title: Massive ascites as a presentation in a young woman with endometriosis: a case report.
abstract: OBJECTIVE
  To report a case of endometriosis associated with massive ascites and an elevated CA-125 level.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Tertiary care center.
  
  
  METHODS
  A 26-year-old woman presented with massive ascites and an increased CA-125 level suggestive of ovarian cancer.
  
  
  METHODS
  Ultrasonography, laparotomy, and bilateral ovarian cystectomy and reconstruction. Endometriosis was diagnosed postoperatively on the basis of histopathology. The patient received 6 months of treatment with a GnRH analogue.
  
  
  METHODS
  Ultrasound examination 6 months after surgery to evaluate for ascites or recurrent ovarian cysts.
  
  
  RESULTS
  Frozen sections obtained at laparotomy and ovarian cystectomy ruled out a malignancy. The final histologic report was compatible with a diagnosis of endometriosis. After 6 months of treatment with the GnRH analogue, the patient experienced a progressive reduction of the ascitic fluid and full remission after 2 years.
  
  
  CONCLUSIONS
  Endometriosis associated with massive bloody ascites is an unusual occurrence. This report draws attention to this condition as a complication of endometriosis. For this reason, endometriosis should be included in the differential diagnosis of reproductive-age women presenting with an apparent ovarian malignancy.
authors.affiliation: Department of Obstetrics and Gynecology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia. khalidsait@yahoo.com
authors.forename: Khalid H
authors.initials: KH
authors.lastname: Sait
mesh_terms: D000328:Adult; D001201:Ascites / Q000209:etiology* / Q000276:immunology / Q000628:therapy; D018394:CA-125 Antigen / Q000032:analysis; D003937:Diagnosis, Differential; D004715:Endometriosis / Q000150:complications / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives / Q000627:therapeutic use; D013509:Gynecologic Surgical Procedures; D006801:Humans; D010048:Ovarian Cysts / Q000209:etiology* / Q000276:immunology / Q000628:therapy; D010051:Ovarian Neoplasms / Q000175:diagnosis*; D016896:Treatment Outcome
chemical_list: D018394:CA-125 Antigen; D007987:Gonadotropin-Releasing Hormone