Abstract

A case of endometriosis of rectum associated with familial polyposis coli which presented difficulty in differentiation from colonic malignant tumor is reported. A 21-year-old woman was seen at the hospitl because of lower abdominal pain and anal bleeding, and was admitted for close examination. Preoperative examinations revealed multiple rought nodular polyps and a submucosal tumor like elevation in the sigmoid colon where narrowed. In addition, a solid tumor occupying the small pelvic cavity, a left ovarian cyst, and left hydronephrosis were confirmed. No malignancy was revealed on a biopsy of the rectum. From these findings, an operation was performed with a suspicion of rectal tumor or endometriosis. Intraoperative frozen section diagnoses of the polyps and submucosal tumor indicated no malignancy. A low anterior resection of the rectum, left oophorectomy and stent indwelling for the left ureter were performed. Histopathologically the definite diagnosis of emdometriosis of rectum was made. This case presented a very rare finding that infiltration of intimal tissue extended into the proper muscle layer of rectal polyps.

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