Endometriosis arising during estrogen and testosterone treatment 17 years after abdominal hysterectomy: a case report

Abstract

Objective: To report the possible association between the use of oestrogen replacement therapy and endometriosis in a postmenopausal woman. Methods: We present a case of a postmenopausal, previously hysterectomised, woman who received hormonal replacement therapy and developed a large broad ligament cyst. Two years prior to her presentation she had been complaining of pelvic pain and deep dyspareunia. Results: Pelvic ultrasound showed an adnexal cyst that was increasing in size. CA-125 was normal. Laparoscopy revealed multiple endometriotic deposits and a broad ligament cyst. Cystectomy and oophorectomy were done. Histology confirmed a diagnosis of endometriosis including the broad ligament cyst. Conclusions: Hormonal replacement therapy can be associated with de novo endometriosis including at sites, which are unusual.