Ascites, elevated CA 125, and a large adnexal mass with an enteroovarian fistula.
BACKGROUND
Rectovaginal and vesicovaginal fistulae occur commonly in human immunodeficiency virus (HIV)-positive women and typically present with a characteristic vaginal discharge.


METHODS
We report a case of a jejunal-ovarian fistula presenting as suspected malignancy in a 38-year-old woman with HIV. The patient presented with ascites, moderately elevated CA 125, and a 12-cm adnexal mass. She was expedited to surgery secondary to a persistent pelvic mass and the patient's desire for definitive treatment. We believe the patient's immunocompromised state caused a microperforation in the small bowel, which subsequently formed a fistula to the ovary. The patient's left adnexa was removed, along with a 3-cm portion of small bowel.


CONCLUSIONS
Uncommon entities should be included in the differential diagnosis of pelvic masses in immunocompromised women.
Robertson
Heather A
HA
Department of Gynecologic Oncology, Baylor College of Medicine, Houston, TX 77030, USA.
Velasco
Veronica
V
Gutierrez
Carolina
C
Anderson
Matthew L
ML
D000290:Adnexa Uteri / Q000473:pathology*; D000328:Adult; D001201:Ascites; D018394:CA-125 Antigen / Q000097:blood*; D048909:Diabetes Complications; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D005402:Fistula / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D015658:HIV Infections / Q000150:complications*; D006630:Hispanic or Latino; D006801:Humans; D007579:Jejunal Diseases / Q000175:diagnosis* / Q000382:microbiology / Q000601:surgery; D009767:Obesity, Morbid / Q000150:complications; D010049:Ovarian Diseases / Q000175:diagnosis* / Q000601:surgery; D010052:Ovariectomy; D014057:Tomography, X-Ray Computed
D018394:CA-125 Antigen