Mistaken identity: endometrial or rectal cancer?

A 59-year-old woman with a previous history of endometrial and breast cancer was referred to the colorectal rapid access clinic with abdominal cramps, per rectal bleeding and diarrhoea. CT, MRI and flexible sigmoidoscopy confirmed a rectal tumour and due to its appearance, it was thought to be a primary rectal malignancy. The patient underwent an anterior resection and end colostomy. Histology confirmed a metastatic endometrial adenocarcinoma, which is an unusual site for endometrial metastasis. Her postoperative recovery has been unremarkable and the patient has subsequently been discharged from the general surgical team.