Korean J Gastroenterol.  2012 Dec;60(6):377-381. 10.4166/kjg.2012.60.6.377.

A Case of a Perivascular Epithelioid Cell Tumor Mimicking Colon Cancer

• Cho YW
• Kim KJ
• Ye BD
• Byeon JS
• Myung SJ
• Yang SK
• Kim JH

• KMID: 1773075
• DOI: http://doi.org/10.4166/kjg.2012.60.6.377

Abstract

Perivascular epithelioid cell tumor (PEComa) is extremely rare, which originated from mesenchymal cells in the intestine, and composed of histologically and immunohistochemically distinctive perivascular epithelioid cells. We report here on a case of PEComa in the sigmoid colon. A 62-year-old woman presented with hematochzia 10 days ago. Her abdominal computed tomography scan showed a 5 cm sized intraluminal fungating heterogeneously enhanced, high density mass, which infiltrated pericolic tissue surrounding the sigmoid colon. Colonoscopy showed a purple colored polypoid mass with lobulating contour in the sigmoid colon. She underwent laparoscopic anterior resection. On the histologic examination, the tumor consisted of polygonal epithelioid cells with sheet-like growth of nests, which looked like alveolar tissues in lung. The tumor cells were strongly positive stained with human melanoma black-45 (HMB-45). Pathologic examination was compatible with PEComa. Sixteen months after surgery, she did well without tumor recurrence after surgery. We review the literatures concerning PEComa of the intestine focusing on endoscopic findings.

Keyword

Perivascular epithelioid cell tumor; Colonoscopy; Intestines

MeSH Terms

Colonic Neoplasms/diagnosis
Colonoscopy
Female
Gastrointestinal Hemorrhage
Humans
Melanoma-Specific Antigens/metabolism
Middle Aged
Perivascular Epithelioid Cell Neoplasms/*diagnosis/pathology/surgery
Tomography, X-Ray Computed
Melanoma-Specific Antigens

Figure

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  Fig. 1 Abdominopelvic CT finding. An about 5 cm sized enhancing fungating mass (white arrow) was seen on the sigmoid colon. Pericolic infiltration was also seen.

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  Fig. 2 Colonoscopic finding. A purple colored polypoid mass with lobulating contour was seen on the sigmoid colon.

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  Fig. 3 Gross finding. (A) A 5.5 cm sized polypoid mass with lobulating contour was noted. (B) The cut surface showed diffuse hemorrhage.

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  Fig. 4 Microscopic finding. (A) H&E stain (×400) showed the sheet-like growth of nests of epithelioid cells with an alveolar appearance. (B) The tumor cells were positive for human melanoma black-45 (×200).

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