{"paper_id":"24372d0e-311a-4123-8808-99cd126f0722","body_text":"A 34-year-old female was evaluated for chronic constipation with intermittent rectal bleeding. Colonoscopy revealed a deformed appendicular orifice with a mass causing indentation of the cecum ( Figure 1 ). Computerized tomography (CT) of abdomen showed solid mass close to 2 cm involving the base of appendix ( Figure 2 ). How to best intervene?\nColonoscopy showing the mass causing indentation of the cecum.\nCT abdomen showing appendix in midline with a filling defect at its base (green arrow) and a 1.9 cm appendicular solid mass (purple arrow).\n\nThe initial diagnosis was a solid neoplasm of appendix, presumably carcinoid tumor. Considering the size and tumor bulging into cecum, patient underwent laparoscopic right hemicolectomy with tumor removal. Histopathology showed endometrioma.\nEndometriosis can affect various parts of gastrointestinal system from small intestine to anus. It can present as acute appendicitis, invagination, colic, melena, or asymptomatic  1 . Often Endometriotic foci were inaccessible to endoscopic biopsy due to the focality as in this case. As the surgical management varies widely from simple appendectomy to right hemicolectomy, there is a need to devise an evaluation method to better differentiate benign versus neoplastic disease preoperatively.\n\nNone declared.","source_license":"CC0","license_restricted":false}