J Gastric Cancer.  2015 Jun;15(2):143-146. 10.5230/jgc.2015.15.2.143.

A Surgically Resected Large Sarcomatoid Carcinoma of the Jejunum: A Case Report and Literature Review

• Lee HM
• Cho MS
• Kim YI

• KMID: 2372363
• DOI: http://doi.org/10.5230/jgc.2015.15.2.143

Abstract

Sarcomatoid carcinoma of the small intestine is rare, and only 30 cases have been reported to date. This disease generally exhibits a very poor prognosis. Here we report the case of a 67-year-old man with a sarcomatoid carcinoma in the jejunum, who was hospitalized for diarrhea, fever, nausea, and vomiting. The tumor was located at the jejunum and had a large round shape with geographic necrosis. It involved the entire wall of the small intestine and had directly invaded the neighboring sigmoid colon. Both lobes of the liver had multiple metastases. The patient underwent surgical resection of the jejunum. On immunohistochemical analysis, the tumor was positive for epithelial and mesenchymal markers. The patient died from rapid progression of the liver metastases 6 weeks after the surgery.

Keyword

Jejunal neoplasms; Sarcomatoid carcinoma; Carcinosarcoma

MeSH Terms

Aged
Carcinosarcoma
Colon, Sigmoid
Diarrhea
Fever
Humans
Intestine, Small
Jejunal Neoplasms
Jejunum*
Liver
Nausea
Necrosis
Neoplasm Metastasis
Prognosis
Vomiting

Figure

• 

  Fig. 1 The tumor was composed of ovoid to anaplastic cells forming solid sheets (H&E, ×400).

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  Fig. 2 The tumor displayed spindle tumor cells forming an interlacing fascicular arrangement (H&E, ×200).

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  Fig. 3 The tumor cells were positive for pan-CK on immunohistochemistry (×400).

• 

  Fig. 4 The tumor cells were negative for DOG-1 on immunohistochemistry (×400).

Reference

1. Reid-Nicholson M, Idrees M, Perino G, Hytiroglou P. Sarcomatoid carcinoma of the small intestine: a case report and review of the literature. Arch Pathol Lab Med. 2004; 128:918–921.

2. Moriwaki Y, Sugiyama M. Severe anemia inducing preshock caused by sarcomatoid carcinoma of the small intestine. Int Surg. 2009; 94:164–170.

3. Yucel AF, Kocakusak A, Arikan S, Demirbag N, Tarlaci A, Batur S. A rare cause of acute abdomen: perforated primary sarcomatoid carcinoma of the small intestine: report of a case, with a brief review of the literature. J Cancer Res Ther. 2011; 7:348–350.

4. Conzo G, Giordano A, Candela G, Insabato L, Santini L. Colonic carcinosarcoma. J Gastroenterol Hepatol. 2003; 18:748–749.

5. Robey-Cafferty SS, Silva EG, Cleary KR. Anaplastic and sarcomatoid carcinoma of the small intestine: a clinicopathologic study. Hum Pathol. 1989; 20:858–863.

6. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T, et al. Cancer statistics, 2008. CA Cancer J Clin. 2008; 58:71–96.

7. Iezzoni JC, Mills SE. Sarcomatoid carcinomas (carcinosarcomas) of the gastrointestinal tract: a review. Semin Diagn Pathol. 1993; 10:176–187.

8. Dikman SH, Toker C. Enteroblastoma complicating regional enteritis. Gastroenterology. 1973; 65:462–466.

9. Radi MF, Gray GF Jr, Scott HW Jr. Carcinosarcoma of ileum in regional enteritis. Hum Pathol. 1984; 15:385–387.

10. Lee SE, Park SY. Sarcomatoid carcinoma of the small intestine: a rare and highly aggressive tumor. J Korean Surg Soc. 2012; 83:321–324.