Tran T A, Holloway R W
Department of Pathology, Florida Hospital Orlando, Orlando, Florida 32803, USA.
Eur J Gynaecol Oncol. 2013;34(1):86-9.
Primary carcinomas of Müllerian origin involving the colon is not an uncommon phenomenon, with most cases reportedly associated with endometriosis. On the other hand, a primary peritoneal low-grade serous carcinoma presenting as a dominant mass in the colon and causing clinical symptoms mimicking a primary colonic carcinoma has not been reported in the literature to the best of the authors' knowledge. A case of a 66-year-old female patient who presented clinically with rectal bleeding and a rectosigmoid mass is described. The final histologic examination revealed a peritoneal low-grade serous carcinoma forming a dominant mass in the rectosigmoid colon. Of particular interest was a microscopic spectrum of serous epithelial proliferation in the peritoneal cavity and lymph nodes with morphologic features reminiscent of non-invasive and invasive implants in ovarian borderline serous tumors, which most likely denoted the precursors of the tumor in the colon.
起源于苗勒管的原发性癌累及结肠并非罕见现象，据报道大多数病例与子宫内膜异位症有关。另一方面，据作者所知，文献中尚未报道过以结肠内主要肿块形式出现并引起类似原发性结肠癌临床症状的原发性腹膜低级别浆液性癌。本文描述了一例66岁女性患者，临床上表现为直肠出血和直肠乙状结肠肿块。最终组织学检查显示为腹膜低级别浆液性癌，在直肠乙状结肠形成主要肿块。特别值得关注的是，在腹膜腔和淋巴结中观察到浆液性上皮增殖的微观图谱，其形态学特征让人联想到卵巢交界性浆液性肿瘤中的非侵袭性和侵袭性种植体，这很可能表明了结肠中肿瘤的前体情况。
