Akbulut Sami, Cakabay Bahri, Sezgin Arsenal, Ozmen Cihan Akgul
Department of Surgery, Diyarbakır Education and Research Hospital, Diyarbakır, Turkey.
Case Rep Gastroenterol. 2009 Aug 28;3(2):248-254. doi: 10.1159/000229755.
Cloacogenic carcinoma (CC, basaloid carcinoma) generally occurs around the dentate line, rarely it can arise from the other sides of the colon. There are only 5 cases of CC located outside the anal canal in the literature. The first occurrence of a CC presents as intraabdominal abscess. We describe a 23-year-old male patient who was admitted with fever and severe abdominal pain. Computed tomography imaging showed diffuse wall thickening about 10-11 cm above the rectosigmoid junction, intraabdominal abscess and a soft tissue lession covering the pelvis with a size of 8 × 8.5 cm including cystic necrotic areas. We performed Hartman procedure since the mass was nonresectable. Histopathological examination showed CC. In total, three times radiotherapy and a concurrent three-drug regimen of irinotecan, fluorouracil and folinic acid chemotherapy were administered for 6 weeks. As a result, the patient was lost because of multiple organ dysfunction syndrome that developed 3 months after radio-chemotherapy.
泄殖腔源性癌(CC,基底样癌)通常发生在齿状线周围,很少能起源于结肠的其他部位。文献中仅有5例CC位于肛管外。首例CC表现为腹腔内脓肿。我们描述了一名23岁男性患者,因发热和严重腹痛入院。计算机断层扫描成像显示,在直肠乙状结肠交界处上方约10 - 11厘米处肠壁弥漫性增厚,腹腔内有脓肿,盆腔有一个大小为8×8.5厘米的软组织病变,包括囊性坏死区域。由于肿块无法切除,我们实施了哈特曼手术。组织病理学检查显示为CC。总共进行了3次放疗,并同时采用伊立替康、氟尿嘧啶和亚叶酸三联化疗方案,持续6周。结果,患者在放化疗后3个月因多器官功能障碍综合征死亡。