Hakoda Keishi, Yoshimitsu Masanori, Miguchi Masashi, Kohashi Toshihiko, Egi Hiroyuki, Ohdan Hideki, Hirabayashi Naoki
Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Kasumi 1-2-3 Minami-ku, Hiroshima-shi, Hiroshima, Japan.
Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, Motomachi 7-33 Naka-ku, Hiroshima-shi, Hiroshima, Japan.
Int J Surg Case Rep. 2020;67:9-12. doi: 10.1016/j.ijscr.2019.12.039. Epub 2020 Jan 9.
We report the case of characteristic findings of appendicular endometriosis that presented as a submucosal tumor in the cecum without any abdominal symptoms treated with single-incision laparoscopic ileocolectomy.
The patient was a 51-year-old woman (body mass index: 21.5) who underwent an examination to investigate the cause of a positive fecal occult blood test. Her laboratory test results were normal, without anemia or tumor marker elevation. Colonoscopy revealed a submucosal tumor in the cecum. Enhanced computed tomography (CT), fluorodeoxyglucose-positron emission tomography-CT and magnetic resonance imaging failed to produce a clear diagnosis. Given the malignant potentiality of the tumor, ileocolectomy was considered potentially necessary, but she wished for minimally invasive surgery. She ultimately underwent ileocolectomy and lymphadenectomy with single-incision laparoscopic surgery. A pathological examination revealed the lesion to be appendicular endometriosis, and 14 lymph nodes with no malignancy were resected.
Appendicular endometriosis can present as a submucosal tumor in the cecum without any abdominal symptoms. Appendicular endometriosis should be considered in the differential diagnosis of ileocecal submucosal tumor. Single-incision laparoscopic ileocolectomy was useful procedure for cecum tumor resection.
我们报告一例阑尾子宫内膜异位症的特征性表现，该病例表现为盲肠黏膜下肿瘤，无任何腹部症状，采用单孔腹腔镜回盲部切除术进行治疗。
患者为一名51岁女性（体重指数：21.5），因粪便潜血试验阳性接受检查以查明病因。她的实验室检查结果正常，无贫血或肿瘤标志物升高。结肠镜检查发现盲肠有一个黏膜下肿瘤。增强计算机断层扫描（CT）、氟脱氧葡萄糖-正电子发射断层扫描-CT和磁共振成像均未能明确诊断。鉴于该肿瘤具有恶性潜能，考虑可能需要进行回盲部切除术，但她希望接受微创手术。她最终接受了单孔腹腔镜回盲部切除术和淋巴结清扫术。病理检查显示病变为阑尾子宫内膜异位症，切除了14个无恶性病变的淋巴结。
阑尾子宫内膜异位症可表现为盲肠黏膜下肿瘤，且无任何腹部症状。在鉴别诊断回盲部黏膜下肿瘤时应考虑阑尾子宫内膜异位症。单孔腹腔镜回盲部切除术是切除盲肠肿瘤的有效方法。
