Rectal Endometriosis Simulating a Stromal Tumor of the Rectum

Introduction: Digestive endometriosis is one of the most severe forms of deep endometriosis, the rectum and sigmoid are most often affected, its clinical diagnosis is most often difficult due to the non-specificity of its clinical signs.

Case Report: We report the case of a 44-year old female patient who presented with chronic pelvic pain, dysuria, frequency and constipation. hysterectomized for a polymyomatous uterusClinical examinations revealed the presence of a mass at the pelvic level which arrives at the intimate contact of the sigmoid with loss of the fatty border of separation by place, The patient benefited from an anterior colorectal resection taking away the pelvic mass and The appendages to the uterus in monobloc with a colorectal anastomosis, with a protective ileostomy and a pelvic drainage. The postoperative follow-up of the patient was simple with an ablation of the salem probe at d4 and the patient was discharged at d6 postoperatively. The anapath of the surgical specimen showed a morphological aspect in favor of endometriosis.

Discussion: Rectal endometriosis is most often misdiagnosed as cancer of the rectum due mainly to a superficial clinical and paraclinical examination, hence the need for thorough investigations

Conclusion: Rectal endometriosis should always be considered as one of the differential diagnoses in women with a mass in the rectum. A good specimen is necessary to confirm the histopathologic diagnosis.