Taketomi Ryuichi, Ujiie Naoto, Enomoto Yoshitaka, Takido Naruhito, Kawaharada Yasushi, Zuguchi Masashi, Kubota Yosuke, Saito Ken
Division of Surgery, Hiraka General Hospital, Yokote, Akita, Japan.
Division of Surgery, Hiraka General Hospital, Yokote, Akita, Japan.
Int J Surg Case Rep. 2019;55:168-170. doi: 10.1016/j.ijscr.2019.01.035. Epub 2019 Jan 31.
Most transitional cell carcinomas (TCCs) occur in the urinary tract. There are no reports of TCC originating in the colon. This report presents a very rare case of TCC that primarily occurred in the colon.
A 78-year-old female presented with adenocarcinoma of the rectum and TCC of the ascending colon. She was screened for urologic and gynecologic carcinomas because the TCC was considered a metastatic lesion; however, cytodiagnosis of urine, the cervix and corpus uteri revealed no abnormal findings. An operation was performed, and histological examination revealed adenocarcinoma of the rectum and TCC of the ascending colon. Immunohistochemical stained specimens of the ascending colon revealed tumor cells of cytokeratin (CK) 7-/CK20+ pattern. Eleven months post-operation, a metastatic TCC was found in the liver. The patient was treated with chemotherapy; however, she died 19 months after the operation.
Our case was clinically considered that the TCC primarily occurred in the colon after analyzing the results of several examinations. Immunohistochemical staining of CK7 and CK20 expression pattern also suggested that the TCC of the ascending colon originated in the colon.
To the best of our knowledge, this is the first literature report of TCC that originated in the colon. TCC that primarily occurs in the colon may rapidly progress, as in the case presented. Therefore, it is necessary to establish more appropriate treatment for similar cases.
大多数移行细胞癌(TCC)发生于泌尿道。尚无起源于结肠的TCC报道。本文报告了一例极为罕见的主要发生于结肠的TCC病例。
一名78岁女性,表现为直肠癌和升结肠TCC。因其TCC被认为是转移瘤,故对其进行了泌尿生殖系统癌筛查;然而,尿液、宫颈和子宫体的细胞诊断未发现异常。患者接受了手术,组织学检查显示为直肠癌和升结肠TCC。升结肠免疫组化染色标本显示肿瘤细胞呈细胞角蛋白(CK)7 - /CK20 + 模式。术后11个月,肝脏发现转移性TCC。患者接受了化疗;然而,术后19个月死亡。
经多项检查结果分析,我们的病例在临床上被认为TCC主要发生于结肠。CK7和CK20表达模式的免疫组化染色也提示升结肠TCC起源于结肠。
据我们所知,这是首例起源于结肠的TCC文献报道。主要发生于结肠的TCC可能如本病例一样迅速进展。因此,有必要为类似病例制定更合适的治疗方案。