Abstract
An 83-year-old woman was admitted to the emergency department with fever. She had a past history of transvaginal hysterectomy due to uterine prolapse. A physical examination revealed the presence of a painful mass in the lower abdomen. Abdominal computed tomography (CT) showed the presence of a cystic tumor containing air in the lower abdomen. CT also revealed that the tumor nutritional vessels arose from the left gonadal artery. Enema revealed the presence of a fistula between the rectum and the lumen of the cystic tumor. A drainage tube was placed inside the cavity through the fistula, and the patient’s fever quickly resolved. Colonoscopic biopsy of the fistula yielded a diagnosis of ovarian carcinoma. Laparotomy revealed a hard tumor arising from the left ovary that had invaded the rectum. The Hartmann procedure and bilateral salpingo-oophorectomy were performed. Histological findings showed that the ovarian endometrioid carcinoma had penetrated the rectum. The patient was transferred without complications to the gynecology ward to receive adjuvant chemotherapy 14 days after surgery. She is alive without recurrence 6 months after surgery.
