Objective: Treat an abdominal wall endometrioma in a post-menopausal patient.
Design: Case report.
Setting: Academic medical center.
Patient(s): A post-menopausal women with a large recurrent abdominal wall endometrioma.
Intervention(s): The patient was managed with the combination of an aromatase inhibitor, a progestin, and serial cyst aspiration.
Main outcome measure(s): Serum and cyst estradiol levels as well as sonographic demonstration of resolution.
Result(s): Serum and cyst estradiol levels were significantly diminished and the cyst diminished in size.
Conclusion(s): Taken together, this case demonstrates a novel approach for managing and monitoring medical therapy for unusual clinical presentations of endometriosis. Furthermore, it illustrates that endometriotic implants can be a source of circulating estrogen in postmenopausal women, and that this source of estrogen is generated by increased aromatase activity.