Limits...
Carcinosarcoma of the Rectum: Report of a Rare Colorectal Malignancy and Review of the Literature.

Sudlow A, Liu MH, Waters G, Velchuru VR - Case Rep Surg (2015)

Bottom Line: Histologically, it is composed of two distinct elements of epithelial and mesenchymal origin.Prognosis is poor despite intervention with the majority of patients dying within six months.Due to the rarity of this condition, there are no specific treatment guidelines presently available.

View Article: PubMed Central - PubMed

Affiliation: Department of Colorectal Surgery, James Paget University Hospital, Gorleston NR31 6LA, UK.

ABSTRACT
Carcinosarcoma (CS) is a rare mixed mesodermal malignancy most commonly affecting the female reproductive organs, respiratory tract, head, and neck. Though infrequent, it may affect the gastrointestinal tract, most often the oesophagus and only very rarely the rectum. Histologically, it is composed of two distinct elements of epithelial and mesenchymal origin. Clinically, it is a very aggressive tumour with many patients presenting with metastatic lymph nodes or distant metastases at the time of diagnosis. Prognosis is poor despite intervention with the majority of patients dying within six months. Due to the rarity of this condition, there are no specific treatment guidelines presently available. We describe the case of an 80-year-old patient with carcinosarcoma of the rectum with discussion of the immunohistochemistry and review the available literature pertaining to this rare presentation.

No MeSH data available.


Related in: MedlinePlus

HPE showing distinct areas of carcinoma visible in resected specimen. The carcinomatous segment is well differentiated.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4664799&req=5

fig2: HPE showing distinct areas of carcinoma visible in resected specimen. The carcinomatous segment is well differentiated.

Mentions: Following a five-week course of preoperative radiotherapy, the patient underwent radical laparoscopic-assisted abdominoperineal excision of the rectum (APER) with curative intent. Postoperative recovery was uneventful. Histological examination of the resected tumour revealed small amount of residual disease consisting largely of a poorly differentiated adenocarcinoma with a cellular stroma. The malignant tumour showed distinct carcinomatous (Figure 2) and sarcomatous (with leiomyosarcomatous differentiation) (Figure 3) components. There was extramural vascular invasion, as well as lymphatic and intramural venous invasion. Large areas of the tumour were necrotic with residual granulation tissue and fibroblastic response replacing the original tumour. All eight lymph nodes showed reactive changes only with small areas of fibrosis present. Histopathological staging was ypT3 N0 Mx, Duke's B2 poorly differentiated residual carcinosarcoma.


Carcinosarcoma of the Rectum: Report of a Rare Colorectal Malignancy and Review of the Literature.

Sudlow A, Liu MH, Waters G, Velchuru VR - Case Rep Surg (2015)

HPE showing distinct areas of carcinoma visible in resected specimen. The carcinomatous segment is well differentiated.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4664799&req=5

fig2: HPE showing distinct areas of carcinoma visible in resected specimen. The carcinomatous segment is well differentiated.
Mentions: Following a five-week course of preoperative radiotherapy, the patient underwent radical laparoscopic-assisted abdominoperineal excision of the rectum (APER) with curative intent. Postoperative recovery was uneventful. Histological examination of the resected tumour revealed small amount of residual disease consisting largely of a poorly differentiated adenocarcinoma with a cellular stroma. The malignant tumour showed distinct carcinomatous (Figure 2) and sarcomatous (with leiomyosarcomatous differentiation) (Figure 3) components. There was extramural vascular invasion, as well as lymphatic and intramural venous invasion. Large areas of the tumour were necrotic with residual granulation tissue and fibroblastic response replacing the original tumour. All eight lymph nodes showed reactive changes only with small areas of fibrosis present. Histopathological staging was ypT3 N0 Mx, Duke's B2 poorly differentiated residual carcinosarcoma.

Bottom Line: Histologically, it is composed of two distinct elements of epithelial and mesenchymal origin.Prognosis is poor despite intervention with the majority of patients dying within six months.Due to the rarity of this condition, there are no specific treatment guidelines presently available.

View Article: PubMed Central - PubMed

Affiliation: Department of Colorectal Surgery, James Paget University Hospital, Gorleston NR31 6LA, UK.

ABSTRACT
Carcinosarcoma (CS) is a rare mixed mesodermal malignancy most commonly affecting the female reproductive organs, respiratory tract, head, and neck. Though infrequent, it may affect the gastrointestinal tract, most often the oesophagus and only very rarely the rectum. Histologically, it is composed of two distinct elements of epithelial and mesenchymal origin. Clinically, it is a very aggressive tumour with many patients presenting with metastatic lymph nodes or distant metastases at the time of diagnosis. Prognosis is poor despite intervention with the majority of patients dying within six months. Due to the rarity of this condition, there are no specific treatment guidelines presently available. We describe the case of an 80-year-old patient with carcinosarcoma of the rectum with discussion of the immunohistochemistry and review the available literature pertaining to this rare presentation.

No MeSH data available.


Related in: MedlinePlus