Bowel endometriosis mimicking gastrointestinal stromal tumor and diagnosed by endoscopic ultrasound

This case report describes evaluation of a 51-year-old asymptomatic woman undergoing colorectal cancer screening who had a rectosigmoid subepithelial lesion resembling a gastrointestinal stromal tumor. Colonoscopy identified a ~2 cm lesion covered by normal mucosa, and endoscopic ultrasound with radial and linear probes showed a hypoechoic lesion infiltrating the muscularis propria; endoscopic ultrasound-guided fine-needle aspiration was then performed. Histopathology demonstrated endometrial glands and stroma, leading to a diagnosis of bowel endometriosis that mimicked GIST, with the authors noting that subepithelial lesion differentiation can be difficult and that accurate imaging is important for therapeutic decisions, though the report is limited to a single patient. This paper is centrally about endometriosis — it documents bowel endometriosis in the rectosigmoid that was diagnosed via endoscopic ultrasound after mimicking a gastrointestinal stromal tumor.

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