A 39-year-old woman with no relevant history of abdominal pain in the left iliac fossa, weight loss and rectal bleeding for six months.
Rectal touch shows a mass effect at 6 cm from the anal margin.
It has elevated CA 125 (522.2 U/ml) with CEA and CA 19.9 normal.
Performing an echoendoscopy due to stenosis is a friable mucosa that suggests compression and prevents it from performing an anal margin of 7 cm.
Biopsies were negative for malignancy.
Abdominal CT showed a large, partially necrotic rectal tumor, perirectal adenopathies and uncertain uterus.
Finally, transvaginal ultrasound showed a solid vascularized mass of 65x56x68 mm of probable digestive origin.
In the absence of histological diagnosis, exploratory surgery was decided.
After opening the peritoneal reflection, a tumor in the middle-low rectum was observed, performing an anterior resection of the rectum.
Pathological anatomy of poorly differentiated adenocarcinoma positive for endometrioid type estrogen reports foci of endometriosis located in the muscular layer of the rectum and negative intestinal wall with lymph node metastases and immunohistochemical pattern cytokeratin 7.
After the results the surgery was completed with hysterectomy and double adnexectomy confirming an endometroid carcinoma arising from contiguity of the rectum the uterine wall without foci of endometriosis in the uterus.
Postoperatively, the patient progresses favorably and is treated at discharge with adjuvant chemo-chemotherapy, free of disease at one year.
