1/666. The effectiveness of chemotherapy with cisplatin and 5-fluorouracil for recurrent small cell neuroendocrine carcinoma of the rectum: report of a case.We report herein the case of a 46-year-old-man with small cell neuroendocrine carcinoma (NEC) concomitant with large villous adenoma of the rectum, who underwent abdominoperineal resection with regional lymphnode dissection. The resected specimen was histologically found to contain a small lesion of NEC confined to the submucosa in the large adenoma. A computed tomography scan done 4 months postoperatively revealed recurrences in the liver, lymph nodes, and bone. Therefore, two cycles of sequential intravenous combined chemotherapy with standard doses of cisplatin and 5-fluorouracil (5-FU) were administered, after which the size of each tumor decreased remarkably. Nevertheless, the patient died 8 months after the operation. As there was a fair response of this tumor to the combined chemotherapy of cisplatin and 5-FU, this regimen against NEC of the colon and rectum should be given consideration.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
2/666. 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 = 1.4keywords = carcinoma (Clic here for more details about this article) |
3/666. A case of chordoma in association with rectal carcinoma.A 74-year-old male patient presented with anal and sacral pain 18 months after abdomino-perineal resection for rectal cancer. Computerized tomography (CT) of the pelvis demonstrated a well defined mass anterior to the lower sacrum, posteriorly infiltrating and destroying the fourth and fifth sacral nerves and invading the right gluteal fossa. A 7.5 x 15 x 2 cm encapsulated mass was demonstrated during the operation using a posterior approach and the lower sacral segments together with the tumour were removed by amputation at S3 level. Histopathology revealed chordoma. This case is unique because of the rarity of chordoma in association with rectal tumour at the sacrococcygeal region.- - - - - - - - - - ranking = 0.8keywords = carcinoma (Clic here for more details about this article) |
4/666. An unusual location of cloacogenic carcinoma.A 61 year-old female presented with abdominal pain, rectal bleeding, mucus discharge, tenesmus and constipation. Rectal examination and proctoscopy demonstrated rectal stenosis at 5 cm from the anal verge. Transrectal ultrasonography detected a capsulated lesion as a mesenchymal rectal tumor. Computed tomography and endorectal magnetic resonance detected a mesenchymal lesion in the lower-middle rectal thirds. serum TPA, GICA, SCC and CYFRA were pathological. At surgery the tumour was fixed to the levator ani muscle with rectal folding. frozen sections of the levator ani muscle biopsies revealed cloacogenic tumour. Abdominoperineal resection was performed. The rectal lesion was cloacogenic carcinoma at 9 cm from the dentate line (pT4 pN0; Ki67 35%; CD31 181 vessels/mm2). Adjuvant radio-chemotherapy was performed. The patient is alive and disease free at 19 months. Extra-anal cloacogenic tumours are an unusual finding. Perhaps cloacal cells were originally present in the rectal wall, but secondary rectal involvement by cloacal remnant from the levator ani muscle cannot be excluded.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
5/666. Myositis and malignancy: is there a true association?There may be an association between polymyositis/dermatomyositis and malignant disease. Cancer occurs in patients with polymyositis/dermatomyositis with a frequency estimated between 2.5% and 29% (relative risk 1.0 to 6.5). We present two such cases, associated with colorectal carcinoma and non-Hodgkin's lymphoma respectively, together with an overview of existing controlled studies in the area.- - - - - - - - - - ranking = 0.2keywords = carcinoma (Clic here for more details about this article) |
6/666. The partial gluteus maximus musculocutaneous turnover flap. An alternative concept for simultaneous reconstruction of combined defects of the posterior perineum/sacrum and the posterior vaginal wall.Three cases with posterior perineo-sacral defects are presented. One is a 57-year-old white female following amputation of her rectum for carcinoma, radiation and chemotherapy with a significant residual sacral/perineal defect and loss of the posterior vaginal wall. The two other patients had radical pelvic exenteration after recurrent rectum carcinoma. A new myocutaneous turnover flap as a modification of the conventional gluteus maximus flap was designed to solve the particular reconstructive problems. The flap is based on branches of the inferior gluteal artery. The posterior cutaneous femoral nerve and the motor branches of the inferior gluteal nerve not leading into the muscle portion of the flap are left intact. The skin island can be used for vaginal reconstruction or can be de-epithelialised to fill perineal cavities. This new flap eventually enabled the successful reconstruction of the posterior vaginal wall and appropriate sacral/perineal soft tissue coverage in the first case. In the other patients the flap was used to achieve closure of the deep through-and-through defect acutely in one case, and after a 3-week interval in the other.- - - - - - - - - - ranking = 0.4keywords = carcinoma (Clic here for more details about this article) |
7/666. Small-cell carcinoma of the rectum: report of two cases.Small-cell carcinoma of the rectum is an infrequent pathologic finding, and its precise incidence is unknown. Its incidence is less than 0.2 percent among all colorectal cancers. This tumor manifests highly aggressive behavior. The treatment of choice is combination chemotherapy similar to that used for small-cell carcinoma of the lung, but in small localized tumors surgery plus chemotherapy is an alternative. We present two cases of small-cell carcinoma of the lower rectum and a review of the literature.- - - - - - - - - - ranking = 1.4keywords = carcinoma (Clic here for more details about this article) |
8/666. 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 = 1.4keywords = carcinoma (Clic here for more details about this article) |
9/666. Peritoneal mucinous carcinomatosis after laparoscopic-assisted anterior resection for early rectal cancer: report of a case.Minimally invasive colon surgery has been shown to be both technically feasible and a safe alternative to laparotomy. Its efficacy for the curative resection of colorectal cancer, however, remains controversial. Of major concern are the increasing reports of port-site recurrence after use of laparoscopic techniques in malignant disease. In this article a heretofore unreported complication of peritoneal mucinous carcinomatosis after laparoscopic-assisted anterior resection for early stage rectal cancer is presented. Isolated peritoneal recurrence is rare after curative resection of Stage I rectal cancer. The effect of pneumoperitoneum on tumor dissemination is discussed.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
10/666. 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 = 1keywords = carcinoma (Clic here for more details about this article) |
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