Adenocarcinoma of the Rectum with Choriocarcinomatous Differentiation: A case report.
10.3393/jksc.2007.23.4.274
- Author:
Jae Hong JEONG
1
;
Yong Bum CHO
;
Chi Min PARK
;
Hae Ran YUN
;
Won Suk LEE
;
Yeon Lim SUH
;
Seong Hyeon YUN
;
Woo Yong LEE
;
Ho Kyung CHUN
Author Information
1. Department of Surgery, Samsung Medical Center, Sunkyunkwan University School of Medicine, Seoul, Korea. hokyung.chun@samsung.com
- Publication Type:Case Report
- Keywords:
Adenocarcinoma;
Choriocarcinoma;
Rectal cancer
- MeSH:
Adenocarcinoma*;
Biopsy;
Carcinoembryonic Antigen;
Choriocarcinoma;
Chorionic Gonadotropin;
Colon;
Colonoscopy;
Colorectal Neoplasms;
Defecation;
Diagnosis, Differential;
Drug Therapy;
Female;
Gastrointestinal Hemorrhage;
Humans;
Liver;
Lung;
Male;
Neoplasm Metastasis;
Pregnancy;
Prognosis;
Rectal Neoplasms;
Rectum*
- From:Journal of the Korean Society of Coloproctology
2007;23(4):274-278
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A choriocarcinoma of the rectum is extremely rare and has a very poor prognosis. Its rarity and the obscurity of its histogenesis make the entity of disease hard to define. We report a case of a choriocarcinoma of the rectum which showed synchronous liver and lung metastasis. A 52-year- old male patient presented with tenesmus, hematochezia and pain on defecation for 4 months. The preoperative colonoscopy revealed a mass at the rectum, 3 cm proximal to the anal verge. The biopsy revealed a poorly differentiated adenocarcinoma. An abdominoperineal resection was performed, and the pathologic examination confirmed a choriocarcinoma arising from an adenocarcinoma. Immunostain for beta-human chorionic gonadotropin (hCG) was strongly positive for the choriocarcinoma component. Serum hCG checked postoperatively was as high as 4,222 IU/L, but the serum carcinoembryonic antigen (CEA) was normal. Although chemotherapy was begun at the 5th week after the operation, the patient died on the 47th day after the operation. A choriocarcinoma of the colon or the rectum is very rare and is aggressive. Although radical resection and chemotherapy are performed, the clinical outcome is very disappointing. Even though a choriocarcinoma of the colon or the rectum is very rare, it should be included on the list for differential diagnosis of a colorectal carcinoma.
