Bright red rectal bleeding with h/o Uterine leiomyoma

A 40 y/o G3, P2, female presented with change in bowel habits and bright red rectal bleeding which had lasted for 1 year. She had a h/o subtotal abdominal hysterectomy for uterine leiomyoma performed 3 years before and a history of right ovarian cystectomy. She has no symptoms of endometriosis and had no history of hormone replacement therapy. CT scan demonstrated thickening of rectal wall with inhomogeneous enhancement and a 4 cm soft tissue mass that involved the rectum and left ovary. What condition is it? how it should be treated?

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Pt is known c/o leiomyoma operated Now c/o per rectal bleeding Ct shows growth or mets in rectum Hence you can consider this case of recurrence of malignancy
Thanx dr Kiran Sali
Adv CA 125 & CEA If it's Colorectal CA then CEA is going to be Raised But it seems to be metastasis Primary can be Ovarian or leiomyosarcoma
CA rectum with secondaries
Rt PUJ obstruction Smallnbowel loops dilated with adhesions
Colorectal cancer consult Oncologist/Oncosurgeon