A CASE OF ENDOMETRIOSIS WITH A GIANT TUMOR IN THE PELVIC CAVITY DIAGNOSED BY CT-GUIDED BIOPSY

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  • KATO Kazuyoshi
    Department of Gastroenterological Surgery, National Cancer Center Hospital
  • SHIRAI Yoshinori
    Department of Gastroenterological Surgery, National Cancer Center Hospital
  • ONO Masato
    Department of Gastroenterological Surgery, National Cancer Center Hospital
  • ARAI Tatsuo
    Department of Gastroenterological Surgery, National Cancer Center Hospital
  • TANIYAMA Shinii
    Department of Gastroenterological Surgery, National Cancer Center Hospital
  • SUGITO Masanori
    Department of Gastroenterological Surgery, National Cancer Center Hospital
  • RYU Munemasa
    Department of Gastroenterological Surgery, National Cancer Center Hospital

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  • CTガイド下生検で確定診断した骨盤内子宮内膜症の1例

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Abstract

A case of endometriosis with a giant tumor in the pelvic cavity presenting with intestinal obstruction is described.<br> A 48-year-old woman was referred to the hospital after colostomy for intenstinal obstruction at another hospital, where she consulted about severe abdominal distention and was diagnosed as having a rectal tumor causing intestinal obstruction. On admission abdominal CT scans and MR images revealed a large tumor occupying the pelvic cavity. The tumor filled the lumen of the rectum to cause complete obstruction and extended to the uterus, sacrum, and left piriformis muscle. It was unable to make a diagnosis by endoscopic bioposies, but CT-guided biopsy successfully provided the definite diagnosis of endometriosis for us. Medication for the disease was started thereafter. It is suggested that we have to make the diagnosis for large tumors in the pelvic cavity causing intestinal obstruction by entertaining not only malignancies such as rectal or ovarian cancer but also endometriosis as possible different diagnosis. If the definitive diagnosis is unable to be made by endoscopic biopsy, CT-guided biopsy is recommended.

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