Recurrent endometriosis following tibolone hormone replacement therapy after mucinous ovarian carcinoma

The aim is to describe an atypical clinical case of endometriosis in a young patient with surgically induced menopause due to an ovarian mucinous carcinoma. Case Report: A 34-year old woman with deep endometriosis developed a large mass occupying the whole abdominal cavity, without ascites or carcinomatosis. A decisional laparoscopy and complete surgical staging were performed according to a FIGO Stage IA ovarian mucinous carcinoma. The patient required hormonal replacement therapy with tibolone. A year later, an endometriotic nodule appeared in the bladder, and two years after, endometriosis on the bowel and the vaginal vault without evidence of tumoral relapse also occurred. The patient was referred to the obesity unit and discontinued tibolone, with clinical and radiological stabilization. Conclusion. Tibolone should be used with caution in patients with a previous history of endometriosis and it is recommended to avoid hyperestrogenic situations in gynaecological malignancies in hormone-dependent diseases.

Endometriosis; Epithelial ovarian cancer; Mucinous adenocarcinoma; Obesity; Tibolone.

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