A Cases of Endometrioid Carcinoma with Lymph Node Metastasis Arising from Endometriosis of the Rectum

Kimimasa Ikeda, Takashi Shimano, Masashi Kitada, Yasuo Tsukahara, Takashi Shibata, Yukio Fukushima, Shinsuke Hata, Kenzou Akagi, Junya Fujita and Masaki Okuyama

Department of Surgery, Toyonaka Municipal Hospital

We report a very rate case of endometrioid adenocarcinoma arising from endometriosis of the rectum. A 56-year-old woman referred for melena was found in colonoscopy and barium enema to have a submucosal tumor with central ulceration in the anterior wall of the middle third of the rectum. Pelvic CT and MRI indicated cystic lymph node metastases in the mesorectum. The tumor was located in the anterior wall of the rectum, fixed to the uterus and ileum. We conducted low anterior resection with additional resection of the uterus, bilateral adnexa and ileum. Histopathological study showed endometrial glands surrounded by stroma adjacent to adenocarcinoma that had metastasized to the lymph nodes, leading to a diagnosis of endometrioid adenocarcinoma arising from endometriosis of the rectum. Multiple cystic liver metastases were detected 5 months later and the patient died 10 months thereafter. Lymph node metastasis is thus a prognostic factor in intestinal endometrioid carcinoma.

Key words
endometrioid carcinoma, endometriosis, rectum

Reprint requests
Kimimasa Ikeda Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, 560-0055 JAPAN

Accepted
December 12, 2001

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