Rectal carcinoma in a young woman

Abstract

Female patient, 25 years old, married, nuliparous, no relevant personal or family history. After three months of changes in bowel movements and already presenting rectal blood loss, she consults the family doctor. There is occasional abdominal pain and an 8% weight loss. Physical examination is negative, and laboratory investigation is normal. Rectosigmoidoscopy elicits a rectal sessile polipoid growth. A superficial biopsy identified low degree dysplasia. The patient was referred to a surgical center. Total colonoscopy and new biopsies were performed. Histopathology showed high degree dysplasia and in situ carcinoma. Staging included chest X-rays, abdominopelvic scan and endoscopic ultrasound scan and was assessed as T2N0M0. Anterior rectum resection was performed, and histopathology of the surgical specimen elicited an invasive adenocarcinoma T3N2M0R0. Before chemotherapy and radiotherapy with uterine protection, in vitro fertilization with embryo freezing was performed. After this episode, the patients father presents with similar complaints, and a rectal adenocarcinoma with identical staging (T3N2M0) is diagnosed.