Abstract
BackgroundEndosalpingiosis in the lymph nodes of the mesocolon is very rare. We reported a case with appendiceal endometriosis who had endosalpingiosis in the lymph nodes of the mesocolon that was found during laparoscopic ileocecal resection.Case presentationThe patient was a 44-year-old woman who had visited a physician for fever, bloody stool, and abdominal pain 1 year earlier. She was diagnosed with ulcerative colitis on colonoscopy, and symptoms improved with oral treatment. A colonoscopy performed 2 months after diagnosis detected a hard, 20-mm submucosal tumor (SMT) in the cecum. On abdominal contrast CT, an intensely stained mass, including a low-density region, was observed in the cecum. A boring biopsy was performed after mucosal resection of the cecal SMT at our hospital, but diagnosis could not be made. Since the possibility of a malignant lesion could not be ruled out, laparoscopic ileocecal resection was performed. In the resected specimen, a 29 × 27 × 21-mm mass was present in the appendicular root. On histopathological examination, appendiceal endometriosis and endosalpingiosis in the lymph nodes around the ileocolic artery were observed. The postoperative course was favorable, and the patient was discharged 7 days after surgery.ConclusionDifferentiation of endosalpingiosis in lymph nodes in the mesocolon from lymph node metastasis of adenocarcinoma is important in patients with an abdominal mass.
Highlights
Endosalpingiosis in the lymph nodes of the mesocolon is very rare
When endosalpingiosis is present in a lymph node, it is important to differentiate it from lymph node metastasis of adenocarcinoma [4, 5]
She was diagnosed with ulcerative colitis on colonoscopy, and symptoms improved with oral treatment
Summary
Endosalpingiosis is considered as ectopic benign epithelial lesion histologically similar to tubal epithelium, and many lesions are observed in either the peritoneum, great omentum, urinary bladder, or pelvic and paraaortic lymph nodes [1,2,3]. We encountered a patient who underwent laparoscopic ileocecal resection for a diagnosis of cecal tumor in which endosalpingiosis was noted in the lymph nodes in. Case presentation The patient was a 44-year-old woman who visited a physician for fever, bloody stool, and abdominal pain 1 year earlier She was diagnosed with ulcerative colitis on colonoscopy, and symptoms improved with oral treatment. A colonoscopy performed 2 months after diagnosis detected a hard, 20-mm submucosal tumor (SMT) in the cecum, and the patient was referred to our hospital for additional examination. Her past medical history included polyostotic fibrous dysplasia that was followed for 2 years and ulcerative colitis treated orally for 1 year. The tumor marker level (CEA) was maintained at about 1–2 ng/dL after surgery
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