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Case Reports in Surgery
Volume 2015 (2015), Article ID 270206, 3 pages
http://dx.doi.org/10.1155/2015/270206
Case Report

Endometriosis of the Vermiform Appendix within a Hernia Sac Infiltrating the Pubic Bone

1Department of General and Vascular Surgery, Medical Faculty in Katowice, Medical University of Silesia in Katowice, Ziolowa Street 45-47, 40-635 Katowice, Poland
2Department of Physiotherapy, Faculty of Health Sciences, Medical University of Silesia in Katowice, Medykow Street 12, 40-752 Katowice, Poland
3Department of Pathology, Silesian Medical Center, Silesian Medical University in Katowice, Ziolowa Street 45-47, 40-635 Katowice, Poland
4Department of Women’s Disease Control and Prevention, Faculty of Health Sciences, Medical University of Silesia in Katowice, Medykow Street 12, 40-752 Katowice, Poland
5Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia in Katowice, Medykow Street 18, 40-752 Katowice, Poland

Received 26 August 2014; Accepted 25 December 2014

Academic Editor: Cheng-Yu Long

Copyright © 2015 Damian Ziaja et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. Appendicular endometriosis mimicking appendicitis is a rare finding. Inguinal tumor in the course of appendicular endometriosis located within an inguinal hernia sac and infiltrating the periosteum of the pubic bone has not yet been described. Case Report. This paper describes a case of a rapidly enlarging, solid, unmovable, very painful upon palpation inguinal tumor, in a 36-year-old nulliparous woman. During surgery, a hard (approximately 4 cm in diameter) tumor infiltrating the periosteum of the right pubic bone and continuous with the inguinal hernia sac was dissected. The distal segment of the vermiform appendix was an element of the dissected tumor. Histological examination revealed endometriosis of the distal vermiform appendix. After 6 months of hormone treatment, she was referred for reoperation due to tumor recurrence. Once again histological examination of the resected tissue revealed endometriosis. There was no further recurrence of the disease with goserelin therapy. In addition to the case report, we present a review of the literature about endometriosis involving the vermiform appendix and the inguinal canal (Amyand’s hernia). Conclusion. This case expands the list of differential diagnoses of nodules found in the inguinal region of women.