Maskrout Meryem, Boutaggount Farah, Mokfi Rania, Ennibi Ghizlane, Hnach Youssef, Tarchouli Mohamed, Rais Ghizlane
Medical Oncology Department, Souss Massa University Hospital Centre, Faculty of Medicine and Pharmacy of Agadir, Ibn Zohr University, Agadir, Morocco.
Nuclear Medicine Department, Oncology Center of Agadir Souss Massa University Hospital Centre, Agadir, Morocco.
Ann Med Surg (Lond). 2022 Aug 19;81:104450. doi: 10.1016/j.amsu.2022.104450. eCollection 2022 Sep.
Sarcomatoid carcinomas or carcinosarcomas are rare tumors with a double component, carcinomatous and sarcomatous. They most commonly arise from the head, neck, respiratory system and female genital tract. To the best of our knowledge, only thirty two cases of colorectal involvement have been reported in the medical litterature.
We report a case of sarcomatoid carcinoma of the colon in a 58 year old woman with unusual sites of metastasis revealed by a whole body 18F-fluoro-2-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT), who presented with right iliac fossa pain. Physical examination revealed only tenderness of the right iliac fossa. A right hemi-colectomy was performed. The immunohistochemical study of the surgical specimen revealed 2 cellular contingents, one carcinomatous and the other sarcomatous, leading to the diagnosis of carcinosarcoma. The evolution was rapidly unfavourable, with death occurring 4 months after the initial surgery.
Colorectal carcinosarcomas are very rare and aggressive tumors with high metastatic potential commonly in the liver, lymph nodes, and peritoneum. In our case, we order a FDG-PET/CT that revealed intriguing pattern of metastasis.
The purpose of presenting this case report is to raise awareness among clinicians to consider this clinical entity as a differential diagnosis of colorectal tumors and order more often FDG-PET/CT for a good clinical staging.
肉瘤样癌或癌肉瘤是一种罕见的肿瘤，具有癌性和肉瘤性双重成分。它们最常发生于头颈部、呼吸系统和女性生殖道。据我们所知，医学文献中仅报道了32例结直肠受累病例。
我们报告一例58岁女性的结肠肉瘤样癌，通过全身18F-氟-2-脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）发现其转移部位异常，患者表现为右下腹疼痛。体格检查仅发现右下腹压痛。进行了右半结肠切除术。手术标本的免疫组织化学研究显示有两种细胞成分，一种为癌性，另一种为肉瘤性，从而诊断为癌肉瘤。病情进展迅速恶化，初次手术后4个月死亡。
结直肠癌肉瘤非常罕见且具有侵袭性，转移潜能高，常见转移部位为肝脏、淋巴结和腹膜。在我们的病例中，我们进行了FDG-PET/CT检查，发现了有趣的转移模式。
呈现此病例报告的目的是提高临床医生的认识，将这种临床实体作为结直肠肿瘤的鉴别诊断加以考虑，并更频繁地进行FDG-PET/CT检查以获得良好的临床分期。
