A CASE OF MALIGNANT MIXED EPITHELIAL TUMOR ARISING FROM ENDOMETRIOSIS OF THE RECTOVAGINAL SEPTUM

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  • 直腸腟中隔原発子宮内膜症癌化の1例

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Abstract

A 49-year-old woman was admitted to the hospital because of anal bleeding. Colonoscopy revealed a tumor with deep ulceration in the rectum. Biopsy specimen taken from the ulcer was diagnosed as squamous cell carcinoma. Abdominal and pelvic CT and MRI revealed a mass occupying the rectovaginal septum with multiple liver metastases.<br> During the operation including rectal resection and hysterectomy with bilateral salpingoophorectomy, panperitonitis carcinomatosa was recognized. Histologically, the tumor was composed of an admixture of squamous cell carcinoma, serous adenocarcinoma and clear cell carcinoma. These cancer cells were in continuity with endometriotic tissue infiltlating in the rectovaginal septum. A diagnosis of malignant transformation of endometriosis was made. She died of panperitonitis carcinomatosa and multiple liver metastasis 2 months after the operation. Malignant transformation of endometriosis is very rare, and this case was found to be the third case in Japan, as far as we could review.

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