Endometriosis invading external iliac vein causing DVT
The present case has been reported in the American Journal of Obstetrics and Gynaecology.

A 25 year old nulliparous woman presented with a 3 day duration of fever, lower abdominal pain, and shortness of breath. On physical examination, there was a 14 week–sized pelvic mass. A CT scan showed bilateral multiloculated adnexal masses with compression on the left external iliac vein and a hypodensity within the vein suggesting a thrombus.

A therapeutic dose of enoxaparin was started at 2 mg/kg daily and an inferior vena cava filter was inserted preoperatively.
Intraoperatively, a bilateral endometriotic cyst was noted with dense adhesion to the ovarian fossa and uterus. A 4 cm endometriotic nodule was also noted encasing the left external iliac vein.

Excision of the nodule was performed after skeletonizing the left external iliac vein and the nodule was completely removed. Histology confirmed endometriosis.

The IVC filter was removed 2 weeks postoperatively and enoxaparin was stopped 3 months later, and a hormonal suppressant was also started for long-term management.

Source: https://pxmd.co/54Nfa