling echogenic fluid in adhesion of the pelvis. An ultrasonic note on pyosalpinx both 2 sides was done.
CT Scan= Posterior and on the left side of uterus there were 2 cystic lesions with thick wall and septa inside, # 5 and 4 cm, which caught the CE in the wall and septa and in adhesion with other pelvic organes. Thought about tubal hydrops (hydrosalpinx) in differential diagnosis with ovarian cystic tumors.
An operation performed to remove ovarian cysts both 2 sides, adhesions at the fundus of uterus and adnexa. Cauterization of endometriotic nodules on the mesometrium (broad ligament)and Douglas' pouch.

Microscopic results: Endometriosis of 2 ovaries= Ovaries with small cavities filling by a brown-red fluid with many papilla covered by epithelium of endometrium and stroma having macrophages eating hemosiderin.