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PubMedDate not supplied

Case report of schwannoma of the rectum--clinical and pathological contribution.

The case of benign schwannoma of the rectum primarily misdiagnosed as myogenic (neurogenic?) sarcoma is presented. A large tumor of 8 cm in diameter of the anterior rectal wall was removed with wide margins and an artificial anus was constructed. During 12 years of follow-up neither local recurrence nor distant metastases were observed. The patient is still alive and free of the disease. For that reason a surgery specimen of the tumor was pathologically reanalyzed and it showed features of type Antoni A and B tissues. These findings, together with strong reactivity for S-100 protein, Vimentin and negative for Actin supported the diagnosis of benign schwannoma. Because the localization of the tumor in the rectum is extremely rare, clinical and pathological features are presented and discussed.

Actins↗
PubMed2001

Adenocarcinoma of rectum metastasizing to penis.

An elderly gentleman with adenocarcinoma of the rectum who had abdominoperineal resection presented with scrotal skin and penile metastasis. Adenocarcinoma of the rectum metastasizing to the groin and penis is very rare and few cases have been reported.

Adenocarcinoma↗
PubMed1975

Some immunologic characteristics of carcinoma of the colon and rectum.

The leukocyte migration inhibition assay was used to asses in vitro cell mediated immunity in patients with surgically staged carcinoma of colon and rectum. Tumor cells and extracts were used in both the autologous and the homologous systems. The study was doubly controlled by the use of leukocytes from normal healthy volunteers and by autologous intestinal mucosa cells and extracts. The results revealed that the leukocytes of patients were significantly sensitized to autologous tumor cells but not to homologous tumor cells or extracts when compared with the leukocytes of normal healthy volunteers. Leukocytes of patients tested with autologous tumors or mucosa showed that only those of patients with Dukes C classification were significantly sensitized to their tumors. These results would suggest that patients with Dukes C classification were highly sensitized to their tumors and that carcinomas of the colon and rectum are heterogenous tumors.

Adenocarcinoma↗
PubMed1999

[Repair of vagina with segment of vascularized ileal graft following pelvic exenteration for carcinoma of rectum].

OBJECTIVE: To introduce a method to repair the vagina following pelvic exenteration for carcinoma of rectum in which the posterior wall of the vagina and cervix of the uterus were often involved. METHODS: From 1990 to 1997 segment of the vascularized ileum was used to repair the vagina in 5 cases, and in 2 of which the whole vagina was repaired while in the other 3 cases only the posterior wall of the vagina was repaired. RESULTS: All of the patients had successful results after operation repair. CONCLUSION: Vascularized graft was an ideal material for the repair of vagina defect following pelvic exenteration for carcinoma of rectum, because this material was easily accessible, and its vascular pedicle was long enough for its transferring to the perineal region and the ileum had good blood supply which made healing easy. The vagina following repair had a thick posterior wall, good elasticity and very little scar tissue surrounded.

Adult↗
PubMed1975

Long-term results in rectum carcinoma. Patients followed up during the period 1959-1968.

During the period 1959 to 1968, a total of 158 patients with carcinoma of the rectum were treated at the surgical department of the Oncological Institute in Bratislava. All these patients were retro spectively classified according to the TNM system into four clinical stages as follows: Stage I -- 26 (16.46%). Stage II -- 12 (7.59%), Stage III -- 61 (36.61%) and Stage IV -- 59 (53.39%) of the patient. Surgical treatment was supplemented with irradiation in 85 (53.73%) of the patients with chemotherapy in 15 (9.49%). All the findings were verified histologically. Favorable results as regards the 5-year survival rate in accordance with literature data were achieved in the early stages of the affection, while in advanced stages this survival rate was rather low, the majority of the patients died in the first and second year following initiation of treatment. The authors express the view that in future, oncologists will have to devote more attention to an early diagnosis and treatment of precanceroses, and this not solely in patients with a carcinoma of the rectum, but also in its other localizations.

Adult↗
PubMed2000

[The expression of cell adhesion molecules on lymphatic endothelial cells in rectum adenocarcinoma of human].

This study was conducted to explore the mechanism of lymphatic dissemination and metastasis of cancer cells; the specific aim was to investigate the expression of cells adhesion molecules on lymphatic endothelial cells. Immunohistochemical method was used. The rectum tissues and lymphnodes were taken from five normal human subjects. The cancer peripheral tissues and lymphnodes, and the metastasized lymphnodes were taken from eight patients with rectum adenocarcinoma. The result showed that the intercellular adhesion molecule-1 (ICAM-1) and carcinoma embryonic antigen (CEA) were expressed on lymphatic endothelial cells in cancer peripheral tissues and metastasized lymphnode. The expression of ICAM-1 and CEA in cancer peripheral tissues and lymphnodes was much more remarkable than that in metastasized lymphnodes. These data suggest that ICAM-1 and CEA be cell adhesion molecules between cancer cells and lymphatic endothelial cells.

Adenocarcinoma↗
PubMed2003

Oxaliplatin: a new drug for the treatment of metastatic carcinoma of the colon or rectum.

Oxaliplatin is a useful agent in combination with 5-fluorouracil/leucovorin for the treatment of patients with metastatic carcinoma of the colon or rectum whose disease has recurred or progressed during or within 6 months of completion of first-line therapy (a combination of bolus 5-fluorouracil/leucovorin and irinotecan). Oxaliplatin works by disrupting DNA replication and transcription and is cell-cycle nonspecific. In vitro, oxaliplatin has shown activity against numerous tumor lines, but it has only been approved for the treatment of metastatic carcinoma of the colon or rectum.

Antineoplastic Agents↗
PubMedDate not supplied

Cavernous haemangioma of the rectum: an uncommon cause of rectal bleeding.

Cavernous haemangioma of the rectum is an uncommon cause of rectal bleeding. Initial diagnosis is often elusive because of lack of awareness. For accurate diagnosis, investigations such as endoscopy, plain X-ray of the abdomen, barium enema and selective angiography of the inferior mesenteric artery are required. Complete surgical excision of the haemangioma and colo-anal sleeve anastomosis is the most favoured operative procedure to eradicate the disease. We report a case of cavernous haemangioma of the rectum and discuss its salient clinical features, investigations and management.

Adolescent↗
PubMed1992

[Defecography and manometry in the postoperative follow-up of patients treated with colo-anal anastomosis by the Parks technique for neoplasm stenosis of the rectum].

The Authors report 15 cases of patients with adenocarcinoma of the rectum who were treated using Park's resection. Morphofunctional parameters are evaluated 3 months after surgery using defecography and manometry before the closure of the neostoma and the reactivation of the ano-rectal canal. Opaque defecography enables the morphology and dimensions of the anal canal to be examined together with modifications to the area between the rectum and the anal canal, and the impression of the pubo-rectal sling. In conclusion these data confirm the importance of surgery, whereas the correlation between defecographic and manometric results allows the functional recovery "ad integrum" of the area to be checked.

Adenocarcinoma↗
PubMedDate not supplied

Cancer of the rectum: comparison of two different surgical approaches.

Surgical treatment of rectal cancer is still controversial as regards the type of operation and the extent of lymphadenectomy. Four hundred and fifty-eight patients with rectal cancer operated on at two different hospitals (206 patients, Surgical Department, S. Martino General Hospital and 252 patients, Surgical Department, Galliera General Hospital) in the decade 1980-1989 were studied. None of the patients were submitted to adjuvant or neoadjuvant therapy. The operations opted for were anterior resection for carcinoma of the upper rectum, anterior resection or abdominoperineal resection for carcinoma of the middle rectum, and abdominoperineal resection for lower rectal cancer. At the S. Martino General Hospital, anterior resection comprised ligation of the inferior mesenteric artery at its origin, with subsequent preaortic lymphadenectomy. In abdominoperineal resection, the pelvis was left open and was closed later. At the Galliera General Hospital, preaortic lymph node dissection was not performed, and abdominoperineal resection comprised a one-stage pelvic floor closure. Survival was no different in the two patient populations. Extended lymphadenectomy was of no benefit in terms of survival in operated rectal cancer patients. Abdominoperineal resection may still be useful for selected patients.

Actuarial Analysis↗
PubMedDate not supplied

Massive rectal bleeding from a Dieulafoy's ulcer of the rectum.

Massive per rectal bleeding caused by a Dieulafoy's ulcer located within the rectum is extremely rare. We herein report such a case occurring in a 76-year-old male patient with a history of chronic renal failure, who presented with massive fresh bleeding in the rectum. He was diagnosed during an endoscopic inspection and was promptly treated by clipping at the same time. Although this is a rare entity, Dieulafoy's ulcer should therefore be taken into consideration in the differential diagnosis of patients presenting with massive lower gastrointestinal bleeding.

Aged↗
PubMedDate not supplied

Neoadjuvant chemo-irradiation in un-resectable carcinoma of rectum.

BACKGROUND: Rectal cancer is one of the most frequent gastrointestinal cancers. Conventionally surgery is the mainstay of treatment, however after surgery alone, local recurrence is high especially in locally advanced rectal cancer, i.e. tethered and fixed rectal cancer. This study was conducted to determine the role of neo-adjuvant (pre-operative) chemoirradiation in locally advanced carcinoma of the rectum to improve resectability, local control and survival. METHODS: Study was conducted in Radiation Oncology department of Shaukat Khanum Memorial Cancer Hospital and Research Center from May 97-Oct 99. Thirteen patients with unresectable/locally advanced adenocarcinoma rectum received neo-adjuvant chemoirradiation, 50 Gray to pelvis by box technique on Cobalt-60 machine with concomitant 5-Flurouracil 500 mg/m2 for first three and last three days followed by abdomino-perineal/low anterior resection. RESULTS: Neo-adjuvant chemoirradiation resulted in resectability rate of 92% and clinical down staging in 11/13 (84%) patients and pathological complete response in 2/13 (15%) patients and a local recurrence rate of 2/13 (15.38%). Non hematological toxicity (diarrhea grade 4--15%, erythema grade 3--23%, dysuria grade 1-2--38%) were main problems observed during neo-adjuvant chemoirradition. CONCLUSION: Concomitant preoperative chemoirradiation for locally advanced rectal cancer is associated with considerable clinical and pathological down staging. Tumor resectability is improved with potential for improved local control and is relatively safe with acceptable morbidity.

Adenocarcinoma↗
PubMed2003

[Tactics and operative procedures in the management of complicated forms of malignant tumors of the left colon and rectum on emergency conditions].

Over the period 1996-2001, a total of 130 patients with complicated cancer of the left colon and 164 patients with complicated cancer of the rectum are subjected to treatment in the Clinic of Emergency Surgery at University Hospital "Queen Joanna", Sofia. Obturation is the commonest form of complication--136 patients (46.2%), followed by perforation either within the tumor or diastatic noted in 21 cases (7.1%), paratumor abscesses and infiltrates in 31 patients (10.5%) and rectohaemorrhage in 12 patients (4.0%). The optimal surgical approach to complicated forms of colorectal cancer of the left colon and rectum remains controversial especially when the patients underwent emergency surgery. Recently there has been a trend towards resection and anastomosis in selected patients. In each patient it's mandatory to make a precise and individual choice of the extend of the operative intervention, consistent with the patient's general condition and contributing to eliminate the life-endangering underlying cause. It must be realized by means of one-stage surgery when it's possible. Authors represent their personal experience with resolve of these actual problems.

Colonic Neoplasms↗
PubMed2004

Klippel-Trenaunay syndrome with involvement of coecum and rectum: a rare cause of lower gastrointestinal bleeding.

Klippel-Trenaunay syndrome (KTS) is a congenital malformation usually presenting limb asymmetry, abnormal development of the deep and superficial veins, and cutaneous capillary malformations. We describe the case of a 56-year-old male KTS patient who suffered from recurrent but life non-threatening lower gastrointestinal bleeding. Colonoscopy revealed multiple extensive cavernous hemangiomas in the coecum and the ascending colon as well as the sigmoid colon and the rectum. MR imaging showed numerous dilated vessels within the left gluteal and inguinal region. The mucosal and the submucosal layers particularly of the sigmoid colon and rectum appeared markedly broadened and displayed high signal intensities in the STIR sequences. Due to only moderate oozing at time of admission the patient was treated with oral iron supplementation so far.

Cecal Diseases↗
PubMed2004

[Recto-seminal fistula and cancer of the rectum].

The authors present a case of left epididymo-orchitis associated with rectal adenocarcinoma and suspected fistula between the left seminal vesicle and the rectum. This fistula was confirmed by pelvic computed tomography and surgical exploration. Treatment consisted of parenteral antibiotics and surgical drainage of the abscess associated with colorectal resection. This is an original case, as, retrospectively, the cancer of the rectum, diagnosed 4 days previously, was found to be responsible for the recto-seminal fistula and the seminal vesicle abscess.

Adenocarcinoma↗
PubMed2004

[Solitary ulcer of the rectum. Report of two cases treated by the Orr-Loygue technique].

We report two cases of solitary ulcer of the rectum treated by Orr Loygue rectopexy technique in a ten-year period at the Surgery Department of Aristide Le Dantec. The first case is about a 39 year-old female who was constipated since approximately seventeen years and had a rectal prolapse associated later to bloody stools. In 1990, she underwent haemorrhoids surgery operation with unsatisfactory results. After the recurrence of the disease, she was admitted at Aristide le Dantec Teaching Hospital, rectoscopy revealed a solitary ulcer. Orr Loygue rectoplexy technique was performed by laparotomy. In the follow up, there was no complication. The second case is about a 43 years old female who suffered from rectal syndrome since twenty years and had pelvis pains with bleeding and phlegmatic diarrhoeas. The physical examination and biologic analysis showed no particularity. Rectoscopy has revealed a solitary ulcer of the rectum which was confirmed by biopsy. Orr Loygue rectoplexy technique was performed. In the follow-up, there was a recurrence and this was confirmed by rectoscopy. The rectopexy alone does not summurize the therapeutic. A final dyskesia or an associated perineal insufficiency must be integrated in a total therapeutic strategy.

Adult↗
PubMed2005

[Modification of rehabilitation stage after inter-sphincter resection of the rectum].

Endoscopic ultrasonic examination for diagnosis of malignant tumors of a lower-ampullar part of the rectum determined indications to inter-sphincter resection consisting in total mesorectumectomy, resection of the rectum and internal sphincter. The method of creation of a globe-shape reservoir with artificial muscular sphincter was developed. Fourteen patients underwent surgery, the follow-up was up to 3,5 years. It is demonstrated that a globe-shape extensible reservoir and autonomic bloching function of muscular sphincter are the main conditions of repair of defecation functions in long-term period after inter-sphincter resection.

Anal Canal↗
PubMed1992

Leiomyosarcoma of the rectum.

Leiomyosarcoma of the rectum is a rare entity. Approximately 150 cases have been described in the literature. Differentiation from its benign counterpart, leiomyoma, and other connective-tissue tumors is often difficult, but it is important because each tumor has an entirely different prognosis. The case of a patient in whom an 11 x 5.5 cm leiomyosarcoma of the rectum was surgically excised by abdominoperineal resection is presented. Literature review shows disagreement over the therapeutic approach, most likely due to the lack of a large series of patients with this disease. At present, a selective treatment approach appears to be the most advocated. Lesions less than 2.5 cm in size and limited to the bowel wall can still be treated by wide local excision. More radical surgical resection is indicated for larger tumors and those extending outside the bowel wall.

Aged↗