Korean J Gastroenterol.  2014 Aug;64(2):98-102. 10.4166/kjg.2014.64.2.98.

Primary Squamous Cell Carcinoma of the Ascending Colon: Report of a Case and Korean Literature Review

• Cho DK
• Kim SH
• Cho SB
• Lee WS
• Joo YE

• KMID: 2164420
• DOI: http://doi.org/10.4166/kjg.2014.64.2.98

Abstract

Primary squamous cell carcinoma of the colon is an extremely rare malignancy. A 48-year-old male visited our hospital for screening colonoscopy. Colonoscopic examination showed a 1 cm sized sessile polyp in the ascending colon. The patient underwent endoscopic mucosal resection (EMR) without any complication. The pathologic findings were compatible with squamous differentiation of tumor cells in inflammatory colonic mucosa. The tumor was confined to the mucosa and the margins of the excised tissue were found to be free of the tumor. There were no other primary sites and no distant metastases in the extensive evaluation using a whole body CT scan and PET-CT. Additional surgical resection was not done. Follow-up colonoscopy performed eight month later showed a whitish scar without evidence of local recurrence and follow-up PET-CT demonstrated no evidence of recurrence. Herein, we report a case of primary squamous cell carcinoma of the ascending colon presenting as a sessile polyp which was removed by EMR.

Keyword

Squamous cell carcinoma; Ascending colon; Endoscopic resection

MeSH Terms

Adult
Aged
Asian Continental Ancestry Group
Carcinoma, Squamous Cell/*diagnosis/pathology
Colon, Ascending
Colonic Neoplasms/*diagnosis/pathology
Colonoscopy
Female
Humans
Intestinal Mucosa/pathology/surgery
Male
Middle Aged
Positron-Emission Tomography
Republic of Korea
Tomography, X-Ray Computed

Figure

• 

  Fig. 1. Colonoscopic findings. (A) About 10 mm sized sessile polyp is seen in the ascending colon. (B) Follow-up colonoscopy after endoscopic mucosal resection 8 month later shows whitish scar without gross evidence of intraluminal local recurrence.

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  Fig. 2. Microscopic findings of the resected specimen (H&E stain). (A) Squamous differentiation of tumor cells is invading lamina propria in the inflammatory colonic mucosa. There is no malignant adenomatous component (×100). (B) Squamous differentiation of tumor cells with interceullular bridge (black arrows) (×400). (C) Atypical squamous metaplasia (black arrow) is seen around tumor cells (arrowhead) and normal colonic epithelial cells (×200).

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  Fig. 3. Immunohistochemical stain findings. (A) Mucicarmine stain for mucin shows pink colored stain in normal colon mucosa but negative stain in squamous cell carcinoma, thereby establishing the absence of any glandular or adenomatous component (×100). (B) p63 stain shows diffuse and strong positivity in squamous cell carcinoma (×100).

Reference

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