unraveling the diagnostic complexity of abnormal uterine bleeding: a case report on the role of sigmoid cancer with uterine infiltration

Abnormal uterine bleeding (aub) can sometimes arise from extragynecologic causes, as demonstrated in this case of a 44-year-old woman who presented with persistent lower abdominal pain, aub, and fecal vaginal discharge. initially suspected to be a gynecologic condition, further imaging revealed advanced sigmoid colon cancer infiltrating the uterus and forming a fistula. surgical management involved sigmoid colectomy, hysterectomy, and bladder repair. histopathological analysis confirmed invasive adenocarcinoma, and postoperative chemotherapy was initiated. this case underscores the importance of considering non-gynecologic sources in patients with aub, particularly when accompanied by atypical symptoms. early imaging played a pivotal role in identifying the true origin of symptoms, highlighting the value of prompt diagnostic evaluation. multidisciplinary collaboration ensured timely and effective treatment, optimizing patient outcomes. recognizing rare presentations, such as colorectal cancer invading the uterus, is essential to prevent delays in diagnosis and management. vigilance for such unusual causes can significantly improve prognosis in complex clinical scenarios.