1/100. 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 = cancer, neoplasm (Clic here for more details about this article) |
2/100. Mucinous adenocarcinoma in chronic anorectal fistula.adenocarcinoma in association with chronic anal fistula is a rare disease which gives rise to difficult problems of diagnosis and treatment. A case of mucinous adenocarcinoma arising on a long standing fistula in ano is described. A patient with a long history of mucinous discharge, pain and perianal induration underwent a biopsy of the external opening of the fistula that showed mucinous infiltrating adenocarcinoma. After a colonoscopy and a preoperative abdominal CT scan, she underwent a successful abdominoperineal resection with adjuvant chemoradiation therapy. diagnosis of this condition is often difficult; deep and multiple biopsies of the fistulous tracks or perianal mass are necessary to establish the diagnosis. An accurate staging of the neoplasm, using endorectal ultrasound, NMR or CT scans is needed to plan the appropriate treatment. Recent studies have shown that locally advanced anal adenocarcinomas could benefit from pre or postoperative chemoradiation therapy. However, an accurate and complete removal of the tumor, which usually entails abdominoperineal resection, is often necessary to achieve radicality. Despite new therapy protocols, the prognosis of mucinous adenocarcinoma is still poor, mostly due to its advanced nature at the time of diagnosis. This reinforces the importance of biopsy of all perianal abscesses and fistulas for early detection and treatment.- - - - - - - - - - ranking = 0.078904580474412keywords = neoplasm (Clic here for more details about this article) |
3/100. Photodynamic therapy for residual neoplasms of the perianal skin.PURPOSE: The aim of this study was to evaluate the efficacy of photodynamic therapy in the management of residual neoplasms of the perianal skin. methods: This is a retrospective review. Five patients with pathologic confirmation of residual perianal neoplasms were treated with photodynamic therapy. There were three females. The mean age was 52 (range, 33-79) years. pathology consisted of bowen's disease in two patients, squamous-cell carcinoma in two patients, and extramammary Paget's disease in one patient. Four patients received one photodynamic therapy treatment and one patient received two treatments three months apart. RESULTS: Treatment was followed by immediate perianal erythema, subsequent blister formation in 36 to 48 hours, and sloughing of the treated area in 72 hours. With a mean follow-up of 5.2 (range, 1-8) years, there were two recurrences. One recurrence was in a patient four years after treatment for Paget's disease, and the other was in a patient nine months after treatment for bowen's disease. The latter was managed successfully with wide local excision. Treatment-related toxicities included significant perianal pain in four patients, controlled with analgesia management. CONCLUSIONS: Photodynamic therapy can successfully be used after wide local excision for residual neoplasms of the perianal skin. Treatment can be rendered with acceptable morbidity.- - - - - - - - - - ranking = 0.55233206332088keywords = neoplasm (Clic here for more details about this article) |
4/100. Is Hartmann's procedure safe in Crohn's disease? Report of three cases.INTRODUCTION: Crohn's disease-associated colorectal cancer may occur in an area of defunctioning bowel. Some patients with Crohn's colitis undergo subtotal colectomy, ileostomy, and low Hartmann's procedure in an effort to preserve the rectum. This procedure has also been advocated for patients with severe anorectal Crohn's disease, in whom nonhealing of the perineal wound after proctectomy occurs with alarming frequency. The authors present a review of the literature and three cases of cancer developing in the defunctioning rectal stump despite surveillance proctoscopy. methods: Twenty-five patients underwent low Hartmann's procedure for severe anorectal Crohn's disease. Surveillance proctoscopy was performed as follow-up. Development of cancer in the rectal remnant or anus or recurrence of symptoms was managed by resection and adjuvant therapy. RESULTS: One patient developed squamous-cell carcinoma of the anal canal, underwent resection and adjuvant therapy, and was disease free at the time of this study. Two patients developed adenocarcinoma of the rectum. Both underwent resection and adjuvant therapy. One patient died and the other developed a recurrence. CONCLUSIONS: The authors recommend interval perineal proctectomy in all patients undergoing low Hartmann's procedure for severe anorectal Crohn's disease in whom rectal preservation is not possible. Regularly scheduled interim surveillance proctoscopy performed every two years, with biopsies of macroscopically normal-appearing and abnormal-appearing rectal mucosa and curetting of fistulous tracts, is also recommended to decrease the possibility of missing occult malignancies.- - - - - - - - - - ranking = 0.69082156464419keywords = cancer (Clic here for more details about this article) |
5/100. Anorectal melanoma: report of two cases.We have described the clinicopathologic findings in two cases of anorectal melanoma, and extracted the salient features from the medical literature. The disease is rare. melanoma arises from the anal squamous membrane and very often spreads upward through submucosal planes, producing secondary satelites in the rectum. Trauma from defecation, vast lymphatic and venous systems in the anorectal region, and high invasiveness of the tumor cells eviden;ly account for early distant metastases. Histologically, the neoplastic cells often mimic other cancers. Treatment is surgical, with dismal end results.- - - - - - - - - - ranking = 0.2302738548814keywords = cancer (Clic here for more details about this article) |
6/100. Extramammary Paget's disease.Extramammary Paget's disease (EMPD) is an uncommon but distinctive tumor. The lesion is defined as an intra-epidermal neoplasm. The lesion may be accompanied by an invasive adenocarcinoma or in situ adenocarcinoma of apocrine glands. Visceral carcinoma may also coexist or develop. Definitive diagnosis requires biopsy of the lesion and immunohistochemical staining. In most cases of noninvasive or minimally invasive EMPD, surgical resection with clear margins and careful follow-up are recommended, since the recurrence rate is high. We review the literature and report two cases of EMPD, one involving the perineal-scrotal area and the other involving the perianal area.- - - - - - - - - - ranking = 0.078904580474412keywords = neoplasm (Clic here for more details about this article) |
7/100. Chemoradiation therapy for squamous cell carcinoma of anal canal cancer: report of a case.We report a case of anal canal cancer in a 65-year-old woman who had complained of bloody stool. physical examination revealed a 2.5 cm ulcerated tumor in the anterior wall of the anal canal astride the dentate line. Histological examination of biopsy specimens confirmed the diagnosis of moderately differentiated squamous cell carcinoma. Chemoradiation therapy included whole pelvic irradiation amounting to 4140 cGy followed by conformal boost irradiation of 2000 cGy and 5-fluorouracil div 750 mg/24 hr 3 days, mitomycin C iv 10 mg day 1, and cisplatinum div 50 mg day 2. Six weeks later the tumor had completely regressed, and there was no evidence of recurrence 21 months later. Her anorectal function was retained.- - - - - - - - - - ranking = 1.151369274407keywords = cancer (Clic here for more details about this article) |
8/100. granular cell tumor--a unique neoplasm of the internal anal sphincter: report of a case.Granular cell tumors are rare, invariably benign, and often solitary tumors, which infrequently involve the gastrointestinal tract. We report the unique presentation of a granular cell tumor of the internal anal sphincter in a 75 year-old female. The tumor was detected during investigation of new rectal bleeding and was excised using a transanal approach and sphincter repair. At five-year follow-up the patient reported normal continence to stool and flatus and demonstrated no evidence of tumor recurrence. Immunohistochemical studies cite the Schwann neural cell as the origin of the granular cell tumor. Cytoplasmic features include acidophilic, p-aminosalicylic acid-positive, diastaseresistant granules. Granular cell tumors may be located anywhere in the body, but anorectal involvement is rare. In our own search of the world literature, no other cases were reported specifically to involve the anal sphincter. Granular cell tumors are usually detected incidentally but may be symptomatic, especially when the anorectal region is involved. Symptoms include perianal discomfort and bleeding. Adequate local excision is effective for both diagnosis and treatment of anorectal granular cell tumors. Careful follow-up should be performed after excision because of the risk of recurrence.- - - - - - - - - - ranking = 0.31561832189765keywords = neoplasm (Clic here for more details about this article) |
9/100. Verrucous carcinoma arising in hidradenitis suppurativa.There are many reported cases of squamous carcinoma complicating hidradenitis suppurativa, but only one previous mention of verrucous carcinoma in this setting. We describe a case of verrucous carcinoma arising in hidradenitis suppurativa of the anal margin in a non-immunosuppressed man. This is the second report of verrucous carcinoma arising in a lesion of hidradenitis suppurativa. Although hidradenitis suppurativa can involve multiple intertriginous sites, malignant degeneration occurs mostly in the anogenital region. This suggests a role for a regional factor which, when combined with chronic inflammation, predisposes to malignant degeneration. A likely candidate for this factor is human papillomavirus; our case showed histologic evidence for this, but the specimen did not show viral dna by polymerase chain reaction in situ hybridization. The ability of anogenital hidradenitis suppurativa to form squamous and verrucous cancers reinforces the argument for early and complete resection.- - - - - - - - - - ranking = 0.2302738548814keywords = cancer (Clic here for more details about this article) |
10/100. Invasive condylomatous vulvar carcinoma associated with multifocal low genital tract neoplasia. A case report.Squamous cell carcinoma is a morphologically heterogenous neoplasm of specific histologic entities involved in human papillomavirus infection. The condylomatous types of squamous cell vulvar carcinoma, caused by HPV-16, most often manifest as exophytic papillary tumors mimicking condylomas.- - - - - - - - - - ranking = 0.078904580474412keywords = neoplasm (Clic here for more details about this article) |
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