A Case of Endometrioid Adenocarcinoma arising from Rectal Endometriosis Seventeen Years after an Operation for Endometriosis

Tatsuya Manabe, Keiichi Uto, Yuji Ueda, Kiyokazu Toyota
In: The Japanese Journal of Gastroenterological Surgery · 2010 · vol. 43(2) , pp. 196–201 · doi:10.5833/jjgs.43.196 · W2329223486
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

A 54-year-old woman with a history of endometriosis surgery and hormone replacement therapy developed a rectal adenocarcinoma diagnosed as endometriosis-associated intestinal tumor.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 · read from full text ⓘ

This paper reports a 54-year-old woman who developed endometrioid adenocarcinoma arising from rectal endometriosis 17 years after hysterectomy and left adnexal removal for endometriosis and subsequent long-term hormone replacement therapy. She presented with postprandial lower abdominal pain, and lower gastrointestinal endoscopy found a submucosal-appearing lesion in the rectal anterior wall; PET showed abnormal uptake limited to that site, and biopsy suggested well-differentiated adenocarcinoma that, based on cytokeratin 7 positivity and cytokeratin 20 negativity, was diagnosed as an endometriosis-associated intestinal tumor (EAIT). She underwent low anterior resection, and because lymph node metastasis was present she received adjuvant chemotherapy with paclitaxel and carboplatin patterned on endometrial cancer regimens. The paper is a single case report, so its conclusions are limited in generalizability. This paper is centrally about endometriosis — it documents endometrioid adenocarcinoma arising from rectal endometriosis long after prior surgical treatment and hormone replacement therapy.

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Abstract

症例は54歳の女性で，37歳時に子宮内膜症に対して子宮摘出術・左付属器摘出術，その後16年間ホルモン補充療法を受けていた．食後の下腹部痛を主訴に当院を受診．下部消化管内視鏡検査にて直腸Ra前壁に粘膜下腫瘍を認めたため，当科紹介となった．Positron emission tomographyでは同部位にのみ異常集積を認めた．生検結果は高分化型腺癌であったが，cytokeratin 7に陽性・cytokeratin 20に陰性のためendometriosis-associated intestinal tumor（以下，EAIT）と診断し，低位前方切除術を施行した．リンパ節転移を認めたため，術後補助療法として子宮内膜癌に準じパクリタキセルとカルボプラチンによる化学療法を施行した．子宮内膜症治療歴とエストロゲン補充療法の既往のある女性の消化器腫瘍では，EAITも鑑別診断に考慮すべきと思われた．
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症例報告 子宮内膜症術後17年目に発症した直腸子宮内膜症由来の類内膜腺癌の1例 2010 年 43 巻 2 号 p. 196-201 詳細 抄録 症例は54歳の女性で，37歳時に子宮内膜症に対して子宮摘出術・左付属器摘出術，その後16年間ホルモン補充療法を受けていた．食後の下腹部痛を主訴に当院を受診．下部消化管内視鏡検査にて直腸Ra前壁に粘膜下腫瘍を認めたため，当科紹介となった．Positron emission tomographyでは同部位にのみ異常集積を認めた．生検結果は高分化型腺癌であったが，cytokeratin 7に陽性・cytokeratin 20に陰性のためendometriosis-associated intestinal tumor（以下，EAIT）と診断し，低位前方切除術を施行した．リンパ節転移を認めたため，術後補助療法として子宮内膜癌に準じパクリタキセルとカルボプラチンによる化学療法を施行した．子宮内膜症治療歴とエストロゲン補充療法の既往のある女性の消化器腫瘍では，EAITも鑑別診断に考慮すべきと思われた． この記事はクリエイティブ・コモンズ [表示 - 非営利 4.0 国際]ライセンスの下に提供されています。 https://creativecommons.org/licenses/by-nc/4.0/deed.ja

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endometriosis

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