Endometriosis en el ciego de una mujer posmenopáusica. Reporte del caso

In: IATREIA · 2017 · vol. 30(2) , pp. 333–339 · doi:10.17533/udea.iatreia.v30n3a09 · W2733136394
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This case report details the surgical and pathological findings of cecal endometriosis in a postmenopausal woman, which initially presented as a suspected malignancy causing intestinal obstruction.

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The paper reports a case of a postmenopausal woman who presented with intestinal obstruction that was surgically suggestive of a cecal neoplasm. Intraoperative and pathological evaluation ultimately showed intestinal endometriosis as the underlying cause, highlighting that isolated cecal involvement is rare and even more so in a postmenopausal patient without hormonal replacement therapy. The authors explicitly frame endometriosis as benign extrauterine growth that can produce chronic inflammatory changes and adhesions that distort anatomy. This paper is centrally about endometriosis — specifically endometriosis presenting as cecal intestinal obstruction in a postmenopausal woman mimicking colorectal cancer.

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Abstract

Endometriosis is a benign disease defined as the extra-uterine implantation and proliferation of tissue similar to endometrium (glands and stroma), causing a chronic inflammatory response and adhesions that distort anatomy. The extra-gonadal involvement is rare, but reports of intestinal endometriosis have increased substantially, mainly affecting the sigmoid colon and rectum; isolated involvement of the cecum is rare, even more so in a postmenopausal woman without use of hormone replacement therapy. We report the case of a postmenopausal woman with intestinal obstruction surgically suggestive of malignancy; however, pathological examination revealed endometriosis.
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Endometriosis en el ciego de una mujer posmenopáusica. Reporte del caso DOI: https://doi.org/10.17533/udea.iatreia.v30n3a09Palabras clave: endometriosis, intestino, neoplasia colorrectal, obstrucción intestinalResumen La endometriosis es una enfermedad benigna definida como la implantación y proliferación extrauterinas de tejido similar al endometrio (glandular y estroma), lo que causa una respuesta inflamatoria crónica y adherencias que distorsionan la anatomía. El compromiso extragonadal es raro, pero los informes de endometriosis intestinal han aumentado de forma sustancial; los sitios afectados principalmente son el colon sigmoides y el recto; el compromiso aislado del ciego es raro y lo es aún más en una mujer posmenopáusica sin uso de terapia de reemplazo hormonal. Presentamos el caso de una mujer posmenopáusica con una obstrucción intestinal sugestiva quirúrgicamente de neoplasia del ciego, pero cuyo examen patológico reveló endometriosis. Descargas Citas (1.) Giudice LC, Kao LC. Endometriosis. Lancet. 2004 Nov;364(9447):1789-99. (2.) Machairiotis N, Stylianaki A, Dryllis G, Zarogoulidis P, Kouroutou P, Tsiamis N, et al. Extrapelvic endometriosis: a rare entity or an under diagno- sed condition? Diagn Pathol. 2013 Dec;8:194. DOI 10.1186/1746-1596-8-194. (3.) Kim JS, Hur H, Min BS, Kim H, Sohn SK, Cho CH, et al. Intestinal endometriosis mimicking carcinoma of rectum and sigmoid colon: a report of five cases. Yonsei Med J. 2009 Oct;50(5):732-5. DOI 10.3349/ ymj.2009.50.5.732. (4.) Jakhmola CK, Kumar A, Sunita BS. Expect the unexpected: Endometriosis mimicking a rectal carcinoma in a post-menopausal lady. J Minim Access Surg. 2016 Apr-Jun;12(2):179-81. DOI 10.4103/0972-9941.169983. (5.) Tong YL, Chen Y, Zhu SY. Ileocecal endometriosis and a diagnosis dilemma: a case report and literature review. World J Gastroenterol. 2013 Jun;19(23):3707-10. DOI 10.3748/wjg.v19.i23.3707. (6.) Yantiss RK, Clement PB, Young RH. Endometriosis of the intestinal tract: a study of 44 cases of a disease that may cause diverse challenges in clinical and pathologic evaluation. Am J Surg Pathol. 2001 Apr;25(4):445-54. (7.) van der Linden PJ. Theories on the pathogenesis of endometriosis. Hum Reprod. 1996 Nov;11 Suppl 3:53-65. (8.) Robboy SJ, Bean SM. Pathogenesis of endometriosis. Reprod Biomed Online. 2010 Jul;21(1):4-5. DOI 10.1016/j.rbmo.2010.03.031. (9.) Bulletti C, Coccia ME, Battistoni S, Borini A. Endometriosis and infertility. J Assist Reprod Genet. 2010 Aug;27(8):441-7. DOI 10.1007/s10815-010-9436-1. (10.) De Ceglie A, Bilardi C, Blanchi S, Picasso M, Di Muzio M, Trimarchi A, et al. Acute small bowel obstruction caused by endometriosis: a case report and review of the literature. World J Gastroenterol. 2008 Jun;14(21):3430-4. (11.) Sampson JA. Intestinal adenomas of endometrial type: Their importance and their relation to ovarian hematomas of endometrial type (perforating hemorrhagic cysts of the ovary). Arch Surg. 1922 Sep;5(2):217-80. DOI 10.1001/archsurg.1922.01110140003001. (12.) Báez F, Espinosa O, Anziani F, González R, Muñoz L. Obstrucción intestinal recurrente por endometrio- sis de ileon distal : reporte de un caso y revisión. Bol Hosp. 2014;70(1):161-4. (13.) Fedele L, Berlanda N, Corsi C, Gazzano G, Morini M, Vercellini P. Ileocecal endometriosis: clinical and pathogenetic implications of an under diagnosed condition. Fertil Steril. 2014 Mar;101(3):750-3. DOI 10.1016/j.fertnstert.2013.11.126. (14.) Ruffo G, Stepniewska A, Crippa S, Serboli G, Zardini C, Steinkasserer M, et al. Laparoscopic ileocecal resection for bowel endometriosis. Surg Endosc. 2011 Apr;25(4):1257-62. DOI 10.1007/s00464-010-1354-x. (15.) Popoutchi P, dos Reis Lemos CR, Silva JC, Nogueira AA, Feres O, Ribeiro da Rocha JJ. Postmenopausal intestinal obstructive endometriosis: case report and review of the literature. Sao Paulo Med J. 2008 May;126(3):190-3. (16.) Heaps JM, Nieberg RK, Berek JS. Malignant neoplasms arising in endometriosis. Obstet Gynecol. 1990 Jun;75(6):1023-8. (17.) Ferrero S, Camerini G, Ragni N, Venturini PL, Biscaldi E, Remorgida V. Norethisterone acetate in the treatment of colorectal endometriosis: a pilot study. Hum Reprod. 2010 Jan;25(1):94-100. DOI 10.1093/ humrep/dep361. (18.) Vercellini P, Crosignani PG, Somigliana E, Berlanda N, Barbara G, et al. Medical treatment for rectovaginal endometriosis: what is the evidence? Hum Reprod. 2009 Oct;24(10):2504-14. DOI 10.1093/humrep/ dep231. (19.) Mosquera-Klinger G, Quintana H, de Ardila AH. Obstrucción intestinal ileal por endometriosis. Acta Med Colomb. 2014 Jul-Sep;39(3):283-7. Descargas Publicado Cómo citar Número Sección Licencia Derechos de autor 2017 Iatreia Esta obra está bajo una licencia internacional Creative Commons Atribución-CompartirIgual 4.0. 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