Abstract
Intestinal endometriosis is a benign disorder characterized by the ectopic growth of endometrial tissue in the intestinal wall, causing various clinical symptoms. However, endometriosis may develop into precancerous lesions due to its neoplastic nature. We report a surgical case of rectal endometriosis in which endometrial tissue was present in the regional lymph nodes as well. The relevant literature is also reviewed.
The patient was a 44-year-old woman with the chief complaints of a feeling of abdominal distension and abdominal pain. Sigmoidoscopy revealed clustered papillary polyps associated with stenosis of the rectosigmoid lumen. A biopsy suggested regenerative lesions without findings of malignancy. CT scans showed the circumferentially thickened rectosigmoid wall as well as marked dilatation of the proximal colon. Based on these findings, intestinal obstruction caused by rectal tumors was strongly suspected, though not definitively diagnosed, and low anterior resection with lymph node dissection was performed. Histopathology revealed glands, similar to endometrial glands in the proliferative stage, in the submucosa, muscularis propria, and subserosa. Intestinal endometriosis was thus diagnosed. The glandular structure was also present in the regional lymph nodes.
