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Abstract：
BACKGROUND: Medullary carcinoma of the colon is a rare subtype of colorectal cancer that has a unique, and sometimes varied, clinical and histologic profile. It usually presents in adult patients older than 50 years. Here, we report a unique case of young male patient who initially presented with abdominal pain followed by a large bowel obstruction.
METHODS: A 40-year-old SriLankan male presented with right-sided abdominal pain and on examination, there was a palpable right iliac fossa mass. Colonoscopy and a computed tomography scan revealed cecal mass. Later, while waiting for elective resection, the patient developed symptoms and signs of a large bowel obstruction. He underwent a laparoscopic right hemicolectomy with an uneventful postoperative course. The histopathologic evaluation of the resected specimens showed invasive carcinoma with syncytial growth pattern, foci of lymphoid host response, and dirty necrosis, in keeping with a medullary carcinoma pT4a pN2b. Unlike most reported medullary carcinoma cases, this patient was young and caudal-related homeobox transcription factor 2 positive.
CONCLUSIONS: We have reported another case of medullary carcinoma of the colon in a young patient with unique histologic characteristics. Reporting such cases helps in refine understanding of the histologic and genetic, as well as clinical, phenotypes of medullary carcinoma of the colon.
METHODS: A 40-year-old SriLankan male presented with right-sided abdominal pain and on examination, there was a palpable right iliac fossa mass. Colonoscopy and a computed tomography scan revealed cecal mass. Later, while waiting for elective resection, the patient developed symptoms and signs of a large bowel obstruction. He underwent a laparoscopic right hemicolectomy with an uneventful postoperative course. The histopathologic evaluation of the resected specimens showed invasive carcinoma with syncytial growth pattern, foci of lymphoid host response, and dirty necrosis, in keeping with a medullary carcinoma pT4a pN2b. Unlike most reported medullary carcinoma cases, this patient was young and caudal-related homeobox transcription factor 2 positive.
CONCLUSIONS: We have reported another case of medullary carcinoma of the colon in a young patient with unique histologic characteristics. Reporting such cases helps in refine understanding of the histologic and genetic, as well as clinical, phenotypes of medullary carcinoma of the colon.
摘要：
背景：结肠髓样癌是一种罕见的结直肠癌亚型，有时变化，临床和组织学特征。它通常出现在50岁以上的成年患者中。这里,我们报道了一例年轻男性患者的独特病例，最初表现为腹痛，随后出现大肠梗阻。
方法：一名40岁的斯里兰卡男性出现右侧腹痛，经检查，有一个明显的右髂窝肿块。结肠镜检查和计算机断层扫描显示盲肠肿块。稍后，在等待择期切除的时候,患者出现大肠梗阻的症状和体征。他接受了腹腔镜右半结肠切除术，术后进展顺利。切除标本的组织病理学评估显示具有合胞体生长模式的浸润性癌，淋巴宿主反应的病灶，肮脏的坏死，与髓样癌pT4apN2b保持一致。与大多数报道的髓样癌病例不同，该患者年轻,尾部相关同源异型盒转录因子2阳性.
结论：我们报道了另一例年轻患者的结肠髓样癌，具有独特的组织学特征。报告此类病例有助于加深对组织学和遗传学的理解，以及临床，结肠髓样癌的表型。
方法：一名40岁的斯里兰卡男性出现右侧腹痛，经检查，有一个明显的右髂窝肿块。结肠镜检查和计算机断层扫描显示盲肠肿块。稍后，在等待择期切除的时候,患者出现大肠梗阻的症状和体征。他接受了腹腔镜右半结肠切除术，术后进展顺利。切除标本的组织病理学评估显示具有合胞体生长模式的浸润性癌，淋巴宿主反应的病灶，肮脏的坏死，与髓样癌pT4apN2b保持一致。与大多数报道的髓样癌病例不同，该患者年轻,尾部相关同源异型盒转录因子2阳性.
结论：我们报道了另一例年轻患者的结肠髓样癌，具有独特的组织学特征。报告此类病例有助于加深对组织学和遗传学的理解，以及临床，结肠髓样癌的表型。
