1/22. Sigmoid colon cancer presenting as complete rectal prolapse: report of a case.We describe herein the unusual case of a 76-year-old woman who was diagnosed as having sigmoid colon cancer after presenting with complete rectal prolapse. The rectal prolapse was considered to have been caused by constipation accelerated by the colon cancer. The relationship between colorectal cancer and rectal prolapse has not yet been clarified; however, this case report suggests that rectal prolapse can present as a symptom of colorectal cancer. Thus, patients with a sudden onset of rectal prolapse should be screened for colorectal cancer.- - - - - - - - - - ranking = 1keywords = cancer (Clic here for more details about this article) |
2/22. Continuous inferior mesenteric ganglion block for the control of abdominal pain.BACKGROUND AND OBJECTIVES: A 71-year-old woman was referred for control of intractable left-sided abdominal pain and constipation caused by stage 2B rectosigmoid colon cancer. She was treated with an intravenous morphine sulfate infusion at 4 mg/h which made her drowsy and lethargic. Because the distal colon is innervated by the inferior mesenteric sympathetic ganglion, it was hypothesized that a continuous block of this ganglion would provide both pain control and increased intestinal motility. methods: The patient was placed in a prone position, and a Tuohy needle was placed at an entry site 7 cm lateral to the L3 spinous process. The needle was advanced 2 cm anterior to the L3 vertebral body with fluoroscopic guidance. An 18-gauge indwelling catheter was placed through the needle and a continuous infusion with 0.1% bupivacaine was maintained for 4 days. RESULTS: The patient obtained immediate pain relief and bowel motility. She remained awake and comfortable throughout the duration of therapy. She was discharged home 3 days after stopping the infusion and required a minimal amount of opioids. CONCLUSION: Continuous inferior mesenteric ganglion block may be an option in providing relief for pain caused by distal colon pathology.- - - - - - - - - - ranking = 0.11111111111111keywords = cancer (Clic here for more details about this article) |
3/22. Reduction in constipation and laxative requirements following opioid rotation to methadone: a report of four cases.constipation is a common symptom in cancer patients, especially in those who are receiving opioid analgesics for pain. Although several articles have recently examined constipation with respect to causation and treatment, little research has been done to elucidate the effects of different opioids on the bowel. Recent research has found that laxative doses may be lower in patients using methadone as an analgesic, but changes in constipation were not measured. We report here on four cases in which patients had improvement in constipation and decreased laxative requirements following opioid rotation to methadone.- - - - - - - - - - ranking = 0.11111111111111keywords = cancer (Clic here for more details about this article) |
4/22. subcutaneous emphysema in advanced cancer.Spontaneous subcutaneous emphysema is a rare and usually benign entity that may occasionally be symptomatic. We report a case of a patient with advanced cancer who developed extensive but asymptomatic subcutaneous emphysema shortly before death. Perforation of the lower gastrointestinal tract, perhaps as a result of straining due to severe unrelieved constipation or due to fistula formation, is suspected to have been the mechanism. The causes, treatment, and implications for management of this condition are discussed.- - - - - - - - - - ranking = 0.55555555555556keywords = cancer (Clic here for more details about this article) |
5/22. struma ovarii in a 50 year old Ethiopian woman.struma ovarii represents the dominant growth of thyroid tissue in a teratoma. This exceedingly rare neoplasm is described in a 50 year-old Ethiopian woman who presented with right lower quadrant pain and mass of 10 years duration. The patient had nonspecific symptoms in addition to the above complaints. The diagnosis was disclosed by pathologic examination. This exceedingly rare neoplasm is discussed with clinicopathologic correlation and literature review.- - - - - - - - - - ranking = 0.010815616060261keywords = neoplasm (Clic here for more details about this article) |
6/22. Gigantic jejunal leiomyosarcoma.Jejunal leiomyosarcoma is a rare neoplasm. We report a case of gigantic leiomyosarcoma of the jejunum in a 30-year old man who presented with abdominal distension, pain and constipation. Computerized tomography scan revealed a giant tumor filling the entire abdominal cavity. Fine needle aspiration cytology was suspicious. At laparotomy, a huge jejunal leiomyosarcoma measuring 30 x 25 x 19 cm and weighing 13 kg was completely excised. To the best of our knowledge, this is the first case of a giant jejunal leiomyosarcoma.- - - - - - - - - - ranking = 0.0054078080301306keywords = neoplasm (Clic here for more details about this article) |
7/22. Radiographic, computed tomographic and histopathologic appearance of a presumed spinal chordoma in a dog.A 4-year-old Labrador Retriever presented for urinary incontinence and constipation of 2 weeks duration. There was a tender abdomen, lumbar pain and conscious proprioceptive deficits in both pelvic limbs. Depressed pelvic limb reflexes were present consistent with a lower motor neuron lesion. In radiographs of the lumbar spine there was narrowing of the intervertebral disc space at L5-L6 with irregular, multifocal areas of mineralized opacities dorsal to the intervertebral disc space, presumably within the vertebral canal. On computed tomography, an intramedullary, partially mineralized mass was identified in the spinal cord at the level of caudal L5 through cranial L6. At necropsy there was a four-centimeter enlarged, irregular segment of spinal cord at the level of L5-L6. When sectioned, the spinal cord bad a mineralized texture. Histologically there were variable sized cells that were stellate in appearance with vacuolated cytoplasm (physaliferous cells) and mucinous background consistent with a chordoma. chordoma is a rare, skeletal neoplasm that originates from mesoderm-derived notochord and has been reported in humans and animals. Extraskeletal development of a chordoma within the spinal cord is a rare manifestation of this neoplasm. However, based on other reports in dogs, solitary extraskeletal locations of chordomas may be the typical expression of this neoplasm in the dog. Differentiation of similar histologically appearing tumors, such as a parachordoma or myxoid chondrosarcoma, will require immunohistochemical characterization of these tumors in veterinary patients.- - - - - - - - - - ranking = 0.016223424090392keywords = neoplasm (Clic here for more details about this article) |
8/22. Perianal mucinous adenocarcinoma: unusual case presentations and review of the literature.Perianal mucinous adenocarcinoma is a rare cancer constituting 3 to 11 per cent of all anal carcinomas. It may arise de novo or from a fistula or abscess cavity. We present two cases of this disease process. Case One is a 52-year-old man with a chronic history of perianal abscesses who presented to the emergency room with a large bowel obstruction. He required diversion and wide local excision with lateral internal sphincterotomy for relief of the obstruction. pathology from the excised material revealed the unexpected diagnosis of invasive mucinous adenocarcinoma of the anus. Case Two is a 59-year-old man with a chronic history of complex fistulas and abscesses who presented to our office with a horseshoe fistula and deep postanal space abscess. Because of the nonhealing nature of the wound, biopsies from the abscess crater, fistulous tract, and the perianal skin opening were taken. The pathology department identified the specimens as invasive mucinous adenocarcinoma of the anal canal. This is an aggressive cancer often misdiagnosed clinically as benign pathology. A high index of suspicion and biopsy of fistulous tracts and abscesses are the keys to early diagnosis and treatment. With combination chemotherapy and radiation therapy in conjunction with aggressive surgical resection long-term survival might be obtained.- - - - - - - - - - ranking = 0.22222222222222keywords = cancer (Clic here for more details about this article) |
9/22. Unrecognized constipation in patients with advanced cancer: a recipe for therapeutic disaster.morphine-induced constipation can lead to therapeutic disasters by several mechanisms. It can be readily prevented by administration of appropriate laxatives, but the importance of this simple intervention is often overlooked. Problems resulting from uncontrolled constipation include not only fecal impaction and spurious diarrhea, but also pseudoobstruction of bowel causing abdominal pain, nausea and vomiting, and serious interference with drug administration and absorption. Cancer pain may also be exacerbated. All of these contribute unnecessarily to morbidity and costs of health care. A case that exemplifies many of these problems is presented and discussed.- - - - - - - - - - ranking = 0.44444444444444keywords = cancer (Clic here for more details about this article) |
10/22. Clinics in diagnostic imaging (101): Multinodular accessory thyroid tissue.A 71-year-old woman with a strong family history of thyroid cancer presented with 3 months of constipation. A carcinoid tumour of the rectum was found at colonoscopy. On physical examination, she had a large goitre and there was a 3-4 cm firm submental mass. The differential diagnosis was accessory thyroid tissue or a carcinoma metastasis. Staging computed tomography was performed to include the neck, followed by ultrasonography and aspiration biopsy of the submental mass, which confirmed the diagnosis of multinodular accessory thyroid tissue. Differences in aetiology and pathophysiology of accessory thyroid tissue and ectopic thyroid glands are discussed.- - - - - - - - - - ranking = 0.11111111111111keywords = cancer (Clic here for more details about this article) |
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