Design:
Case report and review of literature

Setting:
A tertiary care hospital.

Patients or Participants:
A 36-year-old nulligravid presenting for robotic-assisted diagnostic laparoscopy, laparoscopic myomectomy, excision of endometriosis, and cystoscopy.

Interventions:
Robotic-assisted diagnostic laparoscopy, laparoscopic myomectomy, excision of endometriosis, and cystoscopy.

Measurements and Main Results:
The patient had a history of chronic pelvic pain and prior surgeries for uterine fibroids and endometriosis. Polypoid endometriotic masses were identified, resembling malignant tumors during surgery. The pathology confirmed endometriosis. Patient had history of two prior surgeries were performed, but outcomes were suboptimal due to anatomical complexities and previous surgeries. The case highlights possible impact with GnRH antagonist therapy and the importance of a multidisciplinary approach involving Minimally Invasive Gynecologic Surgery (MIGS) and Gynecologic Oncology.

Conclusion:
Polypoid endometriosis can present diagnostic challenges, mimicking carcinomatosis. Visual identification and a systematic approach in minimally invasive techniques are crucial for safe lesion resection. Preoperative and postoperative considerations, including the management of hormonal therapies, are essential for optimal outcomes. This case underscores the need for multidisciplinary collaboration to navigate complex cases and achieve the best possible patient outcomes.