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PubMed1979

Carcinoma of colon after ureterocolic anastomosis: implantation on calyceal mucosa.

Two cases are reported of the development of mucoid adenocarcinoma of the colon in young patients, nineteen and thirty-four years after ureterocolic anastomosis for benign conditions. One patient showed implantation of the colonic neoplasm on the mucosa of an upper calyx in the obstructed kidney. Patients who have undergone ureterocolic anastomosis have a greatly increased risk of the development of large-bowel neoplasms. When suspected, radiologic examination of the colon using a water-soluble contrast material, together with rectosigmoidoscopy or colonoscopy, is essential. Because of the serious nature of this complication, it is suggested that the recent trend to return to the use of large bowel in urinary diversion may be hazardous, especially in the young patient with a benign disease.

Adenocarcinoma, Mucinous↗
PubMed1979

Colon and anorectal neoplasms in a tropical African population.

At the University College Hospital, Ibadan, Nigeria, over a 30-month period (January 1975 to June 1977) more than 29 cases were fully studied. Nine patients presented with acute large bowel obstruction. In five cases, colonic neoplasms were palpated abdominally before surgery, and four of the patients were initially being treated for "hemorrhoids". All the patients presented at late stages. There was neither socio-economic nor sexual bias in this affliction. Sixty-nine percent of all the tumors occurred in the anorectal area well within the reach of the index finger, and 27.5% occurred in the right colon. Differential diagnosis included ameboma, rectal schistosomiasis, rectal tubercolosis, anal fistula and adult chronic intermittent intussusception. The treatment administered depended on the nature, location and stage of the disease. There was a case of metastatic squamous cell carcinoma of the hepatic flexure causing obstruction. The metastasis was from carcinoma of the cervix which had been treated with cesium insertions about three years previously. It is now known that colon and anorectal neoplasms, once regarded as rare among Africans living in tropical Africa, is not that rare. With the Africans boycotting native "doctors" in favor of medical institutions, many of the diseases once thought to be rare in Africans will unfortunately become less rare.

Adenocarcinoma↗
PubMed1978

Dose response to intrarectal administration of N-methyl-N-nitrosourea and histopathologic evaluation of the effect of two retinoids on colon lesions induced in rats.

Male F344 rats, 8 weeks of age, were given 16 intrarectal administrations of N-methyl-N-nitrosourea (NMU) at one of three dose levels over a period of 8 weeks. Five days after the final NMU instillation, rats were placed on one of three diets: chow with gelatin beadlets, chow with beadlets containing 0.024% 13-cis-retinoic acid, or chow and beadlets with 0.006% of the trimethylmethoxy phenyl analog of retinoic acid ethylamide. Groups of 20-40 rats were killed at 22-26 weeks after the first carcinogen treatment. The number of rats with colon carcinoma and the number of tumors per rat were dose related. In addition, "blind" histopathologic evaluation of four predesignate colon locations revealed a dose-related incidence of microscopic preinvasive and invasive colon carcinomas. The feeding of diets containing these two retinoids did not significantly alter the incidence of these parameters of carcinogenesis or the mean histopathologic score at predesignated colon locations for preinvasive or invasive neoplastic lesions. Over 90% of the colon neoplasms induced were invasive tubulopapillary adenocarcinomas. The diameters of the tumors correlated significantly with degrees of invasion of the colons. Only 1 tumor (a signet ring carcinoma) metastasized to the peritoneal cavity. Only 2 of 300 rats treated with NMU had tumors at sites other than the colon.

Adenocarcinoma↗
PubMed1979

[Importance of the analysis of the carcinoembryonic antigen in clinical oncology].

330 patients (126 with gastric neoplasms, 204 with large bowel carcinoma) were submitted to serial assays to evaluate the possible relations between C.E.A. levels, pathologic stage and histologictype of the neoplasm and to define the usefulness of the C.E.A. test in monitoring the followup of the patients with gastrointestinal neoplasms. From our experience it ensues that C.E.A. test positivity (C.E.A. greater than or equal to 5 ng/ml, according to the method employed) is higher in colon neoplasms in comparison with gastric neoplasms, in the adenocarcinomas compared with the anaplastic forms. Besides, the study of the relationship with the pathologic stage points out the scanty usefulness of the C.E.A. test in the early diagnosis of gastroenteric neoplasms (Dukes A-B-C1 = 29.2%; CH stage = 88.1%). The use of C.E.A. test during the follow up seemed us of fundamental importance. We observed that: a) after radical surgery, 72% of the patients showed a normalization of C.E.A. values; b) there is a significant relationship between clinical course and C.E.A. as it can predict, sometimes several months earlier, the occurrence of relapses and metastases; c) there is also a close relationship (P less than 0.001) between the modifications of the antigen under chemotherapy and the clinical response. At present, C.E.A. seems to play, above all, fundamental role in choosing a correct treatment after radical surgery or in modifying the chemotherapeutic treatment in non surgical cases or in non radically resected patients.

Carcinoembryonic Antigen↗
PubMed1977

Association of Streptococcus bovis with carcinoma of the colon.

Two patients with colonic adenocarcinoma and Streptococcus bovis endocarditis suggested a possible association between the two. Non-enterococcal Group D streptococci were isolated from fecal cultures of 11 of 105 controls, 35 of 63 patients with carcinoma of the colon, seven of 25 with inflammatory bowel disease, four of 21 with non-colonic neoplasms and five of 37 with other gastrointestinal disorders. All such streptococci examined for lactose fermentation were S. bovis. The prevalence of S. bovis in fecal cultures from patients with carcinoma of the colon was significantly increased (P less than 0.001) as compared to that in controls, and also to all other groups (P less than 0.001). No other group had results significantly different from those of controls (P less than 0.05) although patients with inflammatory bowel disease were more frequently carriers. The carrier state was unrelated to age, hospitalization status, colonic stasis, gastrointestinal bleeding or recent barium-enema examination. The implications of this association are unknown.

Adenocarcinoma↗
PubMed1979

Colonic adenomas--a colonoscopy survey.

A colonoscopy survey of 620 patients with 1049 colon adenomas showed a predominantly left-sided distribution (77%). Of these lesions 97% were amenable to endoscopic removal or ablation. Sixty per cent of patients presented with rectal bleeding as their major symptom. There was agreement between radiology and colonoscopy in only 62% of patients, as many of the studies were single contrast barium enemas, performed before referral. Forty-eight per cent of adenomas in our series were less than 1.0 cm in diameter. Of the larger adenomas (greater than 2.0 cm in diameter) 66% were situated in the sigmoid colon, and of those containing invasive carcinoma (4.8% of the total) an even higher percentage (94%) were in the sigmoid and low descending colon. With increasing polyp size, there was a greater predominance of villous elements and this was associated with a higher risk of malignant change than the more frequent and generally smaller tubular adenoma. Local colonoscopic excision alone is sufficient treatment for adenomas with malignant change unless they are poorly differentiated histologically and providing adequate resection is demonstrated. Twenty-eight patients treated in this way are alive without recurrence at periods from six to 62 months. Although 65% of patients had only one adenoma, and 90% three or less, there is a risk of developing other benign and malignant colon neoplasms and careful follow-up is required.

Adenoma↗
PubMed1978

Progress in radiology: colorectal tumors: pathology and detection.

The prognosis in colorectal neoplasia has not improved in the past 20 years despite improved diagnostic techniques. The greatest promise lies in wider screening and earlier radiographic and endoscopic detection. To clarify the radiologist's role in finding large bowel tumors, the clinical, pathologic, and radiologic literature is reviewed. Since individuals over 40 years of age harbor the bulk of colon neoplasms, the most diligent efforts to detect these lesions should be made in this group. Controlled studies comparing single and double contrast barium enema techniques are lacking, but available data suggest that the double contrast examination is more sensitive for detection of the numerous small, but potentially malignant colon tumors. Careful radiographic technique, including a thoroughly clean colon, is critical for accurate detection regardless of which technique is used.

Adenoma↗
PubMed1978

Pathological features of the colonic tumours induced in rats by the administration of 1,2-dimethylhydrazine.

The parenteral administration of 1,2-dimethylhydrazine to rats caused the development of colonic neoplasms in about 90% of animals by 24--30 weeks of treatment. Usually there were multiple tumours with a mean of 2.7 per rat. The lesions have been classified histologically into adenomata (26% of all tumours) and carcinomata, the latter showing varying degrees of differentiation. No completely anaplastic tumours were seen, and there were none originating in connective tissue. The distributions of the different tumour types along the length of the colon varied. The more benign lesions were situated predominantly in the distal half of the colon, while the poorly differentiated adenocarcinomata were concentrated in the proximal third of the colon. There was good evidence to suggest that adenomata often progressed to frank malignancy in the distal colon. In the proximal part, however, it appeared that tumours frequently developed de novo as poorly differentiated carcinomata. Perhaps regional variations in the kinetic organisation of the normal colonic mucosa somehow influence the nature of the neoplastic change induced by DMH, thus accounting for the differences in tumor distribution. After 24 weeks of DMH treatment there was only a small increase in the mean number of tumours per rat.

Adenocarcinoma↗
PubMed1979

Colonic intussusception in uremia.

Colonic intussusception is a condition primarily found in infants and young children. In adults, it is usually associated with a colonic neoplasm. The following report illustrates a case of colonic intussusception in an adult uremic patient in whom postmortem examination showed evidence only of intramural colonic hemorrhage.

Adult↗
PubMed1975

[Bone metastases of colonic and rectal neoplasms. Apropos of 11 cases].

The authors report 11 personal cases and discuss the characteristics of bony metastases in carcinoma of the colon and rectum. The frequency of these metastases is fairly low (1.3% of all cases of bony metastases) as tumours of the large intestine do not tend to migrate to the bones. Sometimes bony metastases are the presenting symptom but, usually the metastases occur within 5 years of the diagnosis of the primary tumour. The clinical picture shows no special characteristics. Radiologically, these bony metastases may be either single or multiple. Their distribution recalls that of other metastases in the bones with a few differences, however. The special frequence of pelvic involvement, distal localisations (hands or feet) are not exceptional. Metastases usually give rise to osteolysis. The mixed appearances are, however, not rare, and usually give a pseudo-sarcomatous appearance, with invasion of the soft parts and very marked periosteal reaction. Sometimes, bony condensation may be noted. The treatment of rectal and colonic cancer with bony metastases, is disappointing as the disease is always fatal within a relatively short period, usually less than one year after the diagnosis of the bone involvement. The histological appearances of the bony lesions depend on differenciation of the tumour and the characteristics of the neighbouring bony abnormalities which, in our experience, usually include both osteolysis and osteogenesis.

Age Factors↗
PubMed1976

[Nitrosamin induced neoplasms of the colon and rectum. Investigations on the morphogenesis in rats (author's transl)].

The morphogenesis of neoplasms (carcinomas and pracecancerous polypoid lesions) induced by N-methyl-N-nitroso-N'-nitroguanidine (MNNG) was studied on 154 male Wistar rats (including controls), from which a group received a colostomy. Operated and non-operated rats were treated by intrarectal instillations of 2 mg per kg body weight MNNG twice a week during a period of 210 days.

Animals↗
PubMed1979

[Malignant neoplasms of the colon and rectum in the G.D.R. (author's transl)].

Data of the national cancer registry and the official death statistics are used to analyze the incidence and mortality of malignant neoplasms of the small intestine (ICD 152), the colon (ICD 153) and the rectum (ICD 154) in the German Democratic Republic. An apparent increase of age-adjusted incidence from 1956 to 1975 and of mortality from 1960 to 1970 can be explained by more complete reporting. A further increase of incidence from 1970 on is possible but not proved. There is no conclusive evidence that results of treatment have changed. An international comparison of incidence and mortality is difficult, since sources of information are not as reliable as generally assumed.

Colonic Neoplasms↗