Coexistence of a granulocytic sarcoma and adenocarcinoma of the rectum
Granulocytic sarcomas are rare extramedullary tumour-like
proliferates of myelogenous precursor cells. Rarely, these
tumours may de novo precede acute leukaemia or represent
the initial manifestation of a blast crisis in the course
of a chronic myeloproliferative disease. A case of a 53 year
old male who was admitted to hospital due to intestinal
bleeding combined with weight loss is reported. General
examination, laboratory studies and imaging findings were
nonspecific. Colonoscopy revealed a rectal polypoid mass.
Microscopic pathology and immunohistochemical findings
were consistent to that of a collision tumour composed of
rectal adenocarcinoma arisen on a pre-existing adenomatous
polyp and granulocytic sarcoma. Two months later he
was readmitted to hospital and the diagnosis of acute myetoid
leukaemia was established. The patient finally died due
to infection. Coexistence of rectal adenocarcinoma and granulocytic
sarcoma should be recognized promptly so that
proper therapy is initiated, thus improving prognosis.
Keywords: granulocytic sarcoma, rectal adenocarcinoma,
acute myeloid leukaemia, immunohistochemistry.