Clear cell adenocarcinoma of the rectum.

OBJECTIVE To document the first case of clear cell adenocarcinoma of the rectum (a rare entity) in Kuwait. CLINICAL PRESENTATION AND INTERVENTION A 36-year-old female presented with a 1-year history of constipation and bleeding per rectum. Colonoscopy revealed an ulcerated mass 2 cm above the anal verge. After multiple biopsies an abdomino-perineal resection was performed for the rectal mass. Gross examination of the resected specimen revealed an anorectal mass measuring 5 cm in its long axis. Histopathological examination showed the tumor to be composed of lobules of mostly clear polygonal cells with round vesicular nuclei. Glandular formation was occasional. The tumor was rich in glycogen, focally displayed luminal mucin, and was associated with regional lymph node metastasis. CONCLUSION This report illustrates a case of intestinal clear cell adenocarcinoma with lymph node metastasis that suggested a poor prognosis.