Ileocolic intussusception due to a cecal endometriosis: case report and review of literature

Abstract

Cecal endometriosis and ileocolic intussusception due to a cecal endometriosis is extremely rare. We report a case of a woman who presented an ileocecal intussusception due to a cecal endometriosis. The patient gave two months history of chronic periombilical pain requiring regular hospital admission and analgesia. The symptoms were not related to menses. A laparotomy was performed and revealed an ileocolic intussusception. The abdominal exploration did not find any endometriosis lesion. Ileocaecal resection was performed. Microscopic examination showed a cystic component, lined by a regular cylindric epithelium. Foci of endometrial tissue were observed in the cecal subserosa and muscularis mucosal, with irregular endometrial glands lined by cylindric epithelium without atypia immunostained with CK7, and characteristic endometrial stroma immunostained with CD10. Cecal endometriosis and ileocolic intussusception due to a cecal endometriosis is extremely rare. Diagnose of etiology remains challenging due to the absence of clinical and radiological specific characteristics.

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Figure 1

The computed tomography scan shows one an ileocolocolic intussusception.

Figure 2

At microscopic examination, we observed an endometrial tissue developped in the cecal subserosa and muscularis mucosa(a), with irregular endometrial glands (b), and characteristic stroma positive for CD10 immunostaining (c). Epithelial cells are positive for CK7(d). Moreover, endometrial and stromal cells expressed both estrogen receptors (e) and progestative receptors (f).