A case of endometriosis of the sigmoid colon diagnosed by colonoscopic biopsy

Masao Kusano, Daisuke Komazawa, Hiromichi Ito, Masaki Tosa, Kaname Uno, Tomoyuki Ikeda, Seiichi Takahashi, Shinichi Ikeya, Haruo Nakayama
In: Progress of Digestive Endoscopy · 2017 · vol. 91(1) , pp. 174–175 · doi:10.11641/pde.91.1_174 · W2775875346
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This case report describes the colonoscopic diagnosis and successful treatment of sigmoid colon endometriosis in a 40-year-old woman.

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The paper reports a case of a 40-year-old woman with constipation and hematochezia occurring about 3 days before menstruation, in whom colonoscopy identified a slightly elevated sigmoid colon lesion. Initial biopsy histology showed non-specific colitis, but a repeat colonoscopy during menstruation demonstrated an elevated lesion with an irregular surface and erythematous mucosa, and histopathology revealed ectopic endometrial glands in the muscle layer, supported by positive estrogen/progesterone receptor and CD10 immunostaining. After monthly gonadotropin-releasing hormone agonist therapy for 6 months, endoscopy showed reduced lesion elevation and altered mucosal appearance, and follow-up histology showed no evidence of endometriosis. This paper is centrally about endometriosis — a sigmoid colon case diagnosed by colonoscopic biopsy and tracked over treatment.

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Abstract

A 40-year-old woman was referred to our department because of constipation and hematochezia about 3 days before menstruation. Colonoscopy revealed a slightly elevated lesion in the sigmoid colon. Histopathological examination revealed non-specific colitis. Three months later, a second colonoscopy during menstruation revealed an elevated lesion with an irregular surface and erythematous mucosa. Histopathological examination revealed ectopic glands in the muscle layer. Estrogen and progesterone-receptors, and CD10 stained positively on immunostaining. Therefore, we made a diagnosis of endometriosis of the sigmoid colon. Gonadotropin-releasing hormone agonist treatment was performed once a month for 6 months. Endoscopy revealed reduction of the elevated lesion with irregular surface and erythematous mucosa. Histopathological examination showed no evidence of endometriosis. The patient is still being followed-up regularly.
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症例 大腸内視鏡検査で生検診断し得たS状結腸子宮内膜症の1例 2017 年 91 巻 1 号 p. 174-175 詳細 抄録 A 40-year-old woman was referred to our department because of constipation and hematochezia about 3 days before menstruation. Colonoscopy revealed a slightly elevated lesion in the sigmoid colon. Histopathological examination revealed non-specific colitis. Three months later, a second colonoscopy during menstruation revealed an elevated lesion with an irregular surface and erythematous mucosa. Histopathological examination revealed ectopic glands in the muscle layer. Estrogen and progesterone-receptors, and CD10 stained positively on immunostaining. Therefore, we made a diagnosis of endometriosis of the sigmoid colon. Gonadotropin-releasing hormone agonist treatment was performed once a month for 6 months. Endoscopy revealed reduction of the elevated lesion with irregular surface and erythematous mucosa. Histopathological examination showed no evidence of endometriosis. The patient is still being followed-up regularly. © 2017 一般社団法人 日本消化器内視鏡学会 関東支部

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endometriosis

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