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Abstract
Introduction/Background A 38-year-old woman without any specific underlying disease histories, was initially admitted to the hospital with rectorrhagia, tenesmus and pain in the sacral region.
Methodology During a general examination, including rectal examination, an 11cm mass was identified in the anal margin. A colonoscopy showed a polypoid lesion occupying more than 50% the rectal lumen, which was biopsied; on the other hand, an emergency computed tomography (CT) scan showed a mass measuring 53x43x32mm located in the Douglas pouch infiltrating the rectal wall, the cervix and posterior fornix of the vagina. Based on the anatomopathological results of the biopsy, the lesion was classified as Grade 2 endometrioid adenocarcinoma. Given this result, it was decided to perform a gynaecological examination with speculum inspection, touch and transvaginal ultrasound, which was strictly normal; despite this, it was decided to take an endometrial biopsy, cytology and tumour, gynaecological and rectal cancer markers, which were negative.
Results After the extension study with an MRI that concluded that there was no involvement of the pelvic wall and a thoracic CT scan, it was decided in collaboration with the multidisciplinary team constitutes the Gynaecological Tumour Committee to perform a posterior pelvic exenteration and pelvic lymphadenectomy via laparoscopy to ensure the presence of free margins. After surgery, which was performed without incident and without postoperative complications, the anatomopathological study confirmed the initial diagnosis of endometroid adenocarcinoma of rectal location, with superficial invasion of the cervix without involvement of the endometrial cavity and negative lymph nodes. The patient did not require adjuvant treatment and is currently asymptomatic with correct control of the neoplastic process.
Conclusion Rectal cancer, exceptionally, can present diverse histologies, including histologies of gynaecological origin. It is important to be aware of this fact in order to be able to act in a multidisciplinary manner and apply the correct treatment.
Disclosures No conflict of interest.
