A CASE OF MALIGNANT MIXED EPITHELIAL TUMOR ARISING FROM ENDOMETRIOSIS OF THE RECTOVAGINAL SEPTUM

Masaru Sasaki, Nobukazu Miyoshi, Toshiaki Hirata, Hiroshi Maruyama, Hayao Nakai, Naomi Sasaki, Kiyomi Taniyama
In: The journal of the Japanese Practical Surgeon Society · 1996 · vol. 57(9) , pp. 2268–2272 · doi:10.3919/ringe1963.57.2268 · W2330382202
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This paper describes a rare case of a 49-year-old woman with malignant mixed epithelial tumor arising from rectovaginal septum endometriosis, diagnosed as squamous cell carcinoma with serous and clear cell components.

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This paper reports a clinical case of a 49-year-old woman admitted for anal bleeding, in whom colonoscopy identified a deeply ulcerated rectal tumor initially biopsied as squamous cell carcinoma. CT and MRI showed a mass in the rectovaginal septum with multiple liver metastases, and during surgery involving rectal resection and hysterectomy with bilateral salpingo-oophorectomy, panperitonitis carcinomatosa was recognized. Histology demonstrated a mixed epithelial malignancy composed of squamous cell carcinoma, serous adenocarcinoma, and clear cell carcinoma, with tumor cells continuous with endometriotic tissue infiltrating the rectovaginal septum; the authors diagnosed malignant transformation of endometriosis, noting its rarity and that the case was the third reported in Japan based on their review. This paper is centrally about endometriosis — it describes malignant transformation of endometriosis in the rectovaginal septum presenting as a mixed epithelial tumor with liver metastases.

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Abstract

A 49-year-old woman was admitted to the hospital because of anal bleeding. Colonoscopy revealed a tumor with deep ulceration in the rectum. Biopsy specimen taken from the ulcer was diagnosed as squamous cell carcinoma. Abdominal and pelvic CT and MRI revealed a mass occupying the rectovaginal septum with multiple liver metastases. During the operation including rectal resection and hysterectomy with bilateral salpingoophorectomy, panperitonitis carcinomatosa was recognized. Histologically, the tumor was composed of an admixture of squamous cell carcinoma, serous adenocarcinoma and clear cell carcinoma. These cancer cells were in continuity with endometriotic tissue infiltlating in the rectovaginal septum. A diagnosis of malignant transformation of endometriosis was made. She died of panperitonitis carcinomatosa and multiple liver metastasis 2 months after the operation. Malignant transformation of endometriosis is very rare, and this case was found to be the third case in Japan, as far as we could review.
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A CASE OF MALIGNANT MIXED EPITHELIAL TUMOR ARISING FROM ENDOMETRIOSIS OF THE RECTOVAGINAL SEPTUM 1996 Volume 57 Issue 9 Pages 2268-2272 Details Abstract A 49-year-old woman was admitted to the hospital because of anal bleeding. Colonoscopy revealed a tumor with deep ulceration in the rectum. Biopsy specimen taken from the ulcer was diagnosed as squamous cell carcinoma. Abdominal and pelvic CT and MRI revealed a mass occupying the rectovaginal septum with multiple liver metastases. During the operation including rectal resection and hysterectomy with bilateral salpingoophorectomy, panperitonitis carcinomatosa was recognized. Histologically, the tumor was composed of an admixture of squamous cell carcinoma, serous adenocarcinoma and clear cell carcinoma. These cancer cells were in continuity with endometriotic tissue infiltlating in the rectovaginal septum. A diagnosis of malignant transformation of endometriosis was made. She died of panperitonitis carcinomatosa and multiple liver metastasis 2 months after the operation. Malignant transformation of endometriosis is very rare, and this case was found to be the third case in Japan, as far as we could review. During the operation including rectal resection and hysterectomy with bilateral salpingoophorectomy, panperitonitis carcinomatosa was recognized. Histologically, the tumor was composed of an admixture of squamous cell carcinoma, serous adenocarcinoma and clear cell carcinoma. These cancer cells were in continuity with endometriotic tissue infiltlating in the rectovaginal septum. A diagnosis of malignant transformation of endometriosis was made. She died of panperitonitis carcinomatosa and multiple liver metastasis 2 months after the operation. Malignant transformation of endometriosis is very rare, and this case was found to be the third case in Japan, as far as we could review. © Japan Surgical Association Favorites & Alerts Recently viewed articles

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