International Journal of Contemporary Research in Multidisciplinary

Rectal adenocarcinoma, a significant subset of colorectal cancer, typically presents with rectal bleeding, altered bowel habits, and weight loss. However, in elderly patients, the disease may manifest atypically, delaying diagnosis and management. This case report discusses a 60-year-old postmenopausal female who presented with diffuse epigastric pain and abdominal distension, without hallmark gastrointestinal symptoms such as hematochezia or altered bowel habits. Initial investigations revealed ascites with omental thickening, raising concerns for peritoneal carcinomatosis. Tumor markers (CEA, CA 19-9) and digital rectal examination were unremarkable, further complicating the clinical picture. However, contrast-enhanced CT imaging and colonoscopy subsequently revealed a rectal mass, confirmed as moderately differentiated adenocarcinoma on biopsy. This case underscores the importance of considering colorectal malignancy in elderly patients with nonspecific abdominal symptoms, even in the absence of classical signs or elevated tumor markers. A thorough diagnostic approach is essential to facilitate early detection and improve clinical outcomes in such atypical presentations.