Endometriosis Presenting as a Malignant Appearing Cecal Mass

Area of Science:

• Gynecology
• Gastroenterology
• Surgical Pathology

Background:

• Endometriosis is a gynecological condition characterized by endometrial tissue outside the uterus.
• It commonly affects pelvic organs but can occur in extra-pelvic sites, including the gastrointestinal tract.
• Cecal and appendiceal endometriosis are rare but can present with symptoms mimicking malignancy, such as anemia.

Purpose of the Study:

• To present a case of a 50-year-old female with symptomatic anemia due to extensive endometriosis involving the cecum and appendix.
• To highlight the diagnostic challenges and the importance of considering endometriosis in the differential diagnosis of colonic masses.
• To emphasize the role of surgical intervention in suspected cases.

Main Methods:

• A case report of a 50-year-old female presenting with symptomatic anemia.
• Diagnostic workup included imaging (CT scan) and colonoscopy with biopsy.
• Surgical resection of the affected area followed by histopathological examination.

Main Results:

• Imaging revealed a cecal and appendiceal mass with lymphadenopathy, initially suspicious for malignancy.
• Colonoscopy showed a suspicious tumor, but biopsy results were inconclusive.
• Surgical resection confirmed extensive endometriosis involving the cecum and appendix, mimicking neoplasia.
• The patient's anemia resolved postoperatively.

Conclusions:

• Gastrointestinal endometriosis can present as a colonic mass, posing a diagnostic challenge and necessitating a broad differential diagnosis.
• Symptomatic anemia in the context of a suspected colonic mass should prompt consideration of endometriosis.
• Surgical intervention is crucial for diagnosis and treatment when malignancy is suspected.