A CASE OF COMPOSITE ADENOCARCINOMA-CARCINOID TUMOR OF THE COLON

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  • 結腸に原発した腺癌とカルチノイドのｃｏｍｐｏｓｉｔｅ腫瘍の１例

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Abstract

A 90-year-old woman was admitted to our hospital because of ileus. Colonoscopy revealed severe stenosis in the ascending colon. Gastrografin enema study showed an apple core sign up to 5cm at the ascending colon. The pathological diagnosis of a biopsy specimen showed moderately differentiated adenocarcinoma. Right hemicolectomy with D2 lymphadenectomy was performed under a diagnosis of ascending colon carcinoma. The resected specimen showed that the tumor was solitary and localized ulceration type. Histological examination identified that the tumor was composed of two distinctive components, carcinoid and adenocarcinoma. In the area of carcinoid, the tumor cells were arranged in a solid or small tubular pattern with rosette formation. Immunohistochemical staining revealed positive reaction to CEA, CA19-9 and p53 in the area of adenocarcinoma. In the area of carcinoid, there was positive reaction to synaptophysin and p53, but negative reaction to chromogranin A and gastrin. We report this rare case of composite adenocarcinoma-carcinoid tumor of the colon, together with a review of the literature.

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