Successful management of a ruptured endometrial cyst in acute leukemia

Abstract

Objective: To report a case of acute abdomen due to rupture of ovarian endometrial cysts, manifested as a first symptom of acute leukemia.

Design: Case report.

Setting: University hospital.

Patient(s): A 28-year-old Japanese woman with acute abdomen.

Intervention(s): A diagnosis of rupture of endometrial cysts was made by ultrasonography and magnetic resonance imaging. A diagnosis of acute myeloid leukemia (FAB M5a subtype) was made by bone marrow aspiration.

Main outcome measure(s): Remission-induction chemotherapy for leukemia was initiated. Meanwhile, endometrial cysts were managed expectantly. Once complete remission was achieved, laparoscopic surgery was attempted to remove ovarian cysts and abdominal fluid.

Result(s): Patients tolerated laparoscopy with favorable postoperative course. Consolidation chemotherapy commenced without substantial delay.

Conclusion(s): Accurate diagnosis, optimal timing of surgery, and minimally invasive surgery with laparoscopy enabled us to manage this high-risk case to a favorable outcome.