Nuzhat P Khawaja.
Endometriosis with Myxoid Change.
Mother & Child Jan ;37(4):153-5.

A case of endometriosis with myxoid change simulating pseudomyxoma peritonei is presented.Rarltv of this condition Is of Interest to report the case. A 25-year-old lady had diagnostic laparoscopy for primary Infertility and pelvic pain. Initial diagnosis of pseudomyxoma peritonel was made because of gelatinous grape like vesicles Involving the whole omentum. Pelvic organs were not Identifiable. Therefore exploratory laparotomy was carried out. Uterus was retroverted fixed, pouch of Douglas was obliterated, fundus of the uterus, ovaries and tubes covered with gelatinous material along with omentum. However, there was no evidence of malignancy. Biopsy of left ovary and Infracolic omentectomy was carried out. Histopathology report revealed endometriosis with myxoid change. This case illustrated that endometriosis with mVxold change should be considered In the differential diagnosis of pseudomyxoma peritonel In women.She had diagnostic laparoscopy under GA, which showed fixed retroverted uterus. Pouch of Douglas was obliterated because of adhesions. Tubes, ovaries and fundus of uterus were covered with gelatinous materials and only fimbrial ends of the tube visualised. Grapes like gelatinous vesicles were present on almost whole of omentum. Initial impression was of pseudomyxoma peritonei. Therefore exploratory laparotomy was carried. Omentum was studded with grape like gelatinous material. Uterus could not be mobilised because of adhesion. Both tubes were also adherent to posterior uterine wall and distorted in shape. Right ovary was normal, while left ovary was covered with gelatinous material. Liver, spleen and outer surface of diaphragm were normal. There was no evidence of malignancy. Infracolic omentectomy was carried out and a piece of tissue was taken from left ovary. Histopathology report revealed endometriosis with myxoid change in both specimens. Postoperative recovery was uneventful. She was discharged on 7th postoperative day. She was advised norethisterone 10 mg BD for 6 months, hysterosalpingography later to demonstrate patency of tubes and regular follow up.

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