A Rare Case of Cecal Endometriosis

Document Type

Conference Proceeding - Restricted Access

Publication Date

5-8-2026

Abstract

Endometriosis is a common problem that affects many women in our society. It occurs when endometrial tissue is found outside of the uterus. Many hypothesize that it is caused by retrograde menstruation, although the exact pathogenesis is unknown. Most commonly, it is limited to the reproductive and pelvic organs. However, there are reports of gastrointestinal involvement in 3-37% of patients with endometriosis. The literature documents that close to 90% of these cases affect the rectum and sigmoid colon, while only 3.6-6% affect the cecum. These cases of intestinal endometriosis present significant diagnostic challenges given that they often present with vague, nonspecific symptoms and usual first line imaging is often non-diagnostic. We present the work-up, treatment and diagnosis of a rare case of cecal endometriosis.

A 30 year old female with a history of paroxysmal supraventricular tachycardia, depression and obesity and a family history of gynecologic cancer in her grandmother presented to an outside hospital with acute onset right lower quadrant pain. A computed tomography (CT) scan demonstrated mass-like enlargement of the cecum concerning for malignancy, as well as a large left ovarian lesion. A colonoscopy was subsequently performed showing extrinsic compression on the cecum but normal mucosa. Pelvic magnetic resonance imaging (MRI) was obtained for further classification and revealed a 3.9 cm cecal mass with prominent lymphadenopathy, an 8.3 cm left ovarian cyst compatible with a large hemorrhagic cyst and a few T1 hyper-intense implants in cul-de-sac consistent with possible endometriosis. Tumor markers CA 125 and CA 19-9 were elevated. Given the concern for malignancy she was referred to our hospital for a multidisciplinary evaluation by surgical and gynecologic oncology.

Our case is one of the few cases in the literature that documents a patient with cecal endometriosis. It emphasizes the difficulty in diagnosis of gastrointestinal endometriosis and the importance of maintaining a broad differential when evaluating a young, premenopausal woman with a cecal mass found on imaging.

Comments

2026 Research Day Corewell Health West, Grand Rapids, MI, May 8, 2026. Abstract 2118

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