Endometrioma

Abstract

The current case analysis dealt with a female patient of 30 years of age, regular menstrual cycles 3 x 30, with no history of pregnancies or use of any contraceptive method, with a history of a left oophorectomy nine years ago, which since six years ago, had had abdominal pain type colic, located in hypogastrium and bilateral iliac fossae, which radiated to the lumbosacral region, with an intensity according to EVA scale 8/10. This was related to the menstruation period, also accompanied by occasional dyspareunia, for which NSAID self-administered frequently, presenting slight improvement. The patient also refers to difficulties in being pregnant. The appearance of an endometrioma located in the right ovary was diagnosed echo-graphically, without elevation of the CA - 125 tumor marker, followed by the decision to surgically intervene, evidencing right ovarian endometriosis, the absence of the left ovary and bilateral salpingectomy. A careful cystectomy was performed, conserving most of the ovary, followed by histopathological study, which confirmed the diagnosis of ovarian endometrioma. Subsequently, clinical treatment was started with “Dienogest” with ethinylestradiol for 12 months to reduce recidivism, with a marked decrease in dysmenorrhoea and dyspareunia in subsequent controls. Due to the pregnancy expectation of the patient and the antecedent of the bilateral ligation of the fallopian tubes, she was referred to a fertility clinic to assess the possibility of in vitro fertilization. The patient continues with the combined hormonal treatment and is currently asymptomatic.