Rhabdoid colonic tumors are very rare lesions with just a few publications describing such neoplasms. Even more unusual for these lesions are their primary rectal locations, with only two brief case reports having been published on that subject to date. We present a case of a composite rhabdoid rectal carcinoma in a 49-year-old male. The tumor behaved very aggressively, with rapid patient demise despite radical surgery and intensive postoperative chemotherapy (FOLFIRI [folinic acid {leucovorin}, fluorouracil {5-fluorouracil}, and irinotecan] and FOLFOX4 [folinic acid {leucovorin}, fluorouraci {5-fluorouracil}, and oxaliplatin]). Pathologic examination was supportive of a rhabdoid carcinoma, with a compatible immunohistochemical profile, demonstrating synchronous expression of vimentin and epithelial markers in the tumor cells. In addition, BRAF V600E gene mutation, together with a wild-type KRAS gene, was identified, and no evidence of microsatellite instability based on MLH1, MSH2, MSH6, and PMS2 immunophenotypes, i.e., no loss of expression for all 4 markers, was observed. Our reported case confirms previously published observations of the clinical aggressiveness and the poor therapeutic response for rhabdoid tumors.
Colon ; Drug Therapy ; Fluorouracil ; Humans ; Male ; Microsatellite Instability ; Middle Aged ; Rectum* ; Rhabdoid Tumor ; Vimentin

PURPOSE: The laparoscopic colectomy is avoided principally because of its technical difficulty, steep learning curve, and increased operative time. Hand-assisted laparoscopic surgery (HALS) is an alternative technique that addresses these problems while preserving the short-term benefits of a laparoscopic colectomy. Our study was aimed to describe the characteristics of patients admitted due to left-sided colon and rectal cancer for HALS. METHODS: A prospectively maintained database was used to identify patients who underwent HALS at the Institute of Oncology, Vilnius University, from July 1, 2009, to October 1, 2012. RESULTS: One hundred-three HALS colorectal resections were performed. The patients' mean age was 64 +/- 13.4 years. There were 46 male and 57 female patients. The body mass index was 27.3 +/- 5.8 kg/m2. Forty-three patients (41.8%) had experienced prior abdominal surgery. The mean HALS time was 105 minutes (range, 55-85 minutes). The conversion rate was 2.7% (3/103). The median of return of gastrointestinal function was 2.5 days (range, 2.2-4.5 days). The median length of hospital stay was 9 days. The postoperative complication and mortality rates were 10.7% and 0.97%, respectively. Four incisional hernias (3.9%) were seen at a mean follow-up of 7.0 +/- 3.4 months. None of the patients had a trocar or a hand-port site recurrence. CONCLUSION: A HALS colorectal resection is a safe and effective technique, and it provides all the benefits of minimally invasive surgery.
Body Mass Index ; Colectomy ; Colon* ; Female ; Follow-Up Studies ; Hand-Assisted Laparoscopy ; Hernia ; Humans ; Laparoscopy* ; Learning Curve ; Length of Stay ; Male ; Mortality ; Operative Time ; Postoperative Complications ; Prospective Studies ; Rectal Neoplasms* ; Recurrence ; Surgical Instruments