Endometriosis Involving the Appendix Mimicking Acute Appendicitis and Appendiceal Tumor: Report of a Case

- 期刊 闌尾的子宮內膜異位是少見的，其以闌尾腫瘤作爲表現者則是更加罕見。這是一名44歲的女性罹患闌尾子宮內膜異位，而以急性闌尾炎和闌尾腫瘤作爲表現的病例。這位女性由於下腹痛和高燒兩天至急診室就診。在急診室的理學檢查顯示在McBurney點有嚴重的壓痛和反彈痛。腹部電腦斷層(CT)和腹部超音波懷疑是闌尾炎合併破裂。因此她立刻接受手術。術中發現明顯的腫瘤並伴隨著幾個擴大的腸繫膜淋巴結。由於高度壞疑闌尾癌合併淋巴結轉移，執行了右側大腸切除術。之後病理組織診斷爲闌尾和迴腸的子宮內膜異位合併闌尾周圍膿腫。術後，患者恢復並沒有殘餘的腹痛。 Endometriosis of the appendix is infrequent, and even rarer when it presents as appendiceal tumor. A case of endometriosis of the appendix that manifested as acute appendicitis and appendiceal tumor in a 44-year-old female patient is reported here. The woman visited the emergency room due to lower abdominal pain and high fever for 2 days. At ER, physical examination showed severe tenderness and rebounding pain at the McBurney's point. Abdominal computed tomography (CT) an Abdominal ultrasound suggested appendicitis with rupture. Therefore, she was immediately operated upon under the suspicion of acute appendicitis with rupture. Intra-operatively, an apparent appendiceal tip tumor with several enlarged mesentery lymph nodes was found. As appendiceal cancer with lymph node metastasis was highly suspected, a right hemicolectomy was performed. Later histological examinations showed endometriosis of the appendix and ileum, along with periappendiceal abscess. Post-operatively, the patient recovered with no residual pain.