Sarcomatoid Carcinoma of the Transverse Colon With Extremely Aggressive Brain Metastases

Author:

Ishida Tomo1,Kagawa Yoshinori1,Naito Atsushi1,Kawai Kenji1,Hata Taishi1,Takeno Atsushi1,Goto Takayoshi2,Yoshimura Michiko2,Nakatsuka Shinichi2,Takeda Yutaka1,Kato Takeshi1,Murata Kohei1

Affiliation:

1. Department of Surgery, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan

2. Department of Pathology, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan

Abstract

Introduction Sarcomatoid carcinoma (SC) is a rare subtype of malignant neoplasm with a poor prognosis that involves both carcinomatous and sarcomatous components. Although it may develop in various organs, SC in the large intestine has rarely been reported. It is not rare for patients with SC to have distant metastasis, reflecting its highly aggressive oncologic features, but cases with brain metastasis on initial visit are rare. In this report, we described a case of SC in the transverse colon with brain metastases whose initial symptom was neurological disorder, and reviewed 31 reported cases of SC. Case presentation A 70-year-old man was admitted to our hospital with the chief complaints of gait disorder and severe dizziness. Head magnetic resonance imaging revealed tumor masses in the anterior lobe and cerebellum. A large tumor in the transverse colon was detected by colonoscopy and abdominal enhanced computed tomography (CT), and was diagnosed as undifferentiated adenocarcinoma by histology. Laparoscopic extended right hemicolectomy was performed to remove the obstruction, and the resected specimens revealed an invasive tumor consisting of a mixture of carcinomatous and sarcomatous components. According to the immunopathological study, the patient was diagnosed with SC. The clinical course was extremely aggressive, and the patient died on the 28th postoperative day because of disease progression. Conclusion To the best of our knowledge, this is the first case of SC in the transverse colon with a neurological disorder derived from brain metastases. This experience may contribute to the guidance regarding proper therapeutic options for SC.

Publisher

International College of Surgeons

Subject

Surgery

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