[Sarcomatoid carcinoma of small intestine: diagnostic problems raised by an unusual tumor].
Sarcomatoid carcinomas involving the intestinal tract are rare and usually associated with poor prognosis. We report a case of sarcomatoid carcinoma of the ileum, diagnosed in a 61-year-old man. The patient presented with acute intestinal occlusion. Surgical resection of the ileum was performed. At macroscopic examination, two large polypoid masses were found. Frozen section examination suggested the diagnosis of malignant stromal tumor. At histological examination, both tumors were formed by pleiomorphic, large spindle cells, presenting numerous mitoses and marked nuclear atypia. Immunohistochemical examination showed that tumor cells coexpressed vimentin and epithelial markers (cytokeratins, EMA). The final diagnosis was monomorphic sarcomatoid carcinoma. The patient deceased with metastatic disease after 3 months of follow-up. This report underlines the potential diagnostic problems raised by this unusual type of carcinoma and emphasizes the role of immunohistochemistry in assessing the correct diagnosis.
Gengler
Carole
C
Service Central d'Anatomie et Cytologie Pathologiques, 3 place d'Arsonval, 69437 Lyon Cedex, France.
Tanière
Philippe
P
Béatrix
Olivier
O
Scoazec
Jean-Yves
JY
D002277:Carcinoma / Q000473:pathology*; D017809:Fatal Outcome; D006801:Humans; D007082:Ileum; D007150:Immunohistochemistry; D007414:Intestinal Neoplasms / Q000473:pathology*; D007633:Keratins / Q000032:analysis; D008297:Male; D008875:Middle Aged; D012509:Sarcoma / Q000473:pathology*; D014746:Vimentin / Q000032:analysis
D014746:Vimentin; D007633:Keratins
Carcinome sarcomatoïde de l'intestin grêle: problèmes diagnostiques posés par une tumeur inhabituelle.