Endometriosis of the appendix

PURPOSE: Endometriosis is defined as functioning endometrial tissue outside of the uterus. Endometriosis of the appendix is uncommon. Its clinical presentation varies from asymptomatic to acute abdominal pain. The aims of this study were to describe our experience of managing patients with appendiceal endometriosis and to review the clinical characteristics of this medical condition. METHODS: Five cases of appendiceal endometriosis diagnosed between January 2007 and December 2012 were retrospectively reviewed. Patients treated for intra-abdominal endometriosis were excluded. RESULTS: The mean age at diagnosis was 33.8 years old. One patient was in the second trimester of pregnancy. Two patients were asymptomatic. Three patients had clinical symptoms including two with acute pain in the right lower quadrant and one with abdominal discomfort. Four patients showed appendiceal abnormalities in imaging studies including two cases of suspected mucocele and two cases of appendiceal infection. There were no suspicions of endometriosis of the appendix based on preoperative imaging studies. Three patients underwent appendectomy due to clinical symptoms, and two underwent incidental appendectomy combined with another operation. None of the patients received adjuvant therapy. CONCLUSION: Appendiceal endometriosis should be included in the differential diagnosis for acute abdominal pain, especially when women of childbearing age present with clinical symptoms of acute appendicitis.