Second look of endosalpingiosis: a rare entity
The present case has been reported in the Journal of Obstetrics and Gynaecology of India. A patient presented with dysmenorrhea and heavy menstrual bleeding in January 2013. She was then 31 years old with two living issues born by lower segment cesarean section. USG revealed a cyst measuring 4.3 × 3.2 cm.

Medical management with continuous progesterone therapy was tried but without any improvement in symptoms; moreover, the size of the ovarian cyst increased to 6.8 × 5.5 cm on ultrasound in a month’s period. She underwent laparoscopic left oophorectomy and fulguration of the vesicular deposits on the pelvic peritoneum and uterus in February 2013.

Histopathological examination was suggestive of endosalpingiosis. She was put on continuous oral progesterone therapy for 3 months and was asked to follow up. The patient did not come for further follow-up after one visit during which she was fine. She had stopped oral progesterone after 6 months.

After 2 years of the last visit, she came with 7-week pregnancy. She wanted to continue with the pregnancy. Regular antenatal care was provided. The patient did fine throughout the course of her visits. An elective lower segment cesarean section was done at 38 weeks of gestation. Preoperatively, the uterus was studded with multiple florid deposits. Both tubes and the right ovary were buried under the deposits and adhered to the uterine surface.

The right ovary was normal in size. The pelvic peritoneum was palpated thoroughly, and deposits were present all over it. A 2 × 2 cm nodule was also present on the omentum. Multiple biopsies were taken from the deposits on the uterus, from the deposits in the pelvic peritoneum, and omental nodule was also removed. Tubal sterilization was also performed along with the procedure. Closure was done uneventfully. Histopathology report revealed endosalpingiosis in all the specimens.

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