A Cases of Endometrioid Carcinoma with Lymph Node Metastasis Arising from Endometriosis of the Rectum

Kimimasa Ikeda, Takashi Shimano, Masashi Kitada, Yasuo Tsukahara, Takashi Shibata, Yukio Fukushima, Shinsuke Hata, Kenzou Akagi, Junya Fujita, Masaki Okuyama
In: The Japanese Journal of Gastroenterological Surgery · 2002 · vol. 35(4) , pp. 445–449 · doi:10.5833/jjgs.35.445 · W2323181012
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This case report describes a 56-year-old woman with endometrioid adenocarcinoma arising from rectal endometriosis, characterized by lymph node and liver metastases and a fatal outcome.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

The paper reports a rare case of endometrioid adenocarcinoma arising from rectal endometriosis in a 56-year-old woman with melena. Using colonoscopy and barium enema plus pelvic CT and MRI, the authors identified a submucosal rectal tumor with central ulceration and cystic lymph node metastases in the mesorectum, and the patient underwent low anterior resection with additional resection of the uterus, bilateral adnexa, and ileum. Histopathology showed endometrial glands with surrounding stroma adjacent to adenocarcinoma with lymph node involvement, and multiple cystic liver metastases developed 5 months later before death 10 months after diagnosis. The authors note that lymph node metastasis is a prognostic factor in intestinal endometrioid carcinoma. This paper is centrally about endometriosis — specifically endometriosis of the rectum leading to endometrioid adenocarcinoma with lymph node metastasis.

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Abstract

We report a very rate case of endometrioid adenocarcinoma arising from endometriosis of the rectum. A 56-year-old woman referred for melena was found in colonoscopy and barium enema to have a submucosal tumor with central ulceration in the anterior wall of the middle third of the rectum. Pelvic CT and MRI indicated cystic lymph node metastases in the mesorectum. The tumor was located in the anterior wall of the rectum, fixed to the uterus and ileum. We conducted low anterior resection with additional resection of the uterus, bilateral adnexa and ileum. Histopathological study showed endometrial glands surrounded by stroma adjacent to adenocarcinoma that had metastasized to the lymph nodes, leading to a diagnosis of endometrioid adenocarcinoma arising from endometriosis of the rectum. Multiple cystic liver metastases were detected 5 months later and the patient died 10 months thereafter. Lymph node metastasis is thus a prognostic factor in intestinal endometrioid carcinoma.

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endometriosis

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