Clinical Analysis of Intestinal Endometriosis Misdiagnosed as Gastrointestinal Malignant Tumor

HUANG Lu; HOU Meng; CAI Yu; CHEN Minxiu; FENG Chong; SUN Jinping; ZHOU Li

doi:10.3969/j.issn.1002-3429.2025.11.001

Abstract：Objective To summarize the clinical characteristics of bowel endometriosis(BE),and to explore the methods to effectively improve the diagnostic accuracy of this disease,so as to avoid misdiagnosis.Methods Clinical data of 30 BE patients with gastrointestinal symptoms and newly diagnosed gastrointestinal malignant tumors from 2020 to 2024 were retrospectively analyzed.Results The age of the 30 patients ranged from 28 to 77 years,26 patients had a history of childbearing,7 patients were postmenopausal,and 4 patients had a history of dysmenorrhea.The lesions located in rectum(24 cases),sigmoid colon(5 cases)and terminal ileum(1 case).There was recurrent abdominal pain(n=14),hematochezia(n=12),change of bowel habits(n=10),abdominal distension(n=6),and anal heaviness,difficult defecation or tenesmus(n=3).Cancer antigen 125 increased in 10 patients and cancer antigen 199 increased in 4 patients.Abdominal CT examination showed irregular thickening of the intestinal wall in 30 patients,suggesting the possibility of gastrointestinal tumors.Thirty patients were diagnosed with BE by colonoscopic biopsy,surgical pathology and immunohistochemical staining.The misdiagnosis time ranged from 4 to 11 days.After diagnosis,all patients underwent surgical treatment,and 4 patients were treated with drugs.The patients were followed up for 1 year,and the patients were in good condition without recurrence.Conclusion It is difficult to distinguish BE from gastrointestinal malignant tumors only based on the clinical symptoms,imaging findings and colonoscopy results.Endoscopic biopsy may also lead to misdiagnosis.Therefore,deep biopsy or endoscopic ultrasound-guided fine needle puncture and accurate surgical pathology and immunohistochemical staining are necessary to confirm the diagnosis and reduce the misdiagnosis rate.