A case of infiltrative cecal endometriosis with appendiceal obliteration and lymph node involvement

Endometriosis is a clinical condition with a wide spectrum of severity, and a subset that includes intestinal involvement that may even mimic malignancy, making non-surgical diagnosis difficult. Cecal endometriosis is a rare finding among intestinal endometriosis. We report on 33-year-old woman with ileocecal endometriosis presenting as endoscopic prolapse of the ileocecal valve associated with a mass on cross-sectional imaging. The diagnosis was suggested intraoperatively by peritoneal endometrioma and obliteration of the appendix during laparoscopic right hemicolectomy. Pathological review demonstrated extensive submucosal, infiltrative endometriosis with mass effect and lymph node involvement. This case highlights the difficulty in preoperative diagnosis of intestinal endometriosis and the wide-ranging potential tissue effects in cases of infiltrative disease.