Gross Ascites Secondary to Endometriosis: A Rare Presentation in Pre-Menopausal Women

Abstract

Ascites caused by endometriosis is an unusual phenomenon with approximately 60 cases described since it was first reported in 1954. Moreover, such a case has rarely been reported in the Caribbean literature. Ascites is frequently treated with surgical options that do not preserve fertility. This is due to the association of ascites with gynaecological malignancies in women with elevated serum cancer antigen (CA-125). We describe three cases of severe endometriosis associated with massive ascites, successfully treated with hormonal therapy while preserving fertility.

Radical surgery for pseudo-ovarian malignancy: a case report of bowel endometriosis with massive ascites

“…Therefore, although these minimally invasive techniques are effective to clarify the source of ascites, diagnostic laparoscopy and histopathology are still the gold standards for endometriosis diagnosis and staging. Besides, gross ascites in the present case was reported to increase recurrence risk of endometriosis (8).…”

“…Ascites related to endometriosis is uncommon. The first case was described by Brews in 1954, and to date less than 100 cases have been reported in publications (8).…”

Removal of Large Broad Ligament Fibroid with Fertility Preserved: A Case Report

“…[4] These fibroids might cause an increase in the CA-125 tumor marker which is an indefinite marker as its high levels could also be indicative of endometriosis or neoplastic ovarian masses. [4,9] The best treatment approach for fibroid in the broad ligament is laparoscopic. [10] However, in large-sized fibroid, choosing the procedure still depends on the surgeon's skills, instruments, and assistance availability.…”

A practical approach to laparoscopic myomectomy for large uterine leiomyoma – a case report

“…7 GnRH agonists such as leuprolide or goserelin are administered once every month for up to six months and can reduce leiomyoma size to 67.1% of baseline during standard treatment. 7,8 Notwithstanding the favourable effects of GnRH agonists, leiomyoma enucleation may be cumbersome as these agents induce hyaline degeneration, producing an ill-defined pseudocapsule that obscures surgical cleavage planes. 8,9…”

“…7,8 Notwithstanding the favourable effects of GnRH agonists, leiomyoma enucleation may be cumbersome as these agents induce hyaline degeneration, producing an ill-defined pseudocapsule that obscures surgical cleavage planes. 8,9…”