Background: Rectal prolapse is the protrusion of the rectum through the anal canal, commonly observed in older women with weakened pelvic floor muscles and anal sphincters. Clinical symptoms may include a painful, irreducible anal mass and rectal bleeding. Surgical intervention typically aims to restore normal anatomy through tumor resection and rectal fixation. The occurrence of colorectal cancer within rectal prolapse is rare and may present unique diagnostic and management challenges with distinct clinical implications. Case Series: We present three cases of rectal prolapse associated with colorectal cancer. The patients (aged 40, 79, and 79), one female and two males presented with rectal prolapse. One patient was seen in the outpatient clinic, while the other two presented to the emergency department with painful, strangulated prolapse. All patients underwent tailored surgical resections. Histological analysis revealed adenocarcinomas ranging from pT1 to pT2, all with N0Mx staging, two located in the rectum and one in the descending colon. These cases highlight the importance of preoperative imaging in identifying occult malignancies, particularly in atypical presentations of rectal prolapse. Conclusion: Patients presenting with rectal prolapse, especially without predisposing factors, should be evaluated for underlying malignancy. Preoperative assessment is critical for identifying concomitant tumors and optimizing management to prevent recurrence and complications. Plain Language Summary: Rectal prolapse happens when the rectum slips out through the anus. It’s most commonly seen in older women, often due to weakened pelvic floor muscles. In rare cases, rectal prolapse can be linked to colorectal cancer, making early diagnosis especially important. Symptoms may include pain, bleeding, and difficulty pushing the tissue back inside. Surgery is usually needed to correct the problem, remove any tumors, and help prevent it from happening again. This report describes three patients—two men and one woman, aged 40 and 79—who came to the hospital with rectal prolapse. One patient visited the clinic, while the other two went to the emergency room because their prolapse was painful and the rectal tissue had become trapped. All three underwent surgeries tailored to their specific condition. The elderly woman had a rectal tumor that was successfully treated with rectal resection and reconstruction, revealing early-stage rectal cancer. Two of the patients also required a temporary bowel opening (stoma). Lab tests on the removed tissue confirmed cancer in all three cases, two in the rectum and one in the lower part of the colon. All patients recovered well after surgery. These cases highlight the importance of thoroughly evaluating rectal prolapse, even when no obvious risk factors for cancer are present. Early diagnosis using scans like CT imaging, along with personalized surgical plans, can lead to better outcomes. This study emphasizes why doctors should always consider the possibility of cancer in cases of rectal prolapse, especially when the symptoms are unusual or severe. Keywords: case series, colorectal cancer, rectal prolapse, rectum tumour, sigmoid tumour
Nugraha et al. (Wed,) studied this question.