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Endometriosis in the cecum diagnosed via forward-viewing endoscopic ultrasound-guided tissue acquisition with a 19G fine-needle biopsy needle: a case report.

Created on 06 Jul 2026

Authors

Kensei Kawasaki, Kotaro Takeshita, Shuta Otachi, Kenji Matsuo, Yuki Kano, Eisuke Nakao, Eisuke Akamine, Satoshi Asai

Published in

Clinical journal of gastroenterology. Jul 06, 2026. Epub Jul 06, 2026.

Abstract

Subepithelial lesions (SELs) in the lower gastrointestinal tract are rare, and diagnosis and treatment of colorectal SELs are often challenging. Although endoscopic ultrasound-guided tissue acquisition (EUS-TA) is useful for minimally invasive histological diagnosis, few reports have described its use for right-sided colonic SELs because advancing an oblique-viewing echoendoscope into the right colon is difficult. A 30-year-old woman was referred to our hospital after colonoscopy revealed a protruding cecal lesion suggestive of an SEL. Contrast-enhanced computed tomography showed a 37-mm contrast-enhancing mass and an adjacent lesion, thought to be an enlarged lymph node, and gastrointestinal stromal tumor was suspected. A forward-viewing echoendoscope was inserted transanally and advanced successfully to the cecum in 4 min. EUS-TA of the cecal mass was performed using a 19-gauge fine-needle biopsy needle, and EUS-TA of the adjacent lesion was performed using a 25-gauge fine-needle biopsy needle. Histopathological and immunohistochemical examinations showed endometrial glands and stroma with positivity for estrogen receptor, progesterone receptor, and CD10, leading to a definitive diagnosis of endometriosis. This diagnosis enabled initial non-surgical management without immediate surgery.

PMID:
42406283
Bibliographic data and abstract were imported from PubMed on 06 Jul 2026.

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