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Gastrointestinal endometrioid adenocarcinoma presents as rare metastatic-like lesions in the rectosigmoid and sigmoid colonRare Colon Cancer Case Shows Gynecological Origin

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Key Takeaway
Recognize that gastrointestinal endometrioid adenocarcinoma can present as multiple colonic lesions and requires careful pathology.

This case report and literature review details a rare presentation of endometrioid adenocarcinoma involving two separate tumor lesions in the rectosigmoid and sigmoid colon of a nulliparous woman. The publication focuses on the diagnostic challenges and management of gastrointestinal endometrioid adenocarcinoma, which can mimic primary gastrointestinal malignancies.

Pathological and immunohistochemical analyses confirmed that both colonic lesions were homogeneous adenocarcinomas of gynecological origin. Postoperative histopathological examination of the uterus and appendages showed no evidence of malignancy in those organs. The patient underwent laparoscopic radical resection, platinum- and paclitaxel-based chemotherapy, and a total hysterectomy with bilateral salpingo-oophorectomy.

The authors note that the optimal treatment strategy for these rare cases remains to be established. Due to the single case report nature of the evidence, results should be interpreted with caution. The primary clinical value lies in highlighting the necessity of careful pathological assessment when gastrointestinal lesions are suspected to have a gynecological origin.

How this fits prior evidence

This report addresses a gap in the literature regarding the diagnosis and management of rare gastrointestinal endometrioid adenocarcinoma. While previous coverage has discussed paclitaxel's role in achieving higher pathologic complete response rates compared to endocrine therapy, this case specifically highlights the diagnostic challenges of tumors of gynecological origin presenting in the colon.

A case report describes a woman with two separate tumor lesions in her colon that were found to be endometrioid adenocarcinoma of gynecological origin. The woman, who had never given birth, underwent laparoscopic surgery to remove the colon lesions and nearby lymph nodes, followed by chemotherapy with platinum and paclitaxel. Later, she had a hysterectomy and removal of her ovaries and fallopian tubes. After this treatment, examination of her uterus and appendages showed no signs of cancer.

This case is important because it shows that cancer can spread to the colon from the female reproductive organs, even when the primary tumor is not obvious. The tumors in the colon looked like typical colon cancer, but detailed analysis revealed they were actually from the gynecological tract. This highlights the need for careful evaluation when unusual tumors are found.

The patient was followed for six months after her initial surgery, and she received three months of chemotherapy. No safety issues were reported in the case.

However, this is just one case, so it's not clear what the best treatment is for this rare situation. The authors note that the optimal treatment strategy remains to be established. If you or someone you know has similar symptoms or concerns, talk to a doctor for personalized advice.

What this means for you:
A rare case shows colon tumors can be gynecological cancer, but more research is needed for treatment guidance.

Common questions

What is endometrioid adenocarcinoma?

Endometrioid adenocarcinoma is a type of cancer that usually starts in the lining of the uterus (endometrium). In this case, it was found in the colon, which is unusual. It's treated with surgery and chemotherapy, as described in the report.

How was this cancer treated?

The woman had laparoscopic surgery to remove the colon lesions and lymph nodes, then chemotherapy with platinum and paclitaxel. Later, she had a hysterectomy and removal of her ovaries and fallopian tubes. After treatment, no cancer was found in the uterus or appendages.

Is this type of cancer common?

No, this is a rare case. The report is about a single patient, so it's not common. It highlights the need for careful diagnosis when tumors appear in unusual places.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedAug 2026
View Original Abstract ↓
Separate endometrioid adenocarcinoma involving only the gastrointestinal tract is extremely rare. Its diagnosis requires confirmation through pathological examination and immunohistochemical analysis. We report the case of a nulliparous woman in whom two separate tumour lesions were identified in the rectosigmoid and sigmoid colon, without evidence of malignancy in the uterus or bilateral appendages before surgery. Following laparoscopic radical resection of the colonic lesions and lymph nodes, pathological and immunohistochemical analyses indicated that both lesions represented homogeneous adenocarcinoma of gynaecological origin. Postoperatively, the patient received three months of platinum- and paclitaxel-based chemotherapy. Six months after the initial surgery, the patient underwent a total hysterectomy with bilateral salpingo-oophorectomy, and postoperative histopathological examination again did not reveal any evidence of malignancy in the uterus or bilateral appendages. This report aims to describe the clinical features, diagnostic challenges, and treatment of this disease based on our case and relevant literature. The optimal treatment strategy for such cases remains to be established.
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