TY - JOUR
T1 - An ileal endometrioma
T2 - Of carcinoids and cadherin
AU - Pannala, Rahul
AU - Gafni-Kane, Adam
AU - Kidd, Mark
AU - Modlin, Irvin M.
N1 - Funding Information:
Acknowledgements We acknowledge the help of Dr. Bob Camp (Department of Pathology, Yale University) for the generous access to cadherin antibodies and Drs. Dhanpat Jain and Oluwole Fadare for providing the tissue sections. This work is overall supported by NIH R01-CA-097050 (IMM), and M.K., by the Bruggeman Medical Foundation.
PY - 2007/2
Y1 - 2007/2
N2 - A 38-year-old woman with history of prior adrenalectomy for Cushing's syndrome presented with intermittent right lower quadrant (RLQ) abdominal pain, nausea, bloating, and non-bloody diarrhea for 2 months. Symptoms were not related to her menstrual periods. Examination revealed only an ill-defined mass in the RLQ. Investigations for infectious causes, inflammatory bowel disease, and carcinoid tumor were negative. Computed tomography (CT) demonstrated a terminal ileal mass with mesenteric stranding and dilatation of the proximal bowel. At laparotomy, a fibrotic, terminal ileal mass with matted adhesions involving the mesentery and retroperitoneum was resected. Histopathological examination identified multiple foci of endometriosis extending from the serosal surface into the mucosa of the terminal ileum. Immunostaining revealed E- and P-cadherin, but not N-cadherin immunopositivity. Mucosal involvement without cyclical menstrual symptoms and intestinal obstruction is an unusual presentation of intestinal endometriosis. Although the mechanism of endometriosis is not clear, the role of cell adhesion molecules such as cadherins has received attention. Increased expression of E- and P-cadherin and decreased N-cadherin expression in our patient demonstrates differential expression of these cadherins in endometriotic tissue. Future studies may investigate patterns of differential expression of these cadherins in a series of cases to elucidate the mechanisms of migration of endometriotic tissue.
AB - A 38-year-old woman with history of prior adrenalectomy for Cushing's syndrome presented with intermittent right lower quadrant (RLQ) abdominal pain, nausea, bloating, and non-bloody diarrhea for 2 months. Symptoms were not related to her menstrual periods. Examination revealed only an ill-defined mass in the RLQ. Investigations for infectious causes, inflammatory bowel disease, and carcinoid tumor were negative. Computed tomography (CT) demonstrated a terminal ileal mass with mesenteric stranding and dilatation of the proximal bowel. At laparotomy, a fibrotic, terminal ileal mass with matted adhesions involving the mesentery and retroperitoneum was resected. Histopathological examination identified multiple foci of endometriosis extending from the serosal surface into the mucosa of the terminal ileum. Immunostaining revealed E- and P-cadherin, but not N-cadherin immunopositivity. Mucosal involvement without cyclical menstrual symptoms and intestinal obstruction is an unusual presentation of intestinal endometriosis. Although the mechanism of endometriosis is not clear, the role of cell adhesion molecules such as cadherins has received attention. Increased expression of E- and P-cadherin and decreased N-cadherin expression in our patient demonstrates differential expression of these cadherins in endometriotic tissue. Future studies may investigate patterns of differential expression of these cadherins in a series of cases to elucidate the mechanisms of migration of endometriotic tissue.
KW - Cadherin
KW - Endometriosis
KW - Ileum
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U2 - 10.1007/s11605-006-0080-0
DO - 10.1007/s11605-006-0080-0
M3 - Article
C2 - 17390177
AN - SCOPUS:34548423203
SN - 1091-255X
VL - 11
SP - 229
EP - 232
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 2
ER -