Endometriosis is characterised by the presence of endometrial glands and stroma outside the uterine cavity. Intestinal involvement by endometriosis occurs in 3–37% of affected patients, while lymph node involvement by endometriosis is likely underestimated. We report a 53-year-old female who underwent an anterior resection with en-bloc total abdominal hysterectomy with bilateral salpingo-oophorectomy (THBSO) for a locally advanced rectosigmoid adenocarcinoma which was densely adherent to the uterus. Histopathology of the large bowel wall around the adhesion site sampled showed endometriosis only, affecting the final T staging. Several lymph nodes sampled also showed endometriosis as well as metastatic adenocarcinoma. We discuss the clinical and histopathologic features, diagnostic pitfalls and potential sequelae of this unusual presentation of an otherwise common entity.
Tay et al. (Sun,) studied this question.