A unique pathology associated with pelvic pain and adnexal mass

Objective: To present a unique case of pelvic pain. Design: Case report. Setting: Academic institution. Patient(s): Thirty-nine year-old with history of endometriosis presented with pelvic pain and possible adnexal mass. Intervention(s): Imaging results were not consistent and suggested possible adnexal mass and hydrosalpinx in different studies. Physical exam was concerning for a vaginal mass that was felt not to be contiguous with the adnexa. At laparoscopy, a 3cm pararectal mass was identified immediately lateral to the uterosacral ligament and medial to the ureter. This mass was completely resected laparoscopically. Main Outcome Measure(s): Resolution of pelvic pain. Result(s): Pathologic diagnosis was ganglioneuroma. Postoperatively, the patient had resolution of her pelvic pain. Conclusion(s): Pelvic ganglioneuromas are a very rare entity but emphasize the importance of a broad differential for pelvic pain.