Remo Andrea, Zanella Caterina, Molinari Enrico, Talamini Alberto, Tollini Filippo, Piacentini Paolo, Battaglia Paolo, Baritono Elisabetta, Bonetti Andrea, Lanza Franco, Fasolin Antonio, Manfrin Erminia, Vendraminelli Roberto
Department of Pathology, Mater Salutis Hospital, ULSS 21 Legnago, Verona, Italy.
Int J Surg Pathol. 2012 Apr;20(2):185-90. doi: 10.1177/1066896911415405. Epub 2011 Jul 26.
Rhabdoid colon tumors (RCTs) are rare lesions whose existence as an independent distinct entity remains controversial. To date, 6 RCTs have been reported. This study reports a novel case associated with polyposis coli in a 73-year-old woman. Histologically, the neoplasia was heterogeneous consisting of an adenocarcinoma associated with rhabdoid features. In rhabdoid component, an intense expression of MSH2 was noted but MLH1 was negative. A BRAF V600E mutation and no KRAS mutations were identified. The promoter regions of subset of genes highly specific to characterize the CIMP status (NEUROG1, IGF2, RUNX3, SOCS1, including MLH1) were hypermethylated, suggesting the presence of CIMP+ and MSI high tumor. In conclusion, all RCTs have similar clinical features. The presence of polyposis and adenocarcinoma component as well as the expression of mesenchymal marker suggests a sarcomatous dedifferentiation. It is argued that RCT could be a very aggressive entity of colon, which could benefit from new biological colonic treatments.
横纹肌样结肠肿瘤(RCTs)是罕见病变,其作为一个独立的独特实体的存在仍存在争议。迄今为止,已报道了6例RCTs。本研究报告了1例73岁女性中与结肠息肉病相关的新病例。组织学上,肿瘤具有异质性,由伴有横纹肌样特征的腺癌组成。在横纹肌样成分中,观察到MSH2强烈表达,但MLH1为阴性。未发现BRAF V600E突变,也未发现KRAS突变。高度特异性表征CIMP状态的一组基因(包括MLH1的NEUROG1、IGF2、RUNX3、SOCS1)的启动子区域发生了高甲基化,提示存在CIMP+和微卫星高度不稳定(MSI高)肿瘤。总之,所有RCTs具有相似的临床特征。息肉病和腺癌成分的存在以及间充质标志物的表达提示肉瘤样去分化。有人认为,RCT可能是结肠的一种极具侵袭性的实体,可能受益于新的生物结肠治疗方法。