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© 2005 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 24:1289-1294 • 0278-4297

Case Series

Decidualization of Ovarian Endometriosis During Pregnancy Mimicking Malignancy

Rami N. Sammour, MD, Zvi Leibovitz, MD, Israel Shapiro, MD, Shimon Degani, MD, Zohar Levitan, MD, Ariel Aharoni, MD, Joseph Tal, MD, Michael Lurie, MD and Gonen Ohel, MD

Departments of Obstetrics and Gynecology (R.N.S., Z.L., I.S., S.D., Z.L., A.A., J.T., G.O.) and Pathology (M.L.), Bnai-Zion Medical Center, Technion-Israel Institute of Technology, Haifa, Israel.

Address correspondence to Zvi Leibovitz, MD, Department of Obstetrics and Gynecology, Bnai-Zion Medical Center, PO Box 4940, Haifa 31048, Israel. E-mail: zvi.leibovitz{at}b-zion.org.il

Objective. The purpose of this series is to present deciduosis (the formation of extrauterine decidua) as one of the differential diagnoses of a malignant tumor during pregnancy. Methods. Two cases are described in which pregnant patients had a pelvic tumor. The lesions, which were diagnosed in the early second trimester, consisted of complex masses with an extensive blood supply and had a sonographic appearance of a malignant tumor. The high suspicion for malignancy necessitated surgical intervention. Results. During surgery, the lesions were observed to be of an ovarian origin with papillary excrescences covering their exterior. The lesions were excised and sent for histologic examination. The results showed a markedly decidualized endometriotic cyst in both cases. Conclusions. This phenomenon is a diagnostic challenge and should be considered in the differential diagnosis of a malignant mass during pregnancy.

Key Words: deciduosis • endometriosis • ovarian neoplasm • pregnancy

Abbreviations: RI, resistive index • 3D, 3-dimesional




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