Malignant degeneration of rectal endometriosis

García-Marín JA, José Andrés García-Marín, Pellicer-Franco EM, Enrique Manuel Pellicer-Franco, Enrique Pellicer‐Franco, Victoriano Soria-Aledo, Víctor Soria‐Aledo, Mónica Mengual-Ballester, Mengual-Ballester M, Valero-Navarro G, Graciela Valero-Navarro, José Luís Aguayo-Albasini, José Luis Aguayo-Albasini, Aguayo-Albasini JL
Revista espanola de enfermedades digestivas · 2015 · vol. 107(12) , pp. 761–3 · doi:10.17235/reed.2015.3648/2014 · PMID:26671590 · W2462528561
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This case report describes a rectal lesion initially diagnosed as primary rectal malignancy that was ultimately identified as adenocarcinoma arising from endometrial tissue within the colonic wall.

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This 2015 case report describes a patient with a rectal lesion initially managed as a primary rectal malignancy, whose histopathology ultimately showed adenocarcinoma arising from endometrial tissue within the colonic wall. The authors discuss that while bowel endometriosis is uncommon, malignant transformation of endometriotic lesions is estimated at 0.3%–1%, and that diagnosis of intestinal endometriosis is confirmed by pathological study of specimens, with exploratory laparotomy cited as the gold standard. The report notes that although adjuvant radiotherapy and chemotherapy are used for some patients, they have not proven effective. This paper is centrally about endometriosis — specifically malignant degeneration of rectal endometriosis presenting as an adenocarcinoma.

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Abstract

BACKGROUND: Endometriosis is a relatively common disease among women with child-bearing potential, and rare before puberty or following menopause. It consists of the presence of hormone-responsive endometrium outside the endometrial cavity. CASE REPORT: We report the case of a patient with a rectal lesion, initially approached as a primary rectal malignancy, where histopathology eventually revealed an adenocarcinoma arising from endometrial tissue in the colonic wall. DISCUSSION: Endometriosis has an estimated rated of 10-20%. Sites may be split up into two larger categories - gonadal and extragonadal. The frequency of extragonadal endometriosis in the bowel is estimated to involve 3%-37% of women with pelvic endometriosis, and most lesions are found in the sigmoid colon and rectum. The malignant transformation of endometriotic lesions is estimated between 0.3% and 1% of cases. The gold standard in the diagnosis of intestinal endometriosis is exploratory laparotomy and the pathological study of specimens. Adjuvant radiotherapy and chemotherapy, although used for some patients, have not proven effective.
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Abstract

Background: Endometriosis is a relatively common disease among women with child-bearing potential, and rare before puberty or following menopause. It consists of the presence of hormone-responsive endometrium outside the endometrial cavity. Case report: We report the case of a patient with a rectal lesion, initially approached as a primary rectal malignancy, where histopathology eventually revealed an adenocarcinoma arising from endometrial tissue in the colonic wall.

Discussion

Endometriosis has an estimated rated of 10-20%. Sites may be split up into two larger categories - gonadal and extragonadal. The frequency of extragonadal endometriosis in the bowel is estimated to involve 3%-37% of women with pelvic endometriosis, and most lesions are found in the sigmoid colon and rectum. The malignant transformation of endometriotic lesions is estimated between 0.3% and 1% of cases. The gold standard in the diagnosis of intestinal endometriosis is exploratory laparotomy and the pathological study of specimens. Adjuvant radiotherapy and chemotherapy, although used for some patients, have not proven effective. New comment Comments No comments for this article Related articles Letter Successful endoscopic management of severe low rectal stenosis caused by chemical burns DOI: 10.17235/reed.2024.10868/2024 Letter DOI: 10.17235/reed.2024.10535/2024 Digestive Diseases Image A long rectal foreign body successfully removed after colonoscopy DOI: 10.17235/reed.2024.10251/2024 Digestive Diseases Image DOI: 10.17235/reed.2023.9893/2023 Digestive Diseases Image Gastric heterotopia in the rectum: a rare entity with potential pitfalls DOI: 10.17235/reed.2023.9693/2023 Letter DOI: 10.17235/reed.2022.9273/2022 Digestive Diseases Image Cyclic hematochezia in a young woman with appendiceal endometriosis DOI: 10.17235/reed.2022.9257/2022 Letter Hilar cholangiocarcinoma presenting with hematochezia due to metastases to the rectum DOI: 10.17235/reed.2022.9173/2022 Letter Resection of an anal fistula with endoscopic submucosal dissection DOI: 10.17235/reed.2022.9002/2022 Letter Ileal endometriosis in a patient with Crohn’s disease: a diagnostic challenge DOI: 10.17235/reed.2021.8187/2021 Letter Endometriosis-associated intestinal tumors: a new challenge in clinical practice DOI: 10.17235/reed.2021.8140/2021 Letter Appendicular invagination as a rare manifestation of endometriosis DOI: 10.17235/reed.2020.7002/2020 Letter Laparoscopic management of a small bowel obstruction caused by an endometriotic focus DOI: 10.17235/reed.2019.6220/2019 Letter DOI: 10.17235/reed.2018.5732/2018 Letter to the Editor Bowel obstruction secondary to deep infiltrating endometriosis of the ileum DOI: 10.17235/reed.2018.5364/2017 Letter to the Editor Ileocecal endometriosis as an infrequent cause of intussusception DOI: 10.17235/reed.2017.5183/2017 Letter to the Editor Utility of neoadjuvant therapy in rectal GIST DOI: 10.17235/reed.2017.4751/2016 Digestive Diseases Image Letter to the Editor DOI: 10.17235/reed.2016.4393/2016 Case Report Primary squamous cell carcinoma of the rectum: an atypical histology DOI: 10.17235/reed.2016.3975/2015 Digestive Diseases Image Actinomyces infection as a complication of a post-radiotherapy rectal ulcer Case Report Endoscopic resection of rectal granular-cell tumor using elastic band ligation DOI: 10.17235/reed.2016.3823/2015 Citation tools García Marín J, Pellicer Franco E, Soria Aledo V, Mengual Ballester M, Valero Navarro G, Aguayo Albasini J, et all. Malignant degeneration of rectal endometriosis. 3648/2014 Download the citation for this article by clicking on one of the following citation managers: Metrics Publication history Received: 15/12/2014 Accepted: 12/02/2015 Online First: 17/11/2015 Published: 03/12/2015 Article revision time: 51 days Article Online First time: 337 days Article editing time: 353 days Share This article hasn't been rated yet. Reader rating: Valora este artículo: Submit a manuscript Journal info Articles Submit a manuscript Journal info Articles Submit a manuscript The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva Cookie policy Privacy Policy Legal Notice © Copyright 2026 y Creative Commons. The Spanish Journal of Gastroenterology

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Condition tags

endometriosis

MeSH descriptors

Adenocarcinoma Cell Transformation, Neoplastic Colonic Diseases Endometriosis Precancerous Conditions Rectal Neoplasms Adenocarcinoma Colonic Diseases Endometriosis Female Humans Middle Aged Precancerous Conditions Rectal Neoplasms

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