Laparoscopic management of massive recurrent endometrioma with atypical presentation: A case report

Endometriosis affects 10%–15 % of reproductive age group population. Pelvic endometriosis usually involves ovaries, and it is reported to involve both ovaries in one-third to one-half of cases. Ovarian endometriomas rarely exceed 10–15 cm in diameter. Our case is that of a 31-year-old P1L1 who presented with increasing abdominal girth, and imaging revealed a huge cystic mass extending till the diaphragm around 29 × 24 × 19 cm3 which was later found to be a case of recurrent endometriosis. This was managed by laparoscopy, and the volume of the chocolate fluid evacuated was approximately 11,300 mL. It is rare for endometriomas to grow up to such a large size. This case stresses the importance of suspicion of recurrent endometrioma even in atypical presentations and the need for follow-up in known cases of endometriosis to identify early recurrence.