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29 August 2022 : Case report  USA

[In Press] Sarcomatoid Carcinoma of the Ascending Colon: A Case Report and Literature Review

Rare disease

Zachary J. Naser1ABCDEF, Shawna Morrissey1ABCDEF

DOI: 10.12659/AJCR.937548

Am J Case Rep In Press; DOI: 10.12659/AJCR.937548  

Available online: 2022-08-29, In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule

Abstract

BACKGROUND
Sarcomatoid carcinoma is a rare tumor that can occur in different organs and anatomical locations. Colonic sarcomatoid carcinoma, also known as carcinosarcoma, is an extremely rare tumor, with only 32 cases reported world-wide. The pathogenesis and guidelines for treatment are poorly understood due to the rarity and invasiveness of the disease.
CASE REPORT
A 77-year-old woman presented with worsening lower abdominal pain and associated fever after having initially been diagnosed with stump appendicitis and associated phlegmon 3 weeks prior, which was treated with antibiotics. Repeat imaging revealed an extraluminal versus perforated colonic mass with associated phlegmon. The patient’s condition continued to worsen, with development of obstructive-like symptoms, resulting in operative intervention involving a R2 right hemicolectomy, stapled ileo-colostomy, and partial omentectomy. The patient had an uneventful remainder of her hospitalization other than continued lower abdominal pain. After initial discharge, the patient presented to an outside hospital due to continued deterioration of health, with findings of an additional mass, likely secondary to the previous lymphadenopathy. Ultimately, goals of care were discussed, and the decision was made to provide palliative care, and the patient died due to her illness 32 days after the initial procedure.
CONCLUSIONS
Carcinosarcoma is an extremely rare tumor with scant research guiding treatment guidelines. Current guidelines gathered from previous case reports suggest treating colorectal carcinosarcoma as adenocarcinoma. Additional research and studies are needed to establish appropriate therapeutic guidelines for carcinosarcoma.

Keywords: Carcinosarcoma; Colorectal Neoplasms; Colorectal Surgery; General Surgery

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923