I. Two Cases of Colonic Endometriosis

Toshikatsu Okumura, Takafumi Bandoh, H. Toyoshima, H Futonaka, Tamiko Takemura
In: Nippon Daicho Komonbyo Gakkai Zasshi · 1978 · vol. 31(4) , pp. 347–351,409 · doi:10.3862/jcoloproctology.31.347 · W2317804029
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Two cases of colonic endometriosis were diagnosed via histopathology in patients initially suspected of having cervical myoma and sigmoid colon carcinoma, highlighting the difficulty of distinguishing these conditions without tissue examination.

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This paper presents two clinical cases of women aged 32 and 46 who presented with gastrointestinal symptoms that were initially misdiagnosed as cervical myoma or colon carcinoma. Surgical interventions, including rectal partial resection and sigmoidectomy, were performed after imaging suggested submucosal tumors, but histopathological examination ultimately confirmed the masses as endometriosis. The authors emphasize that distinguishing colonic endometriosis from malignancy is difficult without histological confirmation, noting that symptom exacerbation during menstruation can aid diagnosis, though operative biopsy remains essential for accurate identification. Treatment decisions must be carefully tailored to the patient's age and symptom severity rather than relying solely on preoperative assumptions. This paper is centrally about endometriosis — specifically focusing on the diagnostic challenges and surgical management of deep infiltrating lesions involving the colon.

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Abstract

The first case is a 32-year-old female who visited our hospital complainig of genital bleeding. Though laparotomy was performed under the diagnosis of myoma of the cervix in our gynecological department, there was a tumor at the anterior wall of the rectum. As it looked submucosal tumor of the rectum, partial resection of the rectum was performed. The tumor was hard and measured 2×1×0.8 cm. Histopathological examination revealed it was endometroisis. The second case is a 46-year-old female who visited our hospital complaining of abdominal tumor. Total hysterectomy and bilateral salpingooophorectomy were performed in the gynecological department, and the tumor of the sigmoid colon, which seemed carcinoma was found.Sigmoidectomy was performed under the diagnosis of submucosal tumor of the sigmoid colon after barium enema and proctoscopic examination. The tumor was measured 4×2 cm. Histopathological examination revealed it was endometriosis.It is difficult to distinguish between carcinoma and endometriosis of the colon except on histological grounds though the chances of making correct diagnosis are enhanced if the symptoms occur or are increased during menstruation. The necessity of operative biopsy should be persisted.The treatment should be determined carefully by reference to the age of the patient and the severity of the symptoms.
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I. Two Cases of Colonic Endometriosis 1978 Volume 31 Issue 4 Pages 347-351,409 Details Abstract The first case is a 32-year-old female who visited our hospital complainig of genital bleeding. Though laparotomy was performed under the diagnosis of myoma of the cervix in our gynecological department, there was a tumor at the anterior wall of the rectum. As it looked submucosal tumor of the rectum, partial resection of the rectum was performed. The tumor was hard and measured 2×1×0.8 cm. Histopathological examination revealed it was endometroisis. The second case is a 46-year-old female who visited our hospital complaining of abdominal tumor. Total hysterectomy and bilateral salpingooophorectomy were performed in the gynecological department, and the tumor of the sigmoid colon, which seemed carcinoma was found. Sigmoidectomy was performed under the diagnosis of submucosal tumor of the sigmoid colon after barium enema and proctoscopic examination. The tumor was measured 4×2 cm. Histopathological examination revealed it was endometriosis. It is difficult to distinguish between carcinoma and endometriosis of the colon except on histological grounds though the chances of making correct diagnosis are enhanced if the symptoms occur or are increased during menstruation. The necessity of operative biopsy should be persisted. The treatment should be determined carefully by reference to the age of the patient and the severity of the symptoms. Sigmoidectomy was performed under the diagnosis of submucosal tumor of the sigmoid colon after barium enema and proctoscopic examination. The tumor was measured 4×2 cm. Histopathological examination revealed it was endometriosis. It is difficult to distinguish between carcinoma and endometriosis of the colon except on histological grounds though the chances of making correct diagnosis are enhanced if the symptoms occur or are increased during menstruation. The necessity of operative biopsy should be persisted. The treatment should be determined carefully by reference to the age of the patient and the severity of the symptoms. © The Japan Society of Coloproctology この記事はクリエイティブ・コモンズ [表示 - 非営利 - 改変禁止 4.0 国際]ライセンスの下に提供されています。 https://creativecommons.org/licenses/by-nc-nd/4.0/deed.ja Favorites & Alerts Recently viewed articles Predecessor

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