Supernumerary ovary on recto-sigmoid colon with associated e
A supernumerary ovary is a rare gynaecological anomaly and is usually excised due to its malignant transformation potential. Published in the journal Obstet Gynecol Sci, the authors report a case of a supernumerary ovary and endometriosis situated on the anterior rectosigmoid colon.

A 42-year-old woman, gravida 2 para 2, with a history of repeat cesarean section, had chronic abdominal and pelvic pain. She visited the hospital as an outpatient due to recent worsening. The abdomen was soft, with no palpable mass. Laboratory tests showed elevation of cancer antigen (CA) 125, but CA 19-9 was normal (CA 125: 85.4 U/mL, CA 19-9: <0.8 U/mL); other test results were within normal limits.

The sonogram revealed multiple uterine myomas, and a homogeneous cystic mass on the left. MRI revealed normal ovaries, but a pelvic mass measuring 5.8×4.8 cm was discovered. This suggested ectopic ovarian endometriosis. Laparoscopic surgery under general anesthesia was planned for the diagnosis of endometriosis.

At surgery, both ovaries were normal, but an ovarian cyst measuring approximately 6 cm was discovered on the anterior rectosigmoid colon. The ovarian cyst was not connected to the 2 normal ovaries. Chocolate-colored fluid was aspirated under laparoscopy, and the entire cystic mass was removed.

Microscopically, the cyst consisted of old hemorrhage. Focal spindle cells suggesting ovarian stroma were found. The cells exhibited cytoplasmic immunoreactivity to CD 10. Thus, a supernumerary ovary with an endometrioma was diagnosed, based upon pathologic findings.

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