A Case of Rectal Endometriosis as Differential Diagnosis for Direct Invasion of Advanced Rectal Cancer

Hiroki Hamamoto, Junji Okuda, Keitaro Tanaka, Masashi Yamamoto, M Ozeki, Hiroshi Akutagawa, Yutaro Egashira, Kazuhisa Uchiyama
In: Nihon Gekakei Rengo Gakkaishi (Journal of Japanese College of Surgeons) · 2014 · vol. 39(6) , pp. 1155–1160 · doi:10.4030/jjcs.39.1155 · W2695961641
article OA: bronze CC0
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This report describes a case where rectal endometriosis caused extensive adhesions mistaken for direct invasion of advanced rectal cancer, but intraoperative frozen section confirmed endometriosis, allowing for organ preservation.

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Abstract

症例は58歳，女性，血便を自覚し，近医を受診．下部消化管内視鏡検査にて直腸に２型の進行癌認め，手術目的に当院紹介．直腸癌RS，２，SS，N1，H0，P0の術前診断で腹腔鏡下に手術を開始．腹腔内を観察すると，直腸前壁側と子宮が広範囲に癒着しており直接浸潤が考えられた．腹腔鏡下に中枢側郭清と直腸背側の剝離授動を行った後に，術中内視鏡にて確認すると，子宮癒着部は腫瘍の主座よりやや肛門側に位置していた．炎症性の癒着の可能性を考え，開腹移行し子宮と直腸を丁寧に剝離した．剝離した子宮壁の一部を術中迅速組織診へ提出したところ，悪性所見は認めず，子宮内膜症と診断された．以上より腸管子宮内膜症による炎症性の癒着と診断し，子宮を温存しつつ適切な手術が可能であった．子宮への直接浸潤が疑われたが，術中迅速組織診断と術中内視鏡にて子宮を温存しえた直腸子宮内膜症の１例を経験したので文献的考察を含めて報告する.

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Condition tags

endometriosis

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References (12)

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last seen: 2026-06-04T00:00:01.174412+00:00
License: CC0 · commercial use OK