Endometriosis is defined as presence of endometrium including glands and stroma at locations other than the uterine cavity. Atypical endometriosis is rarely seen, accounting for 4.38% amongst endometriosis cases and is reported to possess a precancerous potential. We are reporting a case of primigravida with term gestation, taken up for emergency caesarean section in view of severe preeclampsia with imminent signs of eclampsia. Intraoperatively left ovary was adherent to posterior uterine wall and a cauliflower like growth was seen extending from posterior part of left mesosalphinx, left ovary, posterior uterine wall upto pouch of douglas. Biopsy was taken from the growth and its histopathological examination was reported as atypical endometriosis. Postoperatively patient was stable and was discharged on postoperative day 8.
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