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A case of sigmoid endometriosis difficult to differentiate from colon cancer.

Dimoulios P, Koutroubakis IE, Tzardi M, Antoniou P, Matalliotakis IM, Kouroumalis EA - BMC Gastroenterol (2003)

Bottom Line: We present a case of a young woman with sigmoid endometriosis, in which the initial diagnostic workup suggested colon cancer.Histologic evidence, obtained from a second colonoscopy, along with pelvic ultrasound findings led to the final diagnosis of intestinal endometriosis which was confirmed by laparoscopy.Colonic endometriosis is often a diagnostic challenge and should be considered in young women with symptoms from the lower gastrointestinal tract.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Gastroenterology, University Hospital Heraklion, Crete, Greece. fdimoul@hotmail.com

ABSTRACT

Background: Although endometriosis with sigmoid serosal involvement is not uncommon in women of childbearing age, the mucosal involvement is rare and differential diagnosis from colon cancer may be difficult due to the lack of pathognomonic symptoms and the poor diagnostic yield of colonoscopy and colonic biopsies.

Case presentation: We present a case of a young woman with sigmoid endometriosis, in which the initial diagnostic workup suggested colon cancer. Histologic evidence, obtained from a second colonoscopy, along with pelvic ultrasound findings led to the final diagnosis of intestinal endometriosis which was confirmed by laparoscopy.

Conclusion: Colonic endometriosis is often a diagnostic challenge and should be considered in young women with symptoms from the lower gastrointestinal tract.

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Related in: MedlinePlus

Barium enema showing stenosis of the rectosigmoid region due to both a filling defect and an extrinsic bowel compression.
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Figure 1: Barium enema showing stenosis of the rectosigmoid region due to both a filling defect and an extrinsic bowel compression.

Mentions: Colonoscopy revealed an extensive polypoid lesion of the mucosa, on the rectosigmoid junction, along with erythema, oedema, and ulcerations that resulted in stenosis of the lumen. The endoscope could not be introduced beyond the lesion. The histology of the above lesion demonstrated a mild dilation of crypts without goblet cell depletion. The lamina propria was edematous with dilated capillaries and inflammatory infiltrates of lymphocytes and plasma cells. A barium enema (figure 1), on the following day, showed stenosis of the rectosigmoid region due to both a filling defect and an extrinsic bowel compression. The rest of the colon was normal. An abdominal CT scan, obtained two days later, revealed an eccentric wall thickening of the sigmoid and confirmed the filling defect. Moreover, it showed ovarian cysts (Figures 2,3).


A case of sigmoid endometriosis difficult to differentiate from colon cancer.

Dimoulios P, Koutroubakis IE, Tzardi M, Antoniou P, Matalliotakis IM, Kouroumalis EA - BMC Gastroenterol (2003)

Barium enema showing stenosis of the rectosigmoid region due to both a filling defect and an extrinsic bowel compression.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC184504&req=5

Figure 1: Barium enema showing stenosis of the rectosigmoid region due to both a filling defect and an extrinsic bowel compression.
Mentions: Colonoscopy revealed an extensive polypoid lesion of the mucosa, on the rectosigmoid junction, along with erythema, oedema, and ulcerations that resulted in stenosis of the lumen. The endoscope could not be introduced beyond the lesion. The histology of the above lesion demonstrated a mild dilation of crypts without goblet cell depletion. The lamina propria was edematous with dilated capillaries and inflammatory infiltrates of lymphocytes and plasma cells. A barium enema (figure 1), on the following day, showed stenosis of the rectosigmoid region due to both a filling defect and an extrinsic bowel compression. The rest of the colon was normal. An abdominal CT scan, obtained two days later, revealed an eccentric wall thickening of the sigmoid and confirmed the filling defect. Moreover, it showed ovarian cysts (Figures 2,3).

Bottom Line: We present a case of a young woman with sigmoid endometriosis, in which the initial diagnostic workup suggested colon cancer.Histologic evidence, obtained from a second colonoscopy, along with pelvic ultrasound findings led to the final diagnosis of intestinal endometriosis which was confirmed by laparoscopy.Colonic endometriosis is often a diagnostic challenge and should be considered in young women with symptoms from the lower gastrointestinal tract.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Gastroenterology, University Hospital Heraklion, Crete, Greece. fdimoul@hotmail.com

ABSTRACT

Background: Although endometriosis with sigmoid serosal involvement is not uncommon in women of childbearing age, the mucosal involvement is rare and differential diagnosis from colon cancer may be difficult due to the lack of pathognomonic symptoms and the poor diagnostic yield of colonoscopy and colonic biopsies.

Case presentation: We present a case of a young woman with sigmoid endometriosis, in which the initial diagnostic workup suggested colon cancer. Histologic evidence, obtained from a second colonoscopy, along with pelvic ultrasound findings led to the final diagnosis of intestinal endometriosis which was confirmed by laparoscopy.

Conclusion: Colonic endometriosis is often a diagnostic challenge and should be considered in young women with symptoms from the lower gastrointestinal tract.

Show MeSH
Related in: MedlinePlus