Endometriosis of the intestines: A report of seven cases

L G Tedeschi, Luke G. Tedeschi, Tedeschi LG, G. P. Masand, Masand GP
Diseases of the colon and rectum · 1971 · vol. 14(5) , pp. 360–365 · doi:10.1007/bf02553423 · PMID:5096011 · W1999534718
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This report details seven cases of intestinal endometriosis found in appendiceal, ileal, rectovaginal, and cecal locations, with two occurring post-menopause, diagnosed pathologically even without clinical symptoms.

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This report analyzes seven cases of intestinal endometriosis identified within a larger cohort of 720 histologically verified patients over two decades. The lesions were located in the appendix, terminal ileum, rectovaginal septum, and cecum, with only two patients showing concurrent uterine or adnexal involvement. Notably, none of the patients presented with clinical symptoms, leading to diagnosis solely through pathological examination, and two postmenopausal cases demonstrated that endometrial tissue can activate after menopause. The authors attribute these subserosal implants to undifferentiated stem cells persisting in the subcoelomic mesenchyme. This paper is centrally about endometriosis — specifically the rare presentation of deep infiltrating disease within the intestinal tract.

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Abstract

Summary and Conclusions In a series of 720 cases of histologically verified endometriosis filed at this hospital in a 20-year period, seven cases of intestinal endometriosis were found: four in appendiceal locations, one in the terminal ileum, one in the rectovaginal septum, and one in the cecum. Two of these patients had concurrent involvement of the uterus and adnexa, and in the remaining patients the lesions were limited to the intestines. No patient had clinical signs and symptoms of endometriosis, and even diagnosis was established by pathologic examination of the lesion. In two of the cases included in this series, the patients were post menopausal; these cases illustrate the point that aberrant endometrial tissue may become activated after the menopause. Embryology gives support to the view that peritoneum, germinal epithelium and uterine epithelium are all derivatives of coelomic epithelium. In all our cases the endometrial implants were subserosal. This presupposes the persistence in the subcoelomic mesenchyma of undifferentiated stem cells capable of differentiating into endometrial tissue.
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Endometriosis of the intestines: A report of seven cases - Luke G. Tedeschi - G. P. Masand Summary and Conclusions In a series of 720 cases of histologically verified endometriosis filed at this hospital in a 20-year period, seven cases of intestinal endometriosis were found: four in appendiceal locations, one in the terminal ileum, one in the rectovaginal septum, and one in the cecum. Two of these patients had concurrent involvement of the uterus and adnexa, and in the remaining patients the lesions were limited to the intestines. No patient had clinical signs and symptoms of endometriosis, and even diagnosis was established by pathologic examination of the lesion. In two of the cases included in this series, the patients were post menopausal; these cases illustrate the point that aberrant endometrial tissue may become activated after the menopause. Embryology gives support to the view that peritoneum, germinal epithelium and uterine epithelium are all derivatives of coelomic epithelium. In all our cases the endometrial implants were subserosal. This presupposes the persistence in the subcoelomic mesenchyma of undifferentiated stem cells capable of differentiating into endometrial tissue.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Intestinal Neoplasms Intestinal Neoplasms Intestinal Neoplasms Intestinal Neoplasms Adult Aged Appendiceal Neoplasms Appendiceal Neoplasms Cecal Neoplasms Cecal Neoplasms Colonic Neoplasms Colonic Neoplasms Diagnosis, Differential Female Humans Ileum

Citation neighborhood

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