Polypoidal rectal endometriosis-a diagnostic dilemma.
Nithye Parvathy1, Hemlata Jangir1, Cherring Tandup2
1Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Journal of Surgical Case Reports
|August 14, 2025
Summary
Polypoidal rectal endometriosis, a rare condition, can mimic colon cancer in women. Accurate diagnosis requires considering endometriosis in reproductive-age women with unexplained rectal bleeding.
Area of Science:
- Gastroenterology
- Gynecology
- Pathology
Background:
- Deep infiltrating endometriosis (DIE) is a complex gynecological condition.
- Rectal endometriosis can present atypically, mimicking colorectal malignancy.
- Diagnostic challenges arise, particularly in the absence of cyclical symptoms.
Observation:
- A 37-year-old female presented with a 2-year history of non-cyclical rectal bleeding, weight loss, and passage of polypoid tissue.
- Imaging studies suggested malignancy.
- Repeated endoscopic biopsies revealed only inflammatory or hyperplastic colonic epithelium.
Findings:
- Histopathological examination of the resected specimen confirmed polypoidal rectal endometriosis.
- Immunohistochemistry showed strong estrogen receptor positivity in glandular and stromal cells.
- This rare presentation highlights diagnostic difficulties.
Implications:
- Endometriosis should be considered in reproductive-age women with unexplained rectal symptoms.
- Multidisciplinary evaluation is crucial for accurate diagnosis.
- Timely diagnosis can prevent misdiagnosis and unnecessary interventions for suspected colorectal cancer.
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