A Case of Adenosquamous Carcinoma of the Rectum with Synchronous Multiple Liver and Bone Metastases

Ken Sasaki, Masaki Kitazono, Kouji Nagata*, Shoji Natsugoe, Takashi Ishizawa and Takashi Aikou

Department of Surgical Oncology, Digestive Surgery and Department of Pathology*,
Kagoshima University School of Medicine

We report a case of adenosquamous carcinoma of the rectum with synchronous multiple liver and bone metastases. A 73-year-old woman was admitted to our hospital complaining of narrow stools and lumbago. A biopsy specimen histologically revealed a poorly differentiated adenocarcinoma. She was diagnosed as having advanced rectal cancer with multiple liver metastases and bone metastasis based on imaging findings. She underwent a Hartmann operation for the relief of symptoms like bleeding and stenosis. Macroscopically, the type 3 tumor had a cross section of 3.0×3.0 cm and was located in the rectum. Histological findings showed an adenosquamous carcinoma invading the subserosa with marked lymphatic and venous invasion. After the operation, she received combination chemotherapy with intrahepatic arterial infusion of 5-FU and intravenous infusion of CPT-11 and l-LV, according to the chemotherapy protocol for colon cancer. The characteristics of a large number of patients with adenosquamous cell carcinoma of the colorectum should be collected and analyzed. Furthermore, to improve the clinical outcome of patients with multiple hematogeneous metastases, new adjuvant therapy using molecular and genetic approaches should be pursued.

Key words
adenosquamous carcinoma, rectum, colon

Reprint requests
Ken Sasaki Department of Surgical Oncology, Digestive Surgery, Kagoshima University School of Medicine
8-35-1 Sakuragaoka, Kagoshima, 890-8520 JAPAN

Accepted
March 22, 2006

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