Endometrial carcinoma presenting as hematometra mimicking a large pelvic cyst

Large pelvic cysts are commonly seen in gynecologic practice; their heterog eneous origin is reflected in their pleomorphic clinical features. We repor t the case of a 64-year-old multiparous postmenopausal woman with an unusua l manifestation of endometrial adenocarcinoma that presented as hematometra mimicking a large pelvic cyst. In this case, hematometra was well demonstr ated by transabdominal sonography, but transvaginal sonography allowed bett er visualization of the endometrial lining and suggested the correct diagno sis of endometrial cancer. Abnormal vaginal bleeding or hematometra in post menopausal women should lead to assessment of the endometrial mucosa. Trans vaginal sonography can be used to visualize neoplastic lesions in the endom etrium when hematometra is detected through transabdominal sonography. (C) 1999 John Wiley & Sons, Inc.