Pericardial effusion, right-sided pleural effusion and ascites associated with stage IV endometriosis. A case report.

BACKGROUND: Endometriosis has rarely been associated with ascites and less often with pleural (usually right-sided) effusion. CASE: A multiparous, reproductive-aged woman was referred for evaluation of possible ovarian carcinoma following the development of dyspnea, progressive abdominal distention, weight loss and increasing secondary dysmenorrhea. Imaging demonstrated normal ovaries in the presence of massive ascites and right-sided pleural and pericardial effusions. At laparotomy, grade IV endometriosis was noted. Total abdominal hysterectomy, bilateral salpingooophorectomy and appendectomy were performed, with subsequent resolution of all cavity fluid accumulations. CONCLUSION: Pericardial and pleural effusions in the presence of ascites may be associated with endometriosis.