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At least 91 records · Page 5Linked to original sources
PubMed1976

Fecaloma simulating colonic neoplasm.

Large, discrete fecal masses in the colon may be confused with neoplasms, particularly if they are relatively immobile. The radiologic features of such masses generally permit their true identification.

Adult↗
PubMedDate not supplied

Rectosigmoid polyps as markers of proximal colonic neoplasms: a cost benefit analysis of different diagnostic protocols.

The predictive value of hyperplastic polyps of the rectosigmoid for neoplastic lesions in the proximal colon is controversial. Some authors who deny predictive value have proposed a protocol which entails initially biopsying rectosigmoid polyps, and only in the case of adenomas then proceeding to total colonoscopy (protocol 1). The diagnostic and economic efficiency of this protocol, and of an alternative which entailed the full exploration of the colon during the initial examination in the case of rectosigmoid polyps (protocol 2), were evaluated by retrospectively simulating their application to 216 patients who had undergone total colonoscopy. A proximal neoplastic pathology was present in 49.5% of patients with rectosigmoid adenoma, 27.3% of patients with distal non neoplastic polyps alone (33.3% if only distal hyperplastic polyps were considered) and 11% of patients with no distal polyps. Protocol 1 gave rise to a higher cost ($ 58,413), not only compared to protocol 2 ($ 50,276), but also compared to total colonoscopy in all patients ($ 57,008); there was also a larger number of patients who eluded diagnosis (29%, against 16% in protocol 2). In terms of cost per lesion detected and of colorectal cancers prevented (on the basis of an evolution to cancer of 5% of adenomas), total colonoscopy for all patients on principle is advantageous compared to either protocol ($ 864 per proximal lesion and $ 7,082 per cancer prevented). Since distal hyperplastic polyps are also predictive of proximal neoplastic pathology, when rectosigmoid polyps are detected it is both indicated and economic to proceed with the exploration of the entire colon during the initial examination. This appears to be a reasonable compromise compared to total colonoscopy on principle, which has higher overall costs. The latter management, however, should not be ruled out, since it has a better diagnostic yield and lower cost per lesion detected and per cancer prevented.

Adenoma↗
PubMedDate not supplied

Are right- and left-sided colon neoplasms distinct tumors?

Cancer of left and right colon has a differing prevalence at varying ages, in high- and low-incidence nations, as well as in men and in women. There also is a difference in clinical presentation, in prognosis, and possibly in genetic and environmental epidemiology. This review proposes that cancers of proximal and distal colon are different tumors because of their embryologic origin, genetic changes, and biologic identity. These factors are important in understanding the 'shift of tumors from more distal to more proximal sites in the colon' and in evaluating potential suggestions for instituting advances in diagnosis and prevention.

Animals↗
PubMed1991

[Fecal occult blood--does a hemoglobin-specific tests improve the diagnosis of relevant colonic neoplasms?].

The object of this study was to assess whether an immunological test specific for human hemoglobin improves the detection of bleeding from colorectal tumors as compared to a conventional guaiac test for occult fecal blood. We examined one stool sample from 134 patients prior to a complete colonoscopy by the Colo-Immun-Test (CI) as well as the Colo-Rectal-Test (CR). CI proved to have a higher sensitivity for occult bleeding from all colonic lesions, but this difference was not statistically significant. There was, however, no difference in the sensitivity of the two tests in detecting bleeding from relevant colonic neoplasms. In this study the immunological CI did not improve the detection of occult fecal blood loss due to adenomas and carcinomas of the colon in comparison with CR.

Colorectal Neoplasms↗
PubMed2004

Magnetic resonance colonography in the detection of colonic neoplasm in high-risk and average-risk individuals.

OBJECTIVES: Magnetic resonance colonography (MRC) is a new noninvasive diagnostic modality for colorectal cancer. However, the use of MRC in the detection of colorectal neoplasm in average-risk individuals remains unknown. This study determined the performance and the patient's preference of MRC in the detection of colorectal neoplasm. METHODS: Both high-risk (i.e., symptoms suggestive of colorectal neoplasm, positive fecal occult blood test, history of colorectal cancer in one or more first-degree relatives) and average-risk (i.e., asymptomatic individuals >50 yr) individuals were recruited. MRC was performed immediately prior to conventional colonoscopy (CC) by using air inflation without contrast. The finding on CC together with histology was used as a gold standard. Patients' pain and discomfort score were recorded immediately and 24 h after the procedure. They were also asked about their preferences for the two procedures. RESULTS: A total of 165 patients (79 average risk and 86 high risk) were recruited. Eight patients had incomplete MRC and one patient had failed CC. Of the remaining 156 patients, 4 were found to have colonic cancer and 31 were found to have 67 polyps. MRC correctly identified 3 cancers (sensitivity 75%, specificity 99.3%) and 4 patients with colonic polyps (sensitivity 12.9% and specificity 97.6%). Sensitivity of MRC tended to be lower in polyps <10 mm in size and in average-risk individuals. The mean procedure time of CC was significantly shorter than MRC (13.6 +/- 6.7 vs 20.6 +/- 2.7 min, p < 0.001). Although there was no significant difference in the pain and discomfort scores of the 2 procedures, 75% of patients preferred CC to MRC. CONCLUSIONS: The performance of MRC when used in the detection of colonic neoplasm in average-risk individuals is unsatisfactory.

Colon↗
PubMed1992

Rectosigmoid stent for obstructing colonic neoplasms.

Attempting proctoscopic placement of a rectosigmoid stent is proposed as a first step in treating obstructing rectosigmoid neoplasms. If stent placement is successful, elective colon resection can be performed following treatment of any coexisting medical problems that would complicate an emergency colon resection and after routine mechanical bowel preparation.

Aged↗
PubMed1975

Colonic neoplasms following ureterosigmoidostomy.

Attention is drawn to the occurrence of colonic tumors at the site of ureterosigmoidostomy. A case of carcinoma is described, the literature is reviewed and regular long-term followup is emphasized.

Adenocarcinoma↗
PubMed1990

Brush cytology in the diagnosis of colonic neoplasms.

During a three-year period (1986-1988), 234 colonic brush specimens were received in the authors' laboratory. Nine samples (4%) were deemed unsatisfactory for evaluation because of inadequate cellularity and/or poor fixation. In 11 cases concomitant or follow-up histologic specimens were not available. The remaining 214 specimens included 82 malignant neoplasms, 88 neoplastic polyps (adenomas), and 44 nonneoplastic lesions. Sixty-seven (82%) of malignant neoplasms were correctly diagnosed by brush cytology. Three cases of adenoma with severe dysplasia or in situ carcinoma were diagnosed as adenocarcinoma by cytology. No false-positive diagnoses were made of nonneoplastic lesions. Brush cytology was found to be a more sensitive technique in the diagnosis of colon cancer than endoscopic biopsy (82% and 74% sensitivity, respectively). The combination of the two techniques increased the sensitivity to 90% and improved the overall accuracy of the test. Seventy-one (82%) of the colonic adenomas were correctly diagnosed by cytology. Brush cytology is a convenient, safe, and accurate technique which should be used concurrently with endoscopic biopsy or polypectomy.

Adenoma↗