title: Recurrent endometriosis following total hysterectomy with oophorectomy mimicking a malignant neoplastic lesion: a diagnostic and therapeutic challenge.
abstract: METHODS
  A woman with a previous hysterectomy and bilateral salpingo-oophorectomy for endometriosis presented with painless vaginal bleeding. Imaging revealed a heterogeneous soft tissue pelvic mass suggestive of a malignant neoplastic lesion. Radical surgery was performed including excision of the pelvic mass and anterior resection of the sigmoid colon. Histopathology revealed endometriosis.
  
  
  CONCLUSIONS
  The risk of malignant transformation and the difficulty in achieving a preoperative diagnosis make radical surgery inevitable in the management of recurrent endometriosis. The use of hormone replacement therapy after bilateral salpingo-oophorectomy for endometriosis remains controversial and requires careful counseling about recurrence and close follow-up.
authors.affiliation: Department of Obstetrics and Gynecology, Norfolk and Norwich University Hospital, Norwich, UK. elgiaren@yahoo.gr
authors.forename: I
authors.initials: I
authors.lastname: Giarenis
authors.forename: P
authors.initials: P
authors.lastname: Giamougiannis
authors.forename: C T M
authors.initials: CT
authors.lastname: Speakman
authors.forename: J J
authors.initials: JJ
authors.lastname: Nieto
authors.forename: S G
authors.initials: SG
authors.lastname: Crocker
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004715:Endometriosis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008279:Magnetic Resonance Imaging; D010386:Pelvic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D012008:Recurrence; D014057:Tomography, X-Ray Computed