1/181. Colorectal cancer recurrence during pregnancy--unique and poorly understood clinical entity: report of a case.The detection of primary or recurrent colorectal cancer during pregnancy is a rare event. early diagnosis is difficult, because symptoms are often attributed to pregnancy. Here we describe a case of recurrent adenocarcinoma of the colon in a 23-year-old pregnant patient. The relationship between various hormonal and immunological changes of pregnancy and colorectal cancer is discussed.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
2/181. Pineal metastasis as first clinical manifestation of colorectal adenocarcinoma. Case report.Cerebral metastases from colorectal adenocarcinomas occur in 8% of the cases. Diagnosis is usually made when primary disease and widespread metastases are already known. We report the case of a patient with single metastases in the pineal region as the first clinical manifestation of a colorectal adenocarcinoma. A 48-year-old female with Parinaud's syndrome for 15 days prior her admission was evaluated in our clinic. She had no symptoms or signs of colorectal disease. MRI examination revealed an heterogeneous lesion with peritumoral gadolinium enhancement, located in the pineal region. The tumor was radically resected through an infratentorial/supracerebellar approach. histology showed metastatic carcinoma and immunohistochemical examination showed gastrointestinal tract adenocarcinoma. Metastases to the pineal region are extremely rare and should be considered in the differential diagnosis of tumors of this region.- - - - - - - - - - ranking = 8keywords = carcinoma (Clic here for more details about this article) |
3/181. Mutations of the adenomatous polyposis coli and p53 genes in a child with Turcot's syndrome.Turcot's syndrome is a rare heritable complex that is characterized by an association between a primary neuroepithelial tumor of the central nervous system and multiple colonic polyps. The aim of this study was to analyze genetic alterations in a case of Turcot's syndrome in a 10.5-year-old boy in whom a colorectal tumor developed 3.5 years following astrocytoma. An APC germline non-sense mutation at codon 1284 leading to a truncated protein was identified, as was a somatic p53 mutation in the colorectal carcinoma in exon 7, codon 244. The latter was not identified in the primary astrocytoma. However, immunohistochemistry revealed high p53 protein expression in both tumors, suggesting an additional p53 mutation in the primary astrocytic tumor. The diverse p53 mutations observed in this unique syndrome in two different sites and stages of the disease may shed light on the multistep progression of the malignant events.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
4/181. 5-fluorouracil-induced small bowel toxicity in patients with colorectal carcinoma.BACKGROUND: diarrhea and oral mucositis are the most frequently reported gastrointestinal side effects caused by 5-fluorouracil (5-FU). diarrhea may be severe in 10-30% of patients and is schedule-dependent. 5-FU-induced gastrointestinal toxicity predominantly affects the upper and the lower gastrointestinal tract. The current study describes 5-FU-induced small bowel toxicity as an entity that to the authors' knowledge has not been reported previously in patients with colon carcinoma receiving 5-FU-based therapy. methods: The authors report a series of six patients with colorectal carcinoma who developed acute small bowel toxicity after treatment with 5-FU and leucovorin. RESULTS: Six patients developed a clinical picture of acute abdominal pain and diarrhea. Small bowel damage was documented by laparotomy in two patients, by colonoscopy in one patient, and by abdominal computed tomography scan in three patients. The course was complicated by recurrence of symptoms in one patient who was rechallenged with 5-FU and leucovorin, but the remaining four patients were rechallenged safely with lower doses of 5-FU and leucovorin after the acute toxicity episode. A possible explanation for this toxicity is 5-FU-induced vasospasm and/or decrease in fibrinolytic activity that results in decreased mucosal blood flow. CONCLUSIONS: 5-FU-induced small bowel toxicity is a potentially severe toxicity that may occur in patients with colon carcinoma or other malignancies who are receiving 5-FU-based therapy. [See editorial on pages 1099-100, this issue.] copyright 1999 american cancer society.- - - - - - - - - - ranking = 7keywords = carcinoma (Clic here for more details about this article) |
5/181. Isolated splenic metastasis from colorectal carcinoma: report of a case and review of the literature.In general, surgical resection for metastatic colorectal adenocarcinoma rarely benefits more than a small percentage of patients long term. In the case of isolated splenic metastasis without evidence of other metastatic disease, splenectomy may increase survival times in patients with previously resected colorectal adenocarcinoma. Currently there are only five case reports involving isolated splenic metastases in the English-language literature. This article presents a sixth case and a review of the previous five cases in the literature, with a discussion on the possible diagnostic and therapeutic approaches to these rare but important cases and the apparently significant survival advantage of early diagnosis and treatment.- - - - - - - - - - ranking = 6keywords = carcinoma (Clic here for more details about this article) |
6/181. Giant solid cystic tumor of the pancreas with a fibrous septum caused by extracapsular growth in middle-aged woman: report of a case.We report herein the case of a 57-year-old female who was admitted to our hospital for treatment of rectal carcinoma and incidentally found to have a giant cystic tumor, 20 cm in diameter, in the body and tail of the pancreas. Several imaging procedures, including ultrasonography, computed tomography, and magnetic resonance imaging, showed that this tumor was round and hypovascular, and had a septum with protuberant lesions. The capsule was 3-4 mm thick with partial calcification. A preoperative diagnosis of a solid cystic tumor (SCT) of the pancreas was made, even though these tumors are rarely found in females in their fifties. Moreover, few reports of SCT with a septum have been described. Distal pancreatectomy and splenectomy were performed, and the tumor was found to be filled with massive necrotic tissue. Microscopically, the tumor was confirmed to be a SCT with a fibrous septum. We present this case due to the atypical findings, including the age of the patient and the existence of a septum caused by extracapsular growth.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
7/181. Crohn's disease and colorectal malignancy.There has been much debate over the past 50 years concerning the association between colorectal carcinoma and inflammatory bowel disease. Until recently, it was widely accepted there was a higher risk in those with widespread ulcerative colitis. However, evidence now suggests an almost equal incidence in those with Crohn's disease of similar extent and duration. We present a case that underlines the important clinical and pathological features of Crohn's disease associated colorectal carcinoma (CDAC). We present a literature review and debate the role of regular colonic surveillance in patients with Crohn's disease affecting the colon.- - - - - - - - - - ranking = 2keywords = carcinoma (Clic here for more details about this article) |
8/181. Unusual 'recurrence' sites for colorectal cancer.Five patients are reported. Four underwent major 'curative' restorative colorectal resections and developed perineal 'recurrence', 2 developed 'recurrence' in the distal ends of previously identified fistulae in ano and 2 developed 'recurrence' at the site of a previously performed haemorrhoidectomy. The fifth patient developed metastasis to a fistula track prior to surgical intervention. The danger of implantation of exfoliated tumour cells in patients with distally situated 'raw' mucosal sites is recognized and anorectal procedures should not be performed prior to resection. Minor anorectal procedures should not be performed at the same time as colorectal resections for carcinoma in these patients either. Some 'recurrences', such as those described in this paper, may be inevitable and in fact really represent preoperative metastases. Routine flexible sigmoidoscopy prior to the performance of any anorectal procedure might identify patients at risk of such 'recurrences' but this may not be cost-effective.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
9/181. Colorectal carcinoma.Two rare cases of colorectal adenocarcinoma seen during the last 3 years in children under 10 years of age are reported. To improve survival, emphasis is given on its early diagnosis by a thorough examination and investigation of the child in every case of prolonged bleeding per rectum, diarrhoea and other non specific abdominal symptoms.- - - - - - - - - - ranking = 5keywords = carcinoma (Clic here for more details about this article) |
10/181. An unusual cause of thigh pain in colonic cancer. Inflammatory oncotaxis?Colonic carcinoma metastasis in order of frequency to the liver, lung, bone and brain. Metastases elsewhere are unusual. We report a very rare case of metastatic spread to skeletal muscle and skin. There follows a review of the theories of anomalous metastatic localization. Inflammatory oncotaxis is offered as the most likely explanation of this phenomenon. The importance of good history taking in colorectal cancer follow up clinics is emphasised.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
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