1/20. Endoscopic features of intestinal smooth muscle tumor in a child with AIDS.Intestinal leiomyosarcomas are exceedingly rare in immunologically intact children, except during infancy. While leiomyosarcomas account for less than 2% of all soft tissue tumors in childhood, they are the second most frequent malignancy in children with the acquired immunodeficiency syndrome (AIDS). In this cohort they are often located in unusual sites for primary soft tissue tumors. This report describes a young girl with advanced AIDS, referred for evaluation of abdominal pain, hematochezia, and wasting syndrome. colonoscopy revealed two 1- to 2-cm submucosal nodules with central umbilication. Repeat colonoscopy 18 months later revealed no changes in these lesions. biopsy revealed a submucosal spindle-cell lesion, with necrosis and cellular atypia. Initially it was characterized as a partially excised low-grade leiomyosarcoma. However, the final consensus diagnosis was smooth muscle tumor of uncertain malignant potential. Because of her advanced AIDS, there was no attempt at surgical resection or chemotherapy. Thirty-six months after initial referral, she remains alive without radiographic or clinical evidence of local extension or metastases. Additional data are required to determine the long-term outcome of these indolent submucosal tumors in the digestive tracts of children with AIDS.- - - - - - - - - - ranking = 1keywords = hematochezia (Clic here for more details about this article) |
2/20. intussusception due to vanishing colon cancer with metastasis of the regional lymph nodes: report of a case.We present herein a case report of vanishing colon cancer with intussusception. A 70-year-old man with hematochezia was admitted to our hospital. Preoperative images showed ileus due to a colonic tumor. At operation, normograde intussusception without any tumor was recognized at the sigmoid colon. Interestingly, the regional lymph nodes were found to be invaded by tubular adenocarcinoma cells, thus suggesting that the colon cancer existed before the necrosis of the wall took place.- - - - - - - - - - ranking = 1keywords = hematochezia (Clic here for more details about this article) |
3/20. Acrokeratosis paraneoplastica (Bazex syndrome) with adenocarcinoma of the colon: report of a case and review of the literature.Acrokeratosis paraneoplastica is a rare disease and is uncommon even in patients with upper aerodigestive tract cancer. We report a 63-year-old man with a 1-month history of numerous pruritic lesions and vesicles on both feet. Although he had received local therapy, progressive dense scale formation involving both palms and both soles was found. colonoscopy was performed because of hematochezia, and it revealed an early colon cancer. After the resection of the cancer, the skin lesions began to fall off dramatically. To the best of our knowledge, there is no report of acrokeratosis paraneoplastica associated with colon cancer in the literature. This is the first case report of acrokeratosis paraneoplastica associated with early colon cancer.- - - - - - - - - - ranking = 1keywords = hematochezia (Clic here for more details about this article) |
4/20. warfarin-associated bleeding complication saved life.A 62-year-old Caucasian man with atrial fibrillation who was taking warfarin reported an episode of hematochezia; his international normalized ratio (INR) was 1.74. His weekly warfarin dose was increased by approximately 5%, and he was given three fecal occult blood cards. At follow-up 1 week later, the patient denied any episodes of hematochezia. His INR was 1.69 despite the increased warfarin dosage. One of the occult blood cards showed a positive result, and colonoscopy revealed a 5-cm lesion, identified as Dukes' A adenocarcinoma. warfarin-associated bleeding generally is considered deleterious; however, in our patient it unmasked an early stage of colon cancer and thus may have saved the patient's life. Although minor gastrointestinal bleeding is common among patients taking anticoagulants, all patients should be fully evaluated because the source of hemorrhage may be malignant.- - - - - - - - - - ranking = 2keywords = hematochezia (Clic here for more details about this article) |
5/20. Turcot syndrome in an elderly adult.A 67-year-old woman presented with hematochezia and an episode of transient expressive dysphasia. She was found to have multiple colonic polyps with adenocarcinomatous changes. Computed tomography brain scan and computed tomography-guided biopsy revealed a left frontoparietal glioblastoma multiforme. This case illustrates the rare presentation of Turcot syndrome-a hereditary colorectal polyposis syndrome-in an older adult.- - - - - - - - - - ranking = 1keywords = hematochezia (Clic here for more details about this article) |
6/20. Endoscopic resection of a large colonic leiomyoma.A 48-year old man suffered from intermittent hematochezia and abdominal cramping over a period of four weeks. A colonoscopy revealed a 4.5 cm semi-pedunculated tumor in the transverse colon. Using a 2-channel colonoscope, the tumor was successfully removed with an electro-surgical snare after normal saline submucosal injection. Microscopic examination revealed it to be a smooth muscle tumor without mitosis. The patient recovered well, and did not have a residual tumor in a follow-up colonoscopy. We found no reports of a colonic leiomyoma larger than 3 cm which was completely removed by a colonoscope. According to the case presented here, intraluminal colonic leiomyoma can be completely resected with skillful manipulation of a colonoscope, even if the tumor is as large as 4.5 cm. Successful endoscopic polypectomy of colonic leiomyoma reduces the cost of treatment and eliminates unnecessary surgery.- - - - - - - - - - ranking = 1keywords = hematochezia (Clic here for more details about this article) |
7/20. Malignant fibrous histiocytoma metastatic to the colon presenting as a lower gastrointestinal bleed.Primary and metastatic malignant fibrous histiocytoma of the alimentary tract is uncommon, even though it is the most frequently diagnosed malignant soft tissue tumor in adults. In this report, we describe a patient with a left gluteal malignant fibrous histiocytoma who had intermittent melena and hematochezia attributed to colon metastases, 1 yr after surgical removal of the gluteal sarcoma.- - - - - - - - - - ranking = 1keywords = hematochezia (Clic here for more details about this article) |
8/20. Primary adenosquamous and squamous cell carcinoma of the colon and rectum.Three new cases of squamous cell and adenosquamous carcinoma of the rectum are reported, bringing the total number of cases in the English medical literature to 72. Each of the three patients presented with painless hematochezia. Therapy was by surgical resection followed by chemoradiation therapy in two patients. The incidence, presentation, diagnostic criteria and methods, tumor location, natural history, theory of etiology and management of this unusual tumor are discussed.- - - - - - - - - - ranking = 1keywords = hematochezia (Clic here for more details about this article) |
9/20. Granulocytic sarcoma of the colon and leukemic infiltration of the liver in a patient presenting with hematochezia and jaundice.Granulocytic sarcoma (GS) is an extramedullary tumor composed of immature cells of the granulocytic series known to occur in patients with myelodysplastic syndrome, chronic myelogenous leukemia, or acute myelogenous leukemia (AML). Involvement of the gastrointestinal tract is relatively rare in GS. We present an extremely rare case of GS of the colon and liver infiltration in a 60-year-old male patient with AML presenting with jaundice and hematochezia and review the literature. It should be kept in mind that hematochezia may be due to colonic involvement of GS besides thrombocytopenia which is usually encountered in patients with AML.- - - - - - - - - - ranking = 6keywords = hematochezia (Clic here for more details about this article) |
10/20. 111Indium-labelled red-cell scintigraphy to detect intermittent gastrointestinal bleeding from synchronous small- and large-bowel adenocarcinomas.A 70-year-old woman presented with symptoms of profound anaemia and evidence of intermittent gastrointestinal haemorrhage. Oesophagogastroduodenoscopy, colonoscopy, abdominal computerised tomography, sulphur colloid scintigraphy and selective mesenteric angiography were non-diagnostic. An indium-labelled red-cell scan was performed, which suggested bleeding from the ileum at 36 h. At laparotomy, a primary small-bowel adenocarcinoma was resected. Six weeks later, she was again anaemic. Repeat colonoscopy showed a synchronous primary colonic adenocarcinoma, which had been masked by intraluminal blood during the original indium scan. The lesion was impalpable, even after full mobilisation of the colon. A right hemicolectomy was performed. indium has a longer half-life (67 h) than the more commonly used technetium isotope (18 h). This allows serial imaging for up to 5 days, which may increase diagnostic efficiency in intermittent gastrointestinal bleeding. Clinicians should be aware that persisting activity from intraluminal blood may mask synchronous lesions.- - - - - - - - - - ranking = 0.17265819980688keywords = gastrointestinal haemorrhage, haemorrhage (Clic here for more details about this article) |
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