Endometriosis may occasionally involve the appendix. It can cause confusion and a number of complications that can be challenging to diagnose.
The patient may present with acute or intermittent right lower quadrant pain.
A mass lesion may be seen in the appendix on imaging studies or at surgery.
The patient may or may not have evidence of endometriosis elsewhere.
On histologic exam of the appendix one of more foci of endometriosis are seen with benign glands and stromal fibrosis with or without hemorrhage or hemosiderin deposition.
Complications:
(1) intussusception of the appendix (invagination of the appendix into the cecum)
(2) luminal obstruction with mucocele formation
Differential diagnosis:
(1) well-differentiated adenocarcinoma of the appendix (endometriosis should be positive for PAX8 and CD10)
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