1/3. 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 = 1keywords = giant (Clic here for more details about this article) |
2/3. A giant villous adenoma case mimicking right colon carcinoma.An 85-year-old woman was admitted to our hospital due to pain and swelling in her right inguinal region. She had a right inguinal hernia. Abdominal computerized tomography revealed an 8 x 8 cm cecal mass and also a 13.5 cm segmental asymmetric nodular thickening of the cecum. Colonoscopic examination revealed a sessile polypoid mucus-secreting mass mimicking carcinoma that narrowed the cecal lumen. Histopathological examinations of sections from colonoscopic biopsy materials on light microscopy revealed villous adenoma morphology. The patient underwent operation, and an 18 x 6 x 4 cm mass, which partially obstructed the cecum, was seen. A right hemicolectomy was performed for complete excision. Histopathological examination revealed a pure villous adenoma, and there was no sign of malignant degeneration. On the 6th postoperative day, the patient was discharged from the hospital. During follow-ups at three-month intervals throughout one year, no abnormal colonoscopic or laboratory findings were assessed. We believe that, in older patients with inguinal hernia, presence of intraabdominal mass should be considered. Furthermore, we showed in this report that villous adenomas can reach significant dimensions without causing any obstructing signs or electrolyte imbalance and can mimic colon carcinoma.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
3/3. Pancreatoduodenectomy for giant benign villous adenoma of the ampulla of vater.The case of a 36-year-old man with a villous adenoma of the duodenum is presented. His history included jaundice, pruritus, and weight loss. physical examination was otherwise unremarkable. Laboratory data included anemia, guaiac-positive stool, hyperamylasemia, and abnormal liver function tests. Biliary ductile dilation was seen on ultrasonography; a filling defect in the duodenum was seen on CT scan, and endoscopic biopsy revealed villous adenoma with dysplasia. Pancreatoduodenectomy was performed and recovery was uneventful. Histopathology confirmed moderate dysplasia. review of the literature reveals this to be a rare lesion (less than 1% of duodenal neoplasms). Local excision has been advocated for small, histologically proven benign, lesions. Where doubt of benignity exists, however, and in the case of "giant" tumors (>3.0 cm greatest dimension), pancreatoduodenectomy is indicated.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |