No abstract

Colorectal cancers (CRC) are on the rise globally with increased incidence rate 5.7/100000 cases in developing countries like India. 1 Majority (90%) of CRC are adenocarcinoma. The primary adenosquamous carcinoma (ASC) of the colon is exceedingly rare variant of adenocarcinoma with incidence of 0.025% and accounts for 0.1% of colonic epithelial malignancies. 2 The squamous differentiation accounts for its aggressiveness and poor prognosis. Here we report a rare case of primary ASC in 80year old male who presented with large bowel obstruction and peritonitis. A 80-year-old male brought to causality with history of fever, vomiting, pain in abdomen, altered sensorium since three days. The clinical examination revealed intestinal obstruction and peritonitis. Patient was immediately subjected for radiological and hematology investigations which showed signs of bowel obstruction and perforation. On emergency exploratory laparotomy, colonic perforation was identified along with an ulcer proliferative mass in ascending colon. Gross examination of right hemicolectomy revealed 9x6x3cm ulcero proliferative mass in ascending colon. The microscopic examination showed an infiltrating tumor composed of adenocarcinoma component and areas of squamous differentiation (60%) noted. Tumor was invading through muscularis propria and serosa. Final diagnosis of primary ASC was made. Colonic ASC is rare and associated with poorer prognosis. The squamous cell differentiation has greater metastatic potential than adenocarcinoma. Compared to adenocarcinoma, ASC is more likely to manifest with advanced disease and complications. Keywords: Adenosquamous, Carcinoma, Colon

Introduction: Para adnexal cysts (paraovarian and paratubal) constitutes a homogenous group of cystic lesions originating from mesosalphinx or broad ligament, located in proximity of the fallopian tube and ovary. As with the lesions of the adnexa, paraovarian and paratubal cysts can be neoplastic but are often misinterpreted as true functional cysts. A correct radiological and clinical diagnosis would be useful in order to render necessary treatment. Aim: To highlight the histomorphologic spectrum of the paraadnexal cysts and correlate with clinical findings. Materials and Methods: The present study was a descriptive study conducted in the Department of Pathology, Rajarajeswari Medical College, Bengaluru, Karnataka, India over a period of two years six months. All specimens including salpingoophorectomy specimens which harboured paratubal or paraovarain cysts, or paratubal/paraovarian cysts diagnosed on radiology and resected and sent separately for histopathologic evaluation were sampled and included in the study. All surgically and radiologically proven paratubal and paraovarian cystic lesions were included and solid lesions were excluded. The results were analysed using descriptive statistics. Results: The mean age of diagnoses was 40.1 years and menstrual abnormalities was the most common presentation. Of the Neoplastic cysts, paraovarian cysts (78.6%) were more common than paratubal cysts (21.4%). About 75.4 % were non neoplastic cysts and 24.6% were neoplastic. Conclusion: Para adnexal cysts are often misdiagnosed or not sampled as they are thought of as functional cysts. Present study analysed 114 cases and found that 28 of the cases showed neoplastic cysts, one of them showing a serous borderline tumour, which have the potential to turn malignant. Hence, histopathologic evaluation of these lesions would help in understanding the different histological types that would arise in para adnexal sites which in turn helps in better management of these patients.