Entamoeba histolytica: A surprising coexistence with adenocarcinoma – Never brush aside brushings for biopsy

Abstract

Entamoeba histolytica has been rarely reported as superadded infection over carcinomatous growth on rectal brushings. We present a case of 68-year-old male who presented with abdominal pain and bleeding per rectum who was found to have an ulceroproliferative growth on sigmoidoscopy. Rectal brushings revealed coexistence of E. histolytica with malignant cells of adenocarcinoma. No organism was detected on biopsy of the tumor, which also showed adenocarcinoma, because of possible surface colonization of the tumor by Entamoeba. This case highlights the role of rectal brushings in detecting superadded infection in a case where both brushings and biopsy were performed. It is always important to report infection superadded on malignancies for optimum management of the patients.

Keywords

Adenocarcinoma - brushings - Entamoeba - rectal - superadded

• References

• 1 Li E, Stanley SL Jr. Protozoa. Amebiasis. Gastroenterol Clin North Am 1996;25:471-92.
• 2 Singh U, Petri WA Jr. Amoebas. In: Gillespie SH, Pearson RD, editors. Principles and Practice of Clinical Parasitology. Chichester: John Wiley & Sons, Ltd.; 2001. p. 197-218.
• 3 WHO/PAHO/UNESCO Report. A consultation with experts on amoebiasis. Mexico City, Mexico 28-29 January, 1997. Epidemiol Bull 1997;18:13-4.
• 4 Gupta KB, Manchanda M, Chaudhary U, Verma M. Superior vena cava syndrome caused by pulmonary amoebic abscess. Indian J Chest Dis Allied Sci 2006;48:275-7.
• 5 Sultan A, Raza A, Khan HM, Khalid S, Akhtar A, Shameem M. Entamoeba histolytica pleuropulmonary infection case report. Int J Adv Case Rep 2015;2:171-3.
• 6 Ximénez C, Morán P, Rojas L, Valadez A, Gómez A. Reassessment of the epidemiology of amebiasis: State of the art. Infect Genet Evol 2009;9:1023-32.
• 7 Ng DC, Kwok SY, Cheng Y, Chung CC, Li MK. Colonic amoebic abscess mimicking carcinoma of the colon. Hong Kong Med J 2006;12:71-3.
• 8 Chatterjee KD, editor. Subphylum sarcomastigophora: Superclass sarcodina, class rhizopodea: Order amoebida. In: Parasitology (Protozoology and Helminthology) in Relation to Clinical Medicine. 12th ed. Kolkata, India: Sree Saraswaty Press Ltd.; 2001. p. 14-36.
• 9 Misra SP, Misra V, Dwivedi M. Ileocecal masses in patients with amebic liver abscess: Etiology and management. World J Gastroenterol 2006;12:1933-6.
• 10 Zhu H, Min X, Li S, Feng M, Zhang G, Yi X, et al. Amebic lung abscess with coexisting lung adenocarcinoma: A unusual case of amebiasis. Int J Clin Exp Pathol 2014;7:8251-4.
• 11 Skappak C, Akierman S, Belga S, Novak K, Chadee K, Urbanski SJ, et al. Invasive amoebiasis: A review of Entamoeba infections highlighted with case reports. Can J Gastroenterol Hepatol 2014;28:355-9.
• 12 Bardawil RG, D’Ambrosio FG, Hajdu SI. Colonic cytology. A retrospective study with histopathologic correlation. Acta Cytol 1990;34:620-6.
• 13 Delsing CE, Bleeker-Rovers CP, van de Veerdonk FL, Tol J, van der Meer JW, Kullberg BJ, et al. Association of esophageal candidiasis and squamous cell carcinoma. Med Mycol Case Rep 2012;1:5-8.