Rectal Lipoma Associated with Genital Prolapse
A 58-year-old post-menopausal woman presented with six months history of hematochezia, tenesmus, constipation, loss of appetite, and vaginal mass prolapsed. On general examination, patient was thin and pale. Abdominal examination was unremarkable. Rectal examination revealed a soft swelling in the anterior wall of rectum measuring approximately 3 × 3 cm and 6 cm above the anal verge. Speculum examination showed second-degree utero-vaginal prolapse, cystocele, and rectocele. In vaginal examination, uterus appeared to be atrophic and retroverted. There were no signs of tumor infiltration into fornices. Recto-vaginal examination showed mass in rectum/recto-vaginal septum with atrophic perineal body. Findings were confirmed by colonoscopy and contrast-enhanced CT scan [] of the abdomen, showing a sub-mucosal rectal mass. She underwent vaginal hysterectomy with pelvic floor repair. This was followed by transrectal excision of the rectal mass []. The macroscopic appearance of excised mass was suggestive of lipoma. Histopathological examination confirmed the diagnosis of lipoma and revealed ulceration of the overlying rectal mucosa [].