[Endometriosis in the sigmoid colon causing obstruction with lymph node involvement]

The case of a 50-year-old woman was presented, whose clinical examination first diagnosed subacute obstruction and then complete intestinal obstruction after several weeks of uncertain abdominal pain. Imaging examinations were inconclusive. An Hartmann’s resection of the sigmoid colon with end-stoma formation was performed as an emergency. The surgical specimen was processed as a malignant preparation, including searching for lymph nodes. The histological examination confirmed extensive endometriosis with lymph node involvement, which was also confirmed by immunohistochemistry, and other possible non-malignant, malignant, or metastatic processes were excluded. There are many theories about the etiology and pathogenesis of endometriosis associated with lymph node involvement, but the process is still not completely clear. Most often, the disease is only recognized during diagnostic laparoscopy. There are no coherent protocols for treatments either; in addition to surgical solutions, drug treatments are considered, the latter can be hormonal and non-hormonal preparations. The type of surgery should be planned based on the adequate anamnesis and diagnostic procedures, taking into account the long-term effects. Treatments should be tailored to the individuals and efforts should be made to avoid complications and recurrences. Orv Hetil. 2025; 166(21): 826–831.