Endometriosis in postmenopausal woman without previous hormonal therapy: A case report

Abstract

Endometriozis pelvik ağrı ve infertilite ile karakterize, benign,östrojen bağımlı, kronik bir hastalıktır. Pelvik endometriozisinprevelansı üreme çağındaki kadınlarda %6-10'dur. Endomet ri o zis menstrüel siklusların varlığıyla ilişkilendirilse de postmenapozal hastaların %2-5'ini etkileyebilir. Bu sunumumuzla, postmenapozal endometriozis olgularına dikkat çekmek istedik.

Endometriosis is a benign, estrogen-dependent, chronic gynecological disorder commonly associatedwith pelvic pain and infertility. The prevalence of pelvic endometriosis is high, affecting approximately 610% of women of reproductive age. Although endometriosis has been associated with the occurence ofmenstrual cycles, it may affect between 2-5% of postmenopausal women. In this presentation, we wouldlike to draw attention to such cases of postmenopausal endometriosis.A 56-year-old woman was presented with postmenopausal vaginal bleeding. Her menopausal status occured at 46 years of age. She had neither personal history of endometriosis and a prior history of pelvicpain nor previous hormone use. A pelvic ultrasound scan revealed a right ovarian cystic mass of approximately 2.6x2.1cm in size and a left ovarian multiple lobated hemorrhagic cystic mass approximately5.0x2.8 cm in size. Cancer antigen 25 (CA 125) level appeared to be within the normal range. The patient was then submitted to a computed tomography scan that showed multiple lobated cystic massesat both adnexa. Total abdominal hysterectomy and bilateral salpingooophorectomy was performed. Thehistological analysis confirmed an ovarian endometriotic cyst.Endometriosis may be found in postmenopausal women, even without a history of previous hormoneuse. Thus, endometriosis should be considered in the differential diagnosis of postmenopausal adnexalmasses.