Case Report
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World J Gastroenterol. Jun 7, 2014; 20(21): 6675-6679
Published online Jun 7, 2014. doi: 10.3748/wjg.v20.i21.6675
Deep endometriosis with pericolic lymph node involvement: A case report and literature review
Andrea Cacciato Insilla, Monnalisa Granai, Grazia Gallippi, Patrizia Giusti, Sabina Giusti, Simone Guadagni, Luca Morelli, Daniela Campani
Andrea Cacciato Insilla, Monnalisa Granai, Grazia Gallippi, Daniela Campani, Department of Surgical Pathology, University Hospital of Pisa, 56124 Pisa, Italy
Patrizia Giusti, Sabina Giusti, Department of Diagnostic Radiology, University Hospital of Pisa, 56124 Pisa, Italy
Simone Guadagni, Luca Morelli, Department of General Surgery, University Hospital of Pisa, 56124 Pisa, Italy
Author contributions: Cacciato Insilla A and Campani D designed the report; Guadagni S and Morelli L reported the case; Cacciato Insilla A and Granai M researched the bibliography; Giusti P and Giusti S contributed to the imaging processing and analysis; Gallippi G, Guadagni S and Morelli L collected the patient’s clinical data; Cacciato Insilla A and Campani D analyzed the data and wrote the paper.
Correspondence to: Daniela Campani, MD, Professor of Medicine, Department of Surgical Pathology, University Hospital of Pisa, Via Paradisa 2, 56124 Pisa, Italy. daniela.campani@med.unipi.it
Telephone: +39-50-995690 Fax: +39-50-996891
Received: November 16, 2013
Revised: December 11, 2013
Accepted: February 20, 2014
Published online: June 7, 2014
Abstract

Deep infiltrating endometriosis is an often-painful disorder affecting women during their reproductive years that usually involves the structures of the pelvis and frequently the gastrointestinal tract. We present the case of a 37-year-old female patient with an endometrial growth on the sigmoid colon wall causing pain, diarrhea and the presence of blood in the feces. The histology of the removed specimen also revealed the involvement of the utero-vesical fold, the recto-vaginal septum and a pericolic lymph node, which are all quite uncommon findings. To identify the endometrial cells, we performed immunohistochemical staining for CD10 and the estrogen and progesterone receptors.

Keywords: Deep infiltrating endometriosis, Gastrointestinal tract, Recto-sigmoid endometriosis, Recto-vaginal node, Lymph node endometriosis, Lymph node removal

Core tip: We present the case of a 37-year-old female patient with an endometrial growth on the sigmoid colon wall causing pain, diarrhea and the presence of blood in the feces associated with the involvement of the utero-vesical fold, the recto-vaginal septum and a pericolic lymph node, which are quite uncommon findings. We also reviewed the literature to examine the behavior of deep infiltrating endometriosis, analyzing the risk of recurrence related to the possible treatments.