Synchronous Endometrioid Adenocarcinoma of the Ovary and Endometrium in a 37-Year-Old Nulligravid Woman: A Case Report.

Synchronous primary malignancies of the endometrium and ovary are uncommon and require careful differentiation from metastatic disease due to differences in staging, management, and prognosis. We report the case of a 37-year-old nulligravid woman presenting with lower abdominal pain and long-standing menstrual irregularity. Imaging revealed a large left adnexal mass with endometrial thickening. Exploratory laparotomy with intraoperative frozen section suggested malignancy, following which comprehensive surgical staging was performed. Final histopathology confirmed synchronous primary endometrioid adenocarcinoma of the ovary (International Federation of Gynecology and Obstetrics (FIGO) IA, grade I) and endometrium (FIGO II, grade II) without nodal or peritoneal involvement. Immunohistochemistry supported independent primary tumors. The patient had an uneventful recovery. This case emphasizes the importance of thorough surgical staging and meticulous pathological evaluation in establishing synchronous primary disease and guiding appropriate management.