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Peutz-Jeghers syndrome associated with adenocarcinoma of the cecum and focal carcinomas in hamartomatous polyps of the colon: a case report.

We report herein a case of Peutz-Jeghers syndrome associated with an adenocarcinoma of the cecum and four focal cancers arising in hamartomatous polyps of the colon. There were a total 27 polyps in the intestine; 4 in the small intestine and the rest in the large intestine. The hamartomatous polyps in which the 4 focal cancers were found showed no component of adenoma, and the other polyps removed from the colon and small intestine at the same time were all hamartomas with no evidence of dysplasia or malignancy. This case was rare in that multiple focal cancers may have arisen directly from the hamartomous polyps of the colon.

Adenocarcinoma↗

[Rectal polyps].

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Humans↗

[Diagnostic and therapeutic reflections on polyps and polyposis of the large intestine].

The systematic employment of pancolonoscopy in patients with diseases of the large intestine has shown that histological typing is essential when a polyp or polyposis is observed, since this is the only way prognosis can determined, and is only possible through endoscopic polypectomy. Familial investigation is also mandatory. If its findings are positive, every "polyp", irrespective of its number, site, and distribution, is a possible sign of polyposis. In this context, rectum preservation techniques are justified in relation to factors associated with both the polyp itself and its host.

Aged↗

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↗

[Potentialities of an x-ray method of determining malignant changes in polyps of the large intestine].

The study was concerned with evaluation of the clinical and roentgenologic data on 57 cases of malignant polyps of the colon. Malignant polyps reaching 10 mm in length were found. Malignancies were identified using endoscopy and biopsy in 58.6% and X-ray examination--45.8%. Among the most effective methods of X-ray examination of the large bowel for cancer should be: high-voltage roentgenography employing incomplete barium enema, primary double contrast examination, direct blow-up and parietography. X-ray signs of malignant transformation of polyps are: persistent retention of barium, wavy and indistinct contours, irregular pattern, rapid growth of neoplasm, retraction of tumor base and disparity between polyp size and its pedicle length.

Colonic Polyps↗

[Endoscopic results of treating malignant polyps of the large intestine].

We present own material of 291 colonoscopic polypectomies performed between 1991 and 1996. In this group 15 (5.1%) polyps contained malignancy (14 adenocarcinoma, 1 lymphoma). Analysis of this material supported well known fact of higher malignant potential of large polyps and of adenoma villosum. In all but one cases of cancers located in polyps histological examination confirmed free margin of electro-resection. There were no local recurrences during follow-up lasting 2 month to 5.5 years. Patient with lymphoma malignum (large polyp over 4 cm in diameter) underwent typical chemotherapy and is now, one year after polypectomy disease-free. In this group colonoscopy is repeated every 3 months during first two years and every 6 months later. In cases of cancer-free margin of electro-ablation colonoscopic polypectomy seems adequate treatment of malignant large bowel polyps.

Adenocarcinoma↗

Perifollicular fibromatosis cutis with polyps of the colon--a cutaneo-intestinal syndrome sui generis.

In the present study, a peculiar fibromatosis cutis in two siblings has been reported the dermatosis being characterized by innumerable perifollicular fibromas on face, neck and trunk as well as multiple fibromata pendulantia. Since the father allegedly had skin lesions resembling those of his two affected children, an inherited condition is assumed for the disease manifesting itself rather late in age. In the female patient, several adenomatous colon polyps one being transformed into carcinoma were found. Since the association of distinct epithelial and mesenchymal tumours of the skin and the cranial bones with multiple colon polyps is typical for Gardner's syndrome, we have discussed in detail the possiblity of an unknown variant of it. On the other hand, most features of Gardner's syndrome (cutaneous and subcutaneous epidermoid cysts, desmoid tumours, generalized osteomas, a marked multitude of colon polyps, early manifestation of skin and bone changes) were absent in both cases whereas, to our knowledge, in Gardner's syndrome perifollicular fibromas have never been seen. Since perifollicular fibromas are organoid tumours of the mesenchymal hair sheath being clearly defined both clinically and histologically, they must not be confused with the equally well characterized cutaneous tumours of Gardner's syndrome. We are prone to assume that the (irregular?) ASSOCAITION OF MULTIPLE PERIFOLLICULAR FIBROMAS AND COLON POLYPS Represents a distinct nosological entity neither identical with Gardner's syndrome nor with any other known dermo-intestinal syndrome. Thus, perifollicular fibromatosis should alert the dermatologist to consider periodic thorough examination for intestinal polyps the more as they may change into malignant growth.

Adult↗

Inflammatory fibroid polyps of the gastrointestinal tract: radiologic evaluation.

Inflammatory fibroid polyps (IFPs) are uncommon lesions of the gastrointestinal tract. Only scattered case reports have appeared in the radiology literature. The authors reviewed the cases of 33 patients (20 women and 13 men; average age, 45 years) to determine if these polyps had any distinctive diagnostic radiologic features. The IFPs were located in the stomach (n = 16), small bowel (n = 13), and colon (n = 4). The lesions originated in the submucosa and were composed of fibroblasts, inflammatory cells, and a network of blood vessels. Gastric IFPs were most often located in the antrum and were usually ulcerated. Most of the patients presented with clinical evidence of gastrointestinal blood loss. Small bowel polyps were usually located in the ileum, and patients were typically older women with intestinal obstruction due to intussusception. Most of the lesions appeared as large, intramural masses at radiologic examination. Some of the lesions were pedunculated, and all were solitary. There were no distinctive features to differentiate IFPs from other mural or intraluminal lesions of the gastrointestinal tract.

Colonic Neoplasms↗