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Gonzalez RS, Horton RK, Zhang X, Graham RP, Longacre TA, Mehrotra A, Allende DS, McHugh KE, Shia J, Westerhoff M, Srivastava A, Chen W, Vazzano J, Swanson PE, Chatterjee D, Cheema H, Ma C, Mannan R, Chetty R, Nowak KM, Serra S, Agostini-Vulaj D, Kazemimood R, Henn P, Kakar S, Choi WT, Adeyi O, Jenkins SM, Nagtegaal ID. Colorectal adenosquamous carcinoma: clinicopathologic analysis of two large cohorts and literature review confirm poor prognosis and reveal prognostic aspects. Histopathology 2025; 86:1064-1081. [PMID: 39887413 DOI: 10.1111/his.15412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2024] [Revised: 12/20/2024] [Accepted: 01/02/2025] [Indexed: 02/01/2025]
Abstract
AIMS We compiled two cohorts of colorectal adenosquamous carcinoma (ASC) to describe its histologic and molecular aspects using modern parameters to compare them with literature reports using meta-analysis of cohorts and individual case series. METHODS AND RESULTS We identified 53 colorectal ASC from 19 North American academic medical centres, in addition to national database reports on 94 Dutch cases. We analysed available clinical, histologic, and immunohistochemical features and patient outcome. ASC comprised 0.02% of colorectal cancers in the Dutch database. The median cohort patient ages at resection were 65 and 69 years (North American and Dutch cohorts, respectively), with a roughly equal male:female ratio. The squamous component represented between 5% and 95% of each tumour, with a median of 50%. Tumour-infiltrating lymphocytes (TILs) were generally low (66%), and tumour budding was often Bd1 (64%). Most cases were pT3 (55%) or pT4 (40%), with nodal metastases in more than half (58%). Twenty-three cases (43%) metastasized distantly, most commonly to the liver. Mismatch repair (MMR) deficiency was identified in 34% of the cases. Follow-up was available for 48 patients; 13 (27%) had recurrent disease and 29 (60%) died. A total of 31 patients progressed, with median time to progression of 18 months. Available data for the Dutch cohort revealed largely similar findings, as did review of cases in the literature. CONCLUSION Colorectal ASC usually presents at an advanced stage. Despite high rates of MMR deficiency and low tumour budding, TILs were generally low, and there is a high recurrence rate and poor prognosis.
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Affiliation(s)
- Raul S Gonzalez
- Department of Pathology and Laboratory Medicine, Emory University Hospital, Atlanta, GA, USA
| | | | - Xuchen Zhang
- Department of Pathology, Yale University, New Haven, CT, USA
| | | | - Teri A Longacre
- Department of Pathology, Stanford University, Stanford, CA, USA
| | | | | | - Kelsey E McHugh
- Department of Pathology, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Jinru Shia
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Maria Westerhoff
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Amitabh Srivastava
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Wei Chen
- Department of Pathology, The Ohio State University, Columbus, OH, USA
| | - Jennifer Vazzano
- Department of Pathology, The Ohio State University, Columbus, OH, USA
| | - Paul E Swanson
- Department of Pathology, University of Washington, Seattle, WA, USA
| | | | - Hassam Cheema
- Department of Pathology, Washington University in St. Louis, St. Louis, MO, USA
| | - Changqing Ma
- Department of Pathology, Washington University in St. Louis, St. Louis, MO, USA
| | - Rifat Mannan
- Department of Pathology, City of Hope, Duarte, CA, USA
| | - Runjan Chetty
- Department of Pathology, University Health Network, Toronto, ON, Canada
| | - Klaudia M Nowak
- Department of Pathology, University Health Network, Toronto, ON, Canada
| | - Stefano Serra
- Department of Pathology, University Health Network, Toronto, ON, Canada
| | - Diana Agostini-Vulaj
- Department of Pathology, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Patrick Henn
- Department of Pathology, University of Colorado, Aurora, CO, USA
| | - Sanjay Kakar
- Department of Pathology, University of California San Francisco, San Francisco, CA, USA
| | - Won-Tak Choi
- Department of Pathology, University of California San Francisco, San Francisco, CA, USA
| | - Oyedele Adeyi
- Department of Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Sarah M Jenkins
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Iris D Nagtegaal
- Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands
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Chohan S, Ahuja S, Sharma A, Zaheer S. Collision-type adenosquamous carcinoma of the colon with signet-ring adenocarcinoma: A rare case report. Int J Surg Case Rep 2025; 127:110808. [PMID: 39793336 PMCID: PMC11864153 DOI: 10.1016/j.ijscr.2024.110808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2024] [Revised: 12/23/2024] [Accepted: 12/28/2024] [Indexed: 01/13/2025] Open
Abstract
INTRODUCTION AND IMPORTANCE Adenosquamous carcinoma (ASC) of the colon is a rare malignancy, representing approximately 0.06 % of colorectal cancers (CRC). It is characterized by the coexistence of adenocarcinoma and squamous cell carcinoma components. CASE PRESENTATION Here, we present a unique case of a 47-year-old male diagnosed with collision-type ASC, featuring both signet-ring adenocarcinoma and squamous cell carcinoma. The patient presented with abdominal pain and distension, and imaging revealed multiple colonic strictures and lymphadenopathy. Surgical intervention included an extended left hemicolectomy. Histopathology confirmed the presence of two distinct tumor components, with no evidence of lymph node metastasis. Immunohistochemistry was positive for p63 in the squamous cell component, while HPV DNA testing was negative. CLINICAL DISCUSSION ASC is known for its aggressive clinical course and poor prognosis compared to adenocarcinoma. Although rare, its clinical and histopathological features are important for guiding management. CONCLUSION This case represents the first reported instance of a collision-type colon ASC with a signet-ring adenocarcinoma component. The patient is currently undergoing neoadjuvant chemotherapy with the modified FOLFOX6 regimen and responding well. Further research is required to elucidate the molecular mechanisms underlying ASC and improve therapeutic outcomes.
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Affiliation(s)
- Shikhar Chohan
- Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Sana Ahuja
- Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Anant Sharma
- Department of Radiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Sufian Zaheer
- Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
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Cornwell C, Kim TJ, Byrne CM. An unexpected primary squamous cell carcinoma of the left colon: a rare case report. J Surg Case Rep 2024; 2024:rjae680. [PMID: 39606043 PMCID: PMC11602190 DOI: 10.1093/jscr/rjae680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2024] [Accepted: 09/21/2024] [Indexed: 11/29/2024] Open
Abstract
Colorectal cancer is a common cancer with a large burden of disease. Adenocarcinomas account for majority of colorectal cancers, arising from glandular epithelium. Other malignancies including neuroendocrine, adenosquamous, spindle cell and squamous cell carcinomas (SCCs) are seldomly encountered. Primary colorectal SCC was first reported in 1919 and is particularly rare. It is difficult to manage as patients present late, with locally invasive or metastatic disease. We present the case of a woman in her 40s with a previously resected sigmoid adenocarcinoma and a new splenic flexure mass. Histopathology revealed an SCC without evidence of extra-colonic disease. The patient underwent resection with clear margins, however, did not tolerate systemic adjuvant treatment and developed local recurrence within twelve months. We add our patient's case to the small compilation of cases of primary colorectal SCC along with a summary of its clinical and histological characteristics, strategies in management and considerations for future research.
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Affiliation(s)
- Charlotte Cornwell
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, 50 Missenden Road Camperdown, NSW 2050, Australia
| | - Tae Jun Kim
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, 50 Missenden Road Camperdown, NSW 2050, Australia
- Surgical Outcomes and Research Centre (SOuRCe), Sydney Local Health District, Royal Prince Alfred Hospital, Level 9, Building, 89 Missenden Rd, Camperdown, NSW 2050, Australia
| | - Chris M Byrne
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, 50 Missenden Road Camperdown, NSW 2050, Australia
- Surgical Outcomes and Research Centre (SOuRCe), Sydney Local Health District, Royal Prince Alfred Hospital, Level 9, Building, 89 Missenden Rd, Camperdown, NSW 2050, Australia
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4
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Lieb DA, M. Thompson H, Verheij FS, Shia J, Sanchez-Vega F, Karagkounis G, Widmar M, Wei IH, Smith JJ, Nash GM, Weiser MR, Paty PB, Cercek A, Saltz LB, Garcia-Aguilar J, Pappou E. Colonic Adenosquamous Carcinoma: A Single-Center Review of Patient Clinicopathologic Characteristics, Genetics, and Clinical Outcomes. Cancers (Basel) 2024; 16:2641. [PMID: 39123369 PMCID: PMC11311507 DOI: 10.3390/cancers16152641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 07/20/2024] [Accepted: 07/23/2024] [Indexed: 08/12/2024] Open
Abstract
(1) Background: Adenosquamous carcinoma (ASC) is a rare subtype of colon cancer. Its rarity makes characterization challenging, although colonic ASC is believed to present at more advanced stages and have worse outcomes versus adenocarcinoma. This study aims to characterize the clinicopathological characteristics and clinical outcomes of colonic ASC. (2) Methods: This is a single-center, retrospective review of patients diagnosed with colonic ASC from 2000 to 2020. Data extracted included patient demographics, staging at diagnosis, tumor clinicopathologic and genetic characteristics, and clinical outcomes. (3) Results: Among 61,126 patients with colorectal cancer, 13 (0.02%) had colonic ASC, with a mean age at diagnosis of 48.7 years. The cecum/ascending colon was the most common primary site (6/13, 46.2%), and all except one patient was diagnosed with Stage III or IV disease. Among the eight patients with mismatch repair genetics available, only one was mismatch repair deficient. Eleven patients (84.6%) underwent surgery, and 11 likewise received some form of chemotherapy. Recurrence occurred in 7 of 13 patients (53.8%), and the overall five-year survival rate was 38.5%. The median survival rate was 39.4 months overall (30.5 months for Stage III, 23.7 months for Stage IV). (4) Conclusions: Overall, colonic ASC is rare, and this cohort of colonic ASC patients demonstrated advanced stage at diagnosis, frequent recurrence, and poor overall survival. Additional research remains to compare these characteristics with those of comparably staged adenocarcinoma and to develop specific management recommendations.
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Affiliation(s)
- David A. Lieb
- Department of Colorectal Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA (I.H.W.); (J.J.S.); (M.R.W.)
- Army Medical Department (AMEDD) Student Detachment, US Army Medical Center of Excellence, JBSA Fort Sam Houston, Fort Sam Houston, TX 78234, USA
| | - Hannah M. Thompson
- Department of Colorectal Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA (I.H.W.); (J.J.S.); (M.R.W.)
| | - Floris S. Verheij
- Department of Colorectal Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA (I.H.W.); (J.J.S.); (M.R.W.)
| | - Jinru Shia
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA
| | - Francisco Sanchez-Vega
- Department of Computational Biology, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA
| | - Georgios Karagkounis
- Department of Colorectal Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA (I.H.W.); (J.J.S.); (M.R.W.)
| | - Maria Widmar
- Department of Colorectal Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA (I.H.W.); (J.J.S.); (M.R.W.)
| | - Iris H. Wei
- Department of Colorectal Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA (I.H.W.); (J.J.S.); (M.R.W.)
| | - J. Joshua Smith
- Department of Colorectal Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA (I.H.W.); (J.J.S.); (M.R.W.)
| | - Garrett M. Nash
- Department of Colorectal Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA (I.H.W.); (J.J.S.); (M.R.W.)
| | - Martin R. Weiser
- Department of Colorectal Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA (I.H.W.); (J.J.S.); (M.R.W.)
| | - Philip B. Paty
- Department of Colorectal Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA (I.H.W.); (J.J.S.); (M.R.W.)
| | - Andrea Cercek
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA
| | - Leonard B. Saltz
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA
| | - Julio Garcia-Aguilar
- Department of Colorectal Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA (I.H.W.); (J.J.S.); (M.R.W.)
| | - Emmanouil Pappou
- Department of Colorectal Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA (I.H.W.); (J.J.S.); (M.R.W.)
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Larkins MC, Bhatt A, Irish W, Kennedy KN, Burke A, Armel K, Honaker MD. Squamous cell carcinoma of the colon: evaluation of treatment modalities and survival. J Gastrointest Surg 2024; 28:1122-1125. [PMID: 38723998 DOI: 10.1016/j.gassur.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 04/24/2024] [Accepted: 05/04/2024] [Indexed: 05/23/2024]
Abstract
BACKGROUND Squamous cell carcinoma of the colon (CSCC) is a rare subtype of colon cancer. This study aimed to evaluate treatment strategies and overall survival (OS). METHODS Using the Surveillance, Epidemiology, and End Results program database from 2008 to 2019, patients aged 18 years with CSCC were identified. Treatment strategies and OS were summarized using the Kaplan-Meier analysis and the log-rank test. Adjusted Cox proportional hazards regression model ratios were calculated to evaluate the effect of confounding variables. RESULTS After exclusions, 153 patients met the inclusion criteria. The most common treatment modalities included surgery alone (52.1%), surgery and adjuvant chemotherapy (12.9%), and no treatment (26.4%). Kaplan-Meier analysis revealed that patients who underwent surgery and adjuvant chemotherapy had significant improvements in OS (log-rank P = .002). Cox regression analysis revealed tumor grade (hazard ratio [HR], 2.12; 95% CI, 1.17-3.86) and receipt of chemotherapy (HR, 2.66; 95% CI, 1.23-5.76) as the only factors associated with improvements in OS. CONCLUSION Patients who underwent surgery in combination with chemotherapy had better OS than those who underwent surgery alone. Tumor grade and receipt of chemotherapy were independently associated with OS.
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Affiliation(s)
- Michael C Larkins
- Brody School of Medicine, East Carolina University Brody School of Medicine, Greenville, North Carolina, United States
| | - Arjun Bhatt
- Brody School of Medicine, East Carolina University Brody School of Medicine, Greenville, North Carolina, United States
| | - William Irish
- Division of Surgical Research, Department of Surgery, East Carolina University Brody School of Medicine, Greenville, North Carolina, United States
| | - Katie N Kennedy
- Department of Hematology and Oncology, East Carolina University Brody School of Medicine, Greenville, North Carolina, United States
| | - Aidan Burke
- Department of Radiation Oncology, East Carolina University Brody School of Medicine, Greenville, North Carolina, United States
| | - Kristen Armel
- Brody School of Medicine, East Carolina University Brody School of Medicine, Greenville, North Carolina, United States
| | - Michael D Honaker
- Division of Surgical Oncology, Department of Surgery, East Carolina University Brody School of Medicine, Greenville, North Carolina, United States.
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6
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Ono Y, Yilmaz O. Emerging and under-recognised patterns of colorectal carcinoma morphologies: a comprehensive review. J Clin Pathol 2024; 77:439-451. [PMID: 38448211 DOI: 10.1136/jcp-2023-208816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/22/2024] [Indexed: 03/08/2024]
Abstract
While the overwhelming majority of colorectal carcinomas (CRC) are diagnosed as adenocarcinoma not otherwise specified, there are numerous under-recognised morphologic patterns of CRC. These patterns are recognised by the WHO, appear in reporting manuals for the American Joint Committee of Cancer, and/or are listed on synoptic reports, while many other variants have either fallen out of favour or are emerging as future bona fide patterns. Herein, we discuss 13 variants: serrated adenocarcinoma, micropapillary adenocarcinoma, medullary carcinoma, neuroendocrine carcinoma, mucinous adenocarcinoma, signet-ring cell carcinoma, adenosquamous carcinoma, adenoma-like adenocarcinoma, lymphoglandular complex-like CRC, carcinoma with sarcomatoid components, cribriform-comedo-type adenocarcinoma, undifferentiated carcinoma and low-grade tubuloglandular adenocarcinoma. The purpose of this review is to scrutinise these variants by assessing their clinical characteristics, morphologic cues, as well as pitfalls, and address their prognostic significance. Our analysis aims to bring clarity and updated understanding to these variants, offering valuable insights for pathologists. This contributes to more nuanced CRC diagnosis and treatment strategies, highlighting the importance of recognising a broad spectrum of morphologic patterns in CRC.
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Affiliation(s)
- Yuho Ono
- Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Osman Yilmaz
- Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
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7
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Collie BL, Bello G, Hernandez AE, Sanchez LQ, Meece M, Lyons NB, Jackson A, Hui VW. The Enigma That is Rectal Squamous Cell Carcinoma: A Case Series. J Surg Res 2024; 298:335-340. [PMID: 38663259 DOI: 10.1016/j.jss.2024.03.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/28/2024] [Accepted: 03/22/2024] [Indexed: 06/03/2024]
Abstract
INTRODUCTION Colorectal cancer is the third most common cancer and the third leading cause of cancer deaths in the United States. As rectal squamous cell carcinoma (SCC) is an uncommon colorectal cancer, there is limited data on this clinical entity. We aimed to evaluate the tumor characteristics, treatment, and clinical outcomes of this rare deadly disease. METHODS Pathological specimens from 2017 to 2022 at a single National Cancer Institute-designated cancer center were screened for all rectal cases with a diagnosis of SCC. All patients with a primary rectal SCC were included. Patients who had extension to the dentate line or evidence of an anal mass, and those who were treated at an outside institution, were excluded. Demographic, treatment, outcome, and surveillance data was extracted. RESULTS There were 56 specimens identified, nine of which met inclusion criteria. Most patients were White (78%), Hispanic (78%), and female (67%). The average age at diagnosis was 57 y [52-65]. All patients had nodal involvement at the time of clinical staging. All patients were treated with Nigro protocol, with one patient treated with surgery first. The median time of follow-up was 12 mo after initial treatment, 33% had recurrence, with median time to recurrence of 25 mo. Overall, mortality from rectal SCC was 33% at a median time of 37 mo from initial diagnosis. CONCLUSIONS Rectal SCC is a colorectal cancer that is not fully understood. Our findings showed that treatment mirrors that of anal SCC, with similar rates of survival to both rectal adenocarcinoma and anal SCC.
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Affiliation(s)
- Brianna L Collie
- Dewitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida.
| | - Gianna Bello
- Dewitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Alexandra E Hernandez
- Dewitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Liz Quesada Sanchez
- Dewitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Matthew Meece
- Dewitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Nicole B Lyons
- Dewitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Alricka Jackson
- Dewitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Vanessa W Hui
- Dewitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida
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8
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Yoon EJ, Song SG, Kim JW, Kim HC, Kim HJ, Hur YH, Hong JH. Comprehensive CT Imaging Analysis of Primary Colorectal Squamous Cell Carcinoma: A Retrospective Study. Tomography 2024; 10:674-685. [PMID: 38787012 PMCID: PMC11125812 DOI: 10.3390/tomography10050052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 04/15/2024] [Accepted: 04/30/2024] [Indexed: 05/25/2024] Open
Abstract
The aim of this study was to evaluate the findings of CT scans in patients with pathologically confirmed primary colorectal squamous-cell carcinoma (SCC). The clinical presentation and CT findings in eight patients with pathologically confirmed primary colorectal squamous-cell carcinoma were retrospectively reviewed by two gastrointestinal radiologists. Hematochezia was the most common symptom (n = 5). The tumors were located in the rectum (n = 7) and sigmoid colon (n = 1). The tumors showed circumferential wall thickening (n = 4), bulky mass (n = 3), or eccentric wall thickening (n = 1). The mean maximal wall thickness of the involved segment was 29.1 mm ± 13.4 mm. The degree of tumoral enhancement observed via CT was well enhanced (n = 4) or moderately enhanced (n = 4). Necrosis within the tumor was found in five patients. The mean total number of metastatic lymph nodes was 3.1 ± 3.3, and the mean short diameter of the largest metastatic lymph node was 16.6 ± 5.7 mm. Necrosis within the metastatic node was observed in six patients. Invasions to adjacent organs were identified in five patients (62.5%). Distant metastasis was detected in only one patient. In summary, primary SCCs that arise from the colorectum commonly present as marked invasive wall thickening or a bulky mass with heterogeneous well-defined enhancement, internal necrosis, and large metastatic lymphadenopathies.
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Affiliation(s)
- Eun Ju Yoon
- Department of Radiology, Chosun University Hospital and Chosun University College of Medicine, Gwangju 61453, Republic of Korea
| | - Sang Gook Song
- Department of Radiology, Chosun University Hospital and Chosun University College of Medicine, Gwangju 61453, Republic of Korea
| | - Jin Woong Kim
- Department of Radiology, Chosun University Hospital and Chosun University College of Medicine, Gwangju 61453, Republic of Korea
| | - Hyun Chul Kim
- Department of Radiology, Chosun University Hospital and Chosun University College of Medicine, Gwangju 61453, Republic of Korea
| | - Hyung Joong Kim
- Medical Science Research Institute, Kyung Hee University Hospital, Seoul 02447, Republic of Korea
| | - Young Hoe Hur
- Department of Hepato-Biliary-Pancreas Surgery, Chonnam National University Hwasun Hospital and Chonnam National University Medical School, Gwangju 61469, Republic of Korea
| | - Jun Hyung Hong
- Department of Radiology, Chosun University Hospital and Chosun University College of Medicine, Gwangju 61453, Republic of Korea
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Wu X, Su S, Wei Y, Hong D, Wang Z. Case Report: A management strategy and clinical analysis of primary squamous cell carcinoma of the colon. Front Oncol 2023; 13:1265421. [PMID: 37901330 PMCID: PMC10600022 DOI: 10.3389/fonc.2023.1265421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 09/18/2023] [Indexed: 10/31/2023] Open
Abstract
Primary colorectal squamous cell carcinoma (CSCC) is a rare pathological subtype. Currently, clinical data with regards to its prognosis and treatment is limited, and there is no optimal treatment method. The case presented involves a proficient mismatch repair (pMMR) and microsatellite-stable (MSS) Colorectal cancer (CRC) patient with squamous cell carcinoma (SCC) located transversely in the colon. Based on the imaging assessment, the tumor infiltration depth is classified as T4. After receiving 4 cycles of neoadjuvant treatment with oxaliplatin and capecitabine (XELOX), the patients were evaluated for partial response (PR) in 2 cycles and stable disease (SD) in 4 cycles. The patient underwent a right hemicolectomy and received postoperative paclitaxel/cisplatin (TC) adjuvant chemotherapy. After 23 months, a systemic examination revealed abdominal metastasis. A needle biopsy was conducted on the detected abdominal metastases, with the resulting pathology indicating the presence of metastatic SCC. The individual exhibited expression of programmed cell death ligand 1 (PD-L1) and a mutation in the TP53 gene. Considering the patient's disease recurrence based on medical history, a treatment plan was formulated. This involved Sintilimab plus Cetuximab and the combination of leucovorin, fluorouracil, and irinotecan (FOLFIRI) regimen. The patient received four cycles of treatment with an efficacy evaluation of SD- and seven cycles of treatment with an efficacy evaluation of SD+, which resulted in a progression-free survival (PFS) duration of 7 months. This case study presents the conventional XELOX chemotherapy protocol, which has shown limited effectiveness, and highlights the favorable results achieved by implementing the TC adjuvant chemotherapy regimen in individuals diagnosed with primary colonic SCC. Furthermore, combining immune checkpoint blockade (ICB) with other therapies for patients with advanced disease is anticipated to provide an extended duration of survival.
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Affiliation(s)
| | | | | | - Dan Hong
- Department of Medical Oncology, Affiliated Hospital of Hebei University, Baoding, China
| | - Zhiyu Wang
- Department of Medical Oncology, Affiliated Hospital of Hebei University, Baoding, China
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10
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Ciardiello D, Del Tufo S, Parente P, Gravina AG, Selvaggi F, Panarese I, Franco R, Caterino M, Martini G, Ciardiello F, Grassi R, Cappabianca S, Reginelli A, Martinelli E. Case report of unusual synchronous anal and rectal squamous cell carcinoma: clinical and therapeutic lesson. Front Oncol 2023; 13:1187623. [PMID: 37361596 PMCID: PMC10285495 DOI: 10.3389/fonc.2023.1187623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
Synchronous tumors of the rectum and anus are sporadic. Most cases in the literature are rectal adenocarcinomas with concomitant anal squamous cell carcinoma. To date, only two cases of concomitant squamous cell carcinomas of the rectum and anus are reported, and both were treated with up-front surgery and received abdominoperineal resection with colostomy. Here, we report the first case in the literature of a patient with synchronous HPV-positive squamous cell carcinoma of the rectum and anus treated with definitive chemoradiotherapy with curative intent. The clinical-radiological evaluation demonstrated complete tumor regression. After 2 years of follow-up, no evidence of recurrence was observed.
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Affiliation(s)
- Davide Ciardiello
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology (IEO), IRCCS, Milan, Italy
- Oncology Unit, Department of Precision Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Sara Del Tufo
- Radiology Unit, Department of Precision Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Paola Parente
- Pathology Unit, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Antonietta Gerarda Gravina
- Gastroenterology Unit, Department of Precision Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Francesco Selvaggi
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Iacopo Panarese
- Pathology UniV, Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Renato Franco
- Pathology UniV, Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Napoli, Italy
| | | | - Giulia Martini
- Oncology Unit, Department of Precision Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Fortunato Ciardiello
- Oncology Unit, Department of Precision Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Roberto Grassi
- Radiology Unit, Department of Precision Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Salvatore Cappabianca
- Radiology Unit, Department of Precision Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Alfonso Reginelli
- Radiology Unit, Department of Precision Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Erika Martinelli
- Oncology Unit, Department of Precision Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
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11
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Hamzaoui JEL, Sekkat H, Bahrou N, Jahid A, Elouarith I, Hrora A. Atypical mid rectal localization of squamous cell carcinoma: A case report and literature review. Int J Surg Case Rep 2023; 106:108215. [PMID: 37119755 PMCID: PMC10173187 DOI: 10.1016/j.ijscr.2023.108215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/10/2023] [Accepted: 04/10/2023] [Indexed: 05/01/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Squamous cell carcinoma occurring in the rectum is a very rare malignancy. When encountered in the gastrointestinal tract, it usually involves the esophagus or the anal canal. The rare incidence of rectal squamous cell carcinomas has raised quite a few questions on the hypothetical etiologies and prognosis. CASE PRESENTATION In this report, we present a case of a 73 years old woman who presented a rare case of squamous cell carcinoma, at 8 cm from the anal margin. CLINICAL DISCUSSION Optimal treatment sequence of such an uncommon disease is yet to be standardized, surgery was the gold standard management for rectal squamous cell carcinoma, but exclusive chemoradiotherapy is slowly but surely supplanting it. CONCLUSION This case allows us to engage in discussions over the uncommon location of the rectal SCC and its current treatment management. The exclusive chemoradiation therapy has given excellent results becoming the gold standard treatment of this rare entity.
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Affiliation(s)
- Jihane E L Hamzaoui
- Digestive Surgical Department C, Ibn Sina University Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco.
| | - Hamza Sekkat
- Digestive Surgical Department C, Ibn Sina University Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco
| | - Najib Bahrou
- Digestive Surgical Department C, Ibn Sina University Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco
| | - Ahmed Jahid
- Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco; Anatomopathological Department, Ibn Sina University Hospital, Rabat, Morocco
| | - Ihssan Elouarith
- Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco; Anatomopathological Department, Ibn Sina University Hospital, Rabat, Morocco
| | - Abdelmalek Hrora
- Digestive Surgical Department C, Ibn Sina University Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco
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12
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Liu Y, Du J, Zhang P, Meng W, Xiao H. Squamous cell carcinoma of ascending colon with pMMR/MSS showed a partial response to PD-1 blockade combined with chemotherapy: A case report. Front Oncol 2023; 13:1051786. [PMID: 36969074 PMCID: PMC10033877 DOI: 10.3389/fonc.2023.1051786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 02/20/2023] [Indexed: 03/11/2023] Open
Abstract
Primary colon squamous cell carcinoma (SCC) is extremely rare and associated with a poor prognosis. Moreover, there is no treatment guideline for this disease. Proficient mismatch repair/microsatellite-stable (pMMR/MSS) colorectal adenocarcinoma is refractory to immune monotherapy. Although the combination of immunotherapy with chemotherapy in pMMR/MSS colorectal cancer (CRC) is currently under investigation, the clinical activity of this approach in colorectal SCC remains unknown. In this article, we report the case of a pMMR/MSS CRC patient with ascending colon SCC who had high programmed cell death–ligand 1 (PD-L1) expression and the a missense mutation in codon 600 of the B-Raf proto-oncogene (BRAF V600E) mutation. The patient exhibited a significant response to the combination of immunotherapy and chemotherapy. After eight cycles of treatment with the combination of sintilimab and mFOLFOX6 (oxaliplatin, fluorouracil, and leucovorin), computed tomography–guided microwave ablation of the liver metastasis was performed. The patient achieved excellent durable response and continues to experience a good quality of life. The present case indicates that programmed cell death 1 blockade combined with chemotherapy may be an effective therapy for patients with pMMR/MSS colon SCC and high PD-L1 expression. Furthermore, PD-L1 expression may be a biomarker for immunotherapy in patients with colorectal SCC.
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13
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Astaras C, De Vito C, Chaskar P, Bornand A, Khanfir K, Sciarra A, Letovanec I, Corro C, Dietrich PY, Tsantoulis P, Koessler T. The first comprehensive genomic characterization of rectal squamous cell carcinoma. J Gastroenterol 2023; 58:125-134. [PMID: 36357817 PMCID: PMC9876866 DOI: 10.1007/s00535-022-01937-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/31/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Rectal cancers represent 35% of colorectal cancers; 90% are adenocarcinomas, while squamous cell carcinoma accounts for 0.3% of them. Given its rarity, little is known concerning its pathogenesis, molecular profile and therapeutic management. The current treatment trend is to treat rectal squamous cell carcinoma by analogy to anal squamous cell carcinoma with definitive chemo-radiotherapy, setting aside surgery in case of local recurrence. METHODS We performed an in-depth genomic analysis (next-generation sequencing, copy number variation, and human papilloma virus characterization) on 10 rectal squamous cell carcinoma samples and compared them in silico to those of anal squamous cell carcinoma and rectal adenocarcinoma. RESULTS Rectal squamous cell carcinoma shows 100% HPV positivity. It has a mutational (PIK3CA, PTEN, TP53, ATM, BCL6, SOX2) and copy number variation profile (3p, 10p, 10q, 16q deletion and 1q, 3q, 5p, 8q, 20p gain) similar to anal squamous cell carcinoma. PI3K/Akt/mTOR is the most commonly affected signaling pathway similarly to anal squamous cell carcinoma. Most commonly gained or lost genes seen in rectal adenocarcinoma (FLT3, CDX2, GNAS, BCL2, SMAD4, MALT1) are not found in rectal squamous cell carcinoma. CONCLUSION This study presents the first comprehensive genomic characterization of rectal squamous cell carcinoma. We confirm the existence of this rare histology and its molecular similarity with anal squamous cell carcinoma. This molecular proximity confirms the adequacy of therapeutic management based on histology and not localization, suggesting that rectal squamous cell carcinoma should be treated like anal squamous cell carcinoma and not as a rectal adenocarcinoma.
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Affiliation(s)
- Christoforos Astaras
- grid.150338.c0000 0001 0721 9812Medical Oncology Department, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, 1205 Geneva, Switzerland
| | - Claudio De Vito
- grid.150338.c0000 0001 0721 9812Pathology Department, Geneva University Hospitals, Geneva, Switzerland
| | - Prasad Chaskar
- grid.150338.c0000 0001 0721 9812Pathology Department, Geneva University Hospitals, Geneva, Switzerland
| | - Aurelie Bornand
- grid.150338.c0000 0001 0721 9812Pathology Department, Geneva University Hospitals, Geneva, Switzerland
| | - Kaouthar Khanfir
- grid.418149.10000 0000 8631 6364Radiation Oncology Department, Valais Hospital, Sion, Switzerland
| | - Amedeo Sciarra
- grid.418149.10000 0000 8631 6364Histopathology, Central Institute, Valais Hospital, Sion, Switzerland
| | - Igor Letovanec
- grid.418149.10000 0000 8631 6364Histopathology, Central Institute, Valais Hospital, Sion, Switzerland
| | - Claudia Corro
- grid.150338.c0000 0001 0721 9812Medical Oncology Department, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, 1205 Geneva, Switzerland ,grid.511014.0Swiss Cancer Center Léman, Lausanne, Geneva Switzerland ,grid.8591.50000 0001 2322 4988Translational Research Center in Onco-Hematology, Department of Medicine, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland
| | - Pierre-Yves Dietrich
- grid.150338.c0000 0001 0721 9812Medical Oncology Department, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, 1205 Geneva, Switzerland ,grid.511014.0Swiss Cancer Center Léman, Lausanne, Geneva Switzerland ,grid.8591.50000 0001 2322 4988Translational Research Center in Onco-Hematology, Department of Medicine, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland
| | - Petros Tsantoulis
- grid.150338.c0000 0001 0721 9812Medical Oncology Department, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, 1205 Geneva, Switzerland ,grid.8591.50000 0001 2322 4988Translational Research Center in Onco-Hematology, Department of Medicine, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland
| | - Thibaud Koessler
- Medical Oncology Department, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, 1205, Geneva, Switzerland. .,Swiss Cancer Center Léman, Lausanne, Geneva, Switzerland.
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14
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Hervé L, Kim S, Boustani J, Klajer E, Pernot M, Nguyen T, Lakkis Z, Borg C, Vienot A. Modified DCF (Docetaxel, Cisplatin and 5-fluorouracil) chemotherapy is effective for the treatment of advanced rectal squamous cell carcinoma. Front Oncol 2022; 12:974108. [DOI: 10.3389/fonc.2022.974108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 11/04/2022] [Indexed: 11/19/2022] Open
Abstract
BackgroundAdvanced rectal squamous cell carcinoma (rSCC) is a very rare and aggressive entity, and the best initial management is crucial for long survival as well as organ preservation and quality of life. Whereas local diseases are treated with chemo-radiotherapy and salvage surgery, data are scarce on how to treat more advanced diseases, and the role of induction chemotherapy is unknown.MethodsWe retrospectively analyzed all consecutive patients with advanced rSCC and treated with modified DCF (docetaxel, cisplatin, 5-fluorouracil; mDCF) regimen, from January 2014 and December 2021 in two French centers. Exploratory endpoints were efficacy (overall survival, recurrence-free survival, response rate, organ preservation rate) and safety.ResultsNine patients with locally advanced or metastatic diseases received a mDCF regimen and were included for analysis. The median age was 62.0 years, 7 patients (77.8%) were women, and all eight available tumors were positive for HPV, mostly (85.7%) to genotype 16. With a median follow-up of 33.1 months, 77.8% of patients were still alive and disease-free, and the median overall survival was not reached at six years. The objective response rate was 87.5% after mDCF, and the complete response rate was 25.0% after mDCF and was increased to 75.0% after chemoradiotherapy. Only one patient underwent surgery on the primary tumor, with a complete pathological response. The median mDCF cycle was eight over eight scheduled, and all patients received the complete dose of radiotherapy without interruptions.ConclusionsInduction mDCF chemotherapy followed by chemoradiotherapy is safe and highly effective in patients with advanced rSCC, and should be considered as an option in metastatic stage or locally advanced disease with an organ-preservation strategy.
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15
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Id Said B, Buchan D, Liu Z, Kim J, Hosni A, Brierley JD, Chadi S, Grant RC, Kalimuthu S, Liu ZA, Lukovic J. Demographics, pattern of practice and clinical outcomes in rectal squamous cell carcinoma. Colorectal Dis 2022; 25:608-615. [PMID: 36394982 DOI: 10.1111/codi.16417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 09/30/2022] [Accepted: 10/10/2022] [Indexed: 11/18/2022]
Abstract
AIM The aim of this study was to describe the baseline clinical features, treatment patterns and outcomes in rectal squamous cell carcinoma (SCC). METHOD This is a retrospective study of patients with rectal SCC treated at the Princess Margaret Cancer Centre (Toronto, Canada) between 1 January 1995 and 31 December 2020. Clinical factors associated with locoregional failure (LRF), distant metastases (DM), disease-free survival (DFS) and overall survival (OS), such as age, sex, HIV status, T-category, nodal status, grade and primary treatment, were investigated with univariate analysis (UVA). RESULTS Twenty nine patients with rectal SCC were analysed with a median follow-up of 7.4 years (range 0.3-20.4 years). The median age at diagnosis was 52 years, with the majority presenting with clinical T3 disease or higher (n = 21, 72%) and positive regional lymph nodes (n = 16, 55%), while more than quarter of patients (28%) had metastatic disease. Definitive chemoradiation was the treatment modality of choice in more than half of all cases (n = 17, 59%) with a response rate of 100%. The 10-year cumulative incidence of LRF and DM was, respectively, 12% (95% CI 1.8%-32.9%) and 31% (95% CI: 12.0%-52.6%). The 5- and 10-year OS was 82% (95% CI 66.1%-100%). UVA revealed a trend towards an association of male gender (hazard ratio = 4.65, 95% CI 0.9%-24.1; p = 0.067) and primary surgical treatment (hazard ratio = 0.76, 95% CI 0.09-6.34; p = 0.061) with DFS. CONCLUSION Definitive chemoradiation is an effective and preferred treatment for rectal SCC allowing for sphincter preservation with complete clinical response observed in all patients.
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Affiliation(s)
- Badr Id Said
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - David Buchan
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Zijin Liu
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - John Kim
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Ali Hosni
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - James D Brierley
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Sami Chadi
- Department of General Surgery, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Robert C Grant
- Department of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Sangeetha Kalimuthu
- Department of Pathology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Zhihui Amy Liu
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Jelena Lukovic
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
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16
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Parente P, Mastracci L, Vanoli A, Businello G, Paudice M, Angerilli V, Castelvetere M, Graziano P, Fassan M, Grillo F. Colorectal adenosquamous carcinoma: Peculiar morphologic features and distinct immunoprofiles in squamous and glandular components. Pathol Res Pract 2022; 236:153967. [PMID: 35662040 DOI: 10.1016/j.prp.2022.153967] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/25/2022] [Accepted: 05/28/2022] [Indexed: 11/21/2022]
Abstract
Colorectal adenosquamous carcinoma (ASC) is exceedingly rare, comprising less than 0.1% of all colorectal malignancies, and is characterized by the admixture of glandular and squamous components. Due to its rarity, immunohistochemical and biological profiles have not been well investigated. The clinico-pathologic features of 29 cases of primary colorectal adenosquamous carcinomas, including four synchronous metastases, as well as the immunohistochemical expression of keratin 20, CDX2, keratin 34βE12, keratin 5/6, p63, p40, β-Catenin, Cyclin D1 and mismatch repair protein (MMR) expression in both squamous and glandular components are described. All ASCs showed aggressive clinico-pathologic features; all cases showed at least one aggressive pathologic characteristic (poorly differentiated, vascular invasion, infiltrative growth pattern) and 69% of cases were either stage III or IV. The squamous component was keratin 34βE12 positive in all cases and keratin 5/6 positive in 27 cases, while only 7 cases showed p63 and/or p40 expression. β-Catenin and Cyclin D1 showed different expression, with nuclear staining of Cyclin D1 in the squamous component of all cases (both primary and metastatic lesions) and nuclear staining of β-Catenin predominantly in the glandular component. All but one case showed proficient MMR profile. Sixteen patients (64%) died of their disease with median survival of 10 months. ASC show aggressive clinical outcome and aggressive pathologic characteristics. A peculiar keratin 34βE12 positive profile in the squamous component is seen differing from squamous cell carcinoma and non-intestinal ASC. The staining patterns for β-Catenin and Cyclin D1 between components, supports a possible divergent clonal evolution of the neoplasm.
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Affiliation(s)
- Paola Parente
- Unit of Pathology, Fondazione IRCCS Ospedale Casa Sollievo della Sofferenza, V.le Cappuccini, 1, San Giovanni Rotondo 71013, FG, Italy.
| | - Luca Mastracci
- Ospedale Policlinico San Martino IRCCS, Largo Rosanna Benzi, 10, 16132 Genova, Italy; Anatomic Pathology, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Largo Rosanna Benzi, 10, 16132 Genova, Italy.
| | - Alessandro Vanoli
- Anatomic Pathology Unit, Department of Molecular Medicine, University of Pavia and Fondazione IRCCS San Matteo Hospital, 27100 Pavia, Italy.
| | - Gianluca Businello
- Surgical Pathology Unit, Department of Medicine (DIMED), University of Padova, 25122 Padova, Italy.
| | - Michele Paudice
- Anatomic Pathology, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Largo Rosanna Benzi, 10, 16132 Genova, Italy.
| | - Valentina Angerilli
- Surgical Pathology Unit, Department of Medicine (DIMED), University of Padova, 25122 Padova, Italy.
| | - Marina Castelvetere
- Unit of Pathology, Fondazione IRCCS Ospedale Casa Sollievo della Sofferenza, V.le Cappuccini, 1, San Giovanni Rotondo 71013, FG, Italy.
| | - Paolo Graziano
- Unit of Pathology, Fondazione IRCCS Ospedale Casa Sollievo della Sofferenza, V.le Cappuccini, 1, San Giovanni Rotondo 71013, FG, Italy.
| | - Matteo Fassan
- Surgical Pathology Unit, Department of Medicine (DIMED), University of Padova, 25122 Padova, Italy; Veneto Institute of Oncology (IOV-IRCCS), Padova, Italy.
| | - Federica Grillo
- Ospedale Policlinico San Martino IRCCS, Largo Rosanna Benzi, 10, 16132 Genova, Italy; Anatomic Pathology, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Largo Rosanna Benzi, 10, 16132 Genova, Italy.
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17
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Nassar H, Ataya K, Hafez B, El Bsat A, Geagea L, Faraj W. Primary squamous cell carcinoma of the colon: A rare case report. Int J Surg Case Rep 2022; 96:107383. [PMID: 35810685 PMCID: PMC9284062 DOI: 10.1016/j.ijscr.2022.107383] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 06/28/2022] [Accepted: 06/30/2022] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Squamous cell carcinoma (SCC) of the colon is an extremely rare pathologic entity, accounting for less than 1 % of all colorectal cancer cases. They tend to be very aggressive with poor outcomes and treatment strategies are still controversial due to the paucity of data available to guide management. CASE PRESENTATION A case of a cecal mass with metastatic liver lesions. Initially diagnosed as an adenocarcinoma, the patient underwent resection with metastasectomy. Despite achieving negative surgical margins and undergoing adjuvant chemotherapy, the patient relapsed and presented with a new mass in the descending colon. The patient underwent resection with subsequent follow-up revealing distant metastasis. The patient passed away soon after. CLINICAL DISCUSSION Primary colorectal SCC has similar presentation to adenocarcinoma of the colon. Unfortunately, it usually presents at a late stage. Diagnosis of colorectal SCC requires histologic confirmation of SCC plus exclusion of possible causes. Management is predominantly definitive radical resection followed by adjuvant chemotherapy and radiotherapy. Surgical margins should be at least 5 cm, preferably 10 cm. Lymph node yield greater than 20 was associated with improved survival. Studies assessing the prognosis of primary colorectal SCC following chemo-radiotherapy have not been done. CONCLUSION Surgery remains the most vital important step in the management of colonic SCC. The role of chemotherapy and/or radiation remains questionable. Depending on the aggressiveness of this disease the need for further frequent.
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Affiliation(s)
- Hussein Nassar
- Department of Hepatobiliary & Pancreatic Surgery, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Karim Ataya
- Department of Upper GI and Bariatric Surgery, Kings College Hospital London, London, United Kingdom
| | - Bassel Hafez
- Department of General Surgery, American University of Beirut Medical Center, Bliss Street, Beirut, Lebanon
| | - Ayman El Bsat
- Department of General Surgery, American University of Beirut Medical Center, Bliss Street, Beirut, Lebanon
| | - Luna Geagea
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Bliss Street, Beirut, Lebanon
| | - Walid Faraj
- Department of General Surgery, American University of Beirut Medical Center, Bliss Street, Beirut, Lebanon,Corresponding author at: Department of General Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
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18
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Wang R, Yan Z. A "conversion-deterioration-double mutation" theory for the evolution and progression of colorectal cancer. Cancer Med 2022; 11:2601-2611. [PMID: 35285179 PMCID: PMC9249989 DOI: 10.1002/cam4.4637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/11/2022] [Accepted: 01/28/2022] [Indexed: 11/09/2022] Open
Abstract
In this study, based on some clinical phenomena and recently published knowledge, we proposed our "conversion-deterioration-double mutation" theory, which provides a possible unifying explanation for the evolutionary process of colorectal cancer cells in the human body. In this theory, we proposed that there is a partial interconversion and a jump conversion relationship among normal colorectal epithelial cells, colorectal cancer cells, stem cells, and cancer stem cells (conversion). This conversion leads to tumor heterogeneity. We also proposed that well-differentiated cancer cells converted from cancer stem cells have a more aggressive pattern than primary cancer cells (deterioration). The deterioration of primary cancer cells leads to differences in treatment responses and prognosis. Finally, we speculate a double mutation theory, indicating that for metastasis to occur, both mutations of cancer cells and mutations of target organs are needed and should match and meet. All these three points constitute the "conversion-deterioration-double mutation" theory.
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Affiliation(s)
- Rui Wang
- Department of Critical Care MedicineShengjing Hospital of China Medical UniversityShenyangChina
| | - Zhaopeng Yan
- Department of General SurgeryShengjing Hospital of China Medical UniversityShenyangChina
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19
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Yang Y, Yu J, Hu J, Zhou C, Niu J, Ma H, Han J, Fan S, Liu Y, Zhao Y, Zhao L, Wang G. A systematic and comprehensive analysis of colorectal squamous cell carcinoma: Implication for diagnosis and treatment. Cancer Med 2022; 11:2492-2502. [PMID: 35194959 PMCID: PMC9189455 DOI: 10.1002/cam4.4616] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/26/2021] [Accepted: 12/27/2021] [Indexed: 11/18/2022] Open
Abstract
Background This study was aimed at establishing a nomogram for survival prediction of Colorectal squamous cell carcinoma (CSCC), understanding the molecular pathogenesis, exploring a better treatment, and predicting the potential therapeutic agents. Methods Surveillance, Epidemiology, and End Results (SEER) database was used to obtained CSCC patients and the nomogram was performed. Propensity score matching (PSM), Kaplan–Meier analysis, subgroup analysis, and interaction test were used to explore the better treatment strategy for CSCC. Bioinformatics were used to explore the molecular mechanism and potential therapeutic drugs of CSCC. Results A total of 3949 CSCC patients were studied. The nomogram was constructed and evaluated to have a good performance. We found that the radiotherapy had a better effect than surgery, and the difference between radiotherapy and combined therapy was not significant. 821 differentially expressed genes in CSCC were obtained from GSE6988 dataset. DNA damage repair, mismatch repair, and cell cycle pathways might contribute to CSCC occurrence as indicated by KEGGpathway and GSEA analysis. Transcription factors analysis revealed that TP63 and STAT1 may have an important role in occurrence and development of CSCC. 1607 potential drugs against CSCC were found using the CMAP database, and molecular docking was carried out to show the binding energy between TP63 and drugs. Conclusions A good prognosis nomogram was constructed for CSCC. We also have a better understanding of the underlying molecular mechanisms of occurrence and development of CSCC and predicted potential therapeutic drugs, providing a theoretical basis for the treatment of CSCC.
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Affiliation(s)
- Yang Yang
- Department of Gastrointestinal Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jiarui Yu
- Department of Radiation Oncology, North China University of Science and Technology Affiliated People's Hospital, Tangshan, Hebei, China
| | - Jitao Hu
- Department of General Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Chaoxi Zhou
- Department of General Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jian Niu
- Department of General Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Hongqing Ma
- Department of General Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jiaxu Han
- Department of General Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Shaoqing Fan
- Department of General Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Youqiang Liu
- Department of General Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yalei Zhao
- Department of General Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Lianmei Zhao
- Research Centers, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Guiying Wang
- Department of Gastrointestinal Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China.,Department of General Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
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20
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Lu SB, Ge FS, Liu C, Hua YW. Adenosquamous carcinoma of sigmoid colon in an adolescent: A case report and literature review. Asian J Surg 2022; 45:1055-1056. [PMID: 35183422 DOI: 10.1016/j.asjsur.2022.01.055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 01/28/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Shuai-Bing Lu
- Department of General Surgery, The Affiliated Tumor Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Fu-Sheng Ge
- Department of General Surgery, The Affiliated Tumor Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Chen Liu
- Department of General Surgery, The Affiliated Tumor Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Ya-Wei Hua
- Department of General Surgery, The Affiliated Tumor Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China.
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21
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Seely KD, Morgan AD, Hagenstein LD, Florey GM, Small JM. Bacterial Involvement in Progression and Metastasis of Colorectal Neoplasia. Cancers (Basel) 2022; 14:1019. [PMID: 35205767 PMCID: PMC8870662 DOI: 10.3390/cancers14041019] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 02/06/2023] Open
Abstract
While the gut microbiome is composed of numerous bacteria, specific bacteria within the gut may play a significant role in carcinogenesis, progression, and metastasis of colorectal carcinoma (CRC). Certain microbial species are known to be associated with specific cancers; however, the interrelationship between bacteria and metastasis is still enigmatic. Mounting evidence suggests that bacteria participate in cancer organotropism during solid tumor metastasis. A critical review of the literature was conducted to better characterize what is known about bacteria populating a distant site and whether a tumor depends upon the same microenvironment during or after metastasis. The processes of carcinogenesis, tumor growth and metastatic spread in the setting of bacterial infection were examined in detail. The literature was scrutinized to discover the role of the lymphatic and venous systems in tumor metastasis and how microbes affect these processes. Some bacteria have a potent ability to enhance epithelial-mesenchymal transition, a critical step in the metastatic cascade. Bacteria also can modify the microenvironment and the local immune profile at a metastatic site. Early targeted antibiotic therapy should be further investigated as a measure to prevent metastatic spread in the setting of bacterial infection.
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Affiliation(s)
- Kevin D. Seely
- College of Osteopathic Medicine, Rocky Vista University, Ivins, UT 84738, USA; (A.D.M.); (L.D.H.)
| | - Amanda D. Morgan
- College of Osteopathic Medicine, Rocky Vista University, Ivins, UT 84738, USA; (A.D.M.); (L.D.H.)
| | - Lauren D. Hagenstein
- College of Osteopathic Medicine, Rocky Vista University, Ivins, UT 84738, USA; (A.D.M.); (L.D.H.)
| | - Garrett M. Florey
- College of Osteopathic Medicine, Rocky Vista University, Parker, CO 80134, USA;
| | - James M. Small
- Department of Biomedical Sciences, Rocky Vista University, Parker, CO 80134, USA;
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22
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Khan AH, Gao X, Goffredo P, Kahl AR, Utria AF, Charlton ME, Ahad S, Hassan I. Presentation, treatment, and prognosis of colorectal adenosquamous carcinoma: A contemporary analysis of the surveillance, epidemiology, and end results database. Am J Surg 2021; 223:957-962. [PMID: 34530984 DOI: 10.1016/j.amjsurg.2021.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/31/2021] [Accepted: 09/06/2021] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Colorectal adenosquamous carcinoma (ASC) represents <0.1% of colorectal cancers. Due to its rarity, there is paucity of data regarding its prognosis and treatment compared to other colorectal cancers. The aim of the study was to evaluate presentation, treatment and prognosis of colorectal ASC in comparison to adenocarcinoma (AC) and squamous cell carcinoma (SCC). METHODS Adult patients diagnosed with colorectal AC, SCC, and ASC between 2000 and 2017 were identified using Surveillance, Epidemiology, and End Results database. RESULTS Among the 446,132 patients diagnosed with colorectal cancer, 0.06% had ASC and were more likely to present with higher T stage and distant metastases compared to AC and SCC (p < 0.001). Major surgery was the primary treatment for colonic ASC, while for rectal ASC, chemotherapy and/or radiation were mainly utilized. Localized and distant colonic ASC had an unadjusted 5-year cause-specific survival that was worse than AC, while rectal ASC had the worst survival across all stages. CONCLUSION Colorectal ASC usually present with advanced stage and have overall worse prognosis. Standardization of treatment strategies may improve survival in colorectal ASC.
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Affiliation(s)
- Adil H Khan
- Raleigh General Hospital, 1710 Harper Road, Beckley, WV, 25801, USA.
| | - Xiang Gao
- Department of Surgery, University of Iowa, 200 Hawkins Dr., Iowa City, IA, 52242, USA.
| | - Paolo Goffredo
- Department of Surgery, University of Iowa, 200 Hawkins Dr., Iowa City, IA, 52242, USA.
| | - Amanda R Kahl
- Department of Epidemiology, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA, 52242, USA.
| | - Alan F Utria
- Department of Surgery, University of Iowa, 200 Hawkins Dr., Iowa City, IA, 52242, USA.
| | - Mary E Charlton
- Department of Epidemiology, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA, 52242, USA.
| | - Sajida Ahad
- Department of Surgery, University of Iowa, 200 Hawkins Dr., Iowa City, IA, 52242, USA.
| | - Imran Hassan
- Department of Surgery, University of Iowa, 200 Hawkins Dr., Iowa City, IA, 52242, USA.
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23
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Squamous rectal carcinoma: a rare malignancy, literature review and management recommendations. ESMO Open 2021; 6:100180. [PMID: 34111760 PMCID: PMC8193111 DOI: 10.1016/j.esmoop.2021.100180] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/13/2021] [Accepted: 05/17/2021] [Indexed: 11/22/2022] Open
Abstract
Squamous cell carcinoma of the rectum is a rare malignancy (0.3% of all rectal cancers), with no known risk factor. These tumours are assessed as rectal cancer using immunohistochemical and radiological tests, and certain criteria (localisation, relationship with neighbouring structures) have to be fulfilled to make the diagnosis. Some clinicians used to stage them with the anal cancer TNM (tumour–node–metastasis), whereas others used the rectal cancer TNM. When localised, the tendency nowadays is to treat those tumours like squamous anal cancers with definitive chemoradiotherapy (5-fluorouracil and mitomycin) and to skip surgery. For metastatic disease there is no clearly validated regimen and treatment should be based on recommendations of squamous anal cancers because of their common histology. Concerning follow-up after a curative approach, techniques should follow those for anal cancer as well, evaluating a delayed response.
Rectal squamous cell carcinoma (rSCC) is a rare entity for which we have limited knowledge and no clear recommendations. Creation of an international registry and a biological repository could increase our understating of this rare entity. Definitive chemoradiotherapy (CRT) should be the gold standard treatment of local/locally-advanced rSCC. Clarification of clinical and pathologic response rates with CRT or radiotherapy alone and patterns of failure is important. Timing for tumour response assessment is paramount. Data tilt towards waiting until 6 months after definitive treatment.
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24
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He Y, Wang L, Li X, Zhang T, Song T, Zhang J, Yu Y, Chen S, Song H. Rectosigmoid-Junction Squamous Cell Carcinoma With pMMR/MSS Achieved a Partial Response Following PD-1 Blockade Combined With Chemotherapy: A Case Report. Front Oncol 2021; 11:596342. [PMID: 34113555 PMCID: PMC8185331 DOI: 10.3389/fonc.2021.596342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/23/2021] [Indexed: 01/10/2023] Open
Abstract
Colorectal squamous cell carcinoma (SCC) is extremely rare and associated with a poor prognosis. And the pMMR/MSS colorectal cancer is related to a limited response to programmed death ligand-1 (PD-1) blockade monotherapy. However, the clinical activity of PD-1 blockade monotherapy or combination therapy in colorectal SCC is unknown. One patient with rectosigmoid-junction SCC was treated with PD-1 blockade combined with chemotherapy. After 3 months of PD-1 blockade and chemotherapy, the computed tomography imaging showed that this patient achieved a partial response. The next generation sequencing and immunohistochemistry analysis showed that the patient had tumors with proficient mismatch repair (pMMR) and microsatellite stability (MSS), strong PD-L1 expression, and tumor mutational burden-high (TMB-High), respectively. This case suggests that PD-1 blockade combined with chemotherapy might be an effective therapy for colorectal SCC with pMMR/MSS status. Moreover, the PD-L1 expression and TMB might be the potential predictors of PD-1 blockade response for colorectal SCC patients.
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Affiliation(s)
- Yanxin He
- Department of Internal Medicine-Oncology, Qingdao Tumor Hospital, The Second Affiliated Hospital of Medical College of Qingdao University, Qingdao, China
| | - Lunqing Wang
- Department of Thoracic Surgery, Qingdao Municipal Hospital, Qingdao, China
| | - Xiao Li
- Department of Internal Medicine-Oncology, Qingdao Tumor Hospital, The Second Affiliated Hospital of Medical College of Qingdao University, Qingdao, China
| | - Tongsong Zhang
- Department of Internal Medicine-Oncology, Qingdao Tumor Hospital, The Second Affiliated Hospital of Medical College of Qingdao University, Qingdao, China
| | - Tingting Song
- Department of Internal Medicine-Oncology, Qingdao Tumor Hospital, The Second Affiliated Hospital of Medical College of Qingdao University, Qingdao, China
| | - Junling Zhang
- The Medical Department, 3D Medicines Inc., Shanghai, China
| | - Yangyang Yu
- The Medical Department, 3D Medicines Inc., Shanghai, China
| | - Shiqing Chen
- The Medical Department, 3D Medicines Inc., Shanghai, China
| | - Haiping Song
- Department of Internal Medicine-Oncology, Qingdao Tumor Hospital, The Second Affiliated Hospital of Medical College of Qingdao University, Qingdao, China
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25
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Singhal S, Singh RB, Potdar R. Metastatic squamous cell carcinoma of the colon: a conundrum in colorectal malignancies. BMJ Case Rep 2021; 14:14/4/e240573. [PMID: 33858889 PMCID: PMC8055152 DOI: 10.1136/bcr-2020-240573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Small-cell carcinoma of the colon is an extremely rare tumour, with poorly understood pathogenesis and unestablished treatment guidelines. The first case was documented in 1919, and only about 100 cases of this condition have been reported to this date. In this case report, we present a case of sigmoid squamous cell carcinoma that eventually led to bowel perforation and was diagnosed on histopathology after emergent surgical intervention. Additionally, we also review the incidence, epidemiology, pathogenesis, immunohistological markers, neogenomics and therapeutic strategies for the same.
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Affiliation(s)
- Sachi Singhal
- Internal Medicine, Crozer-Chester Medical Center, Upland, Pennsylvania, USA
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26
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Wang Y, Yang Y, Wang X, Jin T, Zhu G, Lin Z. Ezrin as a prognostic indicator regulates colon adenocarinoma progression through glycolysis. J Gastroenterol Hepatol 2021; 36:710-720. [PMID: 32710796 DOI: 10.1111/jgh.15195] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 07/01/2020] [Accepted: 07/18/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND AND AIM Aerobic glycolysis (the Warburg effect) is a distinctive metabolic hallmark of colon adenocarcinoma. Ezrin was a member of the Ezrin-Radixin-Moesin protein family and has been found profoundly implicated in tumorigenesis. However, the specific functional roles of Ezrin in metabolic reprogramming of colon adenocarcinoma remain poorly characterized and need to be explored. METHODS The expression of Ezrin in colon adenocarcinoma tissues was screened by bioinformatics analysis and immunohistochemical assay. Si-RNA-mediated transfection and overexpression plasmid transfection were performed in colon adenocarcinoma cells. The proliferation viability was measured using MTT, colony formation, and EdU assays. The migration ability was determined using wound healing and transwell assay. The expression of EMT markers and transcriptional factors was detected using immunofluorescence staining and western blot assays. Glucose uptake, lactate production, and ATP assay were performed to validate the effect of Ezrin on glycolysis-mediated colon adenocarcinoma progression. RESULTS Ezrin was upregulated in colon adenocarcinoma tissues and associated with poor survival. Ezrin stimulated colon adenocarcinoma cell proliferation, migration, and the process of EMT. Ezrin aroused significant increase in glucose uptake, lactate production, and ATP level in colon adenocarcinoma cells. Further investigations demonstrated that treatment with a glycolytic inhibitor 2-deoxy-d-glucose reversed the effects reduced by Ezrin on colon adenocarcinoma cells. CONCLUSIONS Our results evidenced a novel mechanism for colon adenocarcinoma cells proliferation and migration induced by Ezrin via glycolysis.
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Affiliation(s)
- Yixuan Wang
- Department of Pathology and Cancer Research Center, Yanbian University Medical College, Yanji, China.,Key Laboratory of the Science and Technology Department of Jilin Province, Yanji, China
| | - Yang Yang
- Department of Pathology and Cancer Research Center, Yanbian University Medical College, Yanji, China.,Key Laboratory of the Science and Technology Department of Jilin Province, Yanji, China
| | - Xinyue Wang
- Department of Pathology and Cancer Research Center, Yanbian University Medical College, Yanji, China.,Key Laboratory of the Science and Technology Department of Jilin Province, Yanji, China
| | - Tiefeng Jin
- Department of Pathology and Cancer Research Center, Yanbian University Medical College, Yanji, China.,Key Laboratory of the Science and Technology Department of Jilin Province, Yanji, China
| | - Guang Zhu
- Department of Pathology and Cancer Research Center, Yanbian University Medical College, Yanji, China.,Key Laboratory of the Science and Technology Department of Jilin Province, Yanji, China
| | - Zhenhua Lin
- Department of Pathology and Cancer Research Center, Yanbian University Medical College, Yanji, China.,Key Laboratory of the Science and Technology Department of Jilin Province, Yanji, China
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27
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Sayhan S, Kahraman DS. Pathologic Features of Colorectal Carcinomas. COLON POLYPS AND COLORECTAL CANCER 2021:455-480. [DOI: 10.1007/978-3-030-57273-0_23] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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28
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Woischke C, Jung P, Jung A, Kumbrink J, Eisenlohr S, Auernhammer CJ, Vieth M, Kirchner T, Neumann J. Mixed large cell neuroendocrine carcinoma and squamous cell carcinoma of the colon: detailed molecular characterisation of two cases indicates a distinct colorectal cancer entity. JOURNAL OF PATHOLOGY CLINICAL RESEARCH 2020; 7:75-85. [PMID: 33197299 PMCID: PMC7737761 DOI: 10.1002/cjp2.183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/12/2020] [Accepted: 09/19/2020] [Indexed: 12/16/2022]
Abstract
We present two rare cases of mixed large cell neuroendocrine carcinoma and squamous cell carcinoma of the colon. A literature search revealed only three published cases with similar histology but none of these reports provided profound molecular and mutational analyses. Our two cases exhibited a distinct, colon-like immunophenotype with strong nuclear CDX2 and β-catenin expression in more than 90% of the tumour cells of both components. We analysed the two carcinomas regarding microsatellite stability, RAS, BRAF and PD-L1 status. In addition, next-generation panel sequencing with Ion AmpliSeq™ Cancer Hotspot Panel v2 was performed. This approach revealed mutations in FBXW7, CTNNB1 and PIK3CA in the first case and FBXW7 and RB1 mutations in the second case. We looked for similar mutational patterns in three publicly available colorectal adenocarcinoma data sets, as well as in collections of colorectal mixed neuroendocrine-non-neuroendocrine neoplasms (MiNENs) and colorectal neuroendocrine carcinomas. This approach indicated that the FBXW7 point mutation, without being accompanied by classical adenoma-carcinoma sequence mutations, such as APC, KRAS and TP53, likely occurs at a relatively high frequency in mixed neuroendocrine and squamous cell carcinoma and therefore may be characteristic for this rare tumour type. FBXW7 codifies the substrate recognition element of an ubiquitin ligase, and inactivating FBXW7 mutations lead to an exceptional accumulation of its target β-catenin which results in overactivation of the Wnt-signalling pathway. In line with previously described hypotheses of de-differentiation of colon cells by enhanced Wnt-signalling, our data indicate a crucial role for mutant FBXW7 in the unusual morphological switch that determines these rare neoplasms. Therefore, mixed large cell neuroendocrine and a squamous cell carcinoma can be considered as a distinct carcinoma entity in the colon, defined by morphology, immunophenotype and distinct molecular genetic alteration(s).
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Affiliation(s)
- Christine Woischke
- Institute of Pathology, Medical Faculty, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Peter Jung
- Institute of Pathology, Medical Faculty, Ludwig-Maximilians-Universität München, Munich, Germany.,German Cancer Consortium (DKTK), partner site, Munich, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Andreas Jung
- Institute of Pathology, Medical Faculty, Ludwig-Maximilians-Universität München, Munich, Germany.,German Cancer Consortium (DKTK), partner site, Munich, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jörg Kumbrink
- Institute of Pathology, Medical Faculty, Ludwig-Maximilians-Universität München, Munich, Germany.,German Cancer Consortium (DKTK), partner site, Munich, Germany
| | | | - Christoph Josef Auernhammer
- Medizinische Klinik und Poliklinik 4, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich, Germany.,Interdisciplinary Center of Neuroendocrine Tumors of the GastroEnteroPancreatic System (GEPNET-KUM), Klinikum der Universität München (KUM), Ludwig-Maximilians-University, Munich, Germany
| | - Michael Vieth
- Institute of Pathology, Klinikum Bayreuth, Bayreuth, Germany
| | - Thomas Kirchner
- Institute of Pathology, Medical Faculty, Ludwig-Maximilians-Universität München, Munich, Germany.,German Cancer Consortium (DKTK), partner site, Munich, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jens Neumann
- Institute of Pathology, Medical Faculty, Ludwig-Maximilians-Universität München, Munich, Germany.,German Cancer Consortium (DKTK), partner site, Munich, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
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29
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Linardoutsos D, Frountzas M, Feakins RM, Patel NH, Simanskaite V, Patel H. Primary colonic squamous cell carcinoma: a case report and review of the literature. Ann R Coll Surg Engl 2020; 102:e1-e7. [PMID: 32538102 PMCID: PMC7591611 DOI: 10.1308/rcsann.2020.0149] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2020] [Indexed: 02/06/2023] Open
Abstract
Colonic squamous cell carcinoma is extremely rare, with no clear pathogenesis. It usually presents as an emergency. We present the surgical management of a descending colon squamous cell carcinoma, together with a review of the available cases of colonic squamous cell carcinoma in the literature. A 69-year-old woman presented with a palpable mass and abdominal pain. She underwent ultrasound and colonoscopy, which revealed a large obstructing mass at the descending colon, the biopsies of which were not diagnostic. Unfortunately, she was readmitted with bowel obstruction and underwent extended right hemicolectomy with en-bloc excision of attached small bowel and omentum because of local mass expansion. Histopathological analysis demonstrated squamous cell carcinoma with lymph node metastases. Palliative chemotherapy followed, owing to liver and peritoneal deposits. Sixty-six cases of colonic squamous cell carcinoma have been reported in the literature. The most common location is the right colon. Most cases present at a late stage. Several theories for the pathogenesis of colonic squamous cell carcinoma have been reported; the most popular is the squamous transformation of a pluripotent stem cell.
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Affiliation(s)
- D Linardoutsos
- Department of Colorectal Surgery, Barts Health NHS Trust, London UK
- First Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration General Hospital, Athens, Greece
| | - M Frountzas
- First Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration General Hospital, Athens, Greece
| | - RM Feakins
- Department of Histopathology, Barts Health NHS Trust, London UK
| | - NH Patel
- Department of Colorectal Surgery, Barts Health NHS Trust, London UK
| | - V Simanskaite
- Department of Histopathology, Barts Health NHS Trust, London UK
| | - H Patel
- Department of Colorectal Surgery, Barts Health NHS Trust, London UK
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30
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Atypical Expression of CK7 and CK20 in Adenosquamous Carcinoma, Colon-a Rare Case. J Gastrointest Cancer 2020; 52:780-783. [PMID: 32924081 DOI: 10.1007/s12029-020-00512-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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31
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Nasseri Y, Cox B, Shen W, Zhu R, Stettler I, Cohen J, Artinyan A, Gangi A. Adenosquamous carcinoma: An aggressive histologic sub-type of colon cancer with poor prognosis. Am J Surg 2020; 221:649-653. [PMID: 32862977 DOI: 10.1016/j.amjsurg.2020.07.038] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/21/2020] [Accepted: 07/27/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Studies have reported worse overall survival (OS) for adenosquamous carcinoma (ASC) compared to adenocarcinoma (AC) of the colon, but none have analyzed a national dataset for over 30 years. METHODS The National Cancer Database was queried from 2004 to 2016 for patients with ASC and AC of the colon. Kaplan-Meier survival analysis was performed to assess OS. Descriptive variables were evaluated using independent T-test and Chi-square analyses. RESULTS 332 ASC patients were compared to 496,950 AC patients. AC patients were older than ASC patients (68.6 vs. 64.4 years); p < 0.001. Most ASC cancers presented with stage IV (41.3%) and poorly-differentiated disease (57.5%) compared to AC (22.4% and 17.7%). OS of the ASC cohort was 13.9 months. Median OS for stage IV AC versus stage IV ASC was significantly better (14.1 vs. 8.0 months); p < 0.0001. CONCLUSION This is the largest national database study to compare ASC with AC. Our findings confirm that unlike AC, ASC most frequently presents late stage, as poorly-differentiated lesions, and have worse OS.
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Affiliation(s)
- Yosef Nasseri
- Cedars-Sinai Medical Center, Los Angeles, CA, USA; Surgery Group Los Angeles, Los Angeles, CA, USA.
| | - Brian Cox
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Wesley Shen
- Cedars-Sinai Medical Center, Los Angeles, CA, USA; Surgery Group Los Angeles, Los Angeles, CA, USA
| | - Ruoyan Zhu
- Cedars-Sinai Medical Center, Los Angeles, CA, USA; Surgery Group Los Angeles, Los Angeles, CA, USA
| | - Isabella Stettler
- Cedars-Sinai Medical Center, Los Angeles, CA, USA; Surgery Group Los Angeles, Los Angeles, CA, USA
| | - Jason Cohen
- Cedars-Sinai Medical Center, Los Angeles, CA, USA; Surgery Group Los Angeles, Los Angeles, CA, USA
| | - Avo Artinyan
- Adventist Health Glendale, Glendale, CA, USA; Academic Surgical Associates, Glendale, CA, USA
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32
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Di Prete M, Baciorri F, Franceschilli M, Bagaglini G, Sica G, Doldo E, Palmieri G, Orlandi A. Adenosquamous carcinoma of the right colon with diffuse signet-ring mucinous component. Clin J Gastroenterol 2020; 13:555-559. [PMID: 32026256 DOI: 10.1007/s12328-020-01101-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 01/24/2020] [Indexed: 12/25/2022]
Abstract
Colorectal carcinoma is one of the most frequent human malignant neoplasms. Besides the most common histological types, colorectal adenosquamous carcinoma is very rare, being microscopically constituted by tumoural glandular and squamous components. The diagnosis of primary colon adenosquamous carcinoma requires the exclusion of a metastatic squamous cell carcinoma and the extension of a primary squamous cell carcinoma from the anal-rectum junction. We report a case of primary adenosquamous carcinoma of the ascending colon in a 62-year-old Caucasian man affected by long-standing ulcerative colitis. Peritumoural lymph nodes and distant metastasis were present. We reported also a diffuse signet-ring mucinous component, which has not been previously observed. Moreover, we investigated microsatellite and all-RAS/B-RAF status, p16 and p53 protein expression, and the molecular presence of human papillomavirus DNA in all the morphologically distinct components, in order to suggest pathogenetic factors influencing the aggressive prognosis of colon adenosquamous carcinoma.
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Affiliation(s)
- Monia Di Prete
- Anatomic Pathology, University of Rome Tor Vergata, Via Montpellier, 1, 00133, Rome, Italy.
| | - Francesca Baciorri
- Anatomic Pathology, University of Rome Tor Vergata, Via Montpellier, 1, 00133, Rome, Italy
| | | | - Giulia Bagaglini
- Surgery, University of Rome Tor Vergata, Via Montpellier, 1, 00133, Rome, Italy
| | - Giuseppe Sica
- Surgery, University of Rome Tor Vergata, Via Montpellier, 1, 00133, Rome, Italy
| | - Elena Doldo
- Anatomic Pathology, University of Rome Tor Vergata, Via Montpellier, 1, 00133, Rome, Italy
| | - Giampiero Palmieri
- Anatomic Pathology, University of Rome Tor Vergata, Via Montpellier, 1, 00133, Rome, Italy
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier, 1, 00133, Rome, Italy
| | - Augusto Orlandi
- Anatomic Pathology, University of Rome Tor Vergata, Via Montpellier, 1, 00133, Rome, Italy
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier, 1, 00133, Rome, Italy
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33
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G Jahromi N. Primary Squamous Cell Carcinoma of the Descending Colon. Cureus 2020; 12:e8588. [PMID: 32670723 PMCID: PMC7358939 DOI: 10.7759/cureus.8588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Primary squamous cell carcinoma (SCC) of the colon is a rare malignancy. The most reported anatomic location is the rectosigmoid colon. In this paper, we report a case of a 74-year-old man with primary SCC of the descending colon treated by surgery and adjuvant chemotherapy. We diagnosed primary SCC of the descending colon because except in the colon, no malignant lesions were found by systemic CT. The role of chemoradiation regimen and duration remains unclear due to the rarity of this entity.
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34
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Ali Husain AH, Kaundinya KB, Hammed F, Al Sayed AR. The surprise pathology-Primary squamous cell carcinoma of the colon-A case report. Int J Surg Case Rep 2020; 72:75-78. [PMID: 32516701 PMCID: PMC7283961 DOI: 10.1016/j.ijscr.2020.05.062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/14/2020] [Accepted: 05/22/2020] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Primary squamous cell carcinomas are rare in the colon. Identified as colonic growths causing obstructive or ulcerative features, they are treated like usual colonic adenocarcinomas until the surprise findings on histopathology. A thorough search for possible primary with colonic metastasis is warranted prior to confirmation of diagnosis. They can coexist with adenocarcinomas and ulcerative colitis. We present this case with intent to add to existing literature the presentation and catastrophic clinical course of the disease in our patient. CLINICAL FINDINGS The patient presented with obstructive pattern of a colonic growth with rapid weight loss. There was no family history of colonic disease and the patient did not suffer from inflammatory bowel disease. DIAGNOSIS AND THERAPEUTIC INTERVENTION CT Scan of the abdomen revealed the growth which was infiltrating the abdominal musculature causing micro abscess formation. Colonoscopy was inconclusive as the growth was not passable enough to obtain enough biopsy for pathology. The patient underwent surgery for removal of tumor and the histopathology revealed the squamous cell carcinoma. Through the course of patient's recovery in hospital thorough evaluation was done to identify primary in sites mainly the urogenital tract. The patient was discharged and unfortunately succumbed to her disease at home before definitive treatment could be given. CONCLUSION Squamous cell carcinomas in the colon warrants extensive search for the primary and coexistent adenocarcinomas or ulcerative colitis. In patients who recover from surgery, chemoradiation directed towards the pathology should be initiated to prevent rapid deterioration as in our case. Its presentation may be exophytic infiltrating surrounding structures and micro abscesses or perforations may also be encountered. We add our case report to the existing literature of primary squamous cell colon carcinoma series.
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Tschann P, Lechner D, Feurstein B, Abendstein B, Dertinger S, Bösl A, Vitlarov N, Offner F, Königsrainer I. Diagnostically challenging human papillomavirus-associated primary squamous cell carcinoma of the rectum with metastasis in both ovaries: a case report. J Med Case Rep 2020; 14:30. [PMID: 32054542 PMCID: PMC7020507 DOI: 10.1186/s13256-020-2348-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 01/13/2020] [Indexed: 12/26/2022] Open
Abstract
Introduction Squamous cell carcinomas of the rectum are extremely rare and their pathogenesis is still under debate. Their proper diagnosis and treatment may thus be challenging. Case presentation A 52-year-old Caucasian woman was transferred to our department with a history of pelvic pain. Colonoscopy revealed a small tumorous lesion of the upper rectum and an endoscopic biopsy showed infiltration of the rectal mucosa by a squamous cell carcinoma. Afterward, tumorous lesions were found on imaging in both her ovaries. A laparoscopy with adnexectomy and anal mapping was performed and revealed tumor masses of squamous cell carcinoma in both ovaries. Based on the large size of the ovarian tumors and the concurrence of extensive, partly ciliated, macrocystic epithelium in one of the ovaries, a diagnosis of ovarian squamous cell carcinoma arising from a mature teratoma was rendered. However, human papillomavirus genotyping analyses were positive for human papillomavirus-16 in both the rectal tumor and ovarian tumors leading to a final diagnosis of a human papillomavirus-associated rectal squamous cell carcinoma metastatic to both ovaries. Neoadjuvant chemoradiation therapy of her rectum, total mesorectal excision, and hysterectomy were performed followed by adjuvant chemotherapy. Conclusion Colorectal squamous cell carcinoma is a rare disease. In cases of colorectal squamous cell carcinoma, metastatic disease at any other location has to be excluded. Human papillomavirus genotyping is essential in this context. Discussion of the treatment strategies should be interdisciplinary and include chemoradiation therapy and radical surgery.
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Affiliation(s)
- P Tschann
- Department of General and Thoracic Surgery, Academic Teaching Hospital Feldkirch, Feldkirch, Austria.
| | - D Lechner
- Department of General and Thoracic Surgery, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - B Feurstein
- Department of General and Thoracic Surgery, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - B Abendstein
- Department of Gynaecology, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - S Dertinger
- Institute for Pathology, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - A Bösl
- Institute for Pathology, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - N Vitlarov
- Institute for Pathology, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - F Offner
- Institute for Pathology, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - I Königsrainer
- Department of General and Thoracic Surgery, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
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Intestinal adenosquamous carcinoma with a synchronous skin metastasis: a immunohistochemical and molecular analysis. Int J Colorectal Dis 2020; 35:337-341. [PMID: 31823050 DOI: 10.1007/s00384-019-03464-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/14/2019] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Intestinal adenosquamous carcinoma (ASC) is a rare colorectal neoplasm frequently occurring at onset as a locally advanced disease with distant metastases. The liver is the most common site of metastasis, followed by the peritoneum and the lung. Cutaneous metastases from usual colorectal adenocarcinoma occur in about 3% of cases, both at the time of diagnosis in advanced disease and during the follow-up. To the best of our knowledge, skin metastasis from ASC has never been described, and no biological landscape of ASC has ever been investigated. METHODS We report a case of synchronous intestinal ASC and cutaneous single facial metastasis in a 70-year-old man with morphological, immunohistochemical, and molecular analysis of primary and metastatic lesions. RESULTS Primary and metastatic ASC showed the same morphological and immunohistochemical features. Target sequencing analysis revealed, both in primary tumor and metastasis, a pathogenic KRAS gene missense mutation c.38G > A p.(Gly13Asp) and a likely pathogenic CTNNB1 gene missense mutation c.94G > A p.(Asp32Asn). A nuclear localization of β-catenin protein in adenocarcinomatous component of primary and metastatic lesions was observed on immunohistochemistry. CONCLUSION We describe a case of single synchronous facial cutaneous metastasis from intestinal ASC showing KRAS and CTNN1B mutations both on primary and metastatic lesions.
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Taggart MW, Foo WC, Lee SM. Tumors of the Gastrointestinal System Including the Pancreas. ONCOLOGICAL SURGICAL PATHOLOGY 2020:691-870. [DOI: 10.1007/978-3-319-96681-6_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2025]
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Remo A, Fassan M, Vanoli A, Bonetti LR, Barresi V, Tatangelo F, Gafà R, Giordano G, Pancione M, Grillo F, Mastracci L. Morphology and Molecular Features of Rare Colorectal Carcinoma Histotypes. Cancers (Basel) 2019; 11:1036. [PMID: 31340478 PMCID: PMC6678907 DOI: 10.3390/cancers11071036] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 07/15/2019] [Accepted: 07/18/2019] [Indexed: 02/05/2023] Open
Abstract
Several histopathological variants of colorectal carcinoma can be distinguished, some associated with specific molecular profiles. However, in routine practice, ninety/ninety-five percent of all large bowel tumors are diagnosed as conventional adenocarcinoma, even though they are a heterogeneous group including rare histotypes, which are often under-recognized. Indeed, colorectal cancer exhibits differences in incidence, location of tumor, pathogenesis, molecular pathways and outcome depending on histotype. The aim is therefore to review the morphological and molecular features of these rare variants of intestinal carcinomas which may hold the key to differences in prognosis and treatment.
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Affiliation(s)
- Andrea Remo
- Pathology Unit, Services Department, ULSS9 "Scaligera", 37122 Verona, Italy.
| | - Matteo Fassan
- Department of Medicine (DIMED), Surgical Pathology Unit, University of Padua, 35100 Padua, Italy
| | - Alessandro Vanoli
- Unit of Anatomic Pathology, Department of Molecular Medicine, University of Pavia and Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Luca Reggiani Bonetti
- Department of Diagnostic, Clinic and Public Health Medicine, Anatomic Pathology, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Valeria Barresi
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, 37134 Verona, Italy
| | - Fabiana Tatangelo
- Department of Pathology, Istituto Nazionale Tumori Fondazione G. Pascale, IRCCS, 80131 Naples, Italy
| | - Roberta Gafà
- Section of Anatomic Pathology, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara and S. Anna University Hospital, 44121 Ferrara, Italy
| | - Guido Giordano
- U.O.C. Oncologia Medica, Ospedali Riuniti Azienda Ospedaliera Universitaria, 71122 Foggia, Italy
| | - Massimo Pancione
- Department of Sciences and Technologies, University of Sannio, 82100 Benevento, Italy
| | - Federica Grillo
- Anatomic Pathology, Department of Integrated Surgical and Diagnostic Sciences (DISC), University of Genoa and Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Luca Mastracci
- Anatomic Pathology, Department of Integrated Surgical and Diagnostic Sciences (DISC), University of Genoa and Ospedale Policlinico San Martino, 16132 Genoa, Italy
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Ching D, Amanuel B, Khor TS. Primary adenosquamous carcinoma in a patient with Lynch syndrome. Pathology 2019; 51:534-537. [PMID: 31201002 DOI: 10.1016/j.pathol.2019.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 02/09/2019] [Accepted: 02/20/2019] [Indexed: 11/17/2022]
Affiliation(s)
- Daniel Ching
- Department of Anatomical Pathology, PathWest Laboratory Medicine, QEII Medical Centre, Perth, WA, Australia.
| | - Benhur Amanuel
- Department of Anatomical Pathology, PathWest Laboratory Medicine, QEII Medical Centre, Perth, WA, Australia
| | - Tze Sheng Khor
- Department of Anatomical Pathology, PathWest Laboratory Medicine, QEII Medical Centre, Perth, WA, Australia
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Comparison of Anal Versus Rectal Staging in the Prognostication of Rectal Squamous Cell Carcinoma: A Population-Based Analysis. Dis Colon Rectum 2019; 62:302-308. [PMID: 30398999 DOI: 10.1097/dcr.0000000000001205] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Rectal squamous cell carcinoma is a rare malignancy with limited data regarding management and prognosis. It is also unknown whether a rectal squamous cell cancer staging system should be based on size, as for anal squamous cell carcinoma, or depth of invasion, as for rectal adenocarcinoma. OBJECTIVE The aims of the current study were to determine the optimal management strategy, prognostic factors, and staging system for rectal squamous cell carcinoma. DESIGN This was a population-based study. SETTINGS The Surveillance, Epidemiology, and End Results database was used to identify patents diagnosed between 1988 and 2013. PATIENTS Patients ≥18 years of age undergoing radiation or local excision alone, radiation with local excision, or radiation with radical resection were included. Patients were then staged according to both the American Joint Committee on Cancer classification for rectal adenocarcinoma (American Joint Committee on Cancer-rectum) and anal cancer (American Joint Committee on Cancer-anus). MAIN OUTCOME MEASURES The main outcome was 5-year, disease-specific survival. RESULTS In both univariate and multivariate survival analyses, the addition of local excision or radical resection to radiation resulted in similar-to-worse outcomes across all of the stages. Among patients staged according to American Joint Committee on Cancer-rectum (n = 1646), although a significant difference in 5-year survival was observed for stage I as compared with higher stages, no difference was noted between stages II and III (80% vs 61% and 62%). However, in the American Joint Committee on Cancer-anus classification (n = 1327), a significant difference was observed across all of the stages (87% vs 72% vs 59%; p < 0.001). In multivariate analysis, the prognostic discrimination based on HRs provided by the American Joint Committee on Cancer-anus was superior to that of the American Joint Committee on Cancer-rectum. LIMITATIONS This study was limited by lack of data on chemotherapy and location of positive nodes. CONCLUSIONS A treatment approach primarily based on radiation should be considered the optimal management strategy for rectal squamous cell carcinoma. Moreover, a staging system based on size (American Joint Committee on Cancer-anus) rather than on depth of invasion (American Joint Committee on Cancer-rectum) appears to be more accurate in predicting its prognosis. See Video Abstract at http://links.lww.com/DCR/A734.
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Toumi O, Hamida B, Njima M, Bouchrika A, Ammar H, Daldoul A, Zaied S, Ben Jabra S, Gupta R, Noomen F, Zouari K. Adenosquamous carcinoma of the right colon: A case report and review of the literature. Int J Surg Case Rep 2018; 50:119-121. [PMID: 30103094 PMCID: PMC6092453 DOI: 10.1016/j.ijscr.2018.07.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 06/21/2018] [Accepted: 07/02/2018] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Adenosquamous carcinoma is a rare colorectal tumor with both an adenocarcinoma and a squamous cell carcinoma component. To the best of our knowledge, only few cases have been reported in the literature. CASE PRESENTATION We report a case of a 46-year-old woman, hospitalized for large bowel obstruction syndrome. Computed tomography scan showed an irregular mass of the right colic angle, responsible for an occlusive syndrome with distension of the right colon, the appendix and the terminal ileum. The patient underwent right hemicolectomy with D2 lymphadenectomy. Histopathological examination revealed mixed adenocarcinoma and squamous carcinoma. Adjuvant chemotherapy was prescribed for the patient. DISCUSSION Adenosquamous carcinoma is a rare colorectal neoplasm revealed by non-specific complaints. Its clinicopathology is not yet understood. Preoperative diagnosis is often difficult. Surgical resection remains the mainstay of treatment. CONCLUSION Adenosquamous carcinoma is a malignant tumor with poorer prognosis than adenocacinomas.
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Affiliation(s)
- Omar Toumi
- Department of General and Digestive Surgery, Hopital Fattouma Bourguiba, Monastir, Tunisia.
| | - Badii Hamida
- Department of Radiology, Hopital Fattouma Bourguiba, Monastir, Tunisia.
| | - Manel Njima
- Department of Pathology, Hopital Fattouma Bourguiba, Monastir, Tunisia.
| | - Amal Bouchrika
- Department of General and Digestive Surgery, Hopital Fattouma Bourguiba, Monastir, Tunisia.
| | - Houssem Ammar
- Department of General and Digestive Surgery, Hopital Fattouma Bourguiba, Monastir, Tunisia.
| | - Amira Daldoul
- Department of Carcinology, Hopital Fattouma Bourguiba, Monastir, Tunisia.
| | - Sonia Zaied
- Department of Carcinology, Hopital Fattouma Bourguiba, Monastir, Tunisia.
| | - Sadok Ben Jabra
- Department of General and Digestive Surgery, Hopital Fattouma Bourguiba, Monastir, Tunisia.
| | - Rahul Gupta
- Department of Gastrointestinal Surgery, Synergy Institute of Medical Sciences, Dehradun, India.
| | - Faouzi Noomen
- Department of General and Digestive Surgery, Hopital Fattouma Bourguiba, Monastir, Tunisia.
| | - Khadija Zouari
- Department of General and Digestive Surgery, Hopital Fattouma Bourguiba, Monastir, Tunisia.
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Dikshit V, Ali I, Patil C, Manerikar K, Mody P. Squamous Cell Carcinoma of Colon-an Etiopathological Surprise. J Gastrointest Cancer 2018; 50:604-608. [PMID: 29417382 DOI: 10.1007/s12029-018-0072-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Vashisht Dikshit
- Department of Surgery, Dr. D. Y. Patil Medical College and Hospital, Sant Tukaram Nagar, Pimpri, Pune, 411018, India.
| | - Iqbal Ali
- Department of Surgery, Dr. D. Y. Patil Medical College and Hospital, Sant Tukaram Nagar, Pimpri, Pune, 411018, India
| | - Chandradip Patil
- Department of Surgery, Dr. D. Y. Patil Medical College and Hospital, Sant Tukaram Nagar, Pimpri, Pune, 411018, India
| | - Kshitij Manerikar
- Department of Surgery, Dr. D. Y. Patil Medical College and Hospital, Sant Tukaram Nagar, Pimpri, Pune, 411018, India
| | - Pratham Mody
- Department of Surgery, Dr. D. Y. Patil Medical College and Hospital, Sant Tukaram Nagar, Pimpri, Pune, 411018, India
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Sunkara T, Caughey ME, Makkar P, John F, Gaduputi V. Adenosquamous Carcinoma of the Colon. Case Rep Gastroenterol 2017; 11:791-796. [PMID: 29606937 PMCID: PMC5875291 DOI: 10.1159/000485558] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 11/21/2017] [Indexed: 12/26/2022] Open
Abstract
Overall, colorectal cancer is the third most commonly diagnosed cancer in both men and women, meaning that it is one of the more widely recognized preventable cancers. Instances of colorectal malignancies though are overwhelmingly attributable to adenocarcinoma. Colorectal cancers with components of squamous cell carcinoma represent a statistical anomaly. Here, we present the case of a 50-year-old male, who complained of abdominal pain and weight loss over a 3-month period of time. Biopsies from a colonoscopy ultimately revealed that this patient's colon cancer consisted of both adenocarcinoma and squamous cell carcinoma, representing a truly exceptional pathology finding in a patient diagnosed with a colorectal cancer.
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Affiliation(s)
- Tagore Sunkara
- Division of Gastroenterology and Hepatology, The Brooklyn Hospital Center, Clinical Affiliate of The Mount Sinai Hospital, Brooklyn, New York, USA
| | - Megan E Caughey
- Division of Gastroenterology and Hepatology, SBH Health System, Bronx, New York, USA
| | - Priyanka Makkar
- Division of Gastroenterology and Hepatology, SBH Health System, Bronx, New York, USA
| | - Febin John
- Division of Gastroenterology and Hepatology, The Brooklyn Hospital Center, Clinical Affiliate of The Mount Sinai Hospital, Brooklyn, New York, USA
| | - Vinaya Gaduputi
- Division of Gastroenterology and Hepatology, SBH Health System, Bronx, New York, USA
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Kiyani A, Coyle WJ, Bao F. A rare case of primary rectal squamous cell carcinoma diagnosed by endoscopic ultrasound. J Gastrointest Oncol 2017; 8:E56-E59. [PMID: 28890829 DOI: 10.21037/jgo.2017.06.04] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Primary squamous cell carcinoma (SCC) of the rectum is a very rare entity making up to 0.1-0.25/1,000 cases of all colorectal cancers. Here, we present the case of an otherwise healthy 63-year-old female who presented with progressive pelvic discomfort, new onset constipation and a complex mass in presacral region on imaging which was proved to be poorly differentiated SCC of the rectum. The correct diagnosis was achieved by fine needle aspiration (FNA) via endoscopic ultrasound (EUS-guided FNA) as initial conventional colonoscopy failed to establish the diagnosis. Patient completed neoadjuvant chemo-radiation and her tumor was successfully resected. She is following up with oncology clinic for monitoring and further management.
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Affiliation(s)
- Amirali Kiyani
- Department of Medicine, Maricopa Medical Center, Phoenix, AZ, USA
| | - Walter J Coyle
- Department of Gastroenterology, Scripps Green Hospital, La Jolla, CA, USA
| | - Fei Bao
- Department of Pathology, Scripps Green Hospital, La Jolla, CA, USA
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45
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Ramai D, Changela K, Lai J, Shahzad G, Reddy M. Interval Squamous Cell Carcinoma of the Rectum. Case Rep Gastroenterol 2017; 11:396-401. [PMID: 28690492 PMCID: PMC5498956 DOI: 10.1159/000475922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 04/18/2017] [Indexed: 12/12/2022] Open
Abstract
Squamous cell carcinoma (SCC) of the rectum is a rare clinical entity with an incidence rate of 0.1–0.25% per 1,000 cases. Though its etiology and pathogenesis remains unclear, it has been associated with chronic inflammation and infections. Herein, we report a case of an 82-year-old female who presented with a 2-month history of worsening abdominal pain, hematochezia, and bilateral inguinal lymphadenopathy with right-sided purulent discharge. Two years prior, she had had an unremarkable screening colonoscopy which met all quality indicators. Abdominal CT scan showed an irregular rectal mass with bulky pelvic and retroperitoneal adenopathy. Colonoscopy revealed one large circumferential nonobstructing lesion in the rectum. Endoscopic ultrasound confirmed its origin from the rectal wall with an enlarged perirectal lymph node. Cold biopsy followed by histopathology revealed SCC of the rectum.
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Affiliation(s)
- Daryl Ramai
- Department of Anatomical Sciences, St. George's University, True Blue, Grenada
| | - Kinesh Changela
- Division of Gastroenterology, The Brooklyn Hospital Center - Clinical Affiliate of Mount Sinai Hospital, Brooklyn, New York, USA
| | - Jonathan Lai
- Department of Anatomical Sciences, St. George's University, True Blue, Grenada
| | - Ghulamullah Shahzad
- Division of Gastroenterology, The Brooklyn Hospital Center - Clinical Affiliate of Mount Sinai Hospital, Brooklyn, New York, USA
| | - Madhavi Reddy
- Division of Gastroenterology, The Brooklyn Hospital Center - Clinical Affiliate of Mount Sinai Hospital, Brooklyn, New York, USA
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Mohamed S. [Primary squamous cell carcinoma of the colon: about a case]. Pan Afr Med J 2017; 27:124. [PMID: 28904654 PMCID: PMC5567964 DOI: 10.11604/pamj.2017.27.124.12037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Accepted: 05/30/2017] [Indexed: 01/06/2023] Open
Abstract
Primary squamous cell carcinoma (SCC) of the colon is an exceptional tumor. Less than 150 cases have been reported in the literature up to the year 2014. In addition to its rarity, it is distinguished by its frequent association with other digestive neoplasias. We report the case of a 54-year old patient with primary SCC of the colon. In the light of this case study, we will discuss the anatomo-clinical and therapeutic features as well as the etiopathogenic assumptions of this unusual entity.
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Affiliation(s)
- Sinaa Mohamed
- Laboratoire d'Anatomie Pathologique, Hôpital Militaire Moulay Ismail, Meknès, Maroc
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Connolly JG, Goldstone SE. Squamous cell dysplasia in the proximal rectum of three patients treated for ulcerative colitis on immunomodulators. Int J Colorectal Dis 2017; 32:753-756. [PMID: 28091842 DOI: 10.1007/s00384-016-2745-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND Anal canal high-grade squamous intraepithelial lesion (HSIL) is the precursor to anal cancer. Immunocompromised patients are at increased risk and disease is usually within 3 cm from the anal verge. High-resolution anoscopy (HRA) with an 8-cm anoscope is used to identify and guide cautery treatment of HSIL. PURPOSE We report three patients with a long-term history of ulcerative colitis (UC) treated with systemic immunomodulators who developed proximally located rectal HSIL. RESULTS/OUTCOMES Two patients were HIV-negative women, 63 and 48 years old, and the third was a 51-year-old HIV-positive man with underlying UC for 10, 16, and 3 years, respectively. They each presented with a HPV-positive HSIL visibly extending above the limits of the anoscope used for HRA. None developed cancer. All had episodes of active UC. It is unclear what causative role systemic immunomodulators play in predisposing UC patients to proximal HSIL. HSIL probably developed on a tongue of HPV-infected squamous epithelium growing proximally over the inflamed rectum. Islands developed when areas of squamous epithelium degenerated, creating skip areas. DISCUSSION This study highlights the potential for HSIL to extend into the rectum either as a contiguous patch or isolated islands and the need for heightened surveillance in patients with extensive anal canal HSIL treated with immunodulator therapy. HSIL identified at the limit of the anoscope should be investigated further with colonoscopy, and argon plasma coagulation (APC) ablation can serve as an effective treatment option. Patients are at risk for stricture, but it is unclear what role the UC or the ablation played in stricture formation.
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Affiliation(s)
- James G Connolly
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, 13th Floor, New York, NY, 10029, USA.
| | - Stephen E Goldstone
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, 13th Floor, New York, NY, 10029, USA
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48
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Abdelqader A, Jabaji R, Albugeaey M, Palese C. Squamous cell carcinoma of the ascending colon: two cases. J Community Hosp Intern Med Perspect 2017. [PMID: 28634528 PMCID: PMC5463671 DOI: 10.1080/20009666.2017.1309339] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Squamous cell carcinoma (SCC) of the colon without known primary source is a rare finding that needs aggressive management. We report two cases of SCC of the colon without any clear extra-colonic source despite extensive workup. In our experience, the clinical course and prognosis are largely dependent on the presence of metastatic disease at diagnosis. The main treatment is surgery, with chemotherapy having less defined role.
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Affiliation(s)
- Abdelhai Abdelqader
- Departments of Internal Medicine, MedStar Franklin Square Hospital Center, Baltimore, MD, USA
| | - Ramez Jabaji
- Departments of Internal Medicine, MedStar Franklin Square Hospital Center, Baltimore, MD, USA
| | - Mohammed Albugeaey
- Department of Gastroenterology and Hepatology, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Caren Palese
- Department of Gastroenterology and Hepatology, MedStar Georgetown University Hospital, Washington, DC, USA
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Ishida H, Yamaguchi T, Chiba K, Iijima T, Horiguchi SI. A case report of ascending colon adenosquamous carcinoma with BRAF V600E mutation. Int Cancer Conf J 2017; 6:93-97. [PMID: 31149479 DOI: 10.1007/s13691-017-0283-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 03/06/2017] [Indexed: 12/23/2022] Open
Abstract
A 78-year-old Japanese male was referred to our hospital with a 3-month history of anorexia and right abdominal pain. A colonoscopy showed circumferential narrowing of the ascending colon with deep ulceration. Biopsy was performed, and examination of the specimen demonstrated squamous cell carcinoma. Abdominal computed tomography demonstrated thickening of the wall of the ascending colon, multiple lymph node metastases, multiple liver metastases, and peritoneal dissemination. After right hemicolectomy, histological examination demonstrated adenosquamous carcinoma. Biomarker analysis showed a microsatellite stable, wild-type KRAS gene in exon 2 and BRAF V600E mutation. Despite undergoing intensive chemotherapy, the patient died 5 months postoperatively.
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Affiliation(s)
- Hiroyuki Ishida
- 1Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22, Honkomagome, Bunkyo-ku, Tokyo, 113-8677 Japan
| | - Tatsuro Yamaguchi
- 1Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22, Honkomagome, Bunkyo-ku, Tokyo, 113-8677 Japan.,2Hereditary Tumor Research Project, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Kazuro Chiba
- 3Department of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Takeru Iijima
- 2Hereditary Tumor Research Project, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Shin-Ichiro Horiguchi
- 4Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
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Zhao S, Guo J, Sun L, Lv J, Qiu W. Gemcitabine-based chemotherapy in colon squamous cell carcinoma: A case report and literature review. Mol Clin Oncol 2017; 6:561-565. [PMID: 28413669 DOI: 10.3892/mco.2017.1178] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 02/17/2017] [Indexed: 12/15/2022] Open
Abstract
Squamous cell carcinoma (SCC) originating from the colon is rare. In terms of its clinicopathological characteristics, this type of cancer has been reported to be more aggressive and have a worse prognosis compared with adenocarcinoma. We herein present a successful therapeutic approach applying neoadjuvant and adjuvant gemcitabine-based chemotherapy in a patient with colon SCC. A 58-year-old male patient received two cycles of neoadjuvant chemotherapy with a regimen including gemcitabine, oxaliplatin and capecitabine, followed by radical excision and six cycles of adjuvant chemotherapy. Contrast-enhanced computed tomography and serum tumor markers were used for reassessment and evaluation was based on the World Health Organization criteria. Following neoadjuvant chemotherapy, the mass had shrunk and the patient was classed as having stable disease. Surgery and adjuvant chemotherapy were then performed and the patient had achieved a progression-free survival of 10 months when this report was submitted. Therefore, gemcitabine may be a treatment option for colon SCC in the neoadjuvant and/or adjuvant chemotherapy setting.
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Affiliation(s)
- Shufen Zhao
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Jing Guo
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Libin Sun
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Jing Lv
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Wensheng Qiu
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
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