2025 Volume 43 Issue 2 Pages 58-64
Synopsis: We encountered a case of LAMN with appendiceal endometriosis requiring differentiation from an ovarian tumor, ultimately diagnosed through postoperative pathology. The patient, a 43-year-old woman (G1P1), initially presented to a local gastroenterology clinic with constipation and lower abdominal pain. When her symptoms persisted, a contrast-enhanced CT scan suggested a ruptured endometriotic cyst in the right ovary. She was referred to our hospital, where pelvic MRI revealed a suspected ruptured right ovarian tumor, with malignancy difficult to exclude. Blood tests showed an elevated inflammatory response. After antimicrobial treatment, elective laparotomy was performed. Intra-abdominal findings included chocolate-like endometriotic material and ocherous jelly-like ascites. Both adnexa appeared normal, but the appendix was perforated, leading to a suspicion of perforated appendicitis. An appendectomy was performed. Postoperative pathology confirmed the presence of LAMN and appendiceal endometriosis. This case highlights the importance of considering appendiceal mucinous tumors or appendiceal endometriosis in the differential diagnosis when a ruptured ovarian tumor with hemorrhage is suspected.
