Carcinosarcoma in the cecum

Abstract

Carcinosarcoma of the colon is rare. Seventeen cases have been reported in the English literature. Most cases occurred in the left side of the colon. Indeed, there is only one reported case of cecal carcinosarcoma. Carcinosarcoma has a tendency to distantly metastasize and shows dismal prognosis. We report a case of carcinosarcoma in the cecum and review the literature describing colonic carcinosarcoma.

Keywords: Ascending colon; Carcinosarcoma; Cecum; Sarcomatoid carcinoma.

Fig. 1

Colonoscopic and gross findings. (A) Upon the colonoscopic examination, a Yamada type IV polypoid mass with surface ulceration was noted at the cecum. (B) The removed polyp measured 3.1×2×1.8 cm. The cut surface showed focal hemorrhage and a friable appearance.

Fig. 2

Microscopic findings. The tumor cells were spindling and epithelioid. (A) The former had round to ovoid nuclei with a coarse chromatin pattern, had distinct nucleoli and were arranged in a fascicular pattern (H&E stain, ×200). (B) The latter had large, bizarre nuclei and abundant eosinophilic glassy cytoplasm without cohesiveness (H&E stain, ×400). (C) Vimentin was diffusely positive in the spindle cells (×200). (D) Some epithelioid cells expressed cytokeratin (×400).