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. 2009:2009:bcr04.2009.1770.
doi: 10.1136/bcr.04.2009.1770. Epub 2009 Jun 21.

PNET/Ewing's sarcoma of the rectum: a case report and review of the literature

Omar M Aboumarzouk  1 , Robert Coleman, John R Goepel, Andrew J Shorthouse
Affiliations

PNET/Ewing's sarcoma of the rectum: a case report and review of the literature

Omar M Aboumarzouk et al. BMJ Case Rep. 2009.

Abstract

A 34-year-old female presented with anorectal pain and rectal bleeding due to an extensive rectal tumour. A trephine loop ileostomy was fashioned and biopsies were initially reported to show a poorly differentiated cloacogenic carcinoma. CT revealed numerous liver metastases. A histological review and immunohistochemical studies subsequently favoured a primitive neuroectodermal tumour (PNET). Stem-cell supported chemoradiotherapy resulted in complete resolution of her primary tumour and liver metastases. Serial CT scanning and endoscopy revealed no recurrence after 7 years of follow-up, when she presented with a malignant anal fissure. Imaging and subsequently abdominoperineal resection revealed no evidence of metastases from either the anal cancer or the PNET tumour. Histopathology showed a T1N0R0 basaloid squamous carcinoma originating from grade III squamous intraepithelial neoplasia with no obvious wart viral infection.

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Figures

Figure 1
Figure 1
Ewing’s sarcoma: small cells with dark blue staining nucleus and indistinct cell border (×400).
Figure 2
Figure 2
The darkly staining tumour cells can be seen beneath the rectal mucosa (×100).
Figure 3
Figure 3
Ewing’s tumour CD99 showing membrane staining of many tumour cells (×400).
Figure 4
Figure 4
Basaloid carcinoma of anus (×200).
Figure 5
Figure 5
Anal intraepithelial neoplasia near the basaloid carcinoma (×200).
See this image and copyright information in PMC

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