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Malignant Hemangioendothelioma of the Rectum, Report of a Case Yoshihiro Kaga 1 , Jun-ichi Kanoh 1 , Akira Arakawa 1 , Shigekazu Hayashi 1 , Tatsunari Satake 3 1Department of Gastroenterology, Nagoya Ekisaikai Hospital 3Department of Pathaology, Nagoya Ekisaikai Hospital Keyword: 直腸 , 血管肉腫 pp.1191-1197
Published Date 1992/10/25
DOI https://doi.org/10.11477/mf.1403110006
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 A 46-year-old woman was admitted to our hospital with the chief complaint of constipation and hematochezia. A barium enema showed stenosis with a small niche (↑) and a smooth margin in the rectum (Fig. 1). Colonoscopic examination showed a smoothly elevated lesion and an ulcer with an irregular margin and converging folds (Fig. 2).

 Pelvic CT scan revealed a thick posterior wall of the rectum with positive enhancement and enlarged regional lymph nodes (Fig. 3). Histological examination of a punch biopsy specimen showed poorly differentiated adenocarcinoma (Fig. 4). An operation was performed. There was a protruding lesion with an irregular ulcer and fold convergency (Fig. 5a). A cut section of the specimen showed clearly demarcated layers of the rectum. The muscularis was dark and thickened secondary to tumor cell infiltration (Fig. 5b). Microscopic examination showed infiltration of tumor cells into the lamina propria and subserosa (Fig. 6a). Some tumor cells formed tubular structures containing red blood cells (Fig. 6b) and others were solid (Fig. 6c). The pathologic diagnosis was malignant hemangioendothelioma, based on finding of proliferating tumor cells within the reticulin sheath (Fig. 6d). Almost all resected lymph nodes revealed metastasis (Fig. 6e). Malignant hemangioendothelioma comprises 1% of all sarcomas and is rare in the rectum. We could find only 5 such cases in the literature of the past 40 years.


Copyright © 1992, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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