Endometriosis-associated recto-sigmoid cancer: a case report

Ningning Li, Weixun Zhou, Lin Zhao, Jiaolin Zhou
BMC cancer · 2018 · vol. 18(1) , pp. 905 · doi:10.1186/s12885-018-4797-4 · PMID:30236076 · W2890636150
article OA: gold CC0 ⤵ 13 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This case report describes a 55-year-old woman diagnosed with and treated for recto-sigmoid cancer arising from intestinal endometriosis, who later experienced recurrence after initial surgery and chemotherapy.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 ⓘ

This paper reports a single 55-year-old woman with a history of ovarian endometriosis who presented with rectal bleeding and intermittent abdominal pain; colonoscopy, CT, and FDG-PET/CT identified a recto-sigmoid neoplasm that initially appeared consistent with primary intestinal cancer. She underwent rectal anterior resection with lymphadenectomy plus hysterectomy and bilateral salpingo-oophorectomy, and histology/immunohistochemistry confirmed endometrial carcinoma arising from colorectal endometriosis, with high-grade serous carcinoma features, positive lymph nodes, and a positive circumferential resection margin. Adjuvant chemotherapy with taxol and carboplatin was given for eight cycles, with reversible myelosuppression and gastrointestinal reactions; at 22 months, local recurrence in the lower rectum was documented and further chemotherapy and surgery were planned. As a case report, the main limitation is its inability to establish standardized treatment or generalizable outcomes. This paper is centrally about endometriosis — specifically endometriosis-associated recto-sigmoid cancer confirmed by pathology and immunohistochemistry after surgical treatment and recurrence.

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Abstract

BACKGROUND: Endometriosis is a relatively common condition in women of reproductive age. Malignant transformation of intestinal endometriosis is a very rare event. We report a case in which a patient with a history of endometriosis underwent surgery for malignant intestinal endometriosis. CASE PRESENTATION: A 55-year-old woman complained of rectorrhagia and intermittent abdominal pain. A neoplasm was revealed by colonoscopy, CT scan and F18-FDG PET/CT of the recto-sigmoidal colon. The patient underwent a rectal anterior resection, hysterectomy and bilateral salpingo-oophorectomy for treatment. According to the histological and immunohistochemical presentation, the diagnosis of endometriosis-associated recto-sigmoid cancer was confirmed. The patient was treated with adjuvant chemotherapy for 6 months. During the follow-up appointment 22 months later, there was clinical and radiographic evidence of recurrence in the rectum. The patient received chemotherapy again and will receive another surgery after two more cycles of chemotherapy. CONCLUSION: We report a case of malignant intestinal endometriosis. Although there is no standard therapy for malignant intestinal endometriosis due to the rarity of this disease, surgery and adjuvant chemotherapy seemed to be rational. This case indicates that local recurrence may be a common situation after standard therapy.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Endometriosis Sigmoid Neoplasms Sigmoid Neoplasms Biomarkers, Tumor Biopsy Chemotherapy, Adjuvant Endometriosis Endometriosis Endometriosis Female Fluorodeoxyglucose F18 Humans Middle Aged Positron Emission Tomography Computed Tomography Sigmoid Neoplasms Sigmoid Neoplasms Tomography, X-Ray Computed Treatment Outcome

Citation neighborhood

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