Cases reported "Colonic Neoplasms"

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1/85. External beam radiotherapy for pelvic node recurrence after curative resection of colon cancer: report of a case.

    The role of radiotherapy in locally advanced or recurrent colon cancer has not yet been determined. A 59-year-old man undergoing curative resection for advanced descending colon cancer had pelvic lymph node metastasis detected by computed tomography 5 months postoperatively. Intravenous chemotherapy using 5-fluorouracil and CDDP was repeated bimonthly for 7 months; however, his condition deteriorated progressively. External beam radiotherapy (50 Gy) was started thereafter. His serum carcinoembryonic antigen level decreased promptly and abdominal computed tomography showed apparent shrinkage of the metastatic pelvic node with calcification. The patient maintained a partial response for at least 12 months. radiotherapy has a more crucial role in the treatment of a subgroup of recurrent colorectal tumors.
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2/85. Mast cell sarcoma with tissue eosinophilia arising in the ascending colon.

    Mast cell sarcoma is a rare disease. We report an unusual case of this neoplasm arising in the ascending colon of a 32-year-old Japanese woman who presented with abdominal pain. An ulcerating mass in the colon was resected, along with enlarged mesenteric lymph nodes. Two years after surgery, the neoplasm recurred as left cervical lymphadenopathy and an intra-abdominal mass. Despite predonine and radiation therapy, the disease progressed, and the patient died. The tumor cells had abundant fine granular or clear cytoplasm, and oval, lobulated, or indented nuclei. Numerous mature eosinophils were intermingled with the tumor cells. Immunohistologic studies on paraffin sections demonstrated that the majority of the tumor cells were strongly positive for CD45RB, CD68, and mast cell tryptase. They were unreactive, however, with a broad spectrum of antibodies against myelomonocytic and lymphocytic antigens. The mast cell nature of this rare type of tumor can be best identifiable by immunostains for mast cell tryptase.
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3/85. Colonic adenocarcinoma metastatic to the thyroid gland: a case report with immunohistochemical investigation.

    Clinically evident metastases of carcinomas to the thyroid gland are rare, particularly from a colorectal primary tumor. We present a case of colonic adenocarcinoma metastatic to the thyroid gland with histopathologic and immunohistochemical findings. A 68-year-old woman with a history of Dukes' stage B colon carcinoma presented a mass in the thyroid gland. The tumor was confirmed to be metastatic adenocarcinoma from the colon. The immunohistochemical findings demonstrated positive staining for cytokeratin 20, low-molecular-weight cytokeratin, villin and carcinoembryonic antigen, but stains were negative for cytokeratin 7 and thyroglobulin.
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4/85. Carcinoma of the colon with synchronous hepatic metastasis in a cirrhotic liver harboring a hepatocellular carcinoma.

    Tumor metastasis to a cirrhotic liver is rare. It has been suggested that colorectal cancer does not metastasize to the cirrhotic liver. We reported a 65 year-old man, a known carrier of hepatitis b surface antigen, diagnosed to have hepatocellular carcinoma with routine screening. A partial hepatectomy with resection of segments VI and VII was performed. The hepatectomy specimen revealed a 4.5 cm diameter HCC in a cirrhotic liver. Incidentally, 0.8 cm diameter ulcer at the descending colon. Histological examination of the left hemicolectomy specimen showed a moderately differentiated adenocarcinoma.
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5/85. Schwannoma in the sigmoid colon: report of a case.

    Schwann cell tumor occurring in the intestines is rare. A 68-year-old female came to our hospital because of hematemesis. barium enema and colonoscopic examination revealed submucosal tumor in the sigmoid colon. Laboratory data showed mild anemia. No other abnormal finding was found in the blood chemistry. Tumor marker levels of carcinoembryonic antigen (CEA), CA19-9, alpha feto protein (AFP) and neuron specific enolase (NSE) were within normal limits. The exploratory laparotomy confirmed a large sigmoid colon tumor. She received sigmoid colectomy. The resected specimen was a submucosal tumor with central depression, measuring 4.7 x 3.5 x 3.0 cm in size. The cut surface of the tumor was yellowish hue with necrosis. Histological examination showed spindle-shaped tumor cells with palisading comma-shaped nuclei and the nuclear pleomorphism. Immunohistochemical examination revealed that the tumor was positive for S-100 protein staining, and negative for Actin and for H.H.F. staining. These findings showed that this tumor was of Schwann cell origin. We report here the case in detail of a schwannoma in the sigmoid colon.
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6/85. Follicular dendritic cell sarcoma of the colon mimicking stromal tumour.

    AIMS: Follicular dendritic cell tumours are very rare neoplasms that often occur in lymph nodes. We report here a case in the colon, a hitherto unreported site, in a 37-year-old female. The differentiation from gastrointestinal stromal tumour is emphasized. methods and RESULTS: The tumour was tan, elastic and solid with surface ulceration. Microscopically, it was composed of oval to spindle tumour cells with syncytial cytoplasm arranged in fascicular and whorled patterns. There were many infiltrating lymphocytes. The histological appearance resembled gastrointestinal stromal tumour, thymoma or meningioma. Distinct from the stromal tumour, the lymph node was also involved by the tumour. Immunohistochemically, the tumour cells were positive for CD21, CD35 and CD68, but negative for cytokeratin, CD34, smooth muscle actin, desmin, S100 protein, epithelial membrane antigen, leukocyte common antigen, HMB-45 and c-kit. In-situ hybridization study was negative for Epstein-Barr virus rna sequences. Ultrastructurally, the tumour cells possessed cytoplasmic processes joined by desmosomes. CONCLUSIONS: This entity should be considered in the list of differential diagnoses for gastrointestinal stromal tumour. The lymph node metastasis and immunohistochemical features are of value for identification of this rare neoplasm.
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7/85. Solitary pancreatic metastasis from a primary colonic tumor detected by PET scan: report of a case.

    PURPOSE: A case of a solitary pancreatic metastasis from a primary colonic carcinoma is reported. methods: The history and use of carcinoembryonic antigen, computed tomography, and positron emission tomography in this case and the follow-up of colorectal cancer are reviewed. RESULTS: Recurrent disease was suspected by an increasing carcinoembryonic antigen level. However, conventional imaging with computed tomography on more than one occasion failed to identify any recurrence. The pancreatic metastasis was accurately localized by positron emission tomography scanning and confirmed on subsequent laparotomy. A histologically complete resection was performed and the patient remained in remission with a normal carcinoembryonic antigen 12 months postoperatively. CONCLUSION: This case reports an unusual site of solitary metastasis in colorectal cancer and supports the further investigation of positron emission tomography in follow-up of colorectal cancer.
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8/85. Ki-1 anaplastic large-cell lymphoma occurring at the site of ileocolonic anastomosis in a patient treated surgically for colonic adenocarcinoma: case report and review of the literature.

    Systemic anaplastic large-cell lymphoma is an uncommon type of non-Hodgkin lymphoma characterized by strong expression of the Ki-1 (CD30) antigen. Gastrointestinal involvement typically is less common than in other types of non-Hodgkin's lymphoma. We report a case of CD30-positive anaplastic large-cell lymphoma occurring at the site of colonic anastomosis in an elderly patient who had been treated for colonic adenocarcinoma by right hemicolectomy 10 years previously. The lymphoma was a 2-cm mass composed of large, atypical cells infiltrating the mucosa, submucosa, and muscularis propria. Immunoperoxidase stain was strongly positive for Ki-1, and negative for LeuM1, L26, UCHL1, EMA, and cytokeratin. There have been numerous reports of unusual extranodal presentations of systemic anaplastic large-cell lymphoma; the only previously reported case involving the colon, however, occurred in the context of ulcerative colitis. Anastomotic recurrence is a relatively common complication of surgical therapy for adenocarcinoma, but the recurrent tumors are invariably adenocarcinomas. We are aware of no cases of lymphoma of any type occurring at the site of anastomosis after resection for adenocarcinoma.
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9/85. Invasive and metastasizing carcinoma in a small adenomatous polyp of the colon: report of a case with demonstration of a tumor associated antigen.

    An unusual case of metastasis to two lymph nodes from an adenocarcinoma arising in an adenomatous polyp of the sigmoid colon is presented. Invasion of the stalk could not be detected, but penetration of the muscularis mucosae was observed. Immunoperoxidase staining was used to detect an antigen in the invasive and metastatic components of the tumor that reacted with an antiserum to a tumor associated antigen. A focus of intraepithelial carcinoma was also detected by this method. The relevance of these findings to the adenoma-carcinoma sequence is discussed.
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10/85. Early colonic carcinoma with extensive lymph node metastases: case report and review of literature.

    An 81-year-old woman had an early carcinoma invading focally into the upper submucosa of the middle-transverse colon, which was accompanied by extensive lymph node metastases and resulted in a poor prognosis. Although her tumor was small and flat, a rim of pale yellow-speckled mucosa adjacent to the tumor enabled its earlier detection. To further study the exceptional lymph node metastases we studied the expression of intestinal trefoil factor and sialyl Tn antigen immunohistochemically on the resected specimen. Their simultaneous expression in lymph node metastasis further supports the aggressive nature of this tumor.
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