Evidence for colorectal sarcomatoid carcinoma arising from tubulovillous adenoma

查看全文 作　　者：Jeffrey K [1,2,3]Lee;Pradipta [1,2,3]Ghosh;Valerie [4,3]McWhorter;Misty [4,3]Payne;Ryan [4,3]Olson;Mary L [1,2,3]Krinsky;Sonia [5]Ramamoorthy;John M [1,2,3]Carethers

机构地区：[1]Department of Medicine, University of California;[2]San Diego, California;[3]and Veteran Affairs Medical Center, San Diego Healthcare System;[4]Department of Pathology, University of California,San Diego, California;[5]Department of Surgery, University of California

出　　处：《World Journal of Gastroenterology》索引2008年第14卷第27期,共6页

摘　　要：Sarcomatoid carcinomas of the colorectum are rare tu- mors that display both malignant epithelial and stromal components. Clinically, they are aggressive tumors with early metastasis. Due to their infrequent occurrence, the pathogenesis is poorly understood. We report a case of a 52-year-old woman who presented with a rectal mass and intermittent hematochezia. Superficial biopsies during colonoscopy revealed a tubulovillous adenoma with high-grade dysplasia. Endoscopic ultra- sonography confirmed an invasive nature of the mass, and deeper biopsies revealed the presence of neoplasm with mixed histological components. The surgically- excised specimen demonstrated the presence of poorly differentiated spindle cells underneath the tubulovillous adenoma and an intermediate stage of invasive adeno- carcinoma. Based on the histological appearance and immunohistochemical studies, a diagnosis of sarcoma- toid carcinoma was made. Only nine cases of sarcoma- toid carcinomas of the colorectum have been reported to date. As a result, the terminology and pathogenesis of sarcomatoid carcinoma remain speculative. To the best of our knowledge, this is the first report of co- existence of sarcomatoid carcinoma and invasive ad- enocarcinoma with tubulovillous adenoma; all stages represented within the same tumor. This observation supports the 'monoclonal theory' of pathogenesis with an adenoma-sarcoma progression with or without an intermediate stage of carcinoma. 关键词：肉瘤样癌腺瘤腺癌结肠直肠癌

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Evidence for colorectal sarcomatoid carcinoma arising from tubulovillous adenoma

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