융모상피암종성 분화를 보이는 직장의 선암종
Adenocarcinoma of the Rectum with Choriocarcinomatous Differentiation - A case report -
정재홍, 조용범, 박치민, 윤해란, 이원석, 서연림, 윤성현, 이우용, 전호경,
소속 상세정보
정재홍 ( Jeong Jae-Hong )
성균관대학교 의과대학 삼성서울병원 외과학교실
조용범 ( Cho Yong-Beom )
성균관대학교 의과대학 삼성서울병원 외과학교실
박치민 ( Park Chi-Min )
성균관대학교 의과대학 삼성서울병원 외과학교실
윤해란 ( Yun Hae-Ran )
성균관대학교 의과대학 삼성서울병원 외과학교실
이원석 ( Lee Won-Suk )
성균관대학교 의과대학 삼성서울병원 외과학교실
서연림 ( Suh Yeon-Lim )
성균관대학교 의과대학 삼성서울병원 병리학교실
윤성현 ( Yun Seong-Hyeon )
성균관대학교 의과대학 삼성서울병원 외과학교실
이우용 ( Lee Woo-Yong )
성균관대학교 의과대학 삼성서울병원 외과학교실
전호경 ( Chun Ho-Kyung )
성균관대학교 의과대학 삼성서울병원 외과학교실
KMID : 0356720070230040274
Abstract
A choriocarcinoma of the rectum is extremely rare and has a very poor prognosis. Its rarity and the obscurity of its histogenesis make the entity of disease hard to define. We report a case of a choriocarcinoma of the rectum which showed synchronous liver and lung metastasis. A 52-year- old male patient presented with tenesmus, hematochezia and pain on defecation for 4 months. The preoperative colonoscopy revealed a mass at the rectum, 3 cm proximal to the anal verge. The biopsy revealed a poorly differentiated adenocarcinoma. An abdominoperineal resection was performed, and the pathologic examination confirmed a choriocarcinoma arising from an adenocarcinoma. Immunostain for β-human chorionic gonadotropin (hCG) was strongly positive for the choriocarcinoma component. Serum hCG checked postoperatively was as high as 4,222 IU/L, but the serum carcinoembryonic antigen (CEA) was normal. Although chemotherapy was begun at the 5th week after the operation, the patient died on the 47th day after the operation. A choriocarcinoma of the colon or the rectum is very rare and is aggressive. Although radical resection and chemotherapy are performed, the clinical outcome is very disappointing. Even though a choriocarcinoma of the colon or the rectum is very rare, it should be included on the list for differential diagnosis of a colorectal carcinoma. J Korean Soc Coloproctol 2007;23: 274-278
키워드
직장암;선암;융모상피암
Adenocarcinoma;Choriocarcinoma;Rectal cancer
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