Poorly differentiated adenocarcinoma manifesting as multifocal obstructive disease -a rare occurrence
Keywords:
Visceral carcinomatosis, multifocal obstruction, adenocarcinoma
Abstract
We describe an autopsy of a very unusual case of an adult female presenting with multifocal obstructive symptoms like achalasia, obstructive jaundice and bilateral hydronephrosis . Primary clinical diagnosis was tuberculosis and malignancy. Although the patient was extensively worked up in the hospital with multiple biopsies, the diagnosis could not be made. Autopsy revealed contiguous involvement of entire gastrointestinal tract from esophagus till colon by a poorly differentiated adenocarcinoma with diffuse thickening, firmness and rigidity of the wall. The tumor cells were focally expressing CK 20 favouring a colonic primary. Colonic adenocarcinoma usually spread by either lymphatic or hematogenous way to lymph nodes, liver and lung. This unusual way of spread of this tumor contiguously from colon till esophagus, with Urinary bladder and distal CBD infiltration make it very unique.DOI:10.21276/APALM.1757References
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2. Weng SC, Wu CY. Lymphoma presenting as peritoneal lymphomatosis with ascites.
J Chin Med Assoc 2008 ; 71:646-50.
3. Park SY, Kim HS, Hong EK, Kim WH. Expression of cytokeratins 7 and 20 in primary carcinomas of the stomach and colorectum and their value in the differential diagnosis of metastatic carcinomas to the ovary. Hum Pathol 2002;33: 1078-85
4. Chang CL, Chen YT. Metastatic Colon Cancer to the Urinary Bladder: A Case Report
J Soc Colon Rectal Surgeon (Taiwan) 2009;20:39-43
5. Sharma PK, Vijay MK, Das RK, Chatterjee U. Secondary signet-ring cell adenocarcinoma of urinary bladder from a gastric primary. Urol Ann. 2011;3: 97–99.
6. Lee DH, Ahn YJ, Shin R, Lee HW. Metastatic mucinous adenocarcinoma of the distal common bile duct, from transverse colon cancer presenting as obstructive jaundice. Korean J Hepatobiliary Pancreat Surg. 2015;19: 125–128
7. Campo SMA, Zullo A, Scandavini CM, Frezza B, Cerro P, Balducci G. Pseudoachalasia: A peculiar case report and review of the literature. World J Gastrointest Endosc 2013; 5: 450-454
8. Le Ott. Patterns of peritoneal spread of tumor in the abdomen and pelvis. World J Radiol 2013 28; 5: 106–112
9. Mereiter S, Balmaña M, Gomes J, Magalhães A, Reis CA. Glycomic Approaches for the Discovery of Targets in Gastrointestinal Cancer. Front Oncol 2016;6:55.
Published
2018-04-28
Issue
Section
Case Report
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