We report the case of a 78-year-old man with a history of hypertension, congenital heart disease, prostate adenocarcinoma treated with radiotherapy.
Consultation for rectal bleeding.
She was admitted with ulcerated 28 mm of malignant appearance.
Echoendoscopically, the defect is located in the muscular layer with an area of loss of the cleavage plane and deflecation of perirectal fat suggestive of ineffective T3.
No lymph nodes or metastases were identified by CT.
Radiotherapeutic treatment was ruled out because it had been previously received in the prostate, and we opted for mesorectal resection and Hartmann intervention.
Pathology reported large cell neuroendocrine carcinoma with numerous implants in perirectal adipose tissue and metastases in two lymph nodes (pT4aN1b) with positivity for chromomegaly and proliferation of CD67 index 56, Ki67.
One month later, the patient evolved favorably.
