Neuroendocrine appendiceal tumor and endometriosis of the appendix: a case report

Rogério Serafim Parra, Marley Ribeiro Feitosa, Giovana Bachega Badiale Biagi, Daniel Ferracioli Brandão, Margarida Maria Fernandes da Silva Moraes, Liliane Silvestre, José Vitor Cabral Zanardi, Nelson Hitamo Sato, Nelson Hitamo Sato Junior, Omar Féres, José Joaquim Ribeiro da Rocha
Journal of medical case reports · 2020 · vol. 14(1) , pp. 152 · doi:10.1186/s13256-020-02490-x · PMID:32921300 · PMC7489048 · W3086793718
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Abstract

INTRODUCTION: Endometriosis of the appendix is very uncommon, accounting for only about 1% of all cases of endometriosis. However, endometriosis is found in the appendix in approximately 8-13% of patients with deep infiltrating endometriosis and is particularly common in patients with severe forms of deep infiltrating endometriosis. Neuroendocrine tumors are the most common neoplasms of the appendix and may be misdiagnosed when there are multiple endometriosis lesions in the pelvis. CASE PRESENTATION: We describe a case of a Caucasian patient with deep infiltrating endometriosis with rectal involvement, retrocervical lesions, and a right ovarian endometrioma with no suspected lesions in the appendix. She underwent laparoscopy and, after a systematic intraoperative evaluation, suspected involvement of the appendix was observed. The patient underwent ovarian cystectomy, excision of the pelvic endometriosis lesions, appendectomy, and anterior stapler discoid resection. Histopathological analysis of the appendix revealed endometriosis and a well-differentiated neuroendocrine carcinoma at the appendix tip. DISCUSSION: Our patient's case emphasizes the need to approach these lesions carefully and strengthens the indication for appendectomy when the appendix is affected in the setting of endometriosis. Despite the more likely diagnosis of appendiceal endometriosis, neuroendocrine tumors cannot be ruled out by imaging examinations, and both conditions can occur in the same patient.

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Condition tags

endometriosisdie_deep_infiltratingendometrioma

MeSH descriptors

Appendiceal Neoplasms Appendiceal Neoplasms Appendiceal Neoplasms Appendix Appendix Appendix Endometriosis Endometriosis Endometriosis Neuroendocrine Tumors Neuroendocrine Tumors Neuroendocrine Tumors Appendectomy Female Humans

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