A Case of Appendiceal Endometriosis occurring 13 years after Hysterectomy with Bilateral Adnexectomy

Yoshiki Sato, Toshihisa Kimura, Toshiyuki Nakazawa, Shinsuke Obata, Kazuo Takeuchi, Akio Yamaguchi, Yoshiaki Imamura
In: The Japanese Journal of Gastroenterological Surgery · 2010 · vol. 43(11) , pp. 1170–1175 · doi:10.5833/jjgs.43.1170 · W2317914673
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-07 ⓘ

This report describes a rare case of appendiceal endometriosis found 13 years after a patient's hysterectomy and bilateral adnexectomy, confirmed by histology and hormone receptor analysis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This paper reports a case of appendiceal endometriosis that developed 13 years after hysterectomy with bilateral adnexectomy in a 60-year-old woman who originally underwent surgery for uterine fibroids at age 47. She presented with right lower abdominal pain, and CT imaging could not rule out appendiceal perforation, leading to emergency surgery where the appendix was resected at its base; pathology showed chronically inflamed tissue with endometrial glandular structures and stroma in the appendiceal wall, with estrogen receptor positivity and partial progesterone receptor positivity. The authors highlight that appendiceal endometriosis is usually seen in reproductive maturity and that postmenopausal cases are rare, with no prior reports of discovery more than a decade after the cited surgery. This paper is centrally about endometriosis — specifically appendiceal (extra-uterine) endometriosis occurring 13 years after hysterectomy and bilateral adnexectomy.

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Abstract

今回，子宮および両側付属器摘出術13年後に発症した虫垂子宮内膜症の1例を経験したので報告する．患者は60歳の女性で，既往歴は47歳時に子宮筋腫で子宮および両側付属器摘出術を施行されている．平成20年9月，右下腹部痛を主訴に受診し腹部CTを施行したところ虫垂穿孔を否定できず緊急手術をおこなった．虫垂は発赤し壁肥厚化しており虫垂を根部にて切除した．病理組織学的診断では虫垂は委縮しており，粘膜上皮はほとんど認められなかった．壁には慢性炎症と拡張した腺腔構造を呈する子宮内膜組織が内膜間質を伴って認められた．また免疫染色検査でエストロゲンレセプターが陽性，またプロゲステロンレセプターも一部陽性であり，虫垂子宮内膜症と診断した．虫垂子宮内膜症は通常性成熟期に多く，閉経後は報告例も少ない．さらに，子宮および両側付属器摘出10数年後に発見された報告もなく貴重な症例であると考えられた．
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症例報告 子宮および両側付属器摘出術13年後に発症した虫垂子宮内膜症の1例 2010 年 43 巻 11 号 p. 1170-1175 詳細 抄録 今回，子宮および両側付属器摘出術13年後に発症した虫垂子宮内膜症の1例を経験したので報告する．患者は60歳の女性で，既往歴は47歳時に子宮筋腫で子宮および両側付属器摘出術を施行されている．平成20年9月，右下腹部痛を主訴に受診し腹部CTを施行したところ虫垂穿孔を否定できず緊急手術をおこなった．虫垂は発赤し壁肥厚化しており虫垂を根部にて切除した．病理組織学的診断では虫垂は委縮しており，粘膜上皮はほとんど認められなかった．壁には慢性炎症と拡張した腺腔構造を呈する子宮内膜組織が内膜間質を伴って認められた．また免疫染色検査でエストロゲンレセプターが陽性，またプロゲステロンレセプターも一部陽性であり，虫垂子宮内膜症と診断した．虫垂子宮内膜症は通常性成熟期に多く，閉経後は報告例も少ない．さらに，子宮および両側付属器摘出10数年後に発見された報告もなく貴重な症例であると考えられた． この記事はクリエイティブ・コモンズ [表示 - 非営利 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/4.0/deed.ja

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endometriosis

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