Clear cell adenocarcinoma of the colon arising in endometriosis: a rare variant of primary colonic adenocarcinoma

W G McCluggage, McCluggage WG, W. Glenn McCluggage, V Desai, Desai V, P G Toner, Toner PG, Calvert CH, C H Calvert
Journal of clinical pathology · 2001 · vol. 54(1) , pp. 76–77 · doi:10.1136/jcp.54.1.76 · PMID:11271795 · PMC1731275 · W2171385489
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This case report describes a rare primary colonic clear cell adenocarcinoma likely arising in endometriosis, presenting diagnostic challenges in distinguishing it from metastatic disease.

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Abstract

Colonic adenocarcinomas composed predominantly or exclusively of cells with clear cytoplasm are extremely rare.1,2 Considerable diagnostic difficulties can arise in distinguishing primary colonic clear cell adenocarcinoma and metastatic carcinoma from sites such as ovary or kidney. Here, we describe a case of primary colonic clear cell adenocarcinoma that probably arose in endometriosis. The possible presence of endometriosis was only appreciated on review and after the examination of multiple levels and extra histological sections. A 65 year old woman presented with crampy lower abdominal pain and the passage of blood and mucus from the rectum. Barium enema showed an apparently malignant stricture of the rectosigmoid and she underwent an anterior resection. Preoperative serum CA125 was not measured. At surgery, the clinical impression was of a primary colorectal tumour. Small haemorrhagic nodules were present on the pelvic and abdominal peritoneum, suggestive of endometriosis. There were multiple metastatic lesions within the liver. Both ovaries and kidneys appeared normal. The surgical specimen consisted of a 30 cm length of colon. A polypoid ulcerated tumour involved the mucosa and infiltrated through the full thickness of the colonic wall. Histology of the tumour showed an ulcerated surface. The tumour was composed entirely of cells with abundant clear cytoplasm and prominent cell membranes (fig 1A). Several growth patterns were present. Much of the tumour had a pronounced papillary pattern, with hyalinised cores covered by tumour …

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Condition tags

endometriosis

MeSH descriptors

Adenocarcinoma, Clear Cell Colonic Neoplasms Endometriosis Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Aged Colonic Neoplasms Colonic Neoplasms Endometriosis Endometriosis Female Humans

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (18)

Cited by (18)

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