Cecal Endometriosis: A Case Report and Discussion on Management Options

Hiroki Kitagawa, Hiroki Ohge, Wataru Shimizu, Shinnosuke Uegami, Yusuke Watadani, Norifumi Shigemoto, Norimitsu Shimada, Raita Yano, Kenichiro Uemura
In: Nippon Daicho Komonbyo Gakkai Zasshi · 2014 · vol. 68(1) , pp. 40–45 · doi:10.3862/jcoloproctology.68.40 · W2321862356
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A 47-year-old woman with a history of uterine fibroid and ovarian endometriosis surgery presented with a cecal lesion, ultimately diagnosed as cecal endometriosis.

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This paper reports a 47-year-old woman referred for further evaluation of an ileocecal/cecal submucosal tumor–like lesion after positive fecal occult blood, with a history of uterine fibroid enucleation and ovarian endometriosis cystectomy. CT showed a low-contrast-enhancing mass with only mild FDG uptake on FDG-PET/CT, and preoperative diagnosis—especially distinguishing benign from malignant—was difficult, necessitating an operative strategy considering malignancy. The authors discuss that laparoscopic surgery may help assess pelvic inflammation, provide better visualization of disease extent, and incorporate rapid pathological diagnosis to support intraoperative decisions. This paper is centrally about endometriosis — specifically a rare case of cecal (appendiceal/cecal) intestinal endometriosis that was difficult to differentiate from malignancy.

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Full text 538 characters · extracted from oa-doi-fallback · click to expand
症例報告 盲腸粘膜下腫瘍と鑑別が困難であった盲腸子宮内膜症の1例 2015 年 68 巻 1 号 p. 40-45 詳細 抄録 症例は47歳女性．子宮筋腫，右卵巣子宮内膜症性嚢胞に対して他院にて4年前に子宮筋腫核出術，卵巣核出術の既往がある．健康診断で便潜血陽性となり，近医にて大腸内視鏡を施行し，盲腸に粘膜下腫瘍性病変を指摘され精査加療目的に当科紹介となった．CTでは盲腸末端に造影効果の乏しい腫瘤性病変を認め，FDG-PET/CTでは同部位に軽度のFDG集積を認めるのみであった．術前診断，特に良悪性の判断は困難であり，悪性病変を念頭に置いた術式決定が求められた．腹腔鏡手術は本疾患による骨盤内炎症の評価や，病変の拡大視に有効で，迅速病理診断も併せて活用することで，有用性が高いと考えられた．盲腸子宮内膜症は腸管子宮内膜症の中では頻度が低いが，骨盤内炎症を伴う場合に鑑別診断として念頭に置く必要がある． © 2015 日本大腸肛門病学会 この記事はクリエイティブ・コモンズ [表示 - 非営利 - 改変禁止 4.0 国際]ライセンスの下に提供されています。 https://creativecommons.org/licenses/by-nc-nd/4.0/deed.ja

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endometriosis

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