Report on Bilateral Endometrioid Carcinoma of the Ovary in Pregnancy: Diagnostic and Treatment Challenges

Articles in Press

Document Type : Case report

Authors

1 Department of Gynecology- Ghaem Hospital- Mashhad university of medical sciences

2 Department of Gynecology. Faculty of Medicine. Mashhad University of Medical Sciences

3 Ghaem Hospital. Mashhad University of Medical Sciences

10.22038/ijogi.2025.86638.6378

Abstract

Introduction: Endometrioid tumors of the ovary are rare epithelial ovarian tumors. They are extremely rare during pregnancy and may be mistaken for other more common conditions due to physiological changes in the ovary and increased hormone levels, leading to delays in diagnosis and treatment. This article discusses the diagnosis and treatment of bilateral endometrioid carcinoma during pregnancy.

Case Presentation: A 34-year-old female patient, G2L1(ND), at 17 weeks of gestation, presented with mild hypogastric pain and an increase in the size of an ovarian mass in pregnancy ultrasounds. The latest TVS ultrasound reported bilateral ovarian masses and ORADS5, and laboratory tests showed a slight increase in CA125. The patient underwent laparotomy and bilateral cystectomy, and pathology reported endometrioid adenocarcinoma. The patient underwent six cycles of T+C chemotherapy during pregnancy. The pregnancy continued to term, and the patient had a normal vaginal delivery at term gestational age, followed by TAH BSO staging.

Conclusion: Endometrioid tumors of the ovary during pregnancy, especially when bilateral and diagnosed in advanced stages, require a careful and multidisciplinary approach to management. Timely diagnosis, the use of appropriate imaging tools, and tumor markers can aid in accurate diagnosis and effective treatment. Surgery in the second trimester of pregnancy is recommended as the primary treatment method, and continuous follow-up is essential to monitor the condition of the mother and fetus. The presence of capsule rupture is considered a risk factor for metastasis.

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The Iranian Journal of Obstetrics, Gynecology and Infertility

Articles in Press, Accepted Manuscript
Available Online from 15 September 2025

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