title: Primary adenosquamous carcinoma of the rectum. Report of 4 cases and review of the literature.
abstract: OBJECTIVE
  To review the experience of two referral centres in the management of an infrequent condition: primary adenosquamous carcinoma of the rectum, a rare disease.
  
  
  METHODS
  Four cases of primary adenosquamous carcinomas of the rectum are reported with a review of the literature. No preoperative diagnosis of adenosquamous carcinoma was established. All tumours were located in the rectum. Two patients presented with liver metastasis. No preoperative therapies were indicated. All patients underwent surgery.
  
  
  RESULTS
  Patients underwent anterior resections (n=2), recto-sigmoid resection (n=1) and abdomino-perineal excision (n=1). All resected specimens had positive lymph nodes and metastatic liver disease was confirmed in the two cases. No adjuvant therapy was carried out after surgery and patients died within 8 months after surgical treatment.
  
  
  CONCLUSIONS
  Adenosquamous carcinoma of the rectum is a rare and aggressive tumour characterized by coexisting of malignant glandular and squamous components. Presentation is usually at an advanced stage. The tumour is aggressive and metastatic disease at the time of diagnosis is common. Surgery is the treatment of choice. Adjuvant therapy is difficult to evaluate prospectively due to the rarity of the condition. Survival is less than 50% than that for adenocarcinoma.
authors.affiliation: Department of Surgery, Hospital de Clínicas José de San Martín, University of Buenos Aires, Argentina. rschlegel@intramed.net.ar
authors.forename: R D
authors.initials: RD
authors.lastname: Schlegel
authors.forename: N
authors.initials: N
authors.lastname: Dehni
authors.forename: A T
authors.initials: AT
authors.lastname: Cravino
authors.forename: E
authors.initials: E
authors.lastname: Tiret
authors.forename: S
authors.initials: S
authors.lastname: Prevot
authors.forename: H J
authors.initials: HJ
authors.lastname: Waisman
authors.forename: R
authors.initials: R
authors.lastname: Parc