1/87. Ulcerative colitis complicated by dysplasia-adenoma-carcinoma in a man with Bloom's syndrome.Bloom's syndrome (BS) is a rare genetic disorder in which the major clinical feature is growth deficiency. The genome in BS somatic cells is unstable, and hypermutability explains many clinical features. Most notably, affected persons are at enormously increased risk of developing many types of cancers at different sites. It has been well known that ulcerative colitis (UC) is associated with the spectrum of epithelial changes signifying dysplasia and the progression to frank carcinoma. We report here a case of UC complicated by dysplasia-adenoma-carcinoma sequence in a 37-year-old man with BS.- - - - - - - - - - ranking = 1keywords = cancer (Clic here for more details about this article) |
2/87. Colorectal cancer complicating ulcerative colitis: an institutional series.Ulcerative colitis predisposes to colorectal cancer: the risk increases along with disease duration and extension. Also some subsets of patients are at increased risk, namely patients with early onset of colitis, and patients with primary sclerosing cholangitis. Cancer complicating ulcerative colitis affects evenly all the colon, and is not located more frequently in the rectum and in the sigmoid colon, as well as the sporadic counterpart. Multiple cancers and cancers associated with high grade dysplasia are not infrequent in ulcerative colitis; for this reason, and for controlling the colitis, the treatment of choice is total colectomy, with or without colostomy. The prognosis of cancer complicating ulcerative colitis is similar to the sporadic counterpart. The Authors present a colon cancers series as a complication of colitis occurred at Regina Elena Cancer Institute of Rome, italy, over the period 1975-1998.- - - - - - - - - - ranking = 9keywords = cancer (Clic here for more details about this article) |
3/87. A patient with rectal cancer associated with ulcerative colitis in whom endoscopic ultrasonography was useful for diagnosis.Endoscopic ultrasonography (EUS) was helpful for the diagnosis of rectal cancer associated with ulcerative colitis. The patient was a 38-year-old Japanese man with a 19-year history of relapsing-remitting type ulcerative colitis involving the entire colon. Routine colonoscopy revealed multiple polypoid prominences in the upper portion of the rectum. EUS revealed a hypoechoic mass in the submucosa beneath and around the polypoid lesion on the most oral side. Signet ring cells were found in a biopsy specimen from this lesion. Subtotal colectomy was performed. A depressed lesion was observed around the prominence on the most oral side; histologically, this lesion was poorly differentiated mucinous and signet ring cell carcinoma extending into the subserosa. The polypoid lesion on the most anal side was well differentiated adenocarcinoma, which was limited to the mucosa. Our findings suggest that EUS is helpful for detecting invasive cancer associated with ulcerative colitis.- - - - - - - - - - ranking = 6keywords = cancer (Clic here for more details about this article) |
4/87. Ulcerative colitis patients with a family history of colorectal cancer should be subjected to close and careful surveillance.We report two cases affected by neoplasia after colectomy with ileo-rectal anastomosis (IRA) with a positive family history of colon cancer. Case 1, a 41-year-old ulcerative colitis (UC) patient, underwent IRA in 1977. In 1986, biopsies showed high-grade dysplasia. She underwent resection of the rectal stump in 1986. Submucosal invasive carcinoma was found in the surgical specimen. The immunohistological study demonstrated p53 protein overexpression in the neoplastic lesion. Her family history fulfilled the Amsterdam criteria of hereditary non-polyposis colorectal cancer (HNPCC). Case 2, a 47-year-old UC patient, underwent ascending colostomy in 1975 and the following year IRA. Endoscopic mucosal resection (EMR) for a sessile adenoma was performed in 1995 and subsequently polypectomy was performed for the residual tumor. Recurrent adenoma and dysplasia in another area were detected. The immunohistological study demonstrated p53 protein overexpression only in dysplasia. Renal cancer in the right kidney was detected. Resection of the rectal stump with ileal pouch-anal anastomosis (IAA), loop ileostomy and right nephrectomy were performed in 1998. Her mother and her mother's sister had been diagnosed with colon cancer. Only in the dysplastic lesion did we detect microsatellite instability at D5S644. Both cases with neoplasia had two relatives with colorectal carcinoma. In 33 cases with UC who had been followed up, 30 cases (96.8%) without neoplasia had no family history of colorectal carcinoma. These findings suggest that UC patients with a family history of colon cancer should be put under close surveillance. It should also be emphasized that IAA is the procedure of choice for UC patients with this particular condition.- - - - - - - - - - ranking = 9keywords = cancer (Clic here for more details about this article) |
5/87. polymyositis of the skeletal muscles as an extraintestinal complication in quiescent ulcerative colitis.Myositis of the skeletal muscle is a rare complication of inflammatory bowel disease. We report about a 33-year-old woman with quiescent ulcerative colitis known since 1995. She had suffered from recurring fever and pain in the thighs for about 4 weeks. electromyography of quadriceps and deltoid muscles revealed myopathic changes. Diagnosis of polymyositis was confirmed by magnetic resonance imaging indicating edematous changes in the distal extremity muscles. The symptoms rapidly responded to high doses of steroids. review of the literature indicates only a few cases describing an association of ulcerative colitis and myositis, most of them during acute exacerbations of the disease. In contrast, the present patient was in remission. Diagnosis of myositis should be considered in inflammatory bowel disease patients complaining of myalgia or muscular weakness. magnetic resonance imaging may show specific features and can be used in addition to laboratory investigations and muscle biopsy for diagnosis of polymyositis.- - - - - - - - - - ranking = 0.59387197341247keywords = muscle (Clic here for more details about this article) |
6/87. Use of a gracilis muscle flap to facilitate delayed ileal pouch-anal anastomosis.Failure of an ileal pouch-anal anastomosis may result in unsuccessful completion of the anastomosis or removal of an ischemic pouch. We report a technique for preservation of the muscular wall of the rectum after mucosal dissection, which allowed a successful delayed pull-through.- - - - - - - - - - ranking = 0.29693598670624keywords = muscle (Clic here for more details about this article) |
7/87. radiation enteritis: a rare complication of the transverse colon in uterine cancer.radiation therapy is a powerful method for the control of cancer. The utilization of abdominal or pelvic radiation has been extended, and the incidence of radiation enteritis appears to be increasing. The majority of the induced lesions is in the distal ileum, sigmoid colon, or rectum. Reported here is an unusual case of radiation enteritis which caused a severe sequelae of stricture in the transverse colon as a long-term effect of therapeutic irradiation for uterine cancer, and required a surgical resection.- - - - - - - - - - ranking = 6keywords = cancer (Clic here for more details about this article) |
8/87. cholangiocarcinoma.Chronic inflammatory disease of the biliary tract predispose to the development of cholangiocarcinoma. For example, the prevalence of cholangiocarcinoma is between 7% to 14% in patients with primary sclerosing cholangitis. The diagnosis of cholangiocarcinoma is challenging because it is difficult to distinguish benign from malignant strictures. Recently, several advances have helped in the diagnosis of cholangiocarcinoma. The serum Ca 19-9 value is a useful adjunct for the diagnosis of malignant stictures in the absence of bacterial cholangitis. The recent development of digital image analysis for assessing biopsy specimens and brush cytology is also useful for the diagnosis of malignant strictures. Positron emission tomography is a new imaging technique that uses 18F fluoro-2-deoxy-D-glucose to noninvasively assess metabolism in human tissues. Early studies suggest that this technique is sensitive in identifying small bile duct cancers. Thus, the combination of a Ca 19-9 value, digital image analysis, and positron emission tomography scanning have greatly helped in the differential diagnosis of benign from malignant strictures. Management of cholangiocarcinoma is also challenging with limited survival after surgical resection. Recently, we have shown that preoperative chemoirradiation followed by liver transplantation results in prolonged disease-free survival in highly selected patients with early bile duct cancers. Successful treatment outcome of these patients highlights the need for an early diagnosis of cholangiocarcinoma using the approaches described above.- - - - - - - - - - ranking = 2keywords = cancer (Clic here for more details about this article) |
9/87. adenocarcinoma in the ileal pouch: late risk of cancer after restorative proctocolectomy.Restorative proctocolectomy and ileal pouch-anal anastomosis is the surgical treatment of choice for patients with ulcerative colitis. As a long-term complication of this procedure, chronic pouchitis impairs the outcome in a number of patients. Aneuploidia and dysplasia have been observed after long-lasting inflammation of ileal mucosa. The question arises whether chronic inflammation of ileal mucosa predisposes to malignant transformation similar to the situation in the chronically inflamed colon. Cancer of the ileal mucosa has been reported in patients with Brooke's ileostomy and in patients with Kock pouch but not as yet in those with an ileoanal pouch. We report a patient with carcinoma in an ileoanal pouch originating from terminal ileal mucosa who had been suffering from pancolitis with long-term backwash ileitis before, and from chronic pouchitis after, restorative proctocolectomy. This case demonstrates the importance of regular follow-up with pouchoscopy and random biopsies in all patients with long-standing inflammation of the ileal mucosa.- - - - - - - - - - ranking = 4keywords = cancer (Clic here for more details about this article) |
10/87. Successful treatment of idiopathic colitis and proctitis using thalidomide in persons infected with human immunodeficiency virus.Gastrointestinal ulcerations in persons infected with hiv have many causes, the most common being opportunistic infections and neoplasms. Recently, idiopathic ulcerative lesions of the colon and rectum have been described. Two cases are reported of idiopathic colonic and anorectal inflammation and ulceration which failed traditional therapies but responded to thalidomide with complete clinical and histologic resolution.- - - - - - - - - - ranking = 0.018900011857668keywords = neoplasm (Clic here for more details about this article) |
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