A case of a large rectovaginal mass presenting as posterior vaginal wall prolapse

Nuan Cui, Μαρία Ζορμπά, George Lazarou
In: International Urogynecology Journal · 2011 · vol. 22(9) , pp. 1185–1188 · doi:10.1007/s00192-011-1385-4 · PMID:21416285 · W2074798236
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-12 ⓘ

A 66-year-old female with a large rectovaginal mass was treated with hysterectomy, colon resection, and pelvic mass resection, resolving her posterior vaginal wall prolapse.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-12 · read from full text ⓘ

This case report describes a 66-year-old woman with symptoms of posterior pelvic organ prolapse and rectal pressure, whose pelvic examination found a large pelvic mass in the posterior cul-de-sac occupying the rectovaginal septum and compressing the rectum. CT imaging confirmed a 9.4 × 9.8 × 6.2 cm mass separate from the uterus, and colonoscopy/biopsy identified adenocarcinoma of the colon. The patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy along with colon resection and abdominal resection of the pelvic mass in the rectovaginal septum/inferior to the uterus, and posterior vaginal wall prolapse resolved after mass resection; the paper’s main limitation is that it is a single case report with no generalizable cohort evidence. Relevance to endometriosis: the discussion cites prior reports of primary adenocarcinoma arising from endometriosis of the rectovaginal septum, though the main focus of this paper is the described rectovaginal mass presenting as posterior vaginal wall prolapse.

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Abstract

A 66-year-old female presented with symptoms suggestive of pelvic organ prolapse, history of fibroid uterus, and rectal pressure. Pelvic examination revealed a large pelvic mass filling the posterior cul-de-sac, occupying the rectovaginal septum, and compressing the rectum. There was a stage II pelvic organ prolapse of the posterior vaginal wall with distal vaginal wall extending to the hymen during valsalva. A CT scan confirmed the large pelvic mass distinct from the uterus measuring 9.4 × 9.8 × 6.2 cm. Colorectal workup revealed adenocarcinoma of colon on screening colonoscopy with biopsies. Patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy, colon resection, and abdominal resection of the pelvic mass in the rectovaginal septum and inferior to the uterus. The patient did not require any concomitant pelvic reconstruction and the posterior vaginal wall prolapse resolved after resecting the pelvic mass.
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Abstract

A 66-year-old female presented with symptoms suggestive of pelvic organ prolapse, history of fibroid uterus, and rectal pressure. Pelvic examination revealed a large pelvic mass filling the posterior cul-de-sac, occupying the rectovaginal septum, and compressing the rectum. There was a stage II pelvic organ prolapse of the posterior vaginal wall with distal vaginal wall extending to the hymen during valsalva. A CT scan confirmed the large pelvic mass distinct from the uterus measuring 9.4 × 9.8 × 6.2 cm. Colorectal workup revealed adenocarcinoma of colon on screening colonoscopy with biopsies. Patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy, colon resection, and abdominal resection of the pelvic mass in the rectovaginal septum and inferior to the uterus. The patient did not require any concomitant pelvic reconstruction and the posterior vaginal wall prolapse resolved after resecting the pelvic mass.

References

Milano CT, Deppo G, Moshipr JA (1980) Vaginal fibroma presenting as a large rectovaginal septal mass. Am J Proctol Gastroeneterol Colon Rectal Surg 31:21–22 Bennet HG, Ehrligh MM (1941) Myoma of the vagina. Am J Obstet Gynecol 42:314–320 Ruggieri AM, Brody JM, Curhan RP (1996) Vaginal leiomyoma. A case report with imaging findings. J Reprod Med 41:875–877 Yazbeck C, Poncelet C, Chosidow D, Madelenat P (2005) Primary adenocarcinoma arising from endometriosis of the rectovaginal septum: a case report. Int J Gynecol Cancer 15(6):1203–1205 Berger A, Rouzier R, Carnot F, Braunberger E, Cugnenc PH, Danel C (2001) Primary adenocarcinoma of the rectovaginal septum: a case report and literature review. Eur J Obstet Gynecol Reprod Biol 95:111–113 Conflicts of interest None. Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Cui, N., Zormpa, M. & Lazarou, G. A case of a large rectovaginal mass presenting as posterior vaginal wall prolapse. Int Urogynecol J 22, 1185–1188 (2011). https://doi.org/10.1007/s00192-011-1385-4 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00192-011-1385-4

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