Endometriosis of the Vermiform Appendix Presenting as a Tumor

Tadashi Terada
Gastroenterology research · 2009 · vol. 2(6) , pp. 353–355 · doi:10.4021/gr2009.12.1330 · PMID:27990206 · PMC5139697 · W2073666070
article OA: gold CC0 ⤵ 2 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This case report describes a 41-year-old woman whose appendiceal endometriosis presented as a tumor at the appendiceal orifice, found to be positive for estrogen and progesterone receptors.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This paper reports a case of appendiceal endometriosis presenting as a tumor at the appendiceal orifice in a 41-year-old woman with chronic abdominal pain. Colon endoscopy, CT, and MRI all suggested an appendiceal tumor, and despite two biopsies showing no remarkable changes, the patient underwent resection of the appendix, cecum, ascending colon, terminal ileum, and 16 lymph nodes under a clinical diagnosis of gastrointestinal stromal tumor. Histology confirmed endometriosis with endometrial glands and stroma, estrogen and progesterone receptor positivity, negative p53, and very low Ki-67 labeling, and similar endometriosis-like glands or Müllerian duct remnants were found in 6 of 16 lymph nodes. The paper’s limitation is that it is a single case report. This paper is centrally about endometriosis — specifically endometriosis of the vermiform appendix presenting as a tumor.

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Abstract

Endometriosis of the vermiform appendix is a rare condition. Most patients with this disease are asymptomatic or present as acute or chronic appendicitis. The author herein reports a case of appendiceal endometriosis presenting as a tumor at the appendiceal oriffice. A 41-year-old woman complained of chronic abdominal pain. A colon endoscopy showed a tumor in the appendiceal orifice. Two biopsies of the tumor showed no remarkable changes. Imaging modalities including CT and MRI also revealed an appendiceal tumor. Resection of appendix, cecum, ascending colon, terminal ileum, and 16 lymph nodes were performed under the clinical diagnosis of gastrointestinal stromal tumor. Grossly, a tumor measuring 3 x 3 x 3 cm was recognized in the appendiceral orifice. Histologically, the tumor was endometriosis consisting of islands of endometrial glands and stroma. Immunohistochemically, the lesion was positive for estrogen receptor and progesterone receptor, but it was negative for p53 protein and Ki-67 labeling was very low (0.5%). Similar endometriosis-like glands or Mullerian duct remnants were recognized in six out of 16 regional lymph nodes. The present case suggests that appendiceal endometriosis may present as a tumor.

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endometriosis

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