Enterouterine Fistula as Initial Presentation of Advanced Endometrial Cancer: Description of a Rare Case and Review of the Literature

Endometrial cancer is the most common gynecological malignancy, and it usually presents with abnormal uterine bleeding as initial symptom. Cases of advanced endometrial cancer with uncommon symptoms at presentation are reported in the literature but, to our knowledge, no case an of enterouterine fistula as the initial presentation of the disease has been previously described. We report the case of a 54-year-old woman, with a 2-month history of permanent vaginal discharge of partly non-digested stool masses due to an enterouterine fistula that was the initial presentation of an advanced endometrial cancer. Interestingly, in this case, not all the preoperative exams (CT, colonoscopy and hysteroscopy) identified the fistulous openings, and the enterouterine fistula was confirmed only at the time of surgery.