A Case of Adenosquamous Carcinoma of the Cecum

Abstract

Adenosquamous carcinoma of the colon is rare, accounting for approximately 0.1% of all colon cancers. We present a case of primary adenosquamous carcinoma of the cecum treated with resection. A 73-year-old woman was admitted to the hospital because of abdominal pain and vomiting, and ileus was diagnosed on the basis of colonic obstruction suggested by abdominal X-ray examination. Colonoscopy revealed type 2 advanced cancer of the cecum, and a biopsy confirmed adenocarcinoma. Computed tomography (CT) of the chest and abdomen revealed no distant metastases. The levels of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) before the operation were 17ng/ml and 101U/ml, respectively. Ileocecal resection (D3) was performed, and the clinical stage of the tumor was IIIb (T3N2H0P0). Pathological examination showed adenosquamous carcinoma (moderately differentiated adenocarcinoma and well-differentiated squamous cell carcinoma) and regional lymph node metastases (No. 201 and 202, positive; No. 203, negative). Adjuvant chemotherapy with 5-fluorouracil (5-FU)/leucovorin (LV) was performed, and the patient was disease-free for 15 months after the operation. However, metastasis to the para-aorta lymph nodes was detected with CT examination 16 months after the operation. The patient received best supportive care and died 22 months after surgery.