Comedo-cribiform adenocarcinoma of the colon, a rare cause of acute abdomen: A case report

Abstract

The term acute abdomen encompasses a group of diseases that have abdominal pain as a common symptom. Approximately 20% of the causes of acute obstructive abdomen correspond to neoplasms of the digestive tract, with more than 90% of colon cancer cases corresponding to adenocarcinomas. Despite this, the comedo-cribiform subtype is rare, occurring in less than 7% of adenocarcinomas. We present the case of a 72-year-old man with 4 days of abdominal pain accompanied by constipation and signs of peritoneal irritation. He was diagnosed of having a rectosigmoid neoplasm that was causing intestinal obstruction, for which Hartmann procedure was performed. After surgical resection of the tumor, the pathological study reported a comedo-cribiform adenocarcinoma. This histological subtype has as its main characteristic the presence of glands with a cribiform pattern, in addition to an area of central necrosis similar to that observed in intraductal breast carcinomas. Subsequently, he received radiotherapy to the rectal area and cycles of chemotherapy with capecitabine and oxaliplatin. Prior to performing restitution of intestinal transit, the patient died of SARS-CoV-2 pneumonia. It is worth emphasizing that in a patient with suspected acute abdomen the clinical history and complementary tests are the key to establishing the cause of the acute process. If the cause is surgically resolved, this should be done as soon as possible.

Keywords

Colon cancer, intestinal obstruction, acute abdomen, comedo-cribiform adenocarcinoma

Author Biography

Jorge Alberto Sarmiento Bobadilla

Docente práctica quirúrgica y neuroanatomía en Universidad Católica de Santiago de Guayaquil

Miembro del staff de cirugía general de Interhospital

Médico tratante de servicio de cirugía general del Hospital General del Norte de Guayaquil IESS Los Ceibos

Roberto Manuel Correa Bravo

Médico tratante de servicio de cirugía general del Hospital General del Norte de Guayaquil IESS Los Ceibos

Eli Francisco Lucas Mera

Tutor Internado Carrera de Medicina Universidad Católica de Santiago de Guayaquil en Hospital General del Norte de Guayaquil Los Ceibos

Miembro del staff de cirugía general de Omnihospital

Médico tratante de servicio de cirugía general del Hospital General del Norte de Guayaquil IESS Los Ceibos

Lizbeth Leonor Cárdenas Garófalo

Médico Residente Hospital General del Norte de Guayaquil Los Ceibos

Médico de staff Interhospital

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