An unusual case of solid appendicular mass in a young female

The paper reports a 34-year-old woman evaluated for chronic constipation with intermittent rectal bleeding, in whom colonoscopy and CT identified a ~1.9–2 cm solid mass involving the base of the appendix and deforming the appendiceal orifice with indentation of the cecum. The initial working diagnosis was a solid appendiceal neoplasm, presumed to be a carcinoid tumor, and she underwent laparoscopic right hemicolectomy with tumor removal. Histopathology ultimately showed an endometrioma. The authors note a key caveat that endometriotic foci can be inaccessible to endoscopic biopsy due to focality, complicating preoperative differentiation between benign endometriosis-related disease and neoplasia. This paper is centrally about endometriosis — it describes an appendiceal endometrioma presenting as a mass mimicking an appendiceal tumor.

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