Florid Adnexal Polypoid Endometriosis Associated with Very High Serum CA-125 Levels Mimicking Ovarian Malignancy

We report a case of florid polypoid endometriosis presenting with advanced bulky disease in pelvis with serum CA-125 levels of 7844U/ml. The extent of tumor, CT scan findings, elevated serum CA-125 levels were suggestive of ovarian malignancy. Histopathology demonstrated endometrial glands and stroma. Glands were neither crowded nor complex and were separated by a fibromatous stroma that contained endometrial stromal cells. These features were consistent with diagnosis of polypoid endometriosis, a recently described entity with a clinical presentation completely different from conventional endometriosis. Our case emphasizes the association of high levels of CA-125 with benign gynaecologic conditions.