Clinicopathological features of 2 cases of squamous cell carcinoma and 2 cases of adenosquamous carcinoma

doi:10.16150/j.1671-2870.2023.01.007

Abstract

Abstract:

Objective: To investigate the clinicopathological features of colon squamous cell carcinoma and adenosquamous carcinoma. Methods: The clinicopathological data and prognosis of 4 patients with colonic squamous cell carcinoma or adenosquamous carcinoma were collected retrospectively. Results: There were 1 male and 3 female, and the age ranged from 29 to 76 years old. Serum CA19-9 was increased in 2 cases, which were 88.25 ng/mL and 553.13 ng/mL, respectively. Serum CEA increased in 2 cases, which were 116.39 U/mL and 37.22 U/mL, respectively. Three cases occurred in ascending colon and 1 case in descending colon. Microscopically, the squamous cell carcinoma of 4 cases was arranged into irregular nesting or flake shape, the tumor cells were polygonal or irregular, the cells were eosinophilic and expressed P40 and P63, while the adenocarcinoma of 2 adenosquamous carcinoma cases was arranged into irregular glandular tubules or cribriform, and the cell nucleus was deeply stained and expressed CAM5.2 and CK20. P16 was expressed in 3 cases. One case was complicated with schistosome. No patient was with human papilloma virus infection. Mismatch repair protein absently expressed in 3 cases. Three cases were complicated with KRAS gene mutation. At the last of follow-up, 1 patient died at 16.4 months after surgery, and the remaining 3 patients survived without recurrence (median follow-up time: 42 months). Conclusions: Squamous cell carcinoma and adenosquamous carcinoma are rare histopathological types of colorectal cancer with poor biological behavior, often accompanied by loss of mismatch repair protein expression and KRAS gene mutation. Radical resection is an effective way to obtain a good prognosis.

Key words: Squamous cell carcinoma, Colorectal cancer, Prognosis

CLC Number:

R735.3

WANG Han, LU Haidi, WANG Lei, CONG Wenming, ZHENG Jianming, BAI Chenguang. Clinicopathological features of 2 cases of squamous cell carcinoma and 2 cases of adenosquamous carcinoma[J]. Journal of Diagnostics Concepts & Practice, 2023, 22(01): 44-49.

Figures/Tables 6

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References 16

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Case	Sex	Age	Family history	Symptoms and signs	CA19-9 (ng/mL)	CEA (U/mL)	TNM classification
1	Female	29	No	Distension and pain in right upper abdomen for 6 months, worsening with melena for 2 weeks	88.25	1.85	T₃N₁M₀
2	Female	70	No	Bloody stool for 2 weeks	2.00	116.39	T₃N₀M₀
3	Male	76	No	Dull pain in lower abdomen for 2 months	7.97	2.89	T₄N₁M₀
4	Female	52	Yes	Intermittent pain in left upper abdomen for 1 month	553.13	37.22	T₄N₁M₀

Case	Location	Diameter (cm)	pTNM classification	Number of lymph nodes	Vessel carcinoma embolus	Perineural invasion	Diagnosis
1	Ascending colon	5.0	T₃N₀M₀	18	No	No	Squamous cell carcinoma
2	Ascending colon	6.0	T₃N₀M₀	16	No	No	Adenosquamous carcinoma (main component: adenocarcinoma)
3	Ascending colon	7.5	T_4aN₀M₀	25	Yes	No	Squamous cell carcinoma
4	Descending colon	10.0	T_4aN₀M₀	16	No	No	Adenosquamous carcinoma (main component: squamous cell carcinoma)