Small Cell Undifferentiated Carcinoma of the Ascending Colon with Rapid Enlargement after Resection: Report of a Case and Review of the Literature

Abstract

Although adenocarcinoma represents the vast majority of neoplasms of the large intestine, small cell undifferentiated carcinoma (SCUC) also arises from the colorectum. SCUC of the colorectum is highly malignant and shares the similarities in histologic characteristics, behavior, and histochemistry with SCUC of the lung. We report herein a case of SCUC in the ascending colon with rapid enlargement after resection. A 70-year-old male, who presented to a nearby physician with chief complaints of pain in the right lower quadrant, was referred to our hospital. We found a tumor mass that was approximately 15 cm in size in the right lower quadrant. Computed tomography (CT) images showed an irregularly shaped tumor, located inferior to the lower border of the right kidney and in the area of the ascending colon. By colonoscopy, we found a circumferential tumor of the ascending colon. A biopsy indicated it to be SCUC. The patient underwent right hemicolectomy. Two weeks after the resection, we palpated a tumor mass in the same area. The abdominal CT images showed a tumor mass that was approximately 10 cm in size. The tumor rapidly enlarged, and the patient died of multiple organ failure. SCUC is a tumor with a high malignant potential. Radical treatment cannot be achieved by surgical therapy alone and hence further studies of effective adjuvant therapy would be required.small cell undifferentiated carcinoma; SCUC; colon; chemotherapy

Rectal Small Cell Carcinoma: A Case Report and Review of the Literature

“…In the above study of 81 patients, the median time to relapse following initial response in patients with limited disease was 11.5 months [9]. Another study of 16 patients with reported rectal SCC had only 3 long-term survivors who were alive 5 years after the time of diagnosis and as expected, all of them had limited disease [10]. …”

Primary mixed adenocarcinoma and small-cell carcinoma of appendix

“…Colorectal extrapulmonary small-cell carcinoma (EPSCC) is rare with a proposed incidence of 0.3% of all colorectal cancer, according to the National Cancer Institute. [5] Yasui et al [6] reported that colorectal EPSCC was located in the cecum in 7 paitnets (18.4%), ascending colon in 7 patients (18.4%), transverse colon in 3 patients (7.9%), sigmoid colon in 3 patients (7.9%), rectum in 16 patients (42.1%), and proctos in 2 patients (5.3%). The majority of patients had SCC in the recutm.…”

“…[7,10,11] In colorectal SCC, the mean survival times for patients who underwent resection only and for those who also underwent adjuvant chemotherapy were 67.0 and 121.4 weeks, indicating a longer survival time with adjuvant chemotherapy. [6]…”

A clinicopathological aspect of primary small-cell carcinoma of the uterine cervix: a single-centre study of 25 cases

“…The 5-year survival rate of SCCC is much lower than that of all cervical cancers 4 5. The clinicopathological features of SCCC are similar to those of small-cell carcinoma that arise in the lung6 and other extrapulmonary organs, including breast,7 liver,8 salivary gland,9 stomach,10 colon,11 prostate,12 urinary bladder,13 kidney14 and oesophagus 15. Histologically, small-cell carcinoma was characterised by neuroendocrine-like architectural patterns, including nested and trabecular growth with common features 16.…”