Abstract

Deciduosis classically occurs in the context of known endometriosis in the pelvis, most commonly in the ovaries, but also in the peritoneum. However, ovarian deciduosis outside the context of endometriosis is rare and makes diagnosis difficult, especially as the sonographic appearance suggests a malignant process. We report a case of decidualized ovarian mass in a patient without prior history of endometriosis that mimicked an ovarian malignancy. MRI may be a useful imaging modality to monitor these lesions and guide management. Consultation with a multidisciplinary team accustomed to such conditions will help to tailor the management to each individual.

Highlights

  • Decidualization refers to the process in pregnancy whereby the normal endometrium of the uterus undergoes specialized transformation to support the growing fetus

  • We report a case of decidualized ovarian mass in a patient without any previous history of endometriosis that strongly mimicked an ovarian malignancy that resulted in a premature delivery

  • No borderline changes, atypia, or malignancy was observed and immunohistochemistry supported the diagnosis of ovarian deciduosis

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Summary

Introduction

Decidualization refers to the process in pregnancy whereby the normal endometrium of the uterus undergoes specialized transformation to support the growing fetus. Ectopic deciduosis is classically related to a context of known endometriosis [1,2,3,4] It occurs in the pelvis, most commonly in the ovaries, the anterior and posterior surfaces of the uterus, and the omentum and in the peritoneum, pleura, and bladder. It is benign in nature and undergoes spontaneous regression in the postpartum period [1]. We report a case of decidualized ovarian mass in a patient without any previous history of endometriosis that strongly mimicked an ovarian malignancy that resulted in a premature delivery

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