Large 16 cm Multi-Loculated left Ovarian Endometrioma

Authors: Adel Shervin

21 yeas old virgin patient was presented with sever chronic pelvic pain and an ultrasound indicating 16 cm complex muti-loculated left adnexal mass, her CA-125 Antigen was 123 and AMH=2.65
During laparoscopy entire abdomen inspected, 15 endometrioma linings was stripped off , ovarian site of invagination trimmed and peritoneal stigma site of invagination resected.3 month post op AMH was 2.85, pain subsided she was placed on OCP and doing well.

Although pathogenesis of Endometrioma remain controversial we believe on Hughesdon 1957 theory and our approach in treating endometrioma has been the resection of ovarian and peritoneal site of stigma of invagination which has given us excellent result with very minimal recurrence rate.
Trimmed ovarian tissue that brings up the issue of ovarian reserve is unfounded to our opinion merely because this tissue reveals very few to none follicles histologically but islands of endometriotic lesion with extensive cortical fibrosis