[Undifferentiated small cell carcinoma (oat-cell type) of the colon. Prognostic and therapeutic implications].
OBJECTIVE
This report reviews the clinical and pathologic features of four patients with small-cell anaplastic carcinoma (SCAC) of the colon and describes in detail their histological and immunohistochemical characteristics.


METHODS
Four patients with a SCAC of the colon diagnosed by conventional light microscopy, immunohistochemistry and ultrastructure were reviewed; clinical presentation, tumor location and spread, surgical procedure, adjuvant therapy and clinical outcome were recorded.


RESULTS
There were two women and two man, with an average age of 55 (range, 40-66) years. Two tumors were located in the sigmoid and two in right colon. Cases 1, 3 and 4 were removed at laparotomy by segmental resection along with lymph nodes. All cases had liver metastases. Pathologic study identified out-cell subtype in all cases and two histopathologic patterns: pure SCAC (cases 2 and 4) and mixed exocrine-SCC differentiation (cases 1 and 3). Three patients were treated with cyclophosphamide, cisplatin and etoposide. Two patients (cases 2 and 4) died of widely metastatic disease; cases 1 and 3 had partial remission lasting 9 and 3 months, respectively.


CONCLUSIONS
Due to extremely aggressive behavior of colon SCAC with early metastatic spread, CT scans of the chest-abdomen and radionuclide bone scan should be performed. In the presence of metastatic disease, multiagent chemotherapy with combined etoposide and cisplatin should be instituted.
Acea Nebril
B
B
Servicio de Cirugìa General A, Hospital Juan Canalej, La Coruna.
Bouso Montero
M
M
Arnal Monreal
F
F
Gómez Freijoso
C
C
Sánchez González
F
F
Freire Rodríguez
D
D
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D018288:Carcinoma, Small Cell / Q000473:pathology* / Q000628:therapy; D003110:Colonic Neoplasms / Q000473:pathology* / Q000628:therapy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D014408:Biomarkers, Tumor
Carcinomas indiferenciados de células pequeñas (Tipo oat-cell) de colon. Implicaciones pronósticas y terapéuticas.