1/60. 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 = 1keywords = carcinoid (Clic here for more details about this article) |
2/60. Rectal adenocarcinoid with lymph node metastasis.We describe a case of a rare variant of a rectal carcinoid tumor that showed mucous gland differentiation accompanied by a lymph node metastasis with a histological appearance similar to that of the primary site. The tumor consisted of a typical argyrophilic carcinoid component and of goblet cell glands. The carcinoid component was positive for neuron-specific enolase, chromogranin a and synaptophysin. The goblet cells stained positively with periodic acid-Schiff (PAS) and alcian blue, and expressed carcinoembryonic antigen, but were negative for neuroendocrine markers. This case suggests that carcinoid tumor can differentiate towards mucus glands, which can also be found in the metastatic site.- - - - - - - - - - ranking = 8keywords = carcinoid (Clic here for more details about this article) |
3/60. indium-111 octreotide uptake in the surgical scar.indium-111 octreotide uptake has been reported in various somatostatin receptor positive tumors, granulomas and autoimmune diseases in which activated leucocytes may play a role, subcutaneous cavernous hemangioma and angiofibroma. We present indium-111 octreotide uptake in a surgical abdominal scar tissue 1.5 and 6 months after surgery in a patient who had been treated for recurrent carcinoid tumor in the rectosigmoid junction. indium-111 octreotide uptake in a surgical scar may be related to the binding to somatostatin receptors in the activated lymphocytes and fibroblasts that is previously reported.- - - - - - - - - - ranking = 1keywords = carcinoid (Clic here for more details about this article) |
4/60. Aspiration cytology and core biopsy of a carcinoid tumor arising in a retrorectal cyst: a case report.Retrorectal cysts are uncommon lesions of uncertain histogenesis, and primary carcinoid tumors arising in retrorectal cysts are extremely rare. We present the case of a 52-yr-old man who had a 22-cm partially cystic, partially solid mass in the presacral space. A computed tomography-guided fine-needle aspiration of the mass was performed. The smears contained abundant keratinous debris and rare groups of tumor cells. The tumor cells were cuboidal, with slightly granular cytoplasm and centrally located nuclei with speckled chromatin and inconspicuous nucleoli. Immunocytochemical analysis revealed strong reactivity for chromogranin and keratin, and focal reactivity for synaptophysin and neuron-specific enolase. The cytological diagnosis of a carcinoid arising in a tail-gut cyst was confirmed histologically. This is the first reported case of a carcinoid arising in a retrorectal cyst diagnosed preoperatively by cytology. This diagnosis is possible in the setting of consistent clinical, radiographic, and cytological findings.- - - - - - - - - - ranking = 7keywords = carcinoid (Clic here for more details about this article) |
5/60. Gastrointestinal carcinoid tumors and second primary malignancies.The development of second primary malignancies (SPM) in patients with gastrointestinal carcinoid tumors is a well-described phenomenon, with reported rates as high as 55%. There is a predilection for gastrointestinal and genitourinary adenocarcinomas, but a variety of other malignancies have been reported as well. The etiology of this malignant predisposition may be rooted in the tumorigenic properties of the various neuroendocrine peptides elaborated and secreted by neuroendocrine cells. peptides such as secretin, gastrin, bombesin, cholecystokinin (CCK), and vasoactive intestinal peptide (VIP) are believed to promote the growth of tumor cells. As many as 30 peptides and amines identified in neuroendocrine cells may have similar properties. This review of the literature on carcinoid-associated second primary malignancies is accompanied by a case report of metastatic carcinoid identified during surgical exploration for a perforating colon adenocarcinoma.- - - - - - - - - - ranking = 7keywords = carcinoid (Clic here for more details about this article) |
6/60. Unusually aggressive rectal carcinoid metastasizing to larynx, pancreas, adrenal glands, and brain.Rectal carcinoids are slow-growing tumors. They metastasize when their size is more than 2 cm. Common sites of metastasis are the liver, lungs, and bones. Metastases to thyroid, pancreas, kidneys, adrenal glands, pituitary glands, posterior fossa, and spleen are very rare. We present the case of a 79-year-old white man with dysphagia and left vocal cord paralysis from a rapidly growing mass in his neck. Needle biopsy suggested thyroid anaplastic carcinoma, and the patient underwent total laryngectomy, total thyroidectomy, and left radical neck dissection. pathology showed undifferentiated carcinoid of the larynx. biopsy of a rectal mass suggested poorly differentiated carcinoma. Postoperatively the patient developed cardiac arrhythmias and died after 5 weeks. autopsy showed a 5-cm carcinoid of the rectum with extensive vascular invasion extending into the perirectal fat. There was metastatic disease to both lungs, liver, pancreas, both adrenal glands, peritoneum, subcutaneous tissues of thorax and abdomen, ribs, vertebrae, skull, and the leptomeninges of the cerebrum. Rectal carcinoids may present a variable histologic picture. Poorly differentiated tumors can present with widespread metastases and have poor prognosis. Extensive surgery may not improve the survival of patients with this pattern of unusually aggressive carcinoid.- - - - - - - - - - ranking = 9keywords = carcinoid (Clic here for more details about this article) |
7/60. Rectal carcinoid tumor successfully treated by endoscopic resection.We report a case of rectal carcinoid tumor totally resected by endoscopy. A 48-year-old male complained of abdominal discomfort. Digital examination revealed a slightly hard mass. colonoscopy demonstrated a slightly hard mass measuring 13 mm in diameter in the rectum, 5 cm from the anal verge. Endoscopic resection was successfully performed and histological examination led to a diagnosis of carcinoid tumor. No local remnant lesion or distant metastasis was found.- - - - - - - - - - ranking = 6keywords = carcinoid (Clic here for more details about this article) |
8/60. Elevated serum acid phosphatase levels with rectal carcinoid tumor.A case of rectal carcinoid tumor with liver metastases is reported in which a markedly elevated serum acid phosphatase level was found. Tissue assays of the patient's tumor, liver metastasis, and uninvolved liver were performed which demonstrated very high tumor levels of acid phosphatase. The patient also had elevated plasma serotonin levels and urinary 5-hydroxyindole acetic acid levels and did not exhibit the carcinoid syndrome. autopsy showed no prostate cancer or metastatic bone lesions. serum acid phosphatase elevation may occur with carcinoid lesions of the rectum.- - - - - - - - - - ranking = 7keywords = carcinoid (Clic here for more details about this article) |
9/60. Small rectal carcinoid with lymph node metastasis diagnosed prior to treatment.We treated a 59-year-old man with a small, yellowish, submucosal rectal tumour that was detected incidentally during a colonoscopic examination. Endoscopic ultrasonography revealed a hypoechoic submucosal tumour 13 mm in diameter. Computed tomography and magnetic resonance imaging studies were performed, and pararectal and para-obturator lymph node involvement was confirmed. The patient underwent Miles' operation with lymph node dissection; 24 months later, he is disease free. We were able to diagnose rectal carcinoid tumour and evaluate the lymph node metastasis prior to surgery. Even with a small carcinoid, it is important to determine the depth of invasion and the presence of lymph node metastasis prior to treatment.- - - - - - - - - - ranking = 6.2698714159135keywords = carcinoid, carcinoid tumour (Clic here for more details about this article) |
10/60. Tailgut cyst with carcinoid: a case report.Tailgut cyst, an unusual presacral lesion, is lined by a variety of epithelial types including squamous, columnar, transitional and cuboidal epithelium. Disorganized fascicles of smooth muscle may be seen in the cystic wall. Tailgut cysts are usually multiloculated, and often afflict adult women. In rare cases, adenocarcinoma arises within the tailgut cyst. We present a carcinoid tumor developing from the tailgut cyst. The tumor cells grow in ribbon and festoon patterns and are positive for argyrophilic granules. Immunostains for neuron-specific enolase are also positive. Ultrastructurally, dense-core, membrane-bounded neurosecretory granules are present.- - - - - - - - - - ranking = 5keywords = carcinoid (Clic here for more details about this article) |
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