Diagnosis Large endometrioma.
Operation: Laparoscopic resection of Endometrioma, parametrial DIE and enlarged lymph node at left internal iliac region.
Pertinent Medical History: 40 years old G:1, P:1 with h/o one C.section delivery.
Main Complaint: Chronic pelvic pain, Large left ovarian endometrioma 9.5×6.7 mm by ultrasound CA125 Antigen=7.78 AMH=1.0.
Pathology: Endometriosis of ovary and rectovaginal nodule, lymph nodes positive forpigment laden foamy cells, immune histo-chemistry positive for endometriosis stromal cell by CD10.