Appendiceal Endometriosis Presenting as Possible Cecal Mass

The American Surgeon
Danielle J FeldhausSaraswati D Dayal

Abstract

Endometriosis is endometrial tissue located outside of the uterus. Endometriosis is rarely found in the appendix and can present very similar to acute appendicitis and is often indistinguishable on physical exam and imaging. The diagnosis is typically made after an appendectomy on pathology. A 45-year-old female presented with right sided abdominal pain and CT revealed a possible cecal or appendiceal lesion. Colonoscopy revealed a submucosal non-obstructing cecal mass. In the operating room, the appendix was completely adherent to the cecum and a laparoscopic ileocecectomy was performed. Pathology revealed endometriosis of the appendix and cecum. Endometriosis of the appendix is a rare condition reported in less than 1% of females that is diagnosed after an appendectomy is performed for suspected appendicitis or other pathology. This diagnosis is made based on the finding of endometrial glands and stroma in the appendix. This can present as acute appendicitis or appendiceal or peri-appendiceal mass on imaging. When symptomatic, pain can align with the menstrual cycle and hemoperitoneum may be encountered intra-operatively. Treatment can be appendectomy, ileocecectomy, or right hemicolectomy if malignancy is suspected. In the pa...Continue Reading

References

Nov 19, 2011·International Journal of Surgery Case Reports·Abdulaziz SaleemJason Hall
Sep 24, 2014·Annals of Surgical Treatment and Research·Jiho YoonCheong Soo Park
Nov 14, 2018·International Journal of Surgery Case Reports·B P St JohnJ M Nottingham

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