CHOCOLATE CYST WITH SEROUS CYSTADENOMA OF OVARY

Dr Lankapothu Pushpa Pallavi, Postgraduate ,Department of OBGY,Andhra Medical College

Under guidance of Dr.KVSM Sandhya Devi (Professor ) & Dr R.Padmaja (Associate Professor) ,dept of OBGY,AMC,VIZAG.

INTRODUCTION PER OPERATIVE FINDINGS

Large ovarian endometriotic cysts ( endometriomas) are 18*10 cms tense cyst was arising from right ovary.Right
located usually on anterior surface of the ovary and are fallopian tube and epiploicae of intestines adherent to cyst
associated with retraction,pigmentation and adhesions to wall.Chocolate fluid aspirated and found to be 1800 ml.Left
posterior peritoneum. Ovarian endometriotic cysts often ovary 4*4 cm with multiple cysts punctured and found to be
contain a thick,viscous dark brown fluid ( chocolate fluid) corpus luteal cyst with hemorrhagic fluid
composed of hemosiderin derived from previous intraovarian
HPE REPORT
hemorrhage.It appears to be a marker for more extensive
pelvic and intestinal disease.Exclusive ovarian disease is Section studied show ovarian cyst lined by cuboidal to
found only in 1% of endometriosis patients. columnar epithelium with focal areas showing collection of
hemosiderin laden macrophages. Ovarian stroma shows
CASE REPORT
endometrial glands in proliferative phase. Features are
A 28 year P1L1 came to gynaecology OPD with complaints of suggestive of ovarian endometrioma with serous
abdominal distention since 6 months and complaint of mass cystadenoma of ovary .
in right lower abdomen since 3 months with dragging type of
DISCUSSION
pain .She had regular menstrual cycles with increased flow
since 3 months associated with dysmenorrhoea.Her last child Ovarian endometriotic cysts need to be differentiated from
birth was 5 years ago delivered by LSCS for failure to progress hemorrhagic corpus luteum cysts or neoplastic cysts.In larger
ovarian endometriosis malignancy is to be excluded although
of labour.On examination 16 X 10 cms firm midline mass with
rare by histology.This ia an example of such rare
restricted mobility,smooth surface,non tenderwith regular presentation where clinically and peropertively thought to be
margins,all borders are palpable except lower border .On an endometriotic cyst but histopathology revealed serous
bimanual examination uterus was retroverted, mobile,exact cystadenoma of ovary also.
size could not be made out , mass is felt through all
fornices.Mass was felt separately from uterus .Mass
movements are not transmitted through cervix.
INVESTIGATIONS
CA-125 was 75.2IU/mL
USG pelvis – Complex right ovarian cyst
MRI pelvis – Right ovarian dermoid cyst
TREATMENT
Right salphingo-oopherectomy