Open AccessPNET/Ewing's sarcoma of the rectum: a case report and review of the literature
Author(s) -
Omar Aboumarzouk,
Robert Coleman,
J Goepel,
A. J. Shorthouse
Publication year - 2009
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr.04.2009.1770
Subject(s) - medicine , abdominoperineal resection , histopathology , rectum , pathology , chemoradiotherapy , anal cancer , colorectal cancer , sarcoma , proctoscopy , cancer , radiation therapy , radiology , gastroenterology
A 34-year-old female presented with anorectal pain and rectal bleeding due to an extensive rectal tumour. A trephine loop ileostomy was fashioned and biopsies were initially reported to show a poorly differentiated cloacogenic carcinoma. CT revealed numerous liver metastases. A histological review and immunohistochemical studies subsequently favoured a primitive neuroectodermal tumour (PNET). Stem-cell supported chemoradiotherapy resulted in complete resolution of her primary tumour and liver metastases. Serial CT scanning and endoscopy revealed no recurrence after 7 years of follow-up, when she presented with a malignant anal fissure. Imaging and subsequently abdominoperineal resection revealed no evidence of metastases from either the anal cancer or the PNET tumour. Histopathology showed a T1N0R0 basaloid squamous carcinoma originating from grade III squamous intraepithelial neoplasia with no obvious wart viral infection.