Two cases of rectal cancer after radiotherapy for carcinoma of the uterus

Two cases of rectal cancer after radiotherapy for carcinoma of the uterus are reported. Case-1 is a 72-year-old woman who underwent hysterectomy and radiotherapy for a carcinoma of the uterus in 1962. Twenty-seven years later, she came to Shinshu University Hospital for rectal bleeding. Barium enema and proctoscopy demonstrated a cancerous lesion in the rectum, and abdominoperineal excision of the rectum was performed. Histopathological examination showed that thin layer of carcinomatous tissue covered the surface of the ulcer of the rectum. This suggested that the rectal cancer arose from the ulcer due to radiation proctitis. Case-2 is a 67-year-old woman who underwent hysterectomy and radiotherapy with a dose of 40 Gy for a carcinoma of the uterus in 1982. Five years later, she came to Shinshu University Hospital for rectal bleeding. Barium enema and proctoscopy demonstrated a cancerous lesion in the rectum, and sacral excision of the rectum was performed. In the follow-up of patients who underwent pelvic irradiation, attention should be paid for possible occurrence of rectal cancer. (author)