A rare case of coexistence of carcinoid tumor of appendix vermicularis and ileal endometriosis

Appendiceal Endometriosis: A Comprehensive Review of the Literature

Objective: the purpose of this review was to evaluate the prevalence of appendiceal endometriosis and the safety of concomitant appendectomy in women with endometriosis or pelvic pain. Materials and Methods: We searched the electronic databases Medline (PubMed), Scopus, Embase, and Web of Science (WOS). The search was not subject to any limitation in terms of time or method. The primary research question was: what is the prevalence of appendiceal endometriosis? The secondary research question was: is it safe to perform appendectomy during surgery for endometriosis? Publications that reported data about appendiceal endometriosis or appendectomy in women with endometriosis were reviewed regarding the inclusion criteria. Results: We found 1418 records. After review and screening, we included 75 studies published between 1975 and 2021. With regard to the first question of the review, we found 65 eligible studies and divided these into the following two categories: (a) endometriosis of the appendix presenting as acute appendicitis, and (b) endometriosis of the appendix as an incidental finding in gynecological surgery. Forty-four case reports described appendiceal endometriosis in women who were admitted for the treatment of pain in the right-sided lower abdomen. Endometriosis of the appendix was observed in 2.67% (range, 0.36-23%) of women who were admitted due to acute appendicitis. In addition, appendiceal endometriosis was an incidental finding during gynecological surgery in 7.23% of cases (range, 1-44.3%). With regard to the second question of the review, which was the safety of appendectomy in women with endometriosis or pelvic pain, we found 11 eligible studies. Reviewed cases had no significant intraoperative or follow-up complications during the 12 weeks. Conclusion: Based on the reviewed studies, coincidental appendectomy appears reasonably safe and was associated with no complications in the cases reviewed for the present report.

Chronic abdominal pain, appendiceal mucinous neoplasm, and concurrent intestinal endometriosis: a case report

Introduction

Although both appendiceal tumor and intestinal endometriosis have been reported as rare causes of abdominal pain, the coexistence of appendiceal mucinous neoplasm and ileal endometriosis has not previously been reported.

Case presentation

A 41-year-old Japanese woman presented with a positive fecal occult blood test and a 3-year history of menstruation-related lower abdominal pain. A colonoscopy demonstrated extrinsic compression of the cecum, suggesting a mass arising from the appendix or adjacent structures. Abdominal imaging showed a 6-cm cystic mass with intraluminal thick fluids originating from the appendix. At ileocecal resection for an appendiceal tumor, a 2-cm mass in the terminal ileum was incidentally found, which was included in the surgical specimen. Microscopic examination confirmed a diagnosis of a mucinous neoplasm of the appendix with endometriosis of the terminal ileum.

Conclusions

To avoid urgent surgery for subsequent serious events associated with disease progression, appendiceal tumor and intestinal endometriosis should be ruled out in patients with chronic abdominal pain.

Cutaneous endometriosis: review of 15 cases diagnosed at a single institution

INTRODUCTION

Endometriosis is a disease characterized by the presence of endometrial glands and/or stroma outside the uterine cavity. The main location is the ovary, but it has been described in many other extragenital locations, mainly the intestinal wall and the epiplon, but also the lung and the skin.

MATERIALS AND METHODS

In this report we review the cases of cutaneous endometriosis diagnosed at Fundación Jiménez Díaz in Madrid in the last decade.

RESULTS

In this time period we have seen 376 specimens with endometriosis, 330 from ovarian origin, 11 cases involving the appendix, 3 affecting the uterine cervix, 3 involving the epiplon, 1 in an ileal lymph node, 5 in the small intestine, 6 in the large intestine, 2 affecting the lung (with recurring pneumothorax) and 15 involving the skin.

CONCLUSION

We comment on the features of the patients with cutaneous endometriosis and their gynaecological history.