NECROTIC PSEUDOXANTHOMATOUS NODULES OF THE OMENTUM AND PERITONEUM - APECULIAR REACTION TO ENDOMETRIOTIC CYST CONTENTS

Background: Necrotic pseudoxanthomatous nodules of the ovary, omentum, and peritoneum are rare, and have been described as a late manifestat ion of endometriosis. Case: A 39-year-old woman presented with acute a bdominal pain and an abdominopelvic mass. Emergency laparotomy reveale d a ruptured ovarian neoplasm with several liters of old blood in the abdominal cavity. Left adnexectomy was performed, and exploration of t he abdominal cavity revealed no other lesions. Pathologic examination of the neoplasm showed a large endometrioma with an associated endomet rioid adenocarcinoma. At surgery 7 weeks later, multiple pseudoxanthom atous peritoneal and omental nodules were found. Conclusion: This case suggests that pseudoxanthomatous nodules of the peritoneum and omentu m may arise from a peculiar reaction to endometriotic cyst contents an d clinically can mimic metastatic ovarian carcinoma.