Mistaken identity: endometrial or rectal cancer?

A 59-year-old woman with a previous history of endometrial and breast cancer was referred to the colorectal rapid access clinic with abdominal cramps, per rectal bleeding and diarrhoea. CT, MRI and flexible sigmoidoscopy confirmed a rectal tumour and due to its appearance, it was thought to be a primary rectal malignancy. The patient underwent an anterior resection and end colostomy. Histology confirmed a metastatic endometrial adenocarcinoma, which is an unusual site for endometrial metastasis. Her postoperative recovery has been unremarkable and the patient has subsequently been discharged from the general surgical team. 2014 BMJ Publishing Group Ltd.