title: Unusual Case of Postmenopausal Diffuse Endometriosis Mimicking Metastastic Ovarian Malignancy.
abstract: Endometriosis is a common gynecologic condition of the premenopausal years. However, postmenopausal endometriosis is rare (2.2%) and thought to be related to high level of circulating estrogen, especially in hormonal replacement therapy. We present a case of a 69-year-old postmenopausal woman, previously healthy and on no regular medication, with diffuse peritoneal endometriosis and bilateral ovarian endometrioma mimicking metastatic ovarian carcinoma on FDG PET/CT. Both ovarian endometrioma had low-grade activity, but more strikingly, there was diffuse FDG-avid peritoneal dissemination and gross ascites. Endometriosis should not be totally disregarded as a differential diagnosis even at postmenopausal status.
authors.affiliation: From the Departments of *Diagnostic Radiology, and †Obstetrics and Gynaecology, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.
authors.forename: Rajani
authors.initials: R
authors.lastname: Agarwal Sharma
authors.forename: Elaine Yuen Phin
authors.initials: EY
authors.lastname: Lee
authors.forename: Varut
authors.initials: V
authors.lastname: Vardhanabhuti
authors.forename: Pek-Lan
authors.initials: PL
authors.lastname: Khong
authors.forename: Siew-Fei
authors.initials: SF
authors.lastname: Ngu
mesh_terms: D000368:Aged; D000077216:Carcinoma, Ovarian Epithelial; D003937:Diagnosis, Differential; D004715:Endometriosis / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D064847:Multimodal Imaging; D009362:Neoplasm Metastasis; D009375:Neoplasms, Glandular and Epithelial / Q000000981:diagnostic imaging* / Q000473:pathology; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D049268:Positron-Emission Tomography; D017698:Postmenopause; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18