A Mixed Rectal Tumor And Adenocarcinoma: A Case Report

Main Category: Colorectal Cancer
Article Date: 24 Sep 2008 - 10:00 PDT

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Prof. John M. Carethers reported an unusual case of a mixed rectal tumor containing a superficial tubulovillous adenoma with deeper areas of high grade malignant spindle cells and an invasive adenocarcinoma. This was published in the World Journal of Gastroenterology.

A 52-year-old woman presented with a rectal mass and intermittent hematochezia. Superficial biopsies during colonoscopy revealed a tubulovillous adenoma with high-grade dysplasia. Endoscopic ultrasonography 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 with another intermediate stage: invasive adenocarcinoma. Based on the histological appearance and immunohistochemical studies, a diagnosis of sarcomatoid carcinoma was made. Only nine cases of sarcomatoid carcinomas of the colorectum have been reported to date and this is the first report of co-existence of sarcomatoid carcinoma and invasive adenocarcinoma with tubulovillous adenoma. This observation supports the "monoclonal theory" of pathogenesis with an adenoma-sarcoma progression with or without an intermediate stage of carcinoma in between.

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Article adapted by Medical News Today from original press release.
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Reference: Lee JK, Ghosh P, McWhorter V, Payne M, Olsen RK, Krinsky ML, Ramamoorthy SL, Carethers JM. Evidence for Colorectal Sarcomatoid Carcinoma Arising from Tubulovillous Adenoma. World J Gastroenterol 2008; 14(27): 4389-4394 http://www.wjgnet.com/1007-9327/14/4389.asp

Correspondence to: John M. Carethers, MD, Professor of Medicine and Chief, Division of Gastroenterology, University of California, San Diego UC 303 (MC 0063), 9500 Gilman Drive, La Jolla CA 92093-0063, United States.

About World Journal of Gastroenterology

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection. It provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th of every month. The WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the title China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.

About The WJG Press

The WJG Press mainly publishes World Journal of Gastroenterology.

Source: Lai-Fu Li
World Journal of Gastroenterology