1/20. Epithelioid leiomyosarcoma with osteoclast-like giant cells in the rectum.We report a rare case of rectal epithelioid leiomyosarcoma with osteoclast-like giant cells. A 71-year-old Japanese man was admitted to a hospital with melena. Results of a colonoscopy test revealed a polypoid tumor in the rectum, and a biopsy specimen from the lesion showed a sarcoma; the patient underwent rectosigmoidectomy. At gross inspection, the tumor measured 8 x 7 x 4 cm and was polypoid with ulcerations. Necrotic and hemorrhagic foci were scattered. Microscopically, the tumor consisted of 2 cell types: malignant tumor cells with epithelioid features and benign-appearing osteoclast-like giant cells. The tumor cells were polygonal and epithelioid in shape and had eosinophilic or clear cytoplasms, with scattered giant tumor cells. Immunohistochemical examination revealed that the tumor cells were positive for vimentin, muscle actin, alpha-smooth muscle actin, and desmin, whereas the osteoclast-like giant cells were positive for CD68, leukocyte common antigen, and lysozymes. We diagnosed this case as epithelioid leiomyosarcoma with osteoclast-like giant cells. To the best of our knowledge, this is the first case of rectal epithelioid leiomyosarcoma with osteoclast-like giant cells.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/20. Malignant stromal tumour of the rectum: findings at endorectal ultrasound and MRI.This case report describes the findings on endorectal ultrasound and MRI in a patient with a giant malignant stromal tumour of the rectum. A review of imaging characteristics and histopathological findings as described in the literature is presented.- - - - - - - - - - ranking = 0.1keywords = giant (Clic here for more details about this article) |
3/20. Fine-needle aspiration cytologic diagnosis of giant-cell tumor of the sacrum presenting as a rectal mass: A case report.A giant-cell tumor of the sacrum is rare, and poses significant therapeutic and surgical difficulties largely because of its location. patients usually present with pain in the lower back radiating to one or both lower limbs, with or without neurological deficit. The index case presented with difficulty in defecation, in addition to pain in both lower limbs for 6 mo. The patient was seen to have a rectal mass, and a per-rectal fine-needle-aspiration was performed. The smears showed a cellular aspirate composed of a large number of osteoclastic giant cells, admixed intimately with clusters and a scattered population of mononuclear cells. Mitotic figures were not observed. Although the differential diagnosis of osteoclastic giant cell-containing lesions is broad, the presence of strong cohesiveness between the mononucleated cells and giant cells in cohesive clusters is a very helpful diagnostic feature, and was a prominent finding in the present case.- - - - - - - - - - ranking = 0.8keywords = giant (Clic here for more details about this article) |
4/20. 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 = 0.4keywords = giant (Clic here for more details about this article) |
5/20. Perianal verrucose carcinoma spreading to the rectum: report of a case.The case of a 39-year-old man with a perianal verrucose carcinoma of 12 years' duration is presented. After local resection the tumor recurred several times and spread to the rectum. An abdominoperineal resection revealed neither infiltration of deeper layers nor lymph-node metastasis. Five other cases of perianal verrucose carcinoma, only two of which were described in detail, have been reported. Probably other examples have been reported under the names of "perianal florid papillomatosis,"13,23 "giant condyloma acuminatum"26 and "condyloma acuminatum with malignant transformation."9,12,27- - - - - - - - - - ranking = 0.1keywords = giant (Clic here for more details about this article) |
6/20. Laparoscopic giant parastomal hernia repair with prosthetic mesh.laparoscopy is being increasingly used in colorectal surgery interventions. Herein, we present a patient with giant parastomal hernia who underwent laparoscopic repair. A70-year-old man who had undergone abdominoperineal resection and end colostomy for carcinoma of rectum was admitted to our clinic with a giant parastomal hernia. The parastomal hernia was repaired by laparoscopic approach using prosthetic material. The patient was discharged uneventfully on postoperative day 4. Laparoscopic approach is a rational alternative to conventional repair techniques of parastomal hernia and may be a reliable and easily applicable method with the classic benefits of laparoscopic surgery.- - - - - - - - - - ranking = 0.6keywords = giant (Clic here for more details about this article) |
7/20. Pleomorph poorly differentiated endocrine carcinoma of the rectum.We present a case of poorly differentiated endocrine carcinoma (PDEC) of the rectum identified immunohistochemically and characterized by a high degree of cellular pleomorphism, including bizarre giant cells. This case indicates that gastrointestinal PDECs are not restricted to small cell carcinomas. Among the multiple genes investigated, loss of heterozygosity (LOH) of the p53 locus without p53 immohistochemical accumulation, overexpression of c-kit and absent expression of p16 were seen.- - - - - - - - - - ranking = 0.1keywords = giant (Clic here for more details about this article) |
8/20. Giant pelvic retroperitoneal leiomyoma arising from the rectal wall.BACKGROUND: Pelvic retroperitoneal leiomyomas arising from the rectal wall are rare. We present a case of a giant retroperitoneal leiomyoma mimicking bilateral solid adnexal masses in a postmenopausal woman. CASE: A 54-year-old postmenopausal woman presented with a large abdominopelvic mass. At surgery, the uterus was displaced anteriorly by a large retroperitoneal mass. The rectosigmoid colon was noted to course through the retroperitoneal mass. The patient underwent complete excision of the retroperitoneal mass along with a rectosigmoid resection of the involved colon with primary reanastomosis. Histopathology showed a leiomyoma arising from the muscularis propria of the rectum wall. CONCLUSION: Retroperitoneal masses that extend into the pelvis may mimic adnexal masses and, therefore, represent a rare finding at gynecologic surgery.- - - - - - - - - - ranking = 0.1keywords = giant (Clic here for more details about this article) |
9/20. Giant hepatic metastasis from gastrointestinal stromal tumor of the rectum 12 years after surgery.gastrointestinal stromal tumors are non-epithelial neoplasms that arise from the gastrointestinal tract. Their variable cytologic atypia makes it difficult to predict their prognosis. We report a case of right hepatectomy for a giant metastasis detected 12 years after the surgical treatment of a rectal neoplasm, histologically demonstrated as a low-grade leiomyosarcoma initially, having morphological and immunohistochemical features of low malignancy. Histological examination of the hepatic metastases demonstrated that the tumors were composed of spindle cells similar to those in the rectal neoplasm. Immunohistochemical staining of the hepatic metastases with Ki-67 revealed stronger than the primary tumor. In conclusion, although histological and immunohistochemical analyses provide useful prognostic information, the prognosis of gastrointestinal stromal tumors is difficult to predict. Therefore, a patient with gastrointestinal stromal tumor diagnosed as low-grade malignancy requires carefully long-term follow-up.- - - - - - - - - - ranking = 0.1keywords = giant (Clic here for more details about this article) |
10/20. leiomyosarcoma of the rectum with sarcoid-like reaction--a case report.A 57 year-old man was admitted to the hospital because of bloody stools. A barium enema and coloscopy disclosed a tumor of the rectum. The resected tumor was diagnosed as a leiomyosarcoma, histologically. Many epithelioid granulomas with Langhans type giant cells were found in the tumor, and there was no evidence suggestive of generalized sarcoidosis, tuberculosis or mycosis. Thus, the epithelioid granulomas seen in the leiomyosarcoma were interpreted as a sarcoid-like reaction. As far as could be determined, there has been no reported case of a sarcoid-like reaction associated with a leiomyosarcoma. The occurrence of the sarcoid-like reaction in the present case could be due to the reaction to the metabolites or a degenerative substance of the leiomyosarcoma, or to host resistance to the tumor itself.- - - - - - - - - - ranking = 0.1keywords = giant (Clic here for more details about this article) |
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