Aromatase inhibitor for treatment of a recurrent abdominal wall endometrioma in a postmenopausal woman

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. (Fertil Steril (R) 2009;92:1170.e1-e4. (C)2009 by American Society for Reproductive Medicine.)