About a degeneration of a colon endometriosis cystic foci

Mona Mlika, N. Yahia, Ahmed Saidani, Saber Mannaii, Hichem Houissa, Faouzi El Mezni
In: Polish Annals of Medicine · 2018 · doi:10.29089/2017.17.00009 · W2789505173
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This case report describes the challenging diagnosis and surgical management of an in situ carcinoma arising from a cystic endometriosis focus within the colon of a 32-year-old woman.

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This paper is a case report describing a challenging diagnosis of in situ carcinoma arising from cystic foci of colonic endometriosis in a 32-year-old woman with six months of abdominal pain and no notable past medical history. Despite preoperative investigations concluding an ovarian cystic tumor and intraoperative impression that the mass involved the right colon, the right hemicolectomy specimen showed a submucosal 10-cm cyst with microscopic features consistent with in situ carcinoma developed on cystic endometriosis. The authors emphasize delayed diagnosis due to atypical symptoms and the malignant potential of endometriosis, while noting the management for this rare lesion is not standardized and requires multidisciplinary discussion. This paper is centrally about endometriosis — it reports malignant transformation of colonic endometriosis cystic foci into in situ carcinoma.

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ABSTRACT

Introduction

Malignant transformation of endometriosis is a rare entity. Its occurrence in the digestive system is exceptional. In fact, due to the atypical symptoms, the diagnosis is often delayed at an advanced stage. So, the treatment strategy should be discussed in a multidisciplinary meeting. Aim: Our objective was to describe a challenging diagnosis of an in situ carcinoma developed on a cystic foci of endometriosis of the colon in a woman without a particular past medical history. Case study: A 32-year-old female patient presented with abdominal pain for about six months. The different explorations have concluded to an ovarian cystic tumour. Intraoperatively, the mass seemed to be developped in the right colon. This led to perform a right hemicolectomy. Gross findings consisted in a sub-mucosal 10-centimeters cyst and microscopic features were consistent with an in situ carcinoma developed on a cystic endometriosis foci.

Discussion

This case illustrates the malignant potential of endometriosis especially when it is misdiagnosed.

Conclusions

Besides the fact that this case was illustrated by radiological and microsocpic features, it puts emphasis on the non consensual management of a rare lesion of the colon. Malignant transformation of endometriosis is a rare entity. Its occurrence in the digestive system is exceptional. In fact, due to the atypical symptoms, the diagnosis is often delayed at an advanced stage. So, the treatment strategy should be discussed in a multidisciplinary meeting. Aim: Our objective was to describe a challenging diagnosis of an in situ carcinoma developed on a cystic foci of endometriosis of the colon in a woman without a particular past medical history. Case study: A 32-year-old female patient presented with abdominal pain for about six months. The different explorations have concluded to an ovarian cystic tumour. Intraoperatively, the mass seemed to be developped in the right colon. This led to perform a right hemicolectomy. Gross findings consisted in a sub-mucosal 10-centimeters cyst and microscopic features were consistent with an in situ carcinoma developed on a cystic endometriosis foci.

Discussion

This case illustrates the malignant potential of endometriosis especially when it is misdiagnosed.

Conclusions

Besides the fact that this case was illustrated by radiological and microsocpic features, it puts emphasis on the non consensual management of a rare lesion of the colon. CONFLICT OF INTEREST The authors declare that they have no competing interests and disclose any personal or financial support. Share RELATED ARTICLE We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more). You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website. You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.

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Condition tags

endometriosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (9)

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