title: Endometriosis mimicking advanced ovarian cancer.
abstract: OBJECTIVE
  To report a case of endometriosis associated with massive ascites, pleural effusion, and extremely elevated Ca-125.
  
  
  METHODS
  Case report.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  A 46-year-old, white nulligravida with bilateral adnexal masses, Ca-125 of 3,504 U/mL, abdominal pain, ascites, and a pleural effusion.
  
  
  METHODS
  Chemotherapy followed by exploratory laparotomy for suspected ovarian cancer.
  
  
  METHODS
  Surgical findings and histopathology.
  
  
  RESULTS
  Intraoperative examination and histology ruled out malignancy but found stage IV endometriosis.
  
  
  CONCLUSIONS
  In rare instances advanced endometriosis may be associated with ascites, pleural effusions, and large pelvic masses. For this reason endometriosis should be included in the differential diagnosis of reproductive-age women presenting with apparent ovarian malignancy.
authors.affiliation: Department of Obstetrics and Gynecology, University of Crete, Heraklion, Greece.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Goumenou
authors.forename: Ioannis
authors.initials: I
authors.lastname: Matalliotakis
authors.forename: Neal
authors.initials: N
authors.lastname: Mahutte
authors.forename: Eugenios
authors.initials: E
authors.lastname: Koumantakis
mesh_terms: D001201:Ascites / Q000175:diagnosis / Q000209:etiology*; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000517:prevention & control*; D004715:Endometriosis / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000556:secondary*; D010173:Palpation; D010996:Pleural Effusion / Q000175:diagnosis / Q000209:etiology*