1/327. Synchronous and metachronous gastric adenocarcinoma: case report and literature review.Whilst synchronous adenocarcinoma of the stomach is well documented, metachronous primary disease is exceedingly rare. We report a man with a family history of colonic and gastric cancer, who underwent a resection of a Duke's C adenocarcinoma of the rectum, aged 56 years, and a proximal partial gastrectomy for synchronous stage 1 gastric adenocarcinomas of the lesser curve, aged 61 years. Nine years later, a metachronous gastric primary was discovered in the gastric remnant, necessitating total gastrectomy. Total gastrectomy is the operation of choice for synchronous gastric primaries as it ensures clearance and prevents metachronous growth. However, it may not be appropriate for all gastric cancer as operative morbidity and mortality are increased, and because synchronicity and metachronicity of gastric cancer are uncommon. Moreover, there are no consistent data to demonstrate a survival advantage for total compared with partial gastrectomy for operable gastric cancer. If, after partial gastrectomy, synchronous disease is detected in the resected specimen (as in this reported case), endoscopic surveillance for metachronous disease is advised, since this may be amenable to surgical cure.- - - - - - - - - - ranking = 1keywords = adenocarcinoma (Clic here for more details about this article) |
2/327. Squamous-cell carcinoma of the colon responsive to combination chemotherapy: report of two cases and review of the literature.PURPOSE: The majority of colorectal neoplasms diagnosed are adenocarcinomas. Other histologies such as squamous, adenosquamous, carcinoid tumors, or lymphoid tumors are occasionally identified. Given the rarity of squamous-cell tumors, it is very difficult to study their natural course and response to therapy. An attempt is made to describe the frequency, anatomic location, and response to therapy with a review of the literature. methods: From the Cancer Registry at the University of missouri-Columbia Ellis Fischel Cancer Center, tumors of the colon identified above the dentate line were selected for chart review. Data were extracted from cases between the years 1940 and 1996. The key terms used to identify cases were epidermoid, squamous cell, and cancer of the rectum or colon. Using this approach, forty patients were identified and each record was reviewed. RESULTS: The majority of these cases were anal cancers with proximal extension into the rectum and were excluded. Of 4,561 cases of epithelial colon and rectal cancers identified, only one additional case of squamous-cell cancer could be verified. In this report we describe a patient with a primary squamous-cell carcinoma of the sigmoid colon with metastatic disease to the liver at diagnosis who responded to systemic chemotherapy. We believe this to be the first reported case of this rare tumor type in which the patient's tumor responded to systemic chemotherapy. Two cases with a thorough review of literature are presented. CONCLUSIONS: Primary squamous-cell carcinoma of the colon is a rare malignancy of unknown cause and pathogenesis. Metastatic tumors to the colon should be ruled out in all cases before therapy. Early detection and surgery remain the main therapeutic options, but as presented in our case, response to chemotherapy in advanced disease is encouraging.- - - - - - - - - - ranking = 0.14285714285714keywords = adenocarcinoma (Clic here for more details about this article) |
3/327. adenocarcinoma within a rectal duplication cyst: case report and literature review.Intestinal duplications are uncommon but recognised developmental anomalies. Duplications of the rectum are the most uncommon of these anomalies. They may present with perianal fistulae, bleeding, a pelvic mass or symptoms produced by a mass, or, rarely, malignant change. We present a case of an adenocarcinoma within a rectal duplication cyst which was initially thought to be inoperable but was treated by radical surgery.- - - - - - - - - - ranking = 0.14285714285714keywords = adenocarcinoma (Clic here for more details about this article) |
4/327. Paget's disease of the vulva associated with local adenocarcinoma and previous breast adenocarcinoma: report of two cases.We report two women in whom vulval Paget's disease occurred in association with local adenocarcinoma and previous breast adenocarcinoma. The first patient presented at the age of 83 years with moist erythematous changes over the perineum and an indurated area near the anus. biopsy of the indurated area showed Paget's cells throughout the epidermis and, below, adenocarcinoma infiltrating the dermis. Ten years previously, she had undergone a left mastectomy for infiltrating ductal carcinoma of the breast. The second patient was diagnosed as having Paget's disease at the age of 74 years. A vulval biopsy showed Paget's cells in the epidermis but, in addition, there were changes suggestive of adenocarcinoma of the sweat glands. Her symptoms of vulval itching had started at the age of 45 years and had led to a simple vulvectomy at the age of 57 years. Retrospective review of this vulvectomy specimen showed Paget's disease. She had also previously been treated for infiltrating ductal adenocarcinoma of the breast and adenocarcinoma of the rectum. The management of Paget's disease is difficult because of its high recurrence rate and, as illustrated by our two cases, treatment is difficult if the patients are elderly and in poor general health.- - - - - - - - - - ranking = 2keywords = adenocarcinoma (Clic here for more details about this article) |
5/327. radiation-associated rectal cancer: report of four cases.BACKGROUND/AIMS: radiation-associated rectal cancer is a remarkable clinical entity. We demonstrate 4 patients (mean age 68 years, range 63-74) who had undergone pelvic radiotherapy for cervical cancer. We indicate some characteristics of radiation-associated rectal cancer. RESULTS: Two patients had received intracavitary and external pelvic radiotherapy, while the remaining 2 had external pelvic radiotherapy following hysterectomy. The mean total radiation dose was 63 Gy, though radiation dose information was not available for 1 patient. Colorectal cancer developed at a mean time of 20.7 years (range 11-30) after radiation therapy. All patients presented with chronic radiation colitis, and 3 demonstrated abnormal tumor markers. colonoscopy revealed an ulcerative, localized well-differentiated adenocarcinoma of the rectosigmoid colon in 1 patient, and diffusely infiltrating cancers of the lower rectum, one signet-ring cell carcinoma and two mucinous carcinomas in the remaining 3. One case was stage I, 2 were stage IIIa, and the remaining case was stage IV. Three patients underwent abdominoperineal resection. The remaining patient was felt to be inoperable. The colorectal wall demonstrated the changes of chronic radiation injury. Two patients died within a short time because of their advanced cancers. CONCLUSION: radiation-associated rectal cancer has a tendency to be diagnosed in the advanced stage and to have a poor prognosis. A literature review and our case report suggest that since there are no reliable clinical or laboratory indicators of the presence of a curable colorectal cancer in the setting of chronic radiation proctocolitis, surveillance with a colonoscope should be done 10 years after irradiation in patients with previous pelvic radiotherapy.- - - - - - - - - - ranking = 0.14285714285714keywords = adenocarcinoma (Clic here for more details about this article) |
6/327. 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 = 0.14285714285714keywords = adenocarcinoma (Clic here for more details about this article) |
7/327. Total anorectal and partial vaginal reconstruction with dynamic graciloplasty and colonic vaginoplasty after extended abdominoperineal resection: report of a case.PURPOSE: quality of life is altered after abdominoperineal resection, because of permanent iliac colostomy. Psychological rehabilitation is even more difficult after extended abdominoperineal resection to the vagina, because of the loss of both continence and sexual functions. We report the first case of total anorectal and vaginal reconstruction using dynamic graciloplasty and colonic vaginoplasty after extended abdominoperineal resection. methods: A 46-year-old female underwent extended abdominoperineal resection with posterior colpectomy for a low rectal adenocarcinoma infiltrating the anal sphincter and vagina. Anorectal reconstruction was performed with coloperineal anastomosis and double dynamic graciloplasty. Vaginal reconstruction was performed using a 10-cm, isolated, rotated sigmoid loop. The procedure was performed in three stages, including abdominoperineal resection with reconstruction, implantation of the stimulator, and closure of the temporary ileostomy. RESULTS: Resting and electrostimulated pressures of the neosphincter were 40 and 110 cm H2O respectively. Continence was achieved for formed stools two months after closure of the stoma, with spontaneous defecations (30-90 minutes). The patient experienced regular sexual activity six months after closure of the stoma. CONCLUSION: This new original technique can be proposed in selected young females after extended abdominoperineal resection, to preserve continence, sexual activity, and body image.- - - - - - - - - - ranking = 0.14285714285714keywords = adenocarcinoma (Clic here for more details about this article) |
8/327. adenocarcinoma arising within a tailgut cyst: clinicopathological description and follow up of an unusual case.Full clinicopathological details and clinical follow up of a case of malignant transformation within a tailgut cyst are presented. A 43 year old woman presented with signs and symptoms of an imminent threatened abortion. Routine examination identified a coincidental, asymptomatic retrorectal/presacral mass. Following imaging studies, surgical resection was carried out and an adenocarcinoma arising within a pre-existent tailgut cyst was identified by microscopy. Four years later the patient presented with neurological symptoms consistent with local recurrence of the tumour. Surgical biopsies confirmed this diagnosis and she was subsequently started on chemotherapy. She died soon after from a cause unrelated to the disease, after declining further active intervention. Differential diagnosis of such cases includes (cystic) teratoma, epidermal cyst, rectal duplication cyst, anal gland cyst and carcinoma, extension of local carcinoma, and metastatic disease. It is recommended that these lesions be completely excised when detected incidentally.- - - - - - - - - - ranking = 0.14285714285714keywords = adenocarcinoma (Clic here for more details about this article) |
9/327. Humoral hypercalcemia in patients with colorectal carcinoma: report of two cases and review of the literature.BACKGROUND: Humoral hypercalcemia rarely is associated with colorectal carcinoma; to the authors' knowledge only nine cases have been reported to date. methods: Two cases of advanced colorectal carcinoma with humoral hypercalcemia of malignancy (HHM) are presented. RESULTS: The two patients had severe hypercalcemia without bone metastases. The diagnosis of HHM was based on findings of hypercalcemia, hypophosphoremia, elevated serum parathyroid hormone-related peptide (PTHrP), and positive tumor immunoreactivity to monoclonal PTHrP antiserum. One patient had a colonic adenocarcinoma with a neuroendocrine component and the other patient had rectal adenocarcinoma. Immunoreactive PTHrP was found in both tumor components. Bisphosphonate treatment normalized the hypercalcemia within a few days but it recurred in the patients 2 weeks and 3 weeks later, respectively. The prognosis was extremely poor. CONCLUSIONS: To the authors' knowledge the two cases presented in the current study are the first to be reported with HHM-associated colorectal carcinoma with positive tumor immunoreactivity to PTHrP monoclonal antiserum.- - - - - - - - - - ranking = 0.28571428571429keywords = adenocarcinoma (Clic here for more details about this article) |
10/327. Malar metastasis from rectal carcinoma: a case report.Facial metastasis from colorectal carcinoma is extremely rare. Only two cases have been reported in the literature. This is the first reported case of malar metastasis from colon carcinoma. The patient was a 64-year-old, white woman who underwent a low anterior resection for a nearly obstructive carcinoma at 20 cm. Her chest X-ray revealed lung metastases. Postoperatively she was treated with fluorouracil and leucovorin. Twenty months later, she presented with left facial edema, which progressively increased in size. CT scan and magnetic resonance imaging with gadolinium showed a large soft tissue mass centered about the left anterior zygomatic arch. The platysma muscle was displaced laterally, and the masseter muscle was involved. There was extension into the masticator space and bony involvement of the zygomatic arch. True-cut biopsy of the left cheek revealed metastatic adenocarcinoma. histology was similar to that of the primary rectal adenocarcinoma. Metastasis to the malar region is extremely rare. It is a grave prognostic sign, as it is associated with advanced terminal disease. Because of the widespread metastases, only palliative treatment can be provided.- - - - - - - - - - ranking = 0.28571428571429keywords = adenocarcinoma (Clic here for more details about this article) |
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