Rectal mucosal endometriosis primarily misinterpreted as adenocarcinoma: a case report and review of literature.

Hui Chen, Qiuping Luo, Xingqiang Lü, Shaoyan Liu, Hanzhen Xiong, Qingping Jiang
International journal of clinical and experimental pathology · 2015 · vol. 8(5) , pp. 5902–7 · PMID:26191316 · PMC4503187 · W948743858
article OA: green CC0 ⤵ 5 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This case report describes rectal mucosal endometriosis mimicking adenocarcinoma on colonoscopy and biopsy, ultimately diagnosed by immunohistochemistry.

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Abstract

Endometriosis involving intestinal mucosa is relatively uncommon. It poses a diagnostic challenge for clinicians and pathologists. We herein report a case of colonoscopic specimen revealing rectal mucosal endometriosis. A 39-year-old woman complained of red rectal bleeding and intermittent abdominal pain. Colonoscopic examination showed a rectal mass with ulceration and circum wall involvement. Biopsy was processed in the suspicious of carcinoma. Morphologically, irregular glands replaced residual colorectal ones, displayed mucin depletion, nuclear stratification and subtile subnuclear vacuoles. The stroma was full of spindle cells with abundant pink cytoplasm and unclear boundary. Due to subjectively interpreting as dysplastic glands in desmoplastic setting, primary rectal adenocarcinoma was firstly raised. Immunohistochemically, CK7, ER and CD10 identified the essence of ectopic endometrium. CK20 and CDX2 highlighted residual glands. In case of misdiagnosis, any pathologists should be aware of intestinal endometriosis for each female's colorectal biopsy, especially for that morphology not typical for primary adenocarcinoma or endometriosis. Reading slides carefully combined with a panel of immunomarkers would solve the pitfall.

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Condition tags

endometriosis

MeSH descriptors

Adenocarcinoma Endometriosis Intestinal Mucosa Rectal Diseases Rectal Neoplasms Rectum Adenocarcinoma Adenocarcinoma Adenocarcinoma Adult Biomarkers Biomarkers Biopsy Colonoscopy Diagnostic Errors Endometriosis Endometriosis Endometriosis Female Humans

Citation neighborhood

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