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At least 1,063 records · Page 59Linked to original sources
PubMed1992

[A case of endometrioid carcinoma arising from endometriosis of the rectum].

A very rare case with rectal endometriosis heterotopic transformed into carcinoma is reported. A 44-year-old female patient underwent colostomy due to ileus. Postoperative examinations revealed submucosal tumors all around the rectum. Low anterior resection and the closure of the colostomy were performed. Thickening in the muscular layer and serosa were observed in the resected specimen, but the mucosal surface was maintained. Histopathological observation revealed glands of the endometrium and connective fibers with glandular adenocarcinoma in the periphery. Transformation of the benign endometrial tissues into carcinoma and squamous metaplasia were observed. A diagnosis of endometrial carcinoma in the rectum was made.

Adenocarcinoma↗
PubMedDate not supplied

Leucocytoclastic vasculitis as a presentation of adenocarcinoma rectum.

Vasculitis has been linked to several processes, like infections, drugs and allergic, rheumatologic and neoplastic diseases. Neoplasm-associated vasculitis described in the medical literature has mostly been reported in association with haemotological neoplasms. Adenocarcinoma of rectum presenting as leucocytoclastic vasculitis is rare. We present a case of a 43-year-old male with paraneoplastic leucocytoclastic vasculitis preceding the manifestation of adenocarcinoma rectum. The vasculitis subsided on resection of the rectal malignancy and the patient did not require steroid therapy thereafter.

Adenocarcinoma↗
PubMedDate not supplied

Oncological outcome of ultra-low anterior resection with total mesorectal excision for carcinoma of the lower third of the rectum: Comparison of intrapelvic double-stapled anastomosis and transanal coloanal anastomosis.

BACKGROUND/AIMS: The purpose of this study was to determine whether the type of ultra-low anterior resection (intrapelvic double-stapled anastomosis or transanal hand-sewn coloanal anastomosis) with total mesorectal excision for primary adenocarcinoma of the lower third of the rectum affects survival and recurrence after curative surgery. METHODOLOGY: This retrospective study included 112 patients who underwent curative surgery achieved by ultra-low anterior resection in combination with either intrapelvic anastomosis using a double-stapling technique (DST group; n=82) or transanal hand-sewn coloanal anastomosis (CAA group; n=30). Univariate and corrected (multivariate regression) analyses were used to evaluate data. Median follow-up was 51.2 months for patients alive at the conclusion of this study. RESULTS: Disease-free and disease-specific survivals, and the frequency and location of recurrence after surgery did not differ between the two types of operations. Multivariate analyses showed that the type of operation was not a significant independent variable in predicting disease-free survival or in the development of both local and distant recurrences after surgery. Tumor-related factors (stage or histologic grade) were significant predictors of oncological outcome. CONCLUSIONS: The type of ultra-low anterior resection (DST or CAA) did not affect survival and recurrence after curative resection for carcinoma of the lower third of the rectum.

Adenocarcinoma↗
PubMed2005

Comparative study between preoperative and postoperative histologic grading in adenocarcinoma of the colon and rectum.

BACKGROUND: Preoperative histologic grading was used to decide the length of the margin of resection in adenocarcinoma of colon and rectum. OBJECTIVES: The aim of the present study was to determine the accuracy of preoperative histologic grading by comparison with postoperative histologic grading. MATERIAL AND METHOD: Preoperative and postoperative histologic grading of patients with adenocarcinoma of the colon and rectum in the department of surgery, Phramongkutklao Hospital between January 1999 and October 2004 were collected and compared together using percentage and chi-square test. RESULTS: 260 patients were included in the present study. 47.3% of all cases had inaccurate preoperative histologic grading. 43% of all cases had worse differentiation. 52.7% of all cases had the same differentiation. Only 4.3% of all cases had better differentiation. CONCLUSION: Preoperative histologic grading was not accurate and could not be used in deciding the length of the margin of resection.

Adenocarcinoma↗
PubMed2006

Mucinous carcinoma of the colon and rectum in Phramongkutklao Hospital.

OBJECTIVE: The objective of the present study was to compare the clinicopathological significance between mucinous carcinoma and nonmucinous adenocarcinoma. MATERIAL AND METHOD: Patients with carcinoma of the colon and rectum who had the first operation in the Department of Surgery, Phramongkutklao Hospital between 1999 and 2004 were included in the present study. Patients were divided into two groups: nonmucinous group and mucinous group. Clinicopathological data of these patients were recorded. RESULTS: Four hundred and nine patients were included in the present study. Forty four (10.7%) were mucinous carcinoma. There was no difference in sex distribution, location of tumors, depth of invasion, lymph node involvement, distant metastasis, TNM stage, lymphatic invasion, vascular invasion, perineural invasion, peritoneal seeding, curability, positive microscopic margin, and adhesion to the surrounding structure. CONCLUSION: Colorectal mucinous carcinoma had no clinicopathological difference from nonmucinous adenocarcinoma of colon and rectum.

Adenocarcinoma↗
PubMedDate not supplied

On the role of radiologists in the Belgian PROject on CAncer of the REctum, PROCARE.

Radiologists are involved at all stages of the treatment of patients with rectum cancer: in the preoperative staging, in the diagnosis of postoperative complications, in the detection of recurrent or metastatic disease during follow-up, in the monitoring of the therapeutic effect of palliative therapy. PROCARE is a Belgian national project to improve outcome in all patients with rectum cancer. Guidelines were made by a multidisciplinary workgroup and are available on the web. Decentralised implementation of guidelines is organised by the scientific and professional organisations. It is planned that a central review committee of radiologists, delegated by the Royal Belgian Society of Radiology, will survey the quality of preoperative staging. Overall quality of care will be assured by registration in a specific national database starting in 2006. Participating teams will receive annual feedback. Radiologists should provide data on cTNM staging and cCRM. Differentiation between cT2 and cT3, cN0 and cN+, and measurement of the cCRM in mm are crucial as they have a relevant impact on treatment strategy. While spiral abdominal CT is adequate for cM staging, high-resolution MRI is highly recommended and, in fact, a necessity for locoregional staging because its adequacy is superior to that of CT-scan and EUS. However, EUS is mandatory when local excision is considered, i.e. for cT1N0 lesions.

Belgium↗
PubMed2006

Squamous cell carcinoma of colon and rectum.

Primary squamous cell carcinoma SCC of the colon and rectum is a rare malignancy. Less than 100 cases have been reported in literature. We report 2 cases of pure SCC involving the rectum and sigmoid colon. A review of literature has been made starting from the first report in 1919 to the present. We have examined the theories regarding the etiology, available treatment modalities, and prognosis for this variant of colorectal carcinoma. We conclude that this tumor presents later than adenocarcinoma and follows an aggressive course. With a greater awareness among surgeons and pathologists, more cases may become known leading to a better estimation of prevalence and clinicopathological behavior of this tumor.

Adult↗
PubMed1990

[Radical and palliative combined surgery in the surgical treatment of cancer of the rectum].

Analysis of 186 combined resections and extirpations of the rectum for primary carcinoma, among which 31 were palliative operations, showed that the indications for them are limited with age from 21.7% in the young to 12.8% in patients over 60 years of age. Combined interventions were carried out irrespective of the site of the tumor in the rectum. Morphological verification of growth of the tumor into other organs in 32.3% of patients who had been operated on merely points to the expediency of a combined operation excluding ungrounded refusal of treatment. Combined operations failed to lead to an increase in postoperative mortality, which was 5.4%, and produce favourable late-term results--54.5 +/- 4.3% of patients have a survival period of 5 years.

Adult↗
PubMedDate not supplied

Hematochezia due to a renal cell carcinoma metastasis to the rectum: A case report and review of the literature.

While primary tumors of the GI tract are a frequent cause of gastrointestinal bleeding, metastatic lesions to the bowel uncommonly present with hematochezia, and rectal involvement is particularly rare. We describe the case of a 70-year-old man with an exceedingly late recurrence of renal cell carcinoma who presented with hematochezia due to a metastasis in the rectum. This is the first report to include both endoscopic and endoscopic ultrasound images of such a lesion. In the correct clinical setting, metastatic disease to the rectum should be included on the differential diagnosis of lower gastrointestinal bleeding.

Aged↗
PubMedDate not supplied

[Solitary ulcer of the rectum: a report of a clinical case associated with rectal prolapse].

Solitary ulcer of the rectum is an unusual condition occurring more often in young adults. Unfortunately the term is rather confusing, since the lesion may not necessarily be solitary, nor be confined to the rectum; moreover, it may be polypoid rather than ulcerating. The etiology is uncertain, but chronic constipation and fecal impaction could play a role. Today most authors believe solitary ulcer syndrome is a distinct clinical inflammatory manifestation associated with rectal prolapse. Surgical treatment of the prolapse is usually followed by a recovery of the solitary rectal ulcer.

Adult↗
PubMedDate not supplied

[Colonoscopic dilator: a new instrument in the management of benign stenosis of the colon and rectum].

Experience with a colonoscope with a distal segment that allows for the incorporation of dilating olives of the Eder Puestow type is presented. 15 patients with the diagnosis of benign stenosis of the colon or rectum who suffered of abdominal pain and constipation were treated. In 13 patients it was possible to eliminate the patients symptoms. There where no complications. The dilating colonoscope is a valid, alternative in the management of stenosis of the colon and rectum.

Colonic Diseases↗
PubMed1991

Intrathecal phenol rhizotomy for management of pain in recurrent unresectable carcinoma of the rectum.

The medical records of 11 patients with recurrent unresectable adenocarcinoma of the rectum who had intrathecal phenol block for the management of intractable pain were reviewed. There were seven patients with pelvic and four with combined pelvic and perineal recurrences. Five patients had sacral involvement by tumor. Six patients had received prior irradiation. Three patients had good, three had fair and five patients had poor results after phenol rhizotomy. Patients with good results had relief for a median of three months. The over-all survival rate after phenol injection was three months. Phenol rhizotomy is indicated for the relief of intractable pain secondary to recurrent unresectable carcinoma of the rectum in carefully selected patients.

Adenocarcinoma↗
PubMed1991

Massive rectal bleeding from a Dieulafoy's type ulcer of the rectum: a review of this unusual disease.

Dieulafoy's ulcer is an uncommon lesion that usually presents with massive bleeding. Although it has been observed, for the most part, in the stomach, it has also been identified in the small bowel and colon. Both endoscopy and angiography have been used for diagnosis; however, endoscopy has had a high failure rate for localizing colonic disease during active bleeding. Treatment has been primarily surgical, but endoscopic coagulation and sclerotherapy have been recently employed. A 20-year-old male presented with massive lower gastrointestinal bleeding, which was found to be caused by a Dieulafoy's ulcer in the rectum. Observation of Dieulafoy's ulcer in the rectum has not been reported previously. Diagnosis was by rigid sigmoidoscopy. This lesion was treated by widely oversewing the vessel after endoscopic therapy failed. The etiology of this lesion is most likely congenital. Hemorrhage probably occurs as a result of mechanical damage of the mucosa, combined with erosion of the vessel by fecal flow. Unlike colonic Dieulafoy's ulcers, it should be possible to diagnose rectal lesions by rigid sigmoidoscopy. This diagnosis may be difficult with high rectal ulcers, and angiography may have to be employed. Endoscopic therapy failed here, as in other reports on colonic disease. Thus, we would recommend widely oversewing rectal lesions as the primary treatment. Resection should be reserved for cases that have failed this therapy.

Adult↗
PubMed1991

[Sphincter-saving procedure of abdomino-peritoneal amputation? Surgical management of cancer of the lower two third of the rectum].

UNLABELLED: The authors report their results in surgical treatments of carcinoma localized in the low two thirds of the rectum done between 1980 and 1988. The number of patients was 150. Resectability: 119/150 = 79.33 per cent. Lethality: 4/119 = 3.3 per cent. Seventy three of the patients (61 per cent) had sphincter saving procedures and 46 of them (38.7 per cent) had abdominoperineal excision. Out of the 64 low anterior resection 2 patients (L: 2/64 = 3.1 per cent) and out of the 46 abdominoperineal excision also 2 patients (L: 2/46 = 4.5 per cent) were lost. In the sphincter saving group the distal clearance margin was decreased to below 3 cms at 29 patients without having local recurrence. CONCLUSION: in many cases of the carcinoma localized in the middle third of the rectum (at 82 per cent of our own patients) the sphincter can be saved without having more local recurrences. Decreasing the distal clearance margin to 2.5 cms does not increase the possibility of local recurrence if we do it cranially the same way as at Miles operation and remove the mesorectum caudally and laterally.

Anal Canal↗
PubMed1991

[Cancer of the rectum: distal intramural spread is correlated with lymph node involvement].

Cancers of the rectum are only rarely associated with distal intraparietal microscopic extension situated below the apparent pole of the tumour. When such extension exists, it may be either limited to several millimetres and is generally continuous with the tumour, or it may be extensive and composed of tumour lesions separated from the principal lesion by healthy tissue. On 119 rectal resection specimens for cancer, distal intraparietal extension was found to be significantly correlated with the degree and multiplicity of lymph node involvement. Tumours without distal intramural extension were associated with lymph node invasion in only 20% of cases and half of them were multiple involvements. In contrast, the frequency of lymph node invasion in cases of distal intramural extension was 80% with multiple node involvement in every case. In cases of distal intraparietal invasion, immuno-histochemical techniques demonstrated tumour emboli in the vessels and lymphatics. In cases of the rectum, lymph node invasion and its multiplicity are directly related to the presence of distal intraparietal invasion.

Adenocarcinoma↗
PubMedDate not supplied

Adjuvant therapy for patients with colon and rectum cancer.

The National Institutes of Health Consensus Development Conference on Adjuvant Therapy for Patients With Colon and Rectum Cancer brought together surgeons, medical oncologists, radiation oncologists, gastroenterologists, other health care providers, and the public to address the issues regarding adjuvant therapy for colon and rectum cancer. Following 1 1/2 days of presentations by experts and discussion by the audience, a consensus panel weighed the evidence and prepared a consensus statement. Among their findings, the panel recommended that patients with Stage III colon cancer should receive adjuvant therapy with 5-fluorouracil (5-FU) and levamisole. Specific adjuvant therapy is not recommended for Stage II colon cancer patients outside of clinical trials. For rectal cancer, the panel recommended that adjuvant therapy combining chemotherapy and radiation therapy improves local control and survival for Stage II and III patients. The most effective combination at present appears to be 5-FU, methyl-CCNU, and high-dose pelvic irradiation. However, the use of methyl-CCNU outside of clinical trials is discouraged because of documented toxicities. The panel concluded that patients with Stage I colon and rectal cancers are at low risk of recurrence and do not warrant adjuvant therapy. The panel also recommended that the American Joint Committee on Cancer system for classifying stages of colon and rectal cancer, known as the TNM system, become the standard measurement used in clinical trials and in clinical practice.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

[The prognostic value of Jass' histopathological classification of cancer of the left colon and rectum].

Histological material from 121 patients who underwent surgery for cancer of the left colon and rectum was reexamined by two pathologists according to criteria put forward in Jass' histopathological classification. A prevalence of Jass' grades II (36.4%) and III (47.9%) were observed in this series. There was no correlation between the site of neoplasia but there was a clearly increased incidence of advanced stages C and D according to Dukes-Kirklin's classification within Jass' grades II, III and IV (p less than 0.005) and growth pattern, but not for the configuration of tubules. The new histopathological model proved to be more reliable in prognostic terms in the case of cancer of the rectum compared to that of the left colon, but at present its clinical significance is limited to specifying the site and stage of the neoplasia. The latter was found to be the most reliable prognostic parameter.

Adenocarcinoma↗
PubMed1990

[Myelodysplastic syndrome (RAEB-T) occurring after adjuvant chemotherapy for colon and rectum cancers].

A 67-year-old man was admitted to our hospital because of bleeding tendency and high fever. The patient had a past history of gastrectomy and transverse colectomy for cancer of transverse colon at age 57, and rectum resection for rectum cancer at age 59. After these operations, Tegafur 645 g, MMC 56 mg, and Ara-C 560 mg were administered for about 6 years. Hematological examinations revealed hemoglobin of 7.7 g/dl, white cell count of 9,500/microliters with 8% myeloblasts, and platelet count of 7,000/microliters. A diagnosis of myelodysplastic syndrome (RAEB-T) was made from the finding of bone marrow smear, which showed 28% myeloblasts, and neutrophils and megakaryocytes with morphologically abnormal nuclei and cytoplasms. Chromosomal banding study of the bone marrow cells revealed -5, -8, 7q- in all analyzed cells. These findings suggest that the preceding adjuvant chemotherapy is probably related to the occurrence of myelodysplastic syndrome.

Aged↗