A rare case of medullary carcinoma of the colon presenting as intussusception in an adult with rectal bleeding

Shilpa Jain; Ankur Jain; Neil Onizuka; Sarag A Boukhar

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Journal article

A rare case of medullary carcinoma of the colon presenting as intussusception in an adult with rectal bleeding

Shilpa Jain, Ankur Jain, Neil Onizuka and Sarag A Boukhar

Hawai'i journal of medicine & public health, Vol.73(11), pp.348-352

11/2014

PMCID: PMC4238122

PMID: 25414804

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Abstract

Medullary carcinoma is a recently recognized rare subtype of colorectal cancer resembling both poorly differentiated adenocarcinoma and neuroendocrine tumors. Medullary carcinoma most commonly presents in the proximal colon and can be differentiated from other right-sided malignant lesions by histology and immunochemical markers. We present here a rare case of an adult patient with rectal bleeding who was found to have an intussusception due to underlying medullary carcinoma of the splenic flexure. A 72-year-old woman presented to our GI clinic with rectal bleeding. Colonoscopy revealed a necrotic mass of the sigmoid colon, later determined by CT to be a colo-colonic intussusception at the level of the splenic flexure. Patient underwent diagnostic laparoscopy with findings of a large splenic flexure mass, which was resected and found to be medullary carcinoma of the colon. The tumor was poorly differentiated and exhibited microsatellite instability but was discovered at an early stage and thus did not require any adjuvant chemotherapy. Unlike most previously reported cases of medullary carcinoma, our patient presented with a left sided tumor. To our knowledge, this is the first report of a medullary colon cancer presenting with intussusception.

Intussusception - etiology

Sigmoid Neoplasms - complications

Humans

Carcinoma, Medullary - diagnosis

Carcinoma, Medullary - surgery

Carcinoma, Medullary - complications

Sigmoid Neoplasms - diagnosis

Gastrointestinal Hemorrhage - etiology

Colonoscopy

Rectum

Female

Sigmoid Neoplasms - surgery

Aged

Details

Title: Subtitle: A rare case of medullary carcinoma of the colon presenting as intussusception in an adult with rectal bleeding
Creators: Shilpa Jain - Gastroenterology, Private Practice, Honolulu, HI (SJ, AJ)
Ankur Jain - Gastroenterology, Private Practice, Honolulu, HI (SJ, AJ)
Neil Onizuka - Gastroenterology, Private Practice, Honolulu, HI (SJ, AJ)
Sarag A Boukhar - Gastroenterology, Private Practice, Honolulu, HI (SJ, AJ)
Resource Type: Journal article
Publication Details: Hawai'i journal of medicine & public health, Vol.73(11), pp.348-352
Publisher: United States
PMID: 25414804
PMCID: PMC4238122
ISSN: 2165-8218
eISSN: 2165-8242
Language: English
Date published: 11/2014
Academic Unit: Pathology
Record Identifier: 9984047615902771

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