1/10. Systemic lupus erythematosus with a giant rectal ulcer and perforation.A 41-year-old man with systemic lupus erythematosus (SLE) who developed pelvic inflammation due to perforation of a giant rectal ulcer is described. The patient presented with persistent diarrhea, abdominal pain and fever without development of disease activity of SLE. Endoscopic and radiological examinations revealed a perforated giant ulcer on the posterior wall at the rectum below the peritoneal evagination. The ulcerated area was decreased after a colostomy was performed at the transverse colon to preserve anal function. The patient is currently being monitored on an outpatient basis. It should be noted that life-threatening complications such as perforated ulcer of the intestinal tract could occur without SLE disease activity.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/10. Rectal pulse granuloma.pulse granuloma is a rare benign entity, most likely representing a foreign body reaction to vegetable particles. We report a case of a pulse granuloma involving the rectum. The patient presented with a submucosal and intramuscular mass lesion found at routine rectal examination and subsequent colonoscopy. The mass was excised and the microscopic examination revealed acute and chronic inflammatory cells, foreign-body giant cells, vegetable matter, and convoluted hyaline rings and scattered circular structures containing basophilic granules, consistent with pulse granuloma. There are a few reports in the literature of pulse granulomas, with most occurring in the oral cavity or lungs. To the best of our knowledge, this is the first reported example of pulse granuloma in the rectum. Although rare, familiarity with this entity's distinctive histopathologic features may avoid a delay in diagnosis and prevent the expense of distinguishing it from its histologic lookalikes.- - - - - - - - - - ranking = 0.16666666666667keywords = giant (Clic here for more details about this article) |
3/10. Giant condyloma acuminatum of the anorectum: trends in epidemiology and management: report of a case and review of the literature.PURPOSE: Giant condyloma acuminatum (Buschke-Loewenstein tumor) of the anorectum is a rare disease with a potentially fatal course. Controversy exists as to the epidemiology, pathologic nature, and management of the tumor. methods: We present a 42-year-old male with a 12-cm x 10-cm exophytic mass of the anal verge. Treatment included wide local excision and partial closure with rotation flaps. pathology revealed a giant condyloma acuminatum with foci of well-differentiated squamous-cell carcinoma. We identified 51 reported cases of giant condyloma acuminatum in the English literature, and to our knowledge this is the largest review to date. RESULTS: Giant condyloma acuminatum presents with a 2.7:1 male-to-female ratio. For patients younger than 50 years of age, this ratio is increased to 3.5:1. The mean age at presentation is 43.9 years, 42.9 in males and 46.6 in females (P = 0.44). There seems to be a recent trend toward a younger presentation. The most common presenting symptoms are perianal mass (47 percent), pain (32 percent), abscess or fistula (32 percent), and bleeding (18 percent). Giant condyloma acuminatum has been linked to human papilloma virus and has distinct histologic features. Foci of invasive carcinoma are noted in 50 percent of the reports, "carcinoma in situ" in 8 percent, and no invasion in 42 percent. Historically, treatment strategies have included topical chemotherapy, wide local excision, abdominopelvic resection, and the frequent addition of adjuvant and neoadjuvant systemic chemotherapy and radiation therapy. recurrence is common. CONCLUSION: There seems to be a trend toward younger age at presentation and male predominance of giant condyloma acuminatum of the anorectum. Foci of invasive cancer within giant condyloma specimens are of uncertain significance and do not seem to correlate with recurrence or prognosis. Local invasion and local recurrence are the major source of morbidity in this disease. Complete excision is the preferred initial therapy when feasible. Wide local excision, fecal diversion, or abdominoperineal resection have been used. Chemotherapy with 5-fluorouracil and focused radiation therapy may be used in certain cases of recurrence or extensive pelvic disease, with unpredictable response. Controlled, prospective, multi-institutional studies are necessary to further define the nature and treatment of this rare disease.- - - - - - - - - - ranking = 0.66666666666667keywords = giant (Clic here for more details about this article) |
4/10. Topical budesonide for treating giant rectal pseudopolyposis.Pseudopolyps are a frequent finding in the course of inflammatory bowel disease. They are non-neoplastic lesions resulting from a regenerative and healing process that leaves inflamed colonic mucosa in polypoid configuration. Data about their management is lacking. "Giant" pseudopolyps can be mistaken for adenocarcinomas and, as they rarely regress with medical management alone, a surgical resection is often required. A case ofgiantpseudopolyposis treated non-surgically, in a patient with concomitant ulcerative colitis and chronic hepatitis b, is reported, representing a co-morbidity complicating an eventual conservative treatment. The clinical implementation of topical budesonide was originally tested, resulting in clinical, endoscopic and histological remission. budesonide seems a promising therapy for IBD, particularly when a comorbidity with viral hepatitis exist.- - - - - - - - - - ranking = 0.83333333333333keywords = giant (Clic here for more details about this article) |
5/10. Radical excision and mesh-skin grafting for giant anorectal condyloma acuminatum.BACKGROUND Giant Condyloma Acuminatum (GCA) presents difficulties in therapeutic management, mainly due to local invasion and recurrences. Treatment measures vary from topical agents to aggressive methods such as surgical excision, radiation, laser surgery, chemotherapy, immunotherapy or their combination.METHOD A 48-year-old heterosexual, hiv-negative male with a 20 year-year history of GCA, following an unsuccessful surgical operation, underwent radical excision with immediate mesh-skin grafting.CONCLUSION The absence of relapse and the excellent cosmetic results obtained one and a half years post-operative may put this treatment option in the first line of treatment choices for GCA- - - - - - - - - - ranking = 0.66666666666667keywords = giant (Clic here for more details about this article) |
6/10. Urothelial carcinoma of the ureter, giant rectal stone and sigmoid carcinoma 55 years after ureterosigmoidostomy.We present the case of a unique accumulation of complications 55 years after ureterosigmoidostomy for bladder exstrophy and discuss possible implications for follow-up strategies.- - - - - - - - - - ranking = 0.66666666666667keywords = giant (Clic here for more details about this article) |
7/10. sarcoidosis: unusual cause of a rectal mass.We have reported the case of a patient who had a rectal mass 3 years after the diagnosis of sarcoidosis. A malignancy was suspected, but biopsy of the rectal mass showed epithelioid granulomas with giant cells, consistent with sarcoidosis. Therefore, sarcoidosis should be considered as a rare cause of a rectal mass.- - - - - - - - - - ranking = 0.16666666666667keywords = giant (Clic here for more details about this article) |
8/10. Aggressive giant condyloma acuminatum associated with oncogenic human papilloma virus: a case report.Malignant transformation has been described in 30% of cases of giant anorectal condyloma acuminatum. The authors report on a 33-year-old man who was heterosexual and hiv negative and who had a giant anal condyloma. Despite aggressive therapy with multiple fulgurations, interferon alpha and isotretinoin, an invasive squamous cell carcinoma of the rectum developed. An abdominoperineal resection was done followed by radiotherapy and chemotherapy, but this treatment regimen was unsuccessful in controlling the progression of his carcinoma. Human papillomavirus (HPV) serotyping in tumoral tissue was positive for HPV types 11 and 16. In patients with giant anorectal condylomas associated with oncogenic HPV, the course of the disease may be aggressive, so they may benefit from early surgical and medical intervention.- - - - - - - - - - ranking = 1.1666666666667keywords = giant (Clic here for more details about this article) |
9/10. Rectal submucosal tumor-like lesion originating from intestinal tuberculosis.We present the case of a 55-year-old man who underwent transsacral local excision for a rectal submucosal tumor-like lesion suspected to originate from tuberculosis. The lesion, 2 cm in size, was found incidentally in the posterior wall of the lower rectum during anal fistulectomy. The lesion was apart from the primary crypt of the anal fistula. barium enema and colonoscopy revealed a protuberant submucosal growth with a shallow depression of the overlying mucosa. Although computed tomography and magnetic resonance imaging showed a well defined round mass within the rectal wall, digital rectal examination suggested extramural origin. Since repeated endoscopic biopsies were negative, we selected the transsacral approach for excisional biopsy to achieve histological diagnosis. The lesion was confined to the rectal wall and the full-thickness rectal wall was excised. Histologically, a foreign-body granuloma with acute inflammation was the main component of the lesion. Caseating granulomas and Langhans' giant cells, consistent with tuberculosis, were also found.- - - - - - - - - - ranking = 0.16666666666667keywords = giant (Clic here for more details about this article) |
10/10. Condyloma acuminata: a fatal disease?Condyloma acuminata is a virally mediated epithelial overgrowth caused by the human papilloma virus. Its simplest form is the common wart, which may occur almost anywhere on the body surface. Its papillary lesion forms are commonly seen in the genital, perineal, and anal areas, though it also infects the conjunctiva, nose, mouth, larynx, and tracheo-bronchial tree. Malignant degeneration may occur in any of these areas. diagnosis is established by clinical impression and biopsy. immunoassay methods exist but are simply indicative of the presence of infection and are not useful in predicting the course of the disease. Many treatment modalities exist and all work well for minor lesions. For large lesions such as the giant condyloma acuminata, also known as the Buschke-Lowenstein lesion, only radical surgical extirpation is considered to be appropriate treatment. This case report, as well as others referenced in this study, documents the extreme complexity of management of many of these lesions and the fatal outcome of this disease process in a significant number of cases.- - - - - - - - - - ranking = 0.16666666666667keywords = giant (Clic here for more details about this article) |
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