Endometriosis is a frequent benign disorder. Malignancy arising in extraovarian endometriosis is a rare event. A 49-year-old woman is presented with a large painful abdominal wall mass. She underwent a myomectomy, 20 years before, for uterus leiomyoma. Computed tomography suggested that this was a desmoid tumor and she underwent surgery. Histological examination showed a clear cell adenocarcinoma associated with endometriosis foci. Pelvic ultrasound, computed tomography, and endometrial curettage did not show any malignancy or endometriosis in the uterus and ovaries. Adjuvant chemotherapy was recommended, but the patient was lost to follow up. Six months later, she returned with a recurrence of the abdominal wall mass. She was given chemotherapy and then she was reoperated.

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Background: Endocrine tumours of the gastro-intestinal tract are rare and predominate in the small intestine and in the appendix, less commonly in the colon and the rectum.Aim: The aim of this study is to analyze clinical and pathologic features of an endocrine tumour of the colon and the rectum diagnosed in the Department of Pathology (Sousse, Tunisia).Methods: Five cases were diagnosed between 1992 and 2006 in our hospital unit. The medical records of the affected patients were analyzed. The pathological material was reviewed and the tumours were classified according to 2000 WHO classification.Results: The study population consisted of 2 male and 3 female patients. Their median age was 55 years. Two poorly differentiated endocrine carcinomas of the colon, and one colic and two rectal well differentiated endocrine carcinoma were identified.Conclusion: This study illustrates the importance of adequately diagnosing endocrine tumours because their treatment and prognosis are different from those of conventional carcinoma.

Neuroendocrine tumors of the small intestine are often discovered by accident. This tumor can be multiple and can be associated with other tumors, particularly gastrointestinal malignancy. We present a rare case involving a 68-year-old man in whom we discovered multiple neuroendocrine tumors in the ileum, associated with colonic adenocarcinoma. Following this observation we wish to draw attention to the concept of multiple neuroendocrine tumors and the possibility of synchronous malignancy.