Adenocarcinoma comedo-cribiforme de colon una causa poco frecuente de abdomen agudo: Reporte de un caso

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.