Endometriosis Presenting with Massive Ascites: A Case Report

Abstract

Endometriosis presenting as massive ascites is uncommon and often mimics malignancy. Cytologic detection of benign endometrial cells in ascitic fluid is uncommon but can expedite diagnosis and prevent unnecessary interventions. We present a case of abdominopelvic endometriosis in a 30-year-old female, which could be diagnosed directly by cytologic examination of the ascitic fluid and subsequently confirmed on biopsy. Tightly cohesive clusters of benign endometrial cells were highlighted on SurePathTM Liquidbased cytology (LBC) smears and the cell block prepared from the sample could be subjected to immunohistochemistry (IHC) to confirm the nature of these cells. LBC by concentrating ascitic fluid sample helped in detecting benign endometrial cells in the present case, thereby clinching the diagnosis of endometriosis on cytology. Incorporating cytologic evaluation into the diagnostic workup can aid clinicians in preventing misdiagnosis, minimizing overtreatment, and ensuring timely management.