A rare case of coexistence of carcinoid tumor of appendix vermicularis and ileal endometriosis

Background Carcinoid tumor is the most common tumor of appendix with overall good prognosis. Endometriosis is the implantation of endometrial glands and stroma outside the uterus. Case report We here report the coexistence of carcinoid tumor of appendix and ileal endometriosis in a 37-year-old nulliparous woman who came to the emergency room with right lower abdominal pain mimicking acute appendicitis. The main clinical and laboratory findings included fever, leukocytosis and elevated ESR. With preoperative suspicion of acute appendicitis, laparatomy was performed and revealed apparently normal looking appendix, along with a nodule in the terminal ileum. Both the appendix and ileal nodule were removed. Histological examinations revealed carcinoid tumor of appendix and ileal endometriosis. The case was discharged 4 days after surgery with no pain and symptoms and remained symptom free for the 1 year period of follow up.

Many cases of carcinoid tumor of the appendix and ileal endometriosis are diagnosed incidentally. Overall prognosis of these conditions is very good. Surgical treatment seems to be the best intervention for these disorders. Similar content being viewed by others

Addiss DG, Shaffer N, Fowler BS, Tauxe RV (1990) The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol 132:910–925 Moertel CG, Dockerty MB, Judd ES (1968) Carcinoid tumors of the vermiform appendix. Cancer 21:270–278 Connor SJ, Hanna GB, Frizelle FA (1998) Appendiceal tumors: retrospective clinicopathologic analysis of appendiceal tumors from 7, 970 appendectomies. Dis Colon Rectum 41:75–80 Lyss AP (1988) Appendiceal malignancies. Semin Oncol 15:129–137 Sandor A, Modlin IM (1998) A retrospective analysis of 1570 appendiceal carcinoids. Am J Gastroenterol 93:422–428 O’donnell ME, Badger SA, Beattie GC, Carson J, Garstin WI (2007) Malignant neoplasms of the appendix. Int J Colorectal Dis 22:1239–1248 McCusker ME, Coté TR, Clegg LX, Sobin LH (2002) Primary malignant neoplasms of the appendix: a population-based study from the surveillance, epidemiology and end-results program, 1973–1998. Cancer 94:3307–3312 Hemminki K, Li X (2001) Incidence trends and risk factors of carcinoid tumors: a nationwide epidemiologic study from Sweden. Cancer 92:2204–2210 Anderson JR, Wilson BG (1985) Carcinoid tumours of the appendix. Br J Surg 72:545–546 Modlin IM, Lye KD, Kidd M (2003) A 5-decade analysis of 13, 715 carcinoid tumors. Cancer 97:934–959 Corpron CA, Black CT, Herzog CE, Sellin RV, Lally KP, Andrassy RJ (1995) A half century of experience with carcinoid tumors in children. Am J Surg 170:606–608 Dall’Igna P, Ferrari A, Luzzatto C, Bisogno G, Casanova M, Alaggio R, Terenziani M, Cecchetto G (2005) Carcinoid tumor of the appendix in childhood: the experience of two Italian institutions. J Pediatr Gastroenterol Nutr 40:216–219 Tchana-Sato V, Detry O, Polus M, Thiry A, Detroz B, Maweja S, Hamoir E, Defechereux T, Coimbra C, De Roover A, Meurisse M, Honoré P (2006) Carcinoid tumor of the appendix: a consecutive series from 1237 appendectomies. World J Gastroenterol 12:6699–6701 Marudanayagam R, Williams GT, Rees BI (2006) Review of the pathological results of 2660 appendicectomy specimens. J Gastroenterol 41:745–749 Blair NP, Bugis SP, Turner LJ, MacLeod MM (1993) Review of the pathologic diagnoses of 2,216 appendectomy specimens. Am J Surg 165:618–620 Syracuse DC, Perzin KH, Price JB, Wiedel PD, Mesa-Tejada R (1979) Carcinod tumors of the appendix: mesoappendiceal extention and nodal metastases. Ann Surg 190:58–63 Moertel CG, Weiland LH, Nagorney DM, Dockerty MB (1987) Carcinoid tumor of the appendix: treatment and prognosis. N Engl J Med 317:1699–1701 Jónsson T, Jóhannsson JH, Hallgrimsson JG (1989) Carcinoid tumors of the appendix in children younger than 16 years. A retrospective clinical and pathologic study. Acta Chir Scand 155:113–116 Ridha JR, Cassaro S (2003) Acute small bowel obstruction secondary to ileal endometriosis: report of a case. Surg Today 33:944–947 Hornstein MD, Barbieri RL (1999) Endometriosis. In: Ryan Kistner’s gynecology and women’s health, 7th edn. Mosby, St. Louis, pp 492–519 Croom RD 3rd, Donovan ML, Schwesinger WH (1984) Intestinal endometriosis. Am J Surg 148:660–667 Martimbeau PW, Pratt JH, Gaffey TA (1975) Small-bowel obstruction secondary to endometriosis. Mayo Clin Proc 50:239–243 Kinkel K, Chapron C, Balleyguier C, Fritel X, Dubuisson JB, Moreau JF (1999) Magnetic resonance imaging characteristics of deep endometriosis. Hum Reprod 14:1080–1086 Decker D, König J, Wardelmann E, Richter O, Popat S, Wolff M, Hirner A, Ulrich U (2004) Terminal ileitis with sealed perforation—a rare complication of intestinal endometriosis: case report and short review of the literature. Arch Gynecol Obstet 269:294–298 Starzinski-Powitz A, Handrow-Metzmacher H, Kotzian S (1999) The putative role of cell adhesion molecules in endometriosis: can we learn from tumour metastasis? Mol Med Today 5:304–309 Gaetje R, Kotzian S, Herrmann G, Baumann R, Starzinski-Powitz A (1997) Nonmalignant epithelial cells, potentially invasive in human endometriosis, lack the tumor suppressor molecule E-cadherin. Am J Pathol 150:461–467 Chen GT, Tai CT, Yeh LS, Yang TC, Tsai HD (2002) Identification of the cadherin subtypes present in the human peritoneum and endometriotic lesions: potential role for P-cadherin in the development of endometriosis. Mol Reprod Dev 62:289–294 Pannala R, Gafni-Kane A, Kidd M, Modlin IM (2007) An ileal endometrioma: of carcinoids and cadherin. J Gastrointest Surg 11:229–232 Yantiss RK, Clement PB, Young RH (2001) Endometriosis of the intestinal tract: a study of 44 cases of a disease that may cause diverse challenges in clinical and pathologic evaluation. Am J Surg Pathol 25:445–454 Saleh N, Daw E (1980) Endometriosis in non-gynaecological sites. Practitioner 224:1189–1195 Ingerslev M (1977) Danazol: an antigonadotrophic agent in the treatment of recurrent pelvic and intestinal endometriosis. Acta Obstet Gynecol Scand 56:343–346 Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Azordegan, N., Yazdankhah, A. & Moghadasian, M.H. A rare case of coexistence of carcinoid tumor of appendix vermicularis and ileal endometriosis. Arch Gynecol Obstet 279, 183–187 (2009). https://doi.org/10.1007/s00404-008-0660-1 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00404-008-0660-1