A rare tumor revealed by abdominal trauma: case presentation

Vol. 55 No. 3 Suppl., 2014
This supplement was not sponsored by Outside Organizations.


Camelia Cristina Diaconu, Dorel Arsene, Alice Lavinia Balaceanu, Daniela Bartos

Pseudomyxoma peritonei is a rare and poorly understood form of disease characterized by mucin deposits in the peritoneum. The term includes a broad range of neoplasms with different patterns of evolution, from benign to borderline or even to malignant lesions. The disease may be asymptomatic until advanced stages. We present the case of a 65-year-old patient who presented for pain in the right hemiabdomen, after a trauma by falling from small height. Abdominal imaging studies oriented the diagnosis to a traumatic disease. At laparotomy, a mucinous tumor attached to the right colon was discovered. The main particularity of the case is that the origin of the pseudomyxoma could not be identified.

Corresponding author: Camelia Cristina Diaconu, Associate Professor, MD, PhD; e-mail: camiluciemi@yahoo.com

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Andrzej Wincewicz, Piotr Lewitowicz, Slawka Urbaniak-Wasik, Luiza Kanczuga-Koda, Mariusz Koda, Olga Adamczyk-Gruszka, Stanislaw Sulkowski

Background: Adenoid basal carcinoma (ABC) of uterine cervix is an extraordinary example of carcinoma with both basal and glandular cell types. Here we present such a case of ABC combined with invasive squamous cell carcinoma (SCC) of 55-year-old woman. Methods: The tumor was stained with Hematoxylin-Eosin (HE), Mucicarmine, PAS/Alcian Blue, CK AE1/AE3, CK7, CD117 and Ki67. Results: The whitish-grey 1 cm in-depth infiltration of endocervix was composed of infiltrative coalescing areas of CK AE1/AE3 positive carcinoma with peripheral palisading of basal cell type with spaces lined by Mucicarmine- and Alcian Blue-positive benign looking, glandular epithelium. There were also foci of apparently malignant squamous epithelium with evident dyskeratosis. Thus, a lesion was diagnosed of adenoid basal carcinoma combined with invasive squamous cell carcinoma foci of uterine cervix. The tumor was further CD117 negative what favored diagnosis of ABC over adenoid cystic carcinoma (ACC). There were rare mitoses on HE slides but 60% of all tumor cells were positive for Ki67 that would partially contradict reported benign nature of ABC lesion. Moreover, tumor was CK7-positive and this finding was controversial and according to one report favored diagnosis of ABC-like adenosquamous carcinoma (ACC). Due to CK7 positivity and high index of Ki67, the neoplasm was re-classified as adenoid basal carcinoma-like tumor. Conclusions: It seems reasonable to treat the patient in the same manner as in case of pure simple invasive squamous cell carcinoma because much more aggressive, minor component of invasive SCC was found within ABC in our case.

Corresponding author: Andrzej Wincewicz, MD, PhD; e-mail: andwinc@gmail.com, ruahpolin@yahoo.com

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