{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:53:01Z","timestamp":1791359581576,"version":"4.3.1"},"reference-count":25,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gynecol Obstet Invest"],"abstract":"<jats:p>Objectives: Cecoappendiceal endometriosis is rare and frequently mimics colorectal neoplasia, making preoperative diagnosis challenging. We report the first documented case of a true cecal traction diverticulum caused directly by endometriosis-associated smooth muscle hypertrophy and subserosal fibrosis. Case Presentation: A 42-year-old nulliparous woman presented with an incidentally discovered malignant-appearing polypoid cecal mass on colonoscopy. Abdominal CT demonstrated a 1.5-cm enhancing lesion at the proximal appendix. Laparoscopic wedge resection of the cecum and appendix was performed. Histology revealed deep endometriosis (&gt;5 mm) with dramatic smooth muscle hypertrophy (muscularis propria 12 mm vs. normal \u223c0.37 mm; &gt;30-fold increase) in both the cecum and appendix. A true traction diverticulum \u2013 confirmed histologically to contain all three bowel wall layers \u2013 had formed as a direct mechanical consequence of progressive endometriosis-driven hypertrophy and fibrosis. Immunohistochemistry demonstrated estrogen-receptor-positive glands and CD10-positive stroma; beta-catenin negativity excluded mesenteric fibromatosis. Conclusion: This is the first documented case of endometriosis-induced cecal traction diverticulum, establishing a new mechanistic concept in intestinal endometriosis. Endometriosis-driven myoproliferation combined with subserosal fibrosis may generate sufficient mechanical traction to invert the cecal wall into a diverticular configuration. Endometriosis should be included in the differential diagnosis of cecal diverticular lesions in reproductive-aged women, and pelvic MRI should be considered for preoperative characterization before attributing such lesions to neoplasia or diverticulitis.<\/jats:p>","DOI":"10.1159\/goi\/aczag004","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T11:34:07Z","timestamp":1787052847000},"page":"1-1","source":"Crossref","is-referenced-by-count":0,"title":["Cecoappendiceal Endometriosis Presenting as a Cecal Traction Diverticulum: A Case Report"],"prefix":"10.1159","author":[{"given":"Chang Hyeok","family":"Ahn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heejeong","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min Jeong","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na Rae","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/15.4.767"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/3461209"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.35782"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1177\/23247096251363014"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2005.12.076"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.3238\/arztebl.m2022.0176"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.6108-20"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12286"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.13730"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1136\/gut.45.1.143"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.3121\/cmr.2018.1436"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.07.3087"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2010.03.858"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-015-0063-8"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1093\/jscr\/rjaa396"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1186\/1756-0500-1-19"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.19161\/etd.665508"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1299596"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1716687"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1111\/his.15253"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-018-0008-5"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-016-4673-z"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.3348\/jksr.2016.75.3.203"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.20471\/acc.2020.59.03.10"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-025-04907-x"}],"container-title":["Gynecologic and Obstetric Investigation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/goi\/aczag004","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:29:23Z","timestamp":1791358163000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/goi\/aczag004"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,31]]},"references-count":25,"URL":"https:\/\/doi.org\/10.1159\/goi\/aczag004","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.33196749","asserted-by":"subject"}]},"ISSN":["0378-7346","1423-002X"],"issn-type":[{"value":"0378-7346","type":"print"},{"value":"1423-002X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,31]]}}}