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Poorly differentiated cecal adenocarcinoma showing prominent rhabdoid feature combined with appendiceal mucinous cystadenoma: A case report and review of the literature.

Cho IJ, Kim SS, Min YD, Noh MW, Hong R - Oncol Lett (2015)

Bottom Line: Extrarenal rhabdoid tumors (ERRTs) are extremely rare neoplasms; of these, colorectal ERRTs are the most rare, and only nine cases have been previously described in the English language literature.This indicated a diagnosis of poorly differentiated adenocarcinoma with prominent rhabdoid features, combined with appendiceal mucinous cystadenoma.At two months following surgery the patient succumbed to peritoneal seeding and metastasis of liver and bone The emergence of the rhabdoid phenotype is invariably associated with an aggressive and almost always fatal clinical course.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, College of Medicine, Chosun University, Gwangju 501-759, Republic of Korea.

ABSTRACT

Extrarenal rhabdoid tumors (ERRTs) are extremely rare neoplasms; of these, colorectal ERRTs are the most rare, and only nine cases have been previously described in the English language literature. The current study reports the pathological features of a case of poorly differentiated cecal adenocarcinoma with prominent rhabdoid feature, which was combined with mucinous cystadenoma of the appendix in a 73-year-old male, and additionally reviews the previously reported cases. Microscopically, the majority of tumor cells were non-cohesive or loosely cohesive, with a polygonal morphology and prominent rhabdoid feature, showing eccentric vesicular nuclei, prominent nucleoli and abundant eosinophilic cytoplasm. Immunohistochemically, the tumor cells were positive for cytokeratin (CK) and vimentin, but negative for CK20, CK7, desmin and smooth muscle actin. This indicated a diagnosis of poorly differentiated adenocarcinoma with prominent rhabdoid features, combined with appendiceal mucinous cystadenoma. At two months following surgery the patient succumbed to peritoneal seeding and metastasis of liver and bone The emergence of the rhabdoid phenotype is invariably associated with an aggressive and almost always fatal clinical course. The present case is the 10th example of such a tumor in the colon, and to the best of our knowledge, this is the first case of colonic rhabdoid tumor coinciding with appendiceal benign mucinous neoplasm.

No MeSH data available.


Related in: MedlinePlus

(A) Microscopically, the tumor was composed of loosely cohesive, rhabdoid cells. The characteristic strongly and homogeneously acidophilic cytoplasm of the rhabdoid tumor cells was observed with lateral displacement of the nuclei. (B) Transition from adenocarcinoma (lower) to rhabdoid areas (upper) was noted. (C) Small amount of adenocarcinoma component was identified and (D) appendiceal mucinous cystadenoma was identified.
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f2-ol-09-04-1527: (A) Microscopically, the tumor was composed of loosely cohesive, rhabdoid cells. The characteristic strongly and homogeneously acidophilic cytoplasm of the rhabdoid tumor cells was observed with lateral displacement of the nuclei. (B) Transition from adenocarcinoma (lower) to rhabdoid areas (upper) was noted. (C) Small amount of adenocarcinoma component was identified and (D) appendiceal mucinous cystadenoma was identified.

Mentions: A protruding mass of 4.0×3.0×1.5 cm in size, with central ulceration and necrosis was identified in the cecum (Fig 1). Microscopically, the tumor was composed of loosely cohesive, rhabdoid cells which grew in a diffuse, solid and focal alveolar pattern (Fig. 2A). Transition of the gland-forming adenocarcinoma to the area or malignancy demonstrating prominent rhabdoid features was identified (Fig. 2B); the amount of adenocarcinoma component forming the glandular structure was <1% of the total tumor area (Fig. 2C). The most noteworthy feature of these rhabdoid tumor cells was the strongly and homogeneously acidophilic cytoplasm of the tumor cells, with lateral displacement of the nuclei (Fig. 2A). Extensive necrosis was observed and regional lymph node metastasis was also identified in four out of 45 regional lymph nodes, pN2a. The metastatic lesion was entirely composed of rhabdoid tumor cells. Immunohistochemically, the tumor cells of the adenocarcinoma and rhabdoid components were positive for CK (Fig. 3A, adenocarcinoma component; Fig. 3B, rhabdoid component), VMT (Fig. 3C, adenocarcinoma component; Fig. 3D, rhabdoid component) and MLH-1 (Fig. 4A), but negative for skeletal muscle marker, desmin and smooth muscle actin (Fig. 4B and C). In addition to the malignant tumor, separated appendiceal mucinous cystadenoma was also identified (Fig. 2D). The final diagnosis was poorly differentiated adenocarcinoma with prominent rhabdoid features, combined with appendiceal mucinous cystadenoma. At two months following surgery the patient succumbed to peritoneal seeding and metastasis of liver and bone.


Poorly differentiated cecal adenocarcinoma showing prominent rhabdoid feature combined with appendiceal mucinous cystadenoma: A case report and review of the literature.

Cho IJ, Kim SS, Min YD, Noh MW, Hong R - Oncol Lett (2015)

(A) Microscopically, the tumor was composed of loosely cohesive, rhabdoid cells. The characteristic strongly and homogeneously acidophilic cytoplasm of the rhabdoid tumor cells was observed with lateral displacement of the nuclei. (B) Transition from adenocarcinoma (lower) to rhabdoid areas (upper) was noted. (C) Small amount of adenocarcinoma component was identified and (D) appendiceal mucinous cystadenoma was identified.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4356266&req=5

f2-ol-09-04-1527: (A) Microscopically, the tumor was composed of loosely cohesive, rhabdoid cells. The characteristic strongly and homogeneously acidophilic cytoplasm of the rhabdoid tumor cells was observed with lateral displacement of the nuclei. (B) Transition from adenocarcinoma (lower) to rhabdoid areas (upper) was noted. (C) Small amount of adenocarcinoma component was identified and (D) appendiceal mucinous cystadenoma was identified.
Mentions: A protruding mass of 4.0×3.0×1.5 cm in size, with central ulceration and necrosis was identified in the cecum (Fig 1). Microscopically, the tumor was composed of loosely cohesive, rhabdoid cells which grew in a diffuse, solid and focal alveolar pattern (Fig. 2A). Transition of the gland-forming adenocarcinoma to the area or malignancy demonstrating prominent rhabdoid features was identified (Fig. 2B); the amount of adenocarcinoma component forming the glandular structure was <1% of the total tumor area (Fig. 2C). The most noteworthy feature of these rhabdoid tumor cells was the strongly and homogeneously acidophilic cytoplasm of the tumor cells, with lateral displacement of the nuclei (Fig. 2A). Extensive necrosis was observed and regional lymph node metastasis was also identified in four out of 45 regional lymph nodes, pN2a. The metastatic lesion was entirely composed of rhabdoid tumor cells. Immunohistochemically, the tumor cells of the adenocarcinoma and rhabdoid components were positive for CK (Fig. 3A, adenocarcinoma component; Fig. 3B, rhabdoid component), VMT (Fig. 3C, adenocarcinoma component; Fig. 3D, rhabdoid component) and MLH-1 (Fig. 4A), but negative for skeletal muscle marker, desmin and smooth muscle actin (Fig. 4B and C). In addition to the malignant tumor, separated appendiceal mucinous cystadenoma was also identified (Fig. 2D). The final diagnosis was poorly differentiated adenocarcinoma with prominent rhabdoid features, combined with appendiceal mucinous cystadenoma. At two months following surgery the patient succumbed to peritoneal seeding and metastasis of liver and bone.

Bottom Line: Extrarenal rhabdoid tumors (ERRTs) are extremely rare neoplasms; of these, colorectal ERRTs are the most rare, and only nine cases have been previously described in the English language literature.This indicated a diagnosis of poorly differentiated adenocarcinoma with prominent rhabdoid features, combined with appendiceal mucinous cystadenoma.At two months following surgery the patient succumbed to peritoneal seeding and metastasis of liver and bone The emergence of the rhabdoid phenotype is invariably associated with an aggressive and almost always fatal clinical course.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, College of Medicine, Chosun University, Gwangju 501-759, Republic of Korea.

ABSTRACT

Extrarenal rhabdoid tumors (ERRTs) are extremely rare neoplasms; of these, colorectal ERRTs are the most rare, and only nine cases have been previously described in the English language literature. The current study reports the pathological features of a case of poorly differentiated cecal adenocarcinoma with prominent rhabdoid feature, which was combined with mucinous cystadenoma of the appendix in a 73-year-old male, and additionally reviews the previously reported cases. Microscopically, the majority of tumor cells were non-cohesive or loosely cohesive, with a polygonal morphology and prominent rhabdoid feature, showing eccentric vesicular nuclei, prominent nucleoli and abundant eosinophilic cytoplasm. Immunohistochemically, the tumor cells were positive for cytokeratin (CK) and vimentin, but negative for CK20, CK7, desmin and smooth muscle actin. This indicated a diagnosis of poorly differentiated adenocarcinoma with prominent rhabdoid features, combined with appendiceal mucinous cystadenoma. At two months following surgery the patient succumbed to peritoneal seeding and metastasis of liver and bone The emergence of the rhabdoid phenotype is invariably associated with an aggressive and almost always fatal clinical course. The present case is the 10th example of such a tumor in the colon, and to the best of our knowledge, this is the first case of colonic rhabdoid tumor coinciding with appendiceal benign mucinous neoplasm.

No MeSH data available.


Related in: MedlinePlus