A case of a large leiomyomatous uterus with multiple arteriovenous malformations and subsequent high cardiac output state with severe four chamber cardiac enlargement.

Uterine arteriovenous malformations (AVMs) are rare and potentially life-threatening. They can be congenital or acquired. Uterine artery embolization or hysterectomy are considered mainstays of management. AVMs can be associated with leiomyomas, and patients may require both procedures. We present a case of a 42-year-old woman with a massively enlarged leiomyomatous uterus supplied and drained by multiple large AVMs, leading to high cardiac output state with severe four chamber cardiac dilation. Management required a multidisciplinary team of interventional radiology, gynecologic oncology surgery, vascular surgery, cardiac anesthesiology, cardiology, and urology and a 2-day interventional approach of preoperative arterial embolization followed by hysterectomy.

Florid cystic endosalpingiosis with uterine preservation and successful assisted reproductive therapy.

•While endosalpingiosis is often asymptomatic & incidental, florid cystic endosalpingiosis can have a variable presentation•Cystic endosalpingiosis can be difficult to differentiate from other non-neoplastic peritoneal inclusion cysts•Although associated with serous pelvic neoplasms, there is no evidence for oophorectomy at the completion of fertility•There is no strong evidence that hysterectomy along with cyst resection leads to improved outcomes if pathology is benign•This is the first reported case of successful assisted-reproductive therapy after resected florid cystic endosalpingiosis.