[A very rare submucosal tumour of the rectum - primary endometrioid adenocarcinoma of the rectum wall]

Y Vogel, Vogel Y, C Ginsbach, Ginsbach C, M Ende, Ende M, Schwering H, H Schwering, Golz N, N Golz, Rieker O, O Rieker, R Hildenbrand, Hildenbrand R
Zeitschrift fur Gastroenterologie · 2013 · doi:10.1055/s-0032-1325329 · PMID:23315649
case-report OA: closed public-domain-us
Full text JSON View on PubMed View at publisher
⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-08-07 ⓘ

This paper reports a rare case of primary endometrioid adenocarcinoma arising in endometriosis within the rectal wall, presenting as a submucosal tumor in a patient previously hysterectomized for uterine fibroids.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by qwen3.7-flash, 2026-08-18 · read from full text ⓘ

This case report describes a 56-year-old woman with a history of hysterectomy who presented with rectal pain and was found to have a submucosal tumor infiltrating the bowel wall. Initial biopsies were non-diagnostic, but subsequent resection and immunohistochemical analysis identified the mass as an endometrioid adenocarcinoma that originated from endometriosis within the rectal wall rather than metastasizing from the ovaries. The authors note that this represents a very rare instance of primary endometrioid adenocarcinoma arising directly from rectal endometriotic implants. Relevance to endometriosis: This paper is centrally about endometriosis, specifically detailing the malignant transformation of deep infiltrating endometriosis in the rectum into adenocarcinoma.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

A 56-year-old female, with a past history of hysterectomy 13 years previously due to uterine myomata, presented with complaints of pain around the anus of a few months duration. Three years previously she underwent a colonoscopy, which was found to be unremarkable. A high suspicion of a submucosal tumour of the rectum in endoscopic examinations was confirmed by endoscopic ultrasound. The biopsy could not specify the tumour characteristics. Based on the diagnosis of a 4 cm submucosal tumour with infiltration of bowel wall and regional lymph nodes the affected segment was resected. Histolopathology revealed an adenocarcinoma involving tissue from the outer bowel wall to the submucosa. However, immunohistochemistry revealed an endometrioid adenocarcinoma, suspicious for primary endometrioid adenocarcinoma of the ovary with rectum metastasis in the absence of a uterus. But this assumption could not be confirmed in the excised ovary. The tumour cells were immunopositive for cytokeratin 7, CA 12 - 5, vimentin and oestrogen receptor, but negative for cytokeratin 20 and CDX-2. Ultimately, we report a very rare case of primary endometrioid adenocarcinoma arising in endometriosis in the rectum wall and presenting as a submucosal tumour.
Full text 5,749 characters · extracted from oa-doi-fallback · click to expand
Subscribe to RSS DOI: 10.1055/s-0032-1325329 Ein sehr seltener submuköser Tumor des Rektums – primäres endometrioides Adenokarzinom der Rektumwand A Very Rare Submucosal Tumour of the Rectum − Primary Endometrioid Adenocarcinoma of the Rectum WallAuthors Publication History 26 April 2012 18 August 2012 Publication Date: 11 January 2013 (online) Zusammenfassung Eine 56-jährige Patientin stellte sich aufgrund von seit Monaten bestehenden Schmerzen im Afterbereich vor. In der Vorgeschichte war ein Z. n. Hysterektomie bei Uterus myomatosus vor 13 Jahren bekannt. Vor 3 Jahren wurde eine Koloskopie mit unauffälligem Befund durchgeführt. Die aktuellen endoskopischen Untersuchungen ergaben den Verdacht auf einen submukösen Rektumtumor, welcher endosonografisch bestätigt wurde. Die präoperativen Biopsien erbrachten keinen richtungweisenden Befund. Bei einem 4 cm großen submukösen Tumor mit Infiltration der übrigen Wandschichten des Rektums und der regionären Lymphknoten wurde eine Rektumteilresektion durchgeführt. Im Resektat konnten Adenokarzinominfiltrate nachgewiesen werden, die von außen die gesamte Rektumwand infiltrierten und bis in die Submukosa reichten. Konventionell-histomorphologisch und immunhistochemisch (positive Expression von Zytokeratin 7, CA 12 – 5, Vimentin und Östrogenrezeptor, negativ für Zytokeratin 20 und CDX-2) handelte es sich um ein endometrioides Adenokarzinom. Bei Z. n. Hysterektomie ergab sich der Verdacht auf ein primäres endometrioides Adenokarzinom der Ovarien mit Metastasierung ins Rektum. In den nachresezierten Ovarien konnte dies jedoch ausgeschlossen werden. Letztlich handelte es sich um ein sehr seltenes primäres endometrioides Adenokarzinom des Rektums, welches aus Endometrioseherden der Rektumwand entstanden war und sich als submuköser Tumor präsentiert hat. Abstract A 56-year-old female, with a past history of hysterectomy 13 years previously due to uterine myomata, presented with complaints of pain around the anus of a few months duration. Three years previously she underwent a colonoscopy, which was found to be unremarkable. A high suspicion of a submucosal tumour of the rectum in endoscopic examinations was confirmed by endoscopic ultrasound. The biopsy could not specify the tumour characteristics. Based on the diagnosis of a 4 cm submucosal tumour with infiltration of bowel wall and regional lymph nodes the affected segment was resected. Histolopathology revealed an adenocarcinoma involving tissue from the outer bowel wall to the submucosa. However, immunohistochemistry revealed an endometrioid adenocarcinoma, suspicious for primary endometrioid adenocarcinoma of the ovary with rectum metastasis in the absence of a uterus. But this assumption could not be confirmed in the excised ovary. The tumour cells were immunopositive for cytokeratin 7, CA 12 – 5, vimentin and oestrogen receptor, but negative for cytokeratin 20 and CDX-2. Ultimately, we report a very rare case of primary endometrioid adenocarcinoma arising in endometriosis in the rectum wall and presenting as a submucosal tumour. - Literatur - 1 Heaps JM, Nieberg RK, Berek JS. Malignant neoplasms arising in endometriosis. Obstet Gynecol 1990; 75 (06) 1023-1028 - 2 Levitt MD, Hodby KJ, van Merwyk AJ et al. Cyclical rectal bleeding in colorectal endometriosis. Aust N Z J Surg 1989; 59 (12) 941-943 - 3 Dogan S, Agic A, Eilers W et al. Endometriose und Malignomrisiko. In: Geburtshilfe und Frauenheilkunde. Vol. 66, No. 08. Stuttgart: Thieme; 2006: 739-744 - 4 Yantiss RK, Clement PB, Young RH. Neoplastic and pre-neoplastic changes in gastrointestinal endometriosis: a study of 17 cases. Am J Surg Pathol 2000; 24 (04) 513-524 - 5 Slavin RE, Krum R, Van Dinh T. Endometriosis-associated intestinal tumors: a clinical and pathological study of 6 cases with a review of the literature. Hum Pathol 2000; 31 (04) 456-463 - 6 Messmann H. Lehratlas der Koloskopie. Georg Thieme; 2004: 259 - 7 Rösch T, Classen M. Endosonographie in der Gastroenterologie. www.dgvs.de/media/5.5.Endosono.pdf.273 - 8 Ekpo G, Senapati S, Advincula AP. Laparoscopic excision of endometriosis of the obturator nerve: a case report. J Minim Invasive Gynecol 2007; 14 (06) 764-766 - 9 Jones KD, Owen E, Berresford A et al. Endometrial adenocarcinoma arising from endometriosis of the rectosigmoid colon. Gynecol Oncol 2002; 86 (02) 220-222 - 10 Duun S, Roed-Petersen K, Michelsen JW. Endometrioid carcinoma arising from endometriosis of the sigmoid colon during estrogenic treatment. Acta Obstet Gynecol Scand 1993; 72: 676-678 - 11 Sampson JA. Endometrial Carcinoma of ovary, arising in endometrial tissue in that organ. Arch Surg 1925; 10: 1-72 - 12 Bassi MA, Podgaec S, Dias Júnior JA et al. Bowel endometriosis: a benign disease?. Rev Assoc Med Bras 2009; 55 (05) 611-616 - 13 Irvin W, Pelkey T, Rice L et al. Endometrial stromal sarcoma of the vulva arising in extraovarian endometriosis: a case report and literature review. Gynecol Oncol 1998; 71: 313-316 - 14 Koninckx PR, Braet P, Kennedy SH et al. Dioxin pollution and endometriosis in Belgium. Hum Reprod 1994; 9 (06) 1001-1002 - 15 Croom 3rd RD, Donovan ML, Schwesinger WH. Intestinal endometriosis. Am J Surg 1984; 148 (05) 660-667 - 16 Bergqvist A. Different types of extragenital endometriosis: a review. Gynecol Endocrinol 1993; 7 (03) 207-221 - 17 Jubanyik KJ, Comite F. Extrapelvic endometriosis. Obstet Gynecol Clin North Am 1997; 24 (02) 411-440 - 18 Denschlag D, Ulrich U, Emons G. Diagnostik und Therapie des Endometriumkarzinoms: Fortschritt und Kontroversen. Dtsch Arztebl Int 2011; 108 (34) 571-577 - 19 Kobayashi S, Sasaki M, Goto T et al. Endometrioid adenocarcinoma arising from endometriosis of the rectosigmoid. Dig Endosc 2010; 22 (01) 59-63 . Review

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

⚙ Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback ⓘ

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

endometriosis

MeSH descriptors

Adenocarcinoma Endometrial Neoplasms Intestinal Mucosa Neoplasms, Multiple Primary Rectal Neoplasms Adenocarcinoma Endometrial Neoplasms Female Humans Intestinal Mucosa Middle Aged Neoplasms, Multiple Primary Rare Diseases Rare Diseases Rectal Neoplasms

Citation neighborhood (no data yet)

We don't have any in-corpus citations linked to this paper yet. The paper's references may be in our DB but unresolved to ``paper_id`` (resolution happens at ingest when the cited DOI matches a row we already have). Run the cross-source citation reconcile pass to retry.

Source provenance

europepmc
last seen: 2026-08-25T06:10:03.373225+00:00
pubmed
last seen: 2026-05-13T22:19:12.052662+00:00
unpaywall
last seen: 2026-05-14T19:30:52.867331+00:00
License: public-domain-us · commercial use OK · attribution required
Courtesy of the U.S. National Library of Medicine