1/46. The effectiveness of chemotherapy with cisplatin and 5-fluorouracil for recurrent small cell neuroendocrine carcinoma of the rectum: report of a case.We report herein the case of a 46-year-old-man with small cell neuroendocrine carcinoma (NEC) concomitant with large villous adenoma of the rectum, who underwent abdominoperineal resection with regional lymphnode dissection. The resected specimen was histologically found to contain a small lesion of NEC confined to the submucosa in the large adenoma. A computed tomography scan done 4 months postoperatively revealed recurrences in the liver, lymph nodes, and bone. Therefore, two cycles of sequential intravenous combined chemotherapy with standard doses of cisplatin and 5-fluorouracil (5-FU) were administered, after which the size of each tumor decreased remarkably. Nevertheless, the patient died 8 months after the operation. As there was a fair response of this tumor to the combined chemotherapy of cisplatin and 5-FU, this regimen against NEC of the colon and rectum should be given consideration.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
2/46. Peritoneal mucinous carcinomatosis after laparoscopic-assisted anterior resection for early rectal cancer: report of a case.Minimally invasive colon surgery has been shown to be both technically feasible and a safe alternative to laparotomy. Its efficacy for the curative resection of colorectal cancer, however, remains controversial. Of major concern are the increasing reports of port-site recurrence after use of laparoscopic techniques in malignant disease. In this article a heretofore unreported complication of peritoneal mucinous carcinomatosis after laparoscopic-assisted anterior resection for early stage rectal cancer is presented. Isolated peritoneal recurrence is rare after curative resection of Stage I rectal cancer. The effect of pneumoperitoneum on tumor dissemination is discussed.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
3/46. Carcinoma in villous adenoma of ascending colon associated with sarcoid reaction in the regional lymph nodes.A 79-year-old woman was admitted to our hospital due to continuous anal bleeding. colonoscopy showed a huge villous tumor on the middle area of the ascending colon. A typical right colectomy and lymph node dissection were performed. The resected specimen showed a villous type tumor located on the ascending colon. The histopathologic investigation demonstrated a moderately differentiated adenocarcinoma arising in a tubulovillous adenoma and extending to the submucosa. Although there was no evidence of metastatic carcinoma in the dissected lymph nodes, epithelioid cell granulomas with multinucleated giant cells lacking in the central caseous necrosis suggested sarcoid reaction.- - - - - - - - - - ranking = 0.4keywords = carcinoma (Clic here for more details about this article) |
4/46. Tubulovillous adenoma of the urinary bladder.We report a case of vesical tubulovillous adenoma that occurred in a background of protracted chronic cystitis with intestinal-type glandular metaplasia and extensive cellular atypia (dysplasia) in the flat mucosa. flow cytometry analysis showed dna aneuploidy in the adenoma. Increased expression of the tumor suppresser gene, p53, and also of cellular proliferation markers (proliferating cell nuclear antigen and MIB-1) were detected in the villous adenoma and in the dysplastic regions of the flat metaplastic mucosa. These findings provide insight into the biology of intestinal metaplasia and also lend support to the theory of the chronic irritation-metaplasia-dysplasia-carcinoma sequence.- - - - - - - - - - ranking = 0.2keywords = carcinoma (Clic here for more details about this article) |
5/46. Appendiceal intussusception induced by tubulovillous adenoma with carcinoma in situ: report of a case.Appendiceal intussusception is an uncommon pathologic condition; however, villous adenoma of the appendix is a distinctly rare entity. We report herein a case of appendiceal intussusception induced by tubulovillous adenoma with carcinoma in situ. A 67-year-old man was admitted to our hospital with a 1-year history of lower abdominal pain for investigation. barium enema showed a filling defect with an irregular surface in the cecum, and colonoscopy revealed a cecal tumor with a granular surface. Pathological examination of biopsy samples revealed tubulovillous adenoma with well-differentiated adenocarcinoma, and a diagnosis of cecal cancer in tubulovillous adenoma was made. Surgery was performed and the resected specimen was found to contain a tumor arising from the appendix. The tumor was 5.5 x 4.5 cm in size in the cecal cavity, and the appendix had invaginated into the cecum at its base. The cut surface of the appendix showed the villous tumor filling the appendiceal lumen and projecting into the cecal cavity. Microscopic examination revealed well-differentiated adenocarcinoma in tubulovillous adenoma. To the best of our knowledge, this is the first report of appendiceal intussusception caused by tubulovillous adenoma with carcinoma of the appendix.- - - - - - - - - - ranking = 1.6keywords = carcinoma (Clic here for more details about this article) |
6/46. Histopathology of early colorectal cancer.The histopathologic spectrum of early colorectal cancer (ECC) is compared from the Western and Japanese perspective. In the West, most ECC presents as a malignant adenoma, whereas superficial ECC with no adenomatous component is well described in the Japanese literature. Furthermore, superficial ECC is thought to progress rapidly and disseminate early. The discrepant viewpoints are considered in the light of different approaches to histopathologic interpretation. Lesions reported by Japanese pathologists as superficial carcinomas limited to the mucosa are diagnosed as flat adenomas in the West. In one Japanese series only 4 of 218 (1.8%) flat or small sessile neoplasms removed by endoscopic mucosal resection were associated with submucosal invasion by carcinoma. Therefore superficial ECC with submucosal spread is uncommon. Most ECC in hereditary nonpolyposis colorectal cancer evolves through the adenoma-carcinoma pathway (including flat adenoma). However, adenoma removal in the context of population-based screening programs has not lowered the incidence of colorectal cancer; flat colorectal neoplasia may be important in clinical practice.- - - - - - - - - - ranking = 0.6keywords = carcinoma (Clic here for more details about this article) |
7/46. Enteroscopy as a tool for diagnosing gastrointestinal bleeding requiring blood transfusion.iron-deficiency anemia secondary to gastrointestinal blood loss is a common cause of hospitalization. In many cases, the bleeding site cannot be defined despite thorough routine examination of the gastrointestinal tract. The aim of this study was to evaluate push enteroscopy as a diagnostic tool in patients with severe anemia, secondary to recurrent gastrointestinal bleeding, that required management by transfusion. Thirty-five consecutive push enteroscopy investigations were performed in 1998 and 1999 on 25 patients (15 men, 10 women). Mean age was 57 /- 16 years (range, 33-83). All patients had received blood transfusions because of pronounced anemia secondary to gastrointestinal bleeding. Before push enteroscopy, all patients had been investigated with esophagogastroduodenoscopy, colonoscopy, and small-bowel radiography using the double contrast technique; no bleeding site was found. In addition, 10 of 25 patients had been investigated beforehand with 99mTc-labelled red blood cell scintigraphy, and 5 of 25 with scintigraphy for meckel diverticulum. Two patients were also investigated with angiography before the push enteroscopy, and in six patients an additional total intraoperative enteroscopy was performed, preceded by a new colonoscopy, esophagogastroduodenoscopy, and push enteroscopy. A bleeding site was disclosed in 15 of 25 (60%) patients. In 7 of 25 patients (28%) the bleeding site was found in the stomach or esophagus. even though the patients had undergone one or two esophagogastroduodenoscopies earlier with normal findings. Total intraoperative enteroscopy identified a bleeding site in four of six (67%) patients studied. Two patients had bleeding hemangiomas that were resected surgically. Two patients had small intestinal adenomas, one with adenocarcinoma in situ. Push enteroscopy performed with an overtube inserted under fluoroscopic guidance is an important diagnostic tool in patients in whom conventional examinations do not disclose bleeding sites. Interestingly, 28% of patients had bleeding within reach of the gastroscope, indicating that a new upper endoscopy should be recommended before push enteroscopy is performed. When no positive findings are seen on push enteroscopy and the patient is affected by severe, recurrent iron-deficiency anemia, total intraoperative enteroscopy should be considered.- - - - - - - - - - ranking = 0.2keywords = carcinoma (Clic here for more details about this article) |
8/46. Concurrent tubulovillous adenoma and transitional cell carcinoma associated with diffuse gastric and intestinal metaplasia of the defunctioned ureter.Villous adenoma is a common lesion of the gastrointestinal tract, but it is rare in the ureter. Thus, as far as we know, only one case limited to this location has been described. Intestinal metaplasia of the urothelium is not rare. However, only one case of gastric metaplasia with pseudopyloric glands has been described in the literature. We here report in detail on a tubulovillous adenoma of the ureter associated with diffuse gastric and intestinal metaplasia and a concurrent primary, solid, high grade transitional cell carcinoma, with extensive clear cell change, in a 56-year-old male patient. He had undergone a left nephrectomy for renal tuberculosis twenty years earlier, and the lesions developed in the ureteric stump. To the best of our knowledge, such a combination of lesions has not been reported previously either in the ureter or in the rest of the urinary tract. The coexistence of diverse lesions in our case might represent the pluripotentiality of the urothelium in association with chronic inflammation and neoplastic induction. The present report also emphasizes the metaplastic and malignant potential of a defunctioned urothelial structure. This case is of particular interest, because these coexistent lesions arose simultaneously with an anatomically separate adenocarcinoma of the rectum (Dukes' B). The patient died 76 days after admission. The dismal prognosis of our case was determined by the advanced anatomical stage and the histological high grade of the transitional cell carcinoma of the ureter.- - - - - - - - - - ranking = 1.4keywords = carcinoma (Clic here for more details about this article) |
9/46. Fate of a renal tubulopapillary adenoma transmitted by an organ donor.organ transplantation from cadaveric donors has a risk of cancer transmission. However, some reports indicate that kidneys bearing small carcinomas can be safely transplanted, as can other organs harvested from the same donor. We report herein the case of two allograft recipients (left kidney and heart with no evidence of tumor) who developed a renal carcinoma soon after transplantation. The initial tumor of the donor was a 17-mm tubulopapillary adenoma found on the right kidney, which was not transplanted. The left kidney recipient rejected all residual tumoral cells after graft removal and immunosuppression discontinuation. The heart recipient died 7 months after transplantation from metastasis of a renal carcinoma. This strongly suggests that circulating carcinoma cells were present at the time of organ retrieval and that they were not cleared by in situ perfusion. In contrast with the literature data, this report indicates that patients with small renal tubulopapillary tumors should not be considered for organ donation.- - - - - - - - - - ranking = 0.8keywords = carcinoma (Clic here for more details about this article) |
10/46. Genetic alterations in poorly differentiated endocrine colon carcinomas developing in tubulo-villous adenomas: a report of two cases.The genetic study of two cases of tubulovillous adenoma associated with poorly differentiated endocrine carcinoma (PDEC) is reported. Aim of this work was to assess whether the exocrine and endocrine growths share a common genotype. The analysis entailed the search for allelic loss (LOH) or imbalances of polymorphic microsatellite markers at the corresponding chromosomal loci of the genes MEN-1 (11q13), p53 (17p13). Deleted in Colorectal Carcinoma (DCC) (18q21) and hMSH-2 (BAT26) (2p21-22). Additionally, the exons 5-8 of the p53 gene were sequenced in the two PDECs only. One of the two cases investigated showed LOH for 18q DCC markers in the tubulo-villous adenoma while a point mutation of the p53 gene was observed in the PDEC component. No genetic abnormality was observed in both adenoma and PDEC components of the other case. In the two cases p53 protein accumulation was observed in both PDEC and adenoma cells. These data indicate that only the p53 gene abnormality is shared by both colon cancer and PDEC in the two cases reported. The lack of other common genetic defect may suggest a different histogenesis for the two tumor types. The development of colon PDEC implies the defect of p53 gene.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
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