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PubMed2002

[The diagnosis and treatment of 25 cases of laterally spreading tumor of the large intestine].

Laterally spreading tumor (LST) originates from the large intestine mucosa with prominent lesions that mainly extend laterally other than vertically. The pathological morphology and evolvement of this disease distinguish itself from other adenomas, and its close association with colorectal cancer has been noted. Up till now, no report on LST involving the large intestine has been available in China, therefore we presently report our experience in the diagnoses and treatment of 25 LST patients (26 lesions) identified with conventional endoscopy and mucosa staining during the period from Nov, 2000 to Oct, 2001. Among the 26 lesions, 11 were classified into granular homogeneous type, 15 into nodular mixed type, and 3 patients were found to have intramucosa carcinoma and 2 serrated adenoma. The biggest lesion was 60 mmx70 mm, the smallest being 11 mmx12 mm, and 6 lesions were within the range of 11 to 20 mm, 9 within 21 to 30 mm with the rest 11 lesions exceeding 31 mm in diameter. Type IV pit pattern was predominant in the the 26 lesions, accounting for a proportion of 61.54% (16/26). Two lesions with V(A) pit pattern and 1 with IV pattern were pathologically diagnosed to be intramucosa carcinoma, and 8 with type III(L) pit pattern were tubulovillous adenoma. Immediate or elective endoscopic mucosa resection or partitioned mucosa resection was performed in the 25 cases without incidences of the complications as bleeding or perforation.

Adult↗
PubMed2006

[Capsule endoscopy detection of metastasis of a malignant melanoma in the small intestine].

We report a case of a 74-year-old man with a Clark's level II, 2.5 mm melanoma on his back that was excised. A post-operative PET scan found no lesions. One and a half years later, the patient developed anaemia with blood in his stool. A gastroscopy and colonoscopy found no lesions. Video capsule endoscopy, however, detected a tumour in the small intestine. At laparotomy, the tumour was removed. Histological diagnosis showed metastatic malignant melanoma. We believe that video capsule endoscopy may increase the rate of diagnosis of small-bowel melanoma metastases.

Aged↗
PubMed1991

[Organ-preserving principle in the surgical treatment of primary multiple cancer of the large intestine].

This paper presents the analysis of 193 surgical cases of multifocal cancer of the colon. The choice of the radical surgery in synchronous tumors depended on the involved portions of the colon, distance between the lesions, cancer dissemination and general condition of the patient. Out of radical interventions, extensive colon resections (atypical and subtotal) made up 18% only (16 of 89 patients). In metachronous cancer, colon resection (n-67) was performed with due consideration of the second tumor site and lymph outflow from the affected zone (39 typical radical operations and 28 resections with removal of interintestinal anastomosis). Postoperative lethality in synchronous cancer reached 11.2%, in metachronous 10.4%, 5-year survival was 59.3% and 57.7%, respectively. The latter figures appeared only a little lower that in solitary colon cancer (63%).

Adult↗
PubMed1991

Adenocarcinoma of the small intestine in Crohn's disease.

Nineteen patients admitted to The Mount Sinai Hospital with Crohn's disease between 1960 and 1989 had 20 adenocarcinomas of the small intestine. Sixteen patients had regional enteritis and three, ileocolitis. There were 15 males and four females. Carcinomas occurred in association with fistulas (four patients), fistulous tracts (three patients), excluded bowel (five patients/six cancers) and multiple strictures (three patients). None of the patients in our study had cancer develop in the first decade of Crohn's disease, and 11 had carcinoma in the third decade. As cancers occurred in three patients with multiple strictures admitted for strictureplasty, we recommend that all strictures be widely opened and carefully examined prior to strictureplasty, with frozen section biopsies of all suspicious areas. The possibility of small intestinal Crohn's carcinoma should be suspected in patients with long-standing disease, with or without excluded bowel, who present with sudden change in symptoms, especially after a lengthy quiescent period. Cancer should also be considered in patients in whom complete obstruction fails to resolve with adequate decompression and in those with multiple strictures.

Adenocarcinoma↗
PubMed1990

[Adenoma of the large intestine].

In 89 patients 107 adenomectomies in the colon have been performed with pathohistological examination of the adenomas. Fiber coloscopy of the whole colon was performed to all patients, and the results give basis for discussion of the problems of adenomas: their frequency and localization in the different parts of the colon, the relative frequency of their pathologic stages. Most often adenomas were found in the sigma (41.79-50.00%). 67 (62.92%) of the 107 adenomas studied were tubular, 24 (22.43%) were tubulovillous and 16 (14.95%) were villous. The percentage of the villous adenomas found by the authors is somewhat higher than found by other authors. Pathologic stages were found more often in the adenomas localized in the sigma. Most of the adenomas were benign--77.5%. Adenomas with dysplasia were 12.15%, with focal cancer--7.48% and with invasive cancer--2.80% of all adenomas studied.

Adenoma↗
PubMed1990

[Intestinal metastasis of pulmonary cancers. Apropos of 2 cases].

We report 2 new cases of intestinal metastases from lung cancer. Such metastases are not exceptional, but their clinical manifestations are rare and their diagnosis during evaluation of lung cancer is difficult. This diagnosis could be suggested by the presence of iron deficiency anaemia or melena in a patient being investigated for lung cancer. Other metastases are often present, and the prognosis is fatal at short term.

Adult↗
PubMed1990

Malignant intestinal schwannoma. Case report.

Malignant schwannoma of the small intestine is rare and diagnosis often late. Histologic distinction from fibrosarcoma and leiomyosarcoma may require electron microscopy. The primary treatment is surgical. Close postoperative observation is recommended because of the tendency to recurrence. Remission after chemotherapy has been reported, but without controlled studies. The 5-year survival rate is unknown. Two cases are presented.

Aged↗
PubMed1989

[Crohn disease and carcinoma of the small intestine].

A case of cancer of the small bowel associated with Crohn's disease with onset 21 years after the first clinical signs of the latter is reported. The patient survived for 20 months after cancer diagnosis. After noting the rare association between the two conditions, the aetiopathogenetic relations that can be called on to explain relations of causality are analysed and it is emphasised that it is impossible to distinguish symptoms from those of cancer due to the renewed inflammatory activity. Finally it is considered that to clarify unequivocably the relations between the two conditions further studies are required.

Adenocarcinoma, Mucinous↗
PubMed1989

[Immunohistochemical and clinicopathological studies of chromogranin immunoreactive cells in large bowel carcinoma].

We examined the clinicopathological relevance of chromogranin immunoreactive cells in a well documented series of 212 large bowel cancer patients. Chromogranin immunoreactive cells were detected in 33.5% of the carcinomas, occurring either as rare cases (19.3%) or as diffuse cases (14.2%). The tumors with chromogranin immunoreactivity were associated with a more aggressive clinical course than tumors without immunoreactivity (Generalized-Wilcoxon; p less than 0.08). Moreover, the survival of patients with diffusely immunoreactive tumors was significantly shorter than that of patients without such cells (Generalized-Wilcoxon; p less than 0.009). Therefore, the study of chromogranin immunoreactivity in large bowel carcinomas may enable the identification of a subpopulation of colorectal carcinomas associated with a relatively poor prognosis.

Aged↗
PubMed1989

Biology of large bowel cancer.

The progression of large bowel cancer from the colon crypt cell involves a series of sequential stages of altered growth regulation. An increase in the proliferative compartment of the colonic crypt characterizes the earliest stage. This is followed by loss of normal maturation and gain of more autonomous growth. Ultimately, cells that acquire the capability to migrate and grow at a distant site appear as metastases. Clinical and pathologic observations have been used to identify these stages of large bowel cancer progression, but only with the recent application of molecular and biologic tools are we beginning to identify potential mechanisms responsible for the altered growth. The development of laboratory models that reflect the key clinical and pathologic stages of progression should prove particularly valuable in sorting out the biology of large bowel tumor progression. The challenge then will be to use this knowledge for the design of preventive and therapeutic strategies.

Animals↗