Tumor-like ovarian endometriosis with pregnancy decidua reaction: A case report and review of the literature

We describe a case of bilateral ovarian tumor-like lesions detected during pregnancy. It is important to highlight that these masses were not detected for the first time during pregnancy; the patient had already been aware of them 2 years prior, during pregnancy preparation, when an ultrasound exami...

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Main Authors: Yu-Rou Zhang, Zhi-Li Li, Li Guo
Format: Article
Language:English
Published: SAGE Publishing 2025-05-01
Series:Journal of International Medical Research
Online Access:https://doi.org/10.1177/03000605251342519
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author Yu-Rou Zhang
Zhi-Li Li
Li Guo
author_facet Yu-Rou Zhang
Zhi-Li Li
Li Guo
author_sort Yu-Rou Zhang
collection DOAJ
description We describe a case of bilateral ovarian tumor-like lesions detected during pregnancy. It is important to highlight that these masses were not detected for the first time during pregnancy; the patient had already been aware of them 2 years prior, during pregnancy preparation, when an ultrasound examination revealed bilateral space-occupying ovarian lesions. These lesions did not exhibit any increase in size during regular follow-ups until pregnancy. At 17 weeks of gestation, fetal ultrasound showed significant enlargement of the bilateral ovarian lesions. The patient underwent pelvic magnetic resonance imaging, which revealed cystic masses in both the ovaries with septations and multiple nodular and flocculent projections on the walls and septations, exhibiting features resembling malignant tumors. The cystic fluid within each cyst predominantly showed slightly short T1 and long T2 signal characteristics. The final diagnosis of lesions occupying the ovarian space was endometriotic cysts with a decidual reaction associated with pregnancy, which was confirmed on postoperative pathological examination. Subsequently, at 19 weeks of gestation, the patient underwent a “laparoscopic excision of the left ovarian lesion and right ovarian lesion stripping.” The patient recovered well postoperatively and successfully delivered a baby at 39 weeks of gestation. Endometriosis with decidual reaction during pregnancy is rare and ectopic decidual tissue can easily be confused with neoplastic lesions using imaging results. In addition, clinicians must remain vigilant about the special conditions that ectopic decidual tissue may cause, such as cyst rupture, massive hemorrhage, dystocia, and even fetal death.
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spelling doaj-art-d763fbbd00124df185261d9b7efa4ceb2025-08-20T03:12:43ZengSAGE PublishingJournal of International Medical Research1473-23002025-05-015310.1177/03000605251342519Tumor-like ovarian endometriosis with pregnancy decidua reaction: A case report and review of the literatureYu-Rou ZhangZhi-Li LiLi GuoWe describe a case of bilateral ovarian tumor-like lesions detected during pregnancy. It is important to highlight that these masses were not detected for the first time during pregnancy; the patient had already been aware of them 2 years prior, during pregnancy preparation, when an ultrasound examination revealed bilateral space-occupying ovarian lesions. These lesions did not exhibit any increase in size during regular follow-ups until pregnancy. At 17 weeks of gestation, fetal ultrasound showed significant enlargement of the bilateral ovarian lesions. The patient underwent pelvic magnetic resonance imaging, which revealed cystic masses in both the ovaries with septations and multiple nodular and flocculent projections on the walls and septations, exhibiting features resembling malignant tumors. The cystic fluid within each cyst predominantly showed slightly short T1 and long T2 signal characteristics. The final diagnosis of lesions occupying the ovarian space was endometriotic cysts with a decidual reaction associated with pregnancy, which was confirmed on postoperative pathological examination. Subsequently, at 19 weeks of gestation, the patient underwent a “laparoscopic excision of the left ovarian lesion and right ovarian lesion stripping.” The patient recovered well postoperatively and successfully delivered a baby at 39 weeks of gestation. Endometriosis with decidual reaction during pregnancy is rare and ectopic decidual tissue can easily be confused with neoplastic lesions using imaging results. In addition, clinicians must remain vigilant about the special conditions that ectopic decidual tissue may cause, such as cyst rupture, massive hemorrhage, dystocia, and even fetal death.https://doi.org/10.1177/03000605251342519
spellingShingle Yu-Rou Zhang
Zhi-Li Li
Li Guo
Tumor-like ovarian endometriosis with pregnancy decidua reaction: A case report and review of the literature
Journal of International Medical Research
title Tumor-like ovarian endometriosis with pregnancy decidua reaction: A case report and review of the literature
title_full Tumor-like ovarian endometriosis with pregnancy decidua reaction: A case report and review of the literature
title_fullStr Tumor-like ovarian endometriosis with pregnancy decidua reaction: A case report and review of the literature
title_full_unstemmed Tumor-like ovarian endometriosis with pregnancy decidua reaction: A case report and review of the literature
title_short Tumor-like ovarian endometriosis with pregnancy decidua reaction: A case report and review of the literature
title_sort tumor like ovarian endometriosis with pregnancy decidua reaction a case report and review of the literature
url https://doi.org/10.1177/03000605251342519
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