Rectal prolapse following short-course radiotherapy for rectal cancer: report of a case

Palliative short-course radiotherapy may be considered as an alternative to abdominoperineal resection in elderly patients with advanced rectal cancer. A 92-year-old woman was diagnosed with a rectal prolapse after short-course radiotherapy; 2 months before she was diagnosed with advanced lower rectal cancer. A curative approach was declined. Therefore, a palliative short-course radiotherapy followed. Two weeks after termination of radiotherapy, a symptomatic rectal prolapse has been observed. Endoscopy confirmed a tumor completely included in the prolapsing rectum. A rectal prolapse resection by Altemeier's technique was performed. Histological examination downgraded the tumor staging to ypT1 M0. This case discusses whether the prolapse was preexisting and led to overstaging the tumor or whether the prolapse is a new-onset complication of the radiotherapy. It seems of paramount importance to detect preexisting rectal prolapse to avoid overstaging. If presumed rectal prolapse was not present before therapy, rectal prolapse may represent a new-onset adverse event of short-course radiotherapy.