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At least 757 records · Page 42Linked to original sources
PubMed2005

Colorectal cancer: what the clinician wants to know.

Colorectal cancer is a common and lethal disease. The adenoma-carcinoma sequence offers a window of opportunity in which the precursor lesion or early carcinoma can be removed endoscopically to prevent systemic disease. New and advanced techniques to improve endoscopic detection of precursor lesions are being developed. Other, less invasive screening methods are currently being developed and may become of use for population-based screening in the near future. Recently, important developments in the treatment (both surgical and chemotherapeutic) of colorectal cancer have occurred. The extent of the disease (stage) forms the basis for therapeutic decisions and accurate imaging is crucial.

Colonic Neoplasms↗
PubMed1994

Does acromegaly really predispose to an increased prevalence of gastrointestinal tumours?

OBJECTIVE: The few published prospective studies suggest a strong association of colonic tumours with acromegaly, but include small numbers of patients. In addition, the upper gastrointestinal tract of these patients has never been prospectively studied. The aim of the present study was to investigate the incidence of gastric and colonic tumours in a large cohort of acromegalic patients. DESIGN: Acromegalic patients consecutively admitted to an Endocrinology Department for diagnosis and follow-up, were submitted to gastroscopy and colonoscopy, to identify those harbouring gastrointestinal tumours. PATIENTS: Over a 5-year period, 54 out of 61 patients (78% with active disease) received colonoscopy and 42 out of 61 gastroscopy. No patient had a past history of gastrointestinal malignancy. MEASUREMENTS: All polypoid lesions found at colonoscopy and gastroscopy were separately recorded and biopsied. RESULTS: No case of gastrointestinal cancer or gastric polyp was discovered. Nineteen patients (35%) had 1-8 colonic polyps, including 5 (9.3%) with adenomas. When compared to patients with a normal colon, those with polyps were significantly older (44.5 +/- 14.2 vs 52.1 +/- 10.9 years, P = 0.047), but the duration of acromegaly (10.8 +/- 8.4 vs 10.9 +/- 7.1 years, P = 0.9) and the number of patients with active disease were similar in both groups. CONCLUSIONS: Acromegalic patients do not have an increased incidence of gastric tumours. The observed significant variation in the prevalence of colonic adenomas (9-35%, P = 0.03) and cancer (0-15%, P = 0.017), between our patients and those of the published prospective studies with similar demographic characteristics, suggest that environmental and hereditary factors may be more important than the presence of acromegaly.

Acromegaly↗
PubMed1998

Genetic alterations in a patient with Turcot's syndrome.

Turcot's syndrome (TS) is a rare disorder associated with the development of both brain and colon neoplasms. Because of the very low incidence of the disease, its molecular basis remains unclear. Presented is a TS case of a 30-year-old Japanese male with a histopathologically confirmed diagnosis of both brain tumor (glioblastoma multiforme) and colon tumor (well-differentiated adenocarcinoma). Germline mutations of the p53 gene, somatic mutations of the Ki-ras, p53 and APC genes, and microsatellite instability (MSI) was examined using polymerase chain reaction (PCR)-single strand conformation polymorphism analysis, followed by PCR-direct sequencing, and sequencing after subcloning. No germline mutations of the p53 gene were found. Somatic mutations of Ki-ras and APC genes were found in the colon adenocarcinoma but not in the brain tumor. No somatic mutation of the p53 gene was present in either colon or brain tumors. Microsatellite instability of both colon and brain tumors was positive in two of four loci. These results indicate that the colon tumor of the TS patient carries the Ki-ras and APC gene mutations. The finding of MSI in both the brain and the colon tumors may support the hypothesis that alterations of DNA repair genes are involved in the tumor development of the TS patient.

Adenomatous Polyposis Coli↗
PubMed1989

Dysplastic and malignant areas in hyperplastic polyps of the large intestine.

The clinical and pathological findings in a patient with 3 adenocarcinomas of the colon, 16 pure hyperplastic polyps, 1 hyperplastic polyp with adenomatous elements and 1 hyperplastic polyp with malignant transformation to adenocarcinoma within an area of adenomatous dysplasia are described. The possibility of neoplastic transformation of hyperplastic polyps is discussed.

Adenocarcinoma↗
PubMed1990

[Stomach cancer metastasizing into a solitary adenomatous colonic polyp].

A 69-year-old man with known diffuse type gastric stump carcinoma was found at autopsy to have widely disseminated metastasis of this cancer. Metastasis also occurred in the adenomatous polyp of the cecum. This is the third report, to our knowledge, in the literature and the first Hungarian publication of a metastasis to an adenomatous polyp of the colon.

Adenocarcinoma↗
PubMed1993

Laparoscopically assisted subtotal colectomy.

A technique for laparoscopic total resection of the colon performed in six patients is reported. The diseased colon was separated from the mesocolon and the greater omentum by electrocoagulation and sharp dissection. The mesenteric vessels were divided using an Endo GIA stapling device (AutoSuture, France). The whole colon was removed after transection of the rectum and extraction through a right minilaparotomy. A primary stapled end-to-side ileorectal anastomosis was performed through the anus under laparoscopic guidance. This technique can be applied to cases involving a variety of benign lesions of the entire bowel or multifocal small malignant colonic neoplasms with a decrease in patient morbidity and shorter inpatient period.

Adult↗
PubMed1996

Mental retardation and colorectal disease: colonoscopic mass screening to determine whether the risk of adenomatous polyposis syndrome is increased in the mentally retarded.

Adenomatous polyposis syndrome (APS) is often associated with mental retardation, but whether there is a causal relationship between the two is unknown. This study was initiated to determine colorectal disease rates among mentally retarded subjects and whether they are at risk of developing colorectal cancer. Colonoscopic mass screenings were conducted to detect the presence of colonic neoplasms in 134 patients housed at an institution for the mentally retarded. The ages of these subjects ranged from 32 to 69 years (mean: 44 years) and their IQ scores ranged from 35 to 63. Screening presented no difficulties and the colonic regions up to the caecum were inspected in all patients. Polyps were found in 24 patients (17.9%), an abnormal fixation in two (1.5%), melanosis coli in two (1.5%) and haemorrhoids in two (1.5%). Thirteen subjects had a single polyp (54%), five had two polyps (21%), three had three polyps (12.5%) and three had four polyps (12.5%). Twenty one polyps were less than 5 mm in diameter, 14 were 5-9 mm and nine were 10 mm or larger. No cases of APS were detected during this mass screening programme. The mentally retarded patients in this study were not found to be at a high risk of developing either APS or colon cancer.

Adenomatous Polyposis Coli↗
PubMedDate not supplied

Colitis cystica profunda of the rectum: report of a case and review of the literature.

Colitis cystica profunda is a rare intestinal lesion. Because of its clinical expression (rectorrhagia, mucorrhea and abdominal pain) and the way it appears to current imaging techniques this disease presents features which can be associated with colon neoplasm. Its diagnosis has to be confirmed histologically, and its etiology remains unclear. The following is a case report of colitis cystica profunda recurring 20 years after a first episode in a white woman, who had had an anterior resection of the sigmoid colon and upper rectum to deal with a colitis cystica profunda-induced stenosis of the sigmoid colon and at 41 underwent the transanal removal of a polypoid lesion. A review of 20 cases in the literature showed that colitis cystica profunda has a predilection for the male and generally affects the medial and lower rectum and the sigmoid colon. The literature also confirmed the association with ulcerative rectocolitis, Crohn's disease and rectal prolapse. The type of treatment varies from surgical, medical, and endoscopic to no treatment at all.

Adult↗
PubMed1986

Early invasive carcinoma in colonic polyps. A review of the literature with emphasis on the assessment of the risk of metastasis.

The proper treatment of adenomatous colonic polyps containing small foci of invasive cancer is controversial because the metastatic potential of these lesions is not precisely known. This article critically reviews all known English language studies of this lesion. Before the introduction of colonoscopic polypectomy, the estimated incidence of metastasis from this lesion was 10.4% (based on 12 studies containing 347 polyps), with a confidence interval (95% level) of 7.4 to 14.1. The incidence of metastasis estimated from lesions removed via colonoscopic polypectomy was 10.1% (based on 13 studies containing 188 polyps), with a confidence interval of 5.9 to 14.8. Differences in the definitions of the involved lesions, study designs, and indications for resection cause problems with case selection bias and make comparison of studies difficult. These problems are discussed in detail. Most studies had broad confidence intervals for the estimated incidence of metastasis because of small sample size. The histopathologic criteria, as reflected in the literature, for considering polypectomy alone as adequate treatment for this lesion are summarized and discussed.

Carcinoma↗
PubMed1986

Do synchronous adenomas influence prognosis after radical surgery for colorectal carcinoma? A prospective study.

From 1978 to 1983, radical surgery for colorectal cancer was performed in 319 consecutive patients who were included in a prospective evaluation of perioperative and repeated postoperative colonoscopy with polypectomy. Synchronous adenomas were found and removed in 87 patients. The probability of survival without recurrent cancer and of not dying from local and/or distant spread was significantly higher (p less than 0.02) in patients with synchronous adenomas than in those without. This unexpected finding could only to a minor degree be explained by a greater prevalence of well differentiated cancers and fewer poorly differentiated cancers in patients with synchronous adenomas. Detailed analysis revealed only one other major difference between the two groups, namely a higher risk of adenomas developing during follow-up of patients with synchronous adenomas (p less than 0.001). The present results may be relevant to future prospective clinical studies in which perioperative and regular postoperative colonoscopy is included.

Aged↗
PubMed1986

The adenoma-carcinoma sequence of the colon and rectum.

Morphological and epidemiological arguments in favour of an adenoma-carcinoma concept of evolution in the development of colorectal cancers are presented. It is highly probable that most colorectal cancers arise in adenomas. Therefore detection and endoscopic removal of adenomas is a means of reducing the incidence of colorectal carcinomas.

Cell Transformation, Neoplastic↗
PubMed1994

A small pedunculated adenomatous polyp of the colon found to contain the focus of invasive carcinoma extending to the serosa: report of a case.

A small pedunculated polyp was detected among other polyps in the transverse colon of a 64-year-old man, the resected specimen of which showed an adenomatous polyp 1 cm in diameter, containing the foci of adenocarcinoma invading the submucosa, muscularis, and serosa. This case report stresses the importance of performing careful pathologic examination of resected specimens obtained from endoscopic polypectomy, even for small pedunculated colon polyps.

Adenocarcinoma↗
PubMed1988

Early malignant lesions of the colorectum at autopsy.

Examination of 1014 consecutive autopsies revealed four early malignant lesions, comprising: 1) a carcinoma in situ arising from a large (2.5 cm) pedunculated adenomatous polyp; 2) a carcinoma in situ arising from a small (0.8 cm) flat adenoma; 3) an early invasive carcinoma arising from a flat (2.5 cm) adenoma, and 4) an early invasive polypoid adenocarcinoma (0.7 cm) with no identifiable remnants of adenoma. The early malignant lesions encountered in this study reaffirm the importance of the adenoma-cancer sequence in the pathogenesis of colorectal cancers in man. The malignant potential of flat adenomas is emphasized. The occurrence of small carcinomas without evidence of adenomatous elements raises the possibility of de novo origin as an alternative pathway. In the present study, one of four early colorectal cancers may have a de novo origin.

Adenocarcinoma↗