An Ileal Endometrioma: Of Carcinoids and Cadherin

Rahul Pannala, Pannala R, Adam Gafni-Kane, Gafni-Kane A, Mark Kidd, Kidd M, Modlin IM, Irvin M. Modlin
Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2007 · vol. 11(2) , pp. 229–232 · doi:10.1007/s11605-006-0080-0 · PMID:17390177 · W2033994408
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This case report describes a patient with an ileal endometrioma that was initially suspected to be a carcinoid tumor due to its specific histological and immunohistochemical features, highlighting challenges in differential diagnosis.

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Abstract

A 38-year-old woman with history of prior adrenalectomy for Cushing's syndrome presented with intermittent right lower quadrant (RLQ) abdominal pain, nausea, bloating, and non-bloody diarrhea for 2 months. Symptoms were not related to her menstrual periods. Examination revealed only an ill-defined mass in the RLQ. Investigations for infectious causes, inflammatory bowel disease, and carcinoid tumor were negative. Computed tomography (CT) demonstrated a terminal ileal mass with mesenteric stranding and dilatation of the proximal bowel. At laparotomy, a fibrotic, terminal ileal mass with matted adhesions involving the mesentery and retroperitoneum was resected. Histopathological examination identified multiple foci of endometriosis extending from the serosal surface into the mucosa of the terminal ileum. Immunostaining revealed E- and P-cadherin, but not N-cadherin immuno-positivity. Mucosal involvement without cyclical menstrual symptoms and intestinal obstruction is an unusual presentation of intestinal endometriosis. Although the mechanism of endometriosis is not clear, the role of cell adhesion molecules such as cadherins has received attention. Increased expression of E- and P-cadherin and decreased N-cadherin expression in our patient demonstrates differential expression of these cadherins in endometriotic tissue. Future studies may investigate patterns of differential expression of these cadherins in a series of cases to elucidate the mechanisms of migration of endometriotic tissue.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Cadherins Endometriosis Ileal Diseases Adult Cadherins Endometriosis Endometriosis Female Humans Ileal Diseases Ileal Diseases

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (19)

Cited by (3)

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