Abstract

A 57-year-old Caucasian woman, presented to our Endoscopy Unit, complaining several episodes of rectal bleeding during the last 2 weeks, associated with lower abdominal and back pain, mild weight loss and asthenia. On presentation, the patient was hemodynamically stable. Her laboratory tests showed normocytic anemia of 10g/dL, increase of creatine chinase of 264U/L, and mild hypopotassemia (3.4 mEq/l). Moreover, she reported a family history for gastric cancer (father), and she was surveilled by our Oncological center for a recurrent neoplastic disease and for a systemic autoimmune disease, for many years stable under treatment with cycles of radiotherapy, imatinib mesylate, steroids, levothyroxine, and semestral zoledronic acid. After she underwent flexible sigmoidoscopy, a bulky ulcerated rectal mass, of suspected extraparietal origin, was revealed in (Figure 1) and (Figure 2). Multiple random biopsies were obtained from the normal mucosa as well as separately from the ulcers.