Verma Rashmi, Osborn Sally, Horgan Kieran
Department of Breast Surgery, St James's Hospital, Beckett Street, Leeds, West Yorkshire LS97TF, UK.
Case Rep Surg. 2013;2013:714126. doi: 10.1155/2013/714126. Epub 2013 Apr 28.
Malignant transformation of endometriosis is rare and is usually seen in ovarian endometriosis. The colon and rectum are the most common sites for extragonadal endometriosis, and although serosal involvement is commonly seen, mucosal involvement is rare. Malignant transformation of endometriosis is a rare but a well-known complication of endometriosis. We report an unusual presentation of endometrioid adenocarcinoma with lymph node metastasis, arising from endometriosis in the caecal wall and causing ileocaecal intussusception. The patient presented with sudden onset of abdominal pain with features suggestive of acute appendicitis. Diagnostic laparoscopy revealed an ileocaecal intussusception. Conversion to open surgery confirmed a caecal mass causing ileocaecal intussusception, and a radical right hemicolectomy was performed. Histology revealed endometrioid adenocarcinoma arising in a focus of endometriosis in the muscularis propria and involving the mucosa, with one regional metastatic lymph node.
子宫内膜异位症的恶性转化很少见，通常见于卵巢子宫内膜异位症。结肠和直肠是性腺外子宫内膜异位症最常见的部位，虽然浆膜受累常见，但黏膜受累罕见。子宫内膜异位症的恶性转化是一种罕见但众所周知的子宫内膜异位症并发症。我们报告了一例不寻常的子宫内膜样腺癌伴淋巴结转移病例，该病例起源于盲肠壁的子宫内膜异位症并导致回盲部肠套叠。患者突发腹痛，具有提示急性阑尾炎的特征。诊断性腹腔镜检查发现回盲部肠套叠。转为开放手术证实为盲肠肿块导致回盲部肠套叠，并进行了根治性右半结肠切除术。组织学检查显示，子宫内膜样腺癌起源于固有肌层的子宫内膜异位灶并累及黏膜，伴有一个区域转移性淋巴结。
