EP944 - Inside Out: A Case Report on Rectal Adenocarcinoma with Rectal Prolapse

ePoster Presenter(s)

• 

  Ma. Ina Felicia B. Gutierrez

  Fellow in Training
  Quirino Memorial Medical Center
  Makati City, National Capital Region, Philippines

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.

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Author(s)

• JM

  Joseph Martin Anthony Medina, n/a

  General Surgery Resident
  Quirino Memorial Medical Center
  Quezon City, National Capital Region, Philippines

  Disclosure information not submitted.
• KY

  Kenneth Yabut, n/a

  Fellowship Training Officer
  Quirino Memorial Medical Center
  Quezon City, National Capital Region, Philippines

  Disclosure information not submitted.
• RA

  Ryan Rainiel Abary, n/a

  Chief of Section in Colorectal Surgery
  Quirino Memorial Medical Center
  Quezon City, National Capital Region, Philippines

  Disclosure information not submitted.

Purpose/Background: The occurrence of rectal prolapse in the background of rectal carcinoma is extremely rare, and its prevalence remains unknown. We report the case of a 53 year old Filipino male who presented with a bulging mass at the anus, accompanied by hematochezia and weight loss.

Methods/Interventions: Upon consult at the emergency department, the patient had a firm, fungating, irreducible mass at the anus measuring 10cm in widest diameter, for which an incision biopsy revealed an adenocarcinoma. Magnetic resonance imaging of the pelvis was done showing a T3N0M0 lesion with concomitant rectal prolapse.

Results/Outcomes: The patient underwent an open abdominoperineal resection after several blood transfusions and optimization. Final histopathology revealed a Stage IIA well-differentiated adenocarcinoma of the rectum (pT3N0M0).

Conclusion/Discussion: While there is no apparent association between rectal cancer and rectal prolapse, chronic straining because of bowel obstruction together with mechanical irritation of the mucosa might explain their coexistence. It is therefore important to detect both conditions to provide timely and appropriate care to patients with this pathology.

Figure 1
Sagittal view of the patient's T2W pelvic MRI showing a prolapsing mass at the anus

Figure 2
Pre-operative image of the patient's rectal mass with concomitant rectal prolapse