Short stricture of the rectum regressing on discontinuation of hormone replacement therapy: Endoscopic appearance, multiple biopsies and clinical improvement insufficient for diagnosis

Abstract

A short, benign-looking stricture of the rectum presented itself clinically as subileus in a middle-aged woman after 5 years on hormone replacement therapy (HRT) and 8 years after curative surgery for cancer of the ovaries. Radiological work-up and multiple, repeated biopsies supported the endoscopically appearing benign nature of the lesion, and the stricture subsided after discontinuation of HRT. Re-introduction of HRT again caused subileus. At surgery, there was no suspicion of malignant disease. Histological examination of the resection specimen did, however, show metastasis from the ovarian cancer.

• Diagnosis
• hormone replacement therapy
• rectum
• stricture