• Khalid H Sait.
• Department of Obstetrics and Gynecology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia. khalidsait@yahoo.com
• Fertil. Steril. 2008 Nov 1;90(5):2015.e17-9.

ObjectiveTo report a case of endometriosis associated with massive ascites and an elevated CA-125 level.DesignCase report.SettingTertiary care center.Patient(S)A 26-year-old woman presented with massive ascites and an increased CA-125 level suggestive of ovarian cancer.Intervention(S)Ultrasonography, laparotomy, and bilateral ovarian cystectomy and reconstruction. Endometriosis was diagnosed postoperatively on the basis of histopathology. The patient received 6 months of treatment with a GnRH analogue.Main Outcome Measure(S)Ultrasound examination 6 months after surgery to evaluate for ascites or recurrent ovarian cysts.Result(S)Frozen sections obtained at laparotomy and ovarian cystectomy ruled out a malignancy. The final histologic report was compatible with a diagnosis of endometriosis. After 6 months of treatment with the GnRH analogue, the patient experienced a progressive reduction of the ascitic fluid and full remission after 2 years.Conclusion(S)Endometriosis associated with massive bloody ascites is an unusual occurrence. This report draws attention to this condition as a complication of endometriosis. For this reason, endometriosis should be included in the differential diagnosis of reproductive-age women presenting with an apparent ovarian malignancy.

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