Endometrioid adenocarcinoma of the rectovaginal septum: A case report

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2023 Jun 28;48(6):941-946. doi: 10.11817/j.issn.1672-7347.2023.220614.
[Article in English, Chinese]

Abstract

Primary endometrioid adenocarcinoma of the rectovaginal septum is rare. Its pathogenesis is not clear and there is no standard treatment. One patient with endometrioid adenocarcinoma of the rectovaginal septum arising from deep infiltrative endometriosis was admitted to Qingdao Municipal Hospital. The patient presented with incessant menstruation and abdominal distension. She had bilateral ovarian endometriotic cystectomy 6 years ago. Imaging findings suggested a pelvic mass which might invade the rectovaginal septum. Pathological results of primary surgery confirmed endometrioid carcinoma of the pelvic mass arising from the rectovaginal septum. Then she had a comprehensive staged surgery. Postoperative chemotherapy was given 6 times. No recurrence or metastasis was found during the 2-year follow-up. The possibility of deep infiltrating endometriosis and its malignant transformation should be considered in the differential diagnosis of a new extragonadal pelvic lesion in a patient with a history of endometriosis, which would avoid misdiagnosis and missed diagnosis.

原发性阴道直肠隔子宫内膜样腺癌罕见,发病机制尚不明确,临床无标准治疗方案。青岛市市立医院收治1例起源于深部浸润型子宫内膜异位症的阴道直肠隔子宫内膜样腺癌患者,因“月经淋漓不尽伴腹胀1个月、发现盆腔包块3天”就诊,既往曾于6年前行腹腔镜下双侧卵巢子宫内膜异位囊肿剥除术。影像学检查提示盆腔肿块可能侵及阴道直肠隔。初次保守手术病理证实阴道直肠隔子宫内膜样腺癌。其后行全面分期手术,术后化学治疗6次,随访2年无疾病复发及转移。临床遇到有子宫内膜异位症病史的患者,影像学发现卵巢外的盆腔病变时,应考虑到深部浸润型子宫内膜异位症及发生恶变的可能性,避免漏诊和误诊。.

Keywords: deep infiltrating endometriosis; endometrioid adenocarcinoma; endometriosis; rectovaginal septum.

Publication types

  • Case Reports

MeSH terms

  • Carcinoma, Endometrioid* / diagnostic imaging
  • Carcinoma, Endometrioid* / drug therapy
  • Carcinoma, Endometrioid* / pathology
  • Carcinoma, Endometrioid* / surgery
  • Diagnosis, Differential
  • Endometriosis / pathology
  • Endometriosis / surgery
  • Female
  • Humans
  • Rectal Neoplasms* / diagnostic imaging
  • Rectal Neoplasms* / drug therapy
  • Rectal Neoplasms* / pathology
  • Rectal Neoplasms* / surgery
  • Vaginal Neoplasms* / diagnostic imaging
  • Vaginal Neoplasms* / drug therapy
  • Vaginal Neoplasms* / pathology
  • Vaginal Neoplasms* / surgery