1/7. adenocarcinoma of the colon developing on the basis of Crohn's disease in childhood.Colorectal carcinoma rarely affects children and has a dismal prognosis with 5-year survival rates as low as 2.5%-7% despite apparently radical surgery. Here we report the case of an adenocarcinoma of the sigmoid colon in a 15-year-old girl preceded by uncertain abdominal complaints of 5 years' duration. Pathological work-up revealed a tumour with lymph node metastases (pT3NI). Immunohistochemical evidence of p53 overexpression by the tumour cells raised the suspicion of an underlying li-fraumeni syndrome. In addition, there were aphthoid ulceration, fissuration of the non-tumorous mucosa, along with a mixed transmural infiltrate composed of macrophages, eosinophils, and non-typical giant cells, which were compatible with simultaneous Crohn's disease. Anamnestic data concerning the occurrence of idiopathic inflammatory bowel disease or colorectal carcinoma in the patient's relatives were non-contributory. The present results suggest a possible relationship between Crohn's disease and colon cancer due to the defective p53 gene product.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/7. Ulcerative disease of the colon proximal to partially obstructive lesions: report of two cases and review of the literature.Carcinoma complicating idiopathic ulcerative colitis is well known. Conversely, acute colitis complicating obstructing carcinomas and other partially obstructing lesions of the colon has not been recognized until recently. The present study reports two cases of colitis secondary to obstruction: 1) a giant ulcer with colitis proximal to partially obstruction diverticulitis of the sigmoid colon, and 2) colitis proximal to obstructing carcinoma of the sigmoid colon. The purpose of this report is to document these cases and review the literature on this variety of colitis to facilitate its recognition and subsequent correct treatment. An unawareness of this entity prejudices the anastomosis and results in anastomotic complications (approximately 25 per cent), with significant morbidity and mortality.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/7. Giant mesenteric lymphoid tumor (Castleman's lymphoma) - a case report.An autopsy case of a giant mesenteric lymphoid tumor in a 57-year-old female was examined anatomo-biologically. A 17X15X6 cm3-sized pinkish gray-coloured medullary tumor occupying the mesenterium with no evident capsule, invaded the small intestine and pancrease head. Histologically, it was a lymphoid tissue consisting of hyalinized angiofollicular architecture having epithelioid cells and tingible body macrophages in the follicles. Some small-sized follicles showed typical Hassalloid architecture and other follicles consisted of monotonous growth of lymphocytes without a mantle zone, some of them fusing with each other. The histopathological appearance of the tumor was that of Castleman's lymphoma and of hyaline-vascular type of Keller's classification. There was another 0.6X0.5X0.5 cm3-sized tumor having an angiofollicular architecture in the subserosa of the sigmoid colon. The present case was complicated with vertebral caries, hypogammaglobulinemia (1.2%), eosinophilia (50%) and panbronchobronchiolitis, the last one being responsible for her death.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
4/7. Laparoscopic-assisted resection of giant sigmoid lipoma under colonoscopic guidance.Colonic lipomata are rare and mostly asymptomatic lesions; but as they become larger they may produce abdominal pain, constipation, diarrhea, hemorrhage, and intussusception. We report the case of a 75-year-old man who suffered from nonspecific recurrent abdominal pain in the left upper and lower quadrants and had variable episodes of diarrhea and constipation of 4 weeks' duration. During colonoscopy, a giant intraluminal polyp was diagnosed at 35 cm. Abdominal helical computed tomography (CT) revealed a constipating colonic tumor with a diameter of >or=50 mm and density values equal to fat. During laparoscopic surgery in the lithotomy position, the sigmoid and the descending colon were mobilized using a Harmonic scalpel. The origin of the polyp was localized precisely under colonoscopic guidance. The former 12-mm incision in the left lower quadrant was expanded to approximately 70 mm for extracorporal tumor resection. The left and sigmoid colon resections were carried out, and the polyp was removed by full-wall excision. After closure with a single-layer suture, the colon was pushed back into the peritoneal cavity. The patient had an uneventful recovery and was discharged 10 days postoperatively. histology confirmed a benign lipoma of the descending colon. Laparoscopic-assisted resection under endoscopic guidance proved to be suitable for the removal of large colonic polyps without complications.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
5/7. Massive intestinal hemorrhage resulting from a polypoid tumor in the sigmoid colon: an unusual complication of a giant cell tumor of the fifth lumbar vertebra.STUDY DESIGN: Clinicopathologic study of a case of giant cell tumor of the spine. SUMMARY OF BACKGROUND DATA: giant cell tumors of the spine are uncommon, accounting for 1.3-6.5% of all cases in various series. Because of their location, they may cause neurologic deficits. The treatment consists of excision or curettage and has been claimed to give good results. methods: A 33-year-old woman presented with low back pain in 1995; radiologic investigation and biopsy showed features of giant cell tumor involving the fifth lumbar and first sacral vertebrae. Wide excision was performed, but the tumor recurred in 1996 and was curetted. She developed massive intestinal bleeding in 1997 resulting from infiltration of the sigmoid colon by giant cell tumor in the form of a polypoid intraluminal mass. The involved segment of colon was resected, and the patient remained alive, although debilitated, 7 years after initial presentation. RESULTS: Examination of the tumor in the spine and the colon showed typical histology of giant cell tumor with no evidence of malignant transformation. The involved colon was freely mobile and away from the tumor of the spine. CONCLUSION: Giant cell tumor of the spine can result in unusual complication, massive intestinal hemorrhage in our case, which causes considerable morbidity.- - - - - - - - - - ranking = 8keywords = giant (Clic here for more details about this article) |
6/7. Giant localized pseudopolyp of the colon without colonic inflammatory disease--case report.Case report of a 64-year-old man with a large localized inflammatory lesion of the colon. The clinical presentation of this rare tumourlike lesion, which can be considered as a giant pseudopolyp of the colon, mimicks malignancy. In contrast to the reports in literature, no association with ulcerative colitis or Crohn's disease could be demonstrated.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
7/7. Penetrating duodenal ulcer associated with an operatively implanted arterial chemotherapy infusion catheter.A 65-yr-old man with hepatic metastases from adenocarcinoma of the colon treated with hepatic arterial infusion of 5-fluoro-2'-deoxyuridine and radiation therapy, presented with major gastrointestinal bleeding from an endoscopically documented giant duodenal ulcer with a portion of the hepatic arterial catheter visible in the ulcer crater. A penetrating giant duodenal ulcer was confirmed during an operative procedure. This patient with giant duodenal ulcer penetration associated with an operatively implanted arterial infusion catheter represents an unusual complication of this form of chemotherapy for hepatic tumors.- - - - - - - - - - ranking = 3keywords = giant (Clic here for more details about this article) |