Reported herein is an unusual case of carcinosarcoma of the colon. A 13-year-old girl was transferred to Chonbuk National University Hospital, Korea with a known pelvic mass. CT and magnetic resonance imaging confirmed a large pelvic mass. A sarcoma was diagnosed following colonoscopic biopsy. An ultra-low anterior resection with pelvic lymph node dissection was performed. The tumor consisted of a well-differentiated adenocarcinoma showing strong immunoreactivity to epithelial markers (pancytokeratin, cytokeratin 7, cytokeratin 19, cytokeratin 20, epithelial membrane antigen, and CEA) and a sarcomatous lesion with strong diffuse vimentin expression but no immunoreactivity to any of the six epithelial markers. Carcinosarcomas of the colon are extremely rare, and all reported cases involve adults. To the authors' knowledge, this is the first reported case of a carcinosarcoma of the colon in a child.
[Show abstract][Hide abstract] ABSTRACT: A carcinosarcoma is a rare tumor that contains malignant epithelial and mesenchymal elements, and the prognosis is known to be very poor. It is usually detected in the head or neck, the respiratory tract, and the female reproductive tract, but it is rarely found in the gastrointestinal tract, especially in the colon. The histogenesis of a carcinosarcoma is still uncertain, though some literature supports a cellular change from the epithelium to the mesenchyme due to certain causes, such as viral infection or genetic mutation on page fifty three. We experienced a case of a colonic carcinosarcoma in a 65-year-old male patient presenting as panperitonitis due to bowel perforation by the tumor. A right hemicolectomy with lymph node dissection was performed. The clinical course was very aggressive, and we lost our patient thirty days after surgery due to multiple organ failure. Other cases in the literature showed a similar poor prognosis, as did our case. Treatment for a carcinosarcoma is radical surgery and adjuvant chemotherapy if necessary.
Journal of the Korean Society of Coloproctology 10/2010; 26(5):368-72. DOI:10.3393/jksc.2010.26.5.368
[Show abstract][Hide abstract] ABSTRACT: Our case was a 65-year-old male, with the chief complaints of diarrhea and abdominal distention. Three years earlier, the patient had undergone transcatheter arterial embolization and radiofrequency treatment based on a diagnosis of hepatocellular carcinoma due to hepatitis B by another doctor. In October 2007, the patient developed diarrhea and increased abdominal distention. In December, CT examination conducted by the previous doctor revealed a 20-cm tumor within the pelvis. The patient was diagnosed with sigmoid colon cancer based on barium enema examination using gastrografin, and was introduced to our hospital for treatment. He was diagnosed with low-differentiated carcinoma by biopsy of the colon during endoscopy and underwent sigmoidectomy based on a diagnosis of sigmoid colon cancer. The tumor had infiltrated the bladder, and a tumorectomy was conducted through partially combined resection. The tumor was a huge lesion occupying the inside of the lumen, and histopathological findings revealed that the tumor, the main part of which lay beneath the mucous membrane, had a transitional image composed of both spindle-shaped atypical cells and sarcomatoid shape. The result of immunostaining was CK7(+), CK20(-), AFP(-), and the patient was diagnosed as having carcinosarcoma of the colon. Carcinosarcoma of the colon is a malignant tumor with poor prognosis, and the mean survival period in past reports was approximately 6 months. The patient was treated with FOLFIRI+Bevacizumab therapy according to chemotherapy for colon cancer, but he was refractory to the therapy.
Case Reports in Gastroenterology 11/2010; 4(3):484-491. DOI:10.1159/000318739
[Show abstract][Hide abstract] ABSTRACT: Colonic sarcomatoid carcinomas are known to be extremely rare tumors, with only 22 cases reported either as sarcomatoid carcinomas or carcinosarcomas in the literature. The known characteristics are rapid growth, a high recurrence rate, and an extremely poor prognosis. Herein we report a case of a patient who had a sarcomatoid carcinoma of the sigmoid colon and died only 22 days after surgery due to rapid tumor growth.
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