A Case of Adenosquamous Carcinoma of the Cecum
1Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School
2Department of Surgery, Tokyo River Side Hospital
3Department of Surgery, Nippon Medical School Tama Nagayama Hospital
Adenosquamous carcinoma of the colon is rare, accounting for approximately 0.1% of all colon cancers. We present a case of primary adenosquamous carcinoma of the cecum treated with resection. A 73-year-old woman was admitted to the hospital because of abdominal pain and vomiting, and ileus was diagnosed on the basis of colonic obstruction suggested by abdominal X-ray examination. Colonoscopy revealed type 2 advanced cancer of the cecum, and a biopsy confirmed adenocarcinoma. Computed tomography (CT) of the chest and abdomen revealed no distant metastases. The levels of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) before the operation were 17 ng/ml and 101 U/ml, respectively. Ileocecal resection (D3) was performed, and the clinical stage of the tumor was IIIb (T3N2H0P0). Pathological examination showed adenosquamous carcinoma (moderately differentiated adenocarcinoma and well-differentiated squamous cell carcinoma) and regional lymph node metastases (No. 201 and 202, positive; No. 203, negative). Adjuvant chemotherapy with 5-fluorouracil (5-FU)/leucovorin (LV) was performed, and the patient was disease-free for 15 months after the operation. However, metastasis to the para-aorta lymph nodes was detected with CT examination 16 months after the operation. The patient received best supportive care and died 22 months after surgery.
ϊγεγο 2011; 7(3), 129-132
colon cancer, adenosquamous carcinoma
Atsushi Sugiura, Department of Surgery, Tokyo River Side Hospital, 8-4-4 Minami-senjyu, Arakawa-ku, Tokyo 116-0003, Japan