A Case of Endometriosis of the Rectum with Lymph Node Metastasis.

The paper reports a case of a 50-year-old woman presenting with mucoid bloody stool and constipation, in whom imaging and endoscopy led to a diagnosis of rectal endometriosis. High-level evaluation included digital rectal exam, barium enema showing circumferential rectal stenosis with a reticulated surface and a proximal half-spherical lesion, colonoscopy showing a submucosal-like mass without mucosal abnormalities, and pelvic CT demonstrating bilateral ovarian cystic lesions and marked rectal wall thickening; she underwent low anterior resection. Histology confirmed ectopic endometrial tissue in rectal and bilateral ovarian lesions (chocolate cysts) and identified ectopic endometrial tissue in the rectal pararectal and mesenteric lymph nodes, which the authors note is extremely rare. This paper is centrally about endometriosis — it is a detailed case report of rectal endometriosis with lymph node metastasis.

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