A case of recto-sigmoid endometriosis mimicking carcinoma

Ritu Rana, Sandeep Sharma, Harjeet Narula, Harjeet Singh Narula, Brijesh Madhok
SpringerPlus · 2016 · vol. 5(1) , pp. 643 · doi:10.1186/s40064-016-2221-6 · PMID:27330909 · PMC4870527 · W2398130392
article OA: gold CC0 ⤵ 17 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

This paper reports a case of rectosigmoid endometriosis causing bowel obstruction in a young woman, which was difficult to distinguish from colon cancer pre-operatively.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This SpringerPlus case report describes a 43-year-old nulliparous woman with acute large bowel obstruction in whom clinical and CT findings suggested primary sigmoid colorectal cancer, with enlarged lymph nodes and an obstruction confirmed endoscopically at the sigmoid level. Emergency surgery found a recto-sigmoid tumor-like lesion, but histopathology ultimately diagnosed deeply infiltrating intestinal endometriosis with lymph node involvement (6 of 21 nodes). A key limitation is that the diagnosis was only established after resection because colonoscopy and colonic biopsy have limited diagnostic value for recto-sigmoid endometriosis when lesions spare or do not characteristically present as mucosal disease. This paper is centrally about endometriosis — it presents recto-sigmoid endometriosis mimicking carcinoma as a cause of bowel obstruction.

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Abstract

INTRODUCTION: Although endometriosis with sigmoid serosal involvement is not uncommon in women of childbearing age, the mucosal and lymph node involvement is rare and differential diagnosis from colon cancer and diverticulitis may be difficult due to poor diagnostic accuracy of colonoscopy and colonic biopsies. CASE PRESENTATION: We present a case of a nulliparous woman presenting with large bowel obstruction. She underwent emergency sigmoid colectomy based on clinical and radiological findings. At operation, the pathology was thought to be primary sigmoid tumour. However, histopathological examination of the sigmoid colon led to the final diagnosis of large intestinal endometriosis. CONCLUSION: Rectosigmoid endometriosis is often difficult to diagnose but should be considered in differential diagnosis of child bearing aged women with lower gastrointestinal tract obstruction.

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endometriosis

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