Endometriosis mimics general surgical disease

Endometriosis is rarely encountered by the general surgeon but may on occasion mimic general surgical disease. Although usually diagnosed easily because of cyclic symptoms and typical physical findings, six atypical cases are presented. These cases were diagnosed as appendicitis (2), subcutaneous mass (2), pelvic wall malignancy, and lower gastrointestinal hemorrhage. Diagnosis was ultimately made by laparotomy or excisional biopsy in five cases and by fine needle aspiration in one. Resection of the lesion, if feasible, is often curative. If resection is not feasible, therapy depends on the severity of the symptoms, and the patient's desire for fertility. Recognition of the typical appearance of an endometrioma may avoid mistaking it for cancer.