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Case Reports
. 2021 Feb 22;14(2):e239090.
doi: 10.1136/bcr-2020-239090.

Incidental appendiceal mass as the only manifestation of endometriosis

Affiliations
Case Reports

Incidental appendiceal mass as the only manifestation of endometriosis

Marita Yaghi et al. BMJ Case Rep. .

Abstract

Appendiceal endometriosis is a rare condition that remains difficult to diagnose preoperatively. Herein, we present a case of appendiceal endometriosis presenting as a neuroendocrine tumor. A 34-year-old Caucasian woman was found to have an appendiceal mass with a small fluid collection on routine transvaginal ultrasound. The patient denied any symptoms. Features were consistent with those of a neuroendocrine tumour of the appendix. Laparoscopic appendectomy followed by histopathology revealed endometriosis with negative cytology for malignant cells. Preoperative characteristics of appendiceal tumours in women of childbearing age should be further investigated. Establishing clinical and surgical guidelines is the key to avoid invasive procedures and related adverse outcomes.

Keywords: endocrine cancer; gastrointestinal surgery; obstetrics and gynaecology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
(A) Axial and (B) coronal images of a contrast-enhanced CT of the abdomen and pelvis (slice thickness: 3 mm, Kvp: 120, uAs: 72) showing a well-defined soft tissue lesion at the tip of the appendix measuring 1.5×1.0 cm with a CT density of 64 HU. No soft-tissue thickening or border irregularities can be seen. No peri-appendiceal inflammatory changes. No enlarged lymph nodes in the abdomen or pelvis, in particular in the right lower quadrant. Normal liver morphology and enhancement are noted. No liver nodules are seen. Normal calibre intrahepatic and common bile ducts. Normal morphology of the stomach and duodenum. Normal calibre small and large bowel. No lesions suggestive of distant metastasis can be noted elsewhere in the abdomen or pelvis.
Figure 2
Figure 2
The appendix measures 3.5×0.8×0.7 cm. The serosa is smooth and shiny. The distal 1.5 cm of the appendix is curved and thickened. The distal tip also shows fibrotic puckering. No signs of appendicitis or inflammation can be seen.

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