Korean J Gastroenterol.  2013 Dec;62(6):375-378. 10.4166/kjg.2013.62.6.375.

A Case of Basaloid Squamous Cell Carcinoma of Rectosigmoid Colon

• Ha TH
• Jeon TJ
• Park JY
• Jang YH
• Kim DH
• Ryu MJ
• Sinn DH
• Oh TH

• KMID: 1711295
• DOI: http://doi.org/10.4166/kjg.2013.62.6.375

Abstract

Basaloid squamous cell carcinoma is a rare and aggressive variant of squamous cell carcinoma, which mostly occurs in the upper aerodigestive tracts. Basaloid squamous cell carcinoma also typically arises in the anal canal, but is extremely rare in the lower gastrointestinal tract. A 70-year-old man presented with loose stool and intermittent hematochezia 2 months ago. Colonoscopy showed an ulceroinfiltrative mass on the rectosigmoid colon from 16 cm to 18 cm above the anal verge. Conventional colonoscope could not pass through the lesion but it was possible with pediatric colonoscope. Abdominal CT scan showed 1.6 cm sized wall thickening with circumferential luminal narrowing in the rectosigmoid colon and multiple ill-defined low density masses in both lobes of the liver. Therefore, colon cancer with liver metastasis was suspected. However, basaloid cells were noted on histologic examination, and they were weakly positive for synaptophysin on immunohistochemical study. After palliative lower anterior resection, histologic examination of the resected specimen revealed basaloid differentiation with keratin pearls, and tumor cells were positively stained with high molecular weighted cytokeratin (34BE12) and CK 5/6. Thus, the patient was finally diagnosed with basaloid squamous cell carcinoma of rectosigmoid colon with distant metastases.

Keyword

Carcinoma, basosquamous; Colonic neoplasms

MeSH Terms

Aged
Carcinoma, Squamous Cell/*diagnosis/pathology/surgery
Colonoscopy
Colorectal Neoplasms/*diagnosis/pathology/surgery
Humans
Immunohistochemistry
Keratins/metabolism
Liver Neoplasms/radiography/secondary
Lung Neoplasms/radionuclide imaging/secondary
Male
Positron-Emission Tomography
Synaptophysin/metabolism
Tomography, X-Ray Computed
Keratins
Synaptophysin

Figure

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  Fig. 1. Colonoscopic finding. A 2 cm sized encircling ulceroinfiltrative mass with luminal narrowing was seen on the rectoscimoid colon from 16 cm to 18 cm above the anal verge.

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  Fig. 2. Abdominal CT finding. A 1.6 cm sized wall thickening with circumferential luminal narrowing was seen on the rectosigmoid junction of colon.

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  Fig. 3. Gross finding. A 7 cm sized ulceroinfiltrative encircling mass was noted.

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  Fig. 4. Microscopic findings (H&E). (A) The low power view shows basaloid component and sqaumous component of the tumor (×40). (B) The high power view shows hyperchromatic tumor cells with basaloid differentiation and squamous differentiation with keratin pearls (×400).

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  Fig. 5. Immunohistochemical studies.(A) Tumor cells were positive for 34BE12 (×200). (B) Tumor cells were also positive for CK 5/6 (×200).

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