Colic Endometriosis or Colorectal Cancer? : A Case Report
Abstract:
Endometriosis is characterized by the presence of endometrial glands and stroma in extra-uterine locations, primar ily within the pelvic cavity. Endometrial lesions affecting the rectovaginal space and/or intestines are classified as deep infiltrative endometriosis. We describe and discuss a clinical case of a 49-year-old female with a family history of early-onset colorectal cancer, presented in June 2024 at the Health Centre (USF Costa do Estoril) with a recent colonoscopy for screening for colorectal cancer. The colonoscopy revealed a 15 mm ovoid protrusion in the cecal fundus, involving the appendiceal orifice, requiring further imaging. A sessile 8mm polyp in the sigmoid was also excised, diagnosed as a tubular adenoma with low-grade dysplasia. An abdominal-pelvic CT scan a month later, re vealed irregular thickening of the cecal wall near the ileocecal valve with possible pericolic fat infiltration. She was urgently referred to the Portuguese Institute of Oncology (IPO). In September 2024, at IPO, she was proposed for right hemicolectomy and the pathological examination of the surgical piece revealed a colic endometriosis nodule. This case highlights the need to differentiate colic endometriosis from colorectal cancer, especially in young women.
