Zeeneldin Ahmed, Al-Dhaibani Nasser, Saleh Yasser M, Ismail Amal Mostafa, Alzibair Zuhair, Moona Mohamed Shafi, Mohamed Wael
Oncology Center, King Abdulla Medical City, Saudi Arabia.
National Cancer Institute, Cairo University, Egypt.
Case Rep Oncol Med. 2018 Dec 30;2018:9246139. doi: 10.1155/2018/9246139. eCollection 2018.
This is an interesting case of anorectal signet ring carcinoma with first presentation of an early stage disease, showing the aggressive disease and the undetectable behavior of this type of histology which can mislead diagnosis. Brain/CNS metastasis from colorectal cancer (CRC) is rare occurring in 3% of cases, and leptomeningeal carcinomatosis (LMC) is extremely rare in CRC (<0.02%). Symptoms and signs of LMC are pleomorphic and may be localized to three compartments: cerebral hemispheres, cranial nerves, and spinal cords and roots. Treatment of metastatic rectal cancer has been improving over the last few years with a lot of changes toward longer survival and improvement in quality of life and to change the disease into a chronic condition. However, in our case, the overall survival from the onset of LMC was 3 weeks only. Revising the evidence in the treatment of signet ring histology of rectal cancer, there is no specific treatment recommendation that is for this histology and for such very aggressive behavior which could be considered as a separate entity to the classic adenocarcinoma histology.
这是一例有趣的肛管印戒细胞癌病例，首次表现为早期疾病，显示出这种组织学类型的侵袭性疾病及难以察觉的特性，这可能会误导诊断。结直肠癌（CRC）发生脑/中枢神经系统转移很少见，发生率为3%，而软脑膜癌病（LMC）在CRC中极为罕见（<0.02%）。LMC的症状和体征多样，可能局限于三个部位：大脑半球、颅神经以及脊髓和神经根。在过去几年中，转移性直肠癌的治疗一直在改善，在延长生存期、提高生活质量以及将疾病转变为慢性病方面有很多变化。然而，在我们的病例中，从LMC发病起的总生存期仅为3周。回顾直肠癌印戒细胞组织学治疗的证据，对于这种组织学类型以及这种极具侵袭性的行为，没有特定的治疗建议，其可被视为与经典腺癌组织学不同的实体。
