Endometriosis, the great imitator – a successful case of fertility preservation in a woman receiving sterilizing treatment due to a diagnosis of rectosigmoid carcinoma

Abstract

Bowels are the most common site of extrapelvic endometriosis. Still, colonic endometriosis often presents a diagnostic challenge, mimicking a broad spectrum of diseases including primary colonic malignancy. For women of fertile age, the consequences of endometriosis being misdiagnosed as colorectal cancer may include loss of fertility. We hereby present a case of endometriosis mimicking rectosigmoid adenocarcinoma in a young woman, where fertility preservation prior to the start of antineoplastic treatments turned out to be of crucial importance for the woman's future attempts to achieve a pregnancy and livebirth.

A Case of Rectal Endometriosis Misdiagnosed as Rectal Malignancy on Three Colonoscopies and Biopsies Sharing a Combined Literature Review

“…2010 37 36 Cecal Ileocolic Intussusception Laparoscopic debulking of the endometriosis, and right hemicolectomy Yes Marklund A. 2019 38 30 Rectosigmoid colon 2 weeks interval abdominal pain and a 4 days’ history of obstipation Neoadjuvant treatment that included radiotherapy and chemotherapy, later do rectum and a bilateral salpingo-oophorectomy No Alvarado LER.2021 39 41 Rectal Complete large bowel obstruction complicated by sepsis and toxic megacolon Total colectomy with ileostomy No Allan Z. 2018 40 37 Large bowel Large bowel obstruction Laparoscopic wedge resection of rectosigmoid tumour with primary anastomo-sis and endoscopic decompression Yes Garg NK.2009 41 44 Colon Colonic perforation A proximal colostomy was performed and the endometriotic mass resected Yes Lee M. 2021 42 35 At the cecum near the appendiceal orifice Fetal demise and gastrointestinal hemorrhage Symptomatic treatment such as blood transfusion and have a colonoscopy after delivery No Aragone L. 2023 43 39 Appendiceal A week of abdominal pain was diagnosed as appendicitis Appendectomy No Alabbas H. 2019 44 Reports not prompted Small Bowel Recurrent semi-obstructive symptoms Right hemico...…”