Appendiceal or Cecal Endometriosis With Intestinal Metaplasia

Joseph Misdraji, Gregory Y. Lauwers, Julie Irving, Kenneth P. Batts, Robert H. Young
In: American Journal of Surgical Pathology · 2014 · vol. 38(5) , pp. 698–705 · doi:10.1097/pas.0000000000000167 · W2026619038
article OA: closed CC0 ⤵ 11 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-12 ⓘ

Appendiceal or cecal endometriosis with intestinal metaplasia can mimic mucinous tumors due to mural hypertrophy, elastosis, and lumen obliteration, posing diagnostic challenges even without dysplasia.

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Abstract

Appendiceal or cecal endometriosis uncommonly presents diagnostic challenges, but rare cases with intestinal metaplasia can mimic mucinous tumors of the appendix. We describe 6 cases of appendiceal or cecal endometriosis with intestinal metaplasia that grossly and microscopically mimicked appendiceal mucinous tumors. The cases were characterized by marked mural hypertrophy and elastosis, with distortion of the appendix, and virtual obliteration of the lumen of the appendix. All cases had conventional endometriosis, together with varying amounts of endometriosis with intestinal-type epithelium. In 2 cases, scant or virtually no stroma around some mucin-filled glands made their recognition as endometriosis more difficult. None of the cases had dysplasia of the mucinous epithelium. All patients had benign follow-up (mean 3.6 y). Endometriosis with intestinal metaplasia is a rare phenomenon that, when it occurs in the appendix or cecum, may lead to misdiagnosis as a low-grade appendiceal mucinous neoplasm or mucinous carcinoma.

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Condition tags

endometriosis

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.

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