Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 16, 2023; 11(35): 8343-8349
Published online Dec 16, 2023. doi: 10.12998/wjcc.v11.i35.8343
Rare synchronous colorectal carcinoma with three pathological subtypes: A case report and review of the literature
Fang Li, Bin Zhao, Lei Zhang, Guo-Qing Chen, Li Zhu, Xiao-Ling Feng, Hui Yao, Xue-Feng Tang, Hua Yang, Yong-Qiang Liu
Fang Li, Bin Zhao, Lei Zhang, Guo-Qing Chen, Li Zhu, Xiao-Ling Feng, Hua Yang, Yong-Qiang Liu, Department of General Surgery, Chongqing General Hospital, Chongqing 401120, China
Hui Yao, Xue-Feng Tang, Department of Pathology, Chongqing General Hospital, Chongqing 401147, China
Author contributions: Li F provided patient information and wrote the manuscript; Zhao B and Zhu L conceived the manuscript; Zhang L and Feng XL collected the data; Chen GQ consulted the treatment plan; Yao H and Tang XF prepared histopathological examination and illustrations; Yang H reviewed the topic presentation, structure of the manuscript, illustrations, and photographs; Liu YQ obtained resources and reviewed and edited the manuscript; all authors have read and approved the final manuscript.
Informed consent statement: Informed consent was obtained from the patient for the publication of this case report and any accompanying images.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong-Qiang Liu, MD, PhD, Assistant Professor, Department of General Surgery, Chongqing General Hospital, No. 118 Xingguang Avenue, Liangjiang New District, Chongqing 401147, China. wklyq007@163.com
Received: July 14, 2023
Peer-review started: July 14, 2023
First decision: August 30, 2023
Revised: September 14, 2023
Accepted: November 30, 2023
Article in press: November 30, 2023
Published online: December 16, 2023
Processing time: 152 Days and 20.6 Hours
Abstract
BACKGROUND

Synchronous colorectal carcinomas (SCRC) are two or more primary colorectal carcinomas identified simultaneously or within 6 mo of the initial presentation in a single patient. Their incidence is low and the number of pathological types of SCRC is usually no more than two. It is very unusual that the pathological findings of a patient with SCRC show more than two different pathological subtypes. Here, we report a rare case of SCRC with three pathological subtypes.

CASE SUMMARY

A 75-year-old woman who had no previous medical history or family history was admitted to the hospital because of intermittent hematochezia for more than a month. Colonoscopy displayed an irregularly shaped neoplasm of the rectum, a tumor-like lesion causing intestinal stenosis in the descending colon, and a polypoidal neoplasm in the ileocecum. Subsequently, she underwent total colectomy, abdominoperineal resection for rectal cancer, and ileostomy. After operation, the pathological report showed three pathological subtypes including well-differentiated adenocarcinoma of the ascending colon, moderately differentiated adenocarcinoma of the descending colon, and mucinous adenocarcinoma of the rectum. She is now recovering well and continues to be closely monitored during follow-up.

CONCLUSION

Preoperative colonoscopy examination, imaging examination, and extensive intraoperative exploration play important roles in reducing the number of missed lesions.

Keywords: Synchronous colorectal cancer; Colon; Rectum; Adenocarcinoma; Tumor location; Different pathological subtypes; Case report

Core Tip: In most cases, the number of pathologic types of synchronous colorectal carcinomas (SCRC) is limited to 1-2. It is very rare that the pathological findings of a patient with SCRC show more than two different pathological subtypes. Here, we report a rare case of SCRC with three different pathological subtypes without a family history of cancer or genetic predisposing factors.