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PubMed2005

[Oral and maxillofacial manifestations of familial adenomatosis polyposis. Gardner's syndrome].

Patients suffering from familial adenomatosis polyposis develop multiple pre-malignant gastrointestinal polyps and are at high risk of developing colon cancer. In addition extra-intestinal manifestations are observed frequently. The combination of extra-intestinal manifestations and familial adenomatosis polyposis is named Gardner's syndrome. An early diagnosis of this disease is important because it could mean a better prognosis for the patient. This review describes the oral and maxillofacial symptoms of FAP, and its potential implications for dental treatment.

Abnormalities, Multiple↗
PubMedDate not supplied

[Adenomatous polyps in colon and rectum after cholecystectomy].

The frequency of rectal and colonic polyps was compared in 33 patients with history of cholecystectomy and 37 patients without it. The data were evaluated retrospectively from our medical bank records. We found a major incidence of adenomatous polyps in the group of patients with cholecystectomy, the same in females as in males, with a female prevalence in 2.7:1 ratio in contrast with the group without surgery, where the ratio was 1.5:1 with a male prevalence. We didn't find any association between cholecystectomy and colorectal cancer. All the patients with adenocarcinoma were in the group without cholecystectomy.

Adenocarcinoma↗
PubMed1989

[Recto-colic polyps in the child. Analysis of 183 cases].

Between January 1974 and April 1988, 1,533 colonoscopy were carried out in children less than 15 years old. Two hundred and seventy-four polyps were demonstrated in 183 children (106 boys, 77 girls, mean age: 6 years). The main symptom in most cases was rectal bleeding during defecation. A family history of polyps or digestive cancer was found in 6% of all patients. Two hundred and thirty-nine polyps were removed by endoscopic resection, 232 of them by the diathermic snare and 7 by William's hot biopsy technique. Histological examination of 129 polyps revealed a juvenile polyp in 125 cases, an hyperplastic polyp in 2 cases, a lymphoid polyp in 1 case and an adenoma in 1 case. No complications were observed except for one case each of hemorrhage and perforation following endoscopic polypectomy.

Adolescent↗
PubMedDate not supplied

[Myocardial infarction and rectocolonic polyps].

The prevalence of polyps in the rectum and sigmoid colon was estimated in 103 patients with recent myocardial infarction and 200 controls. All patients were asymptomatic and older than 35 years. A flexible proctosigmoidoscopy was performed. One or more adenomatous polyps were found in 19.6 p. 100 of patients with myocardial infarction and in 16.2 p. 100 of controls (difference not statistically significant). In males, the odds ratio for adenomatous polyps was 0.92 (confidence limits, 0.43-1.93). Acceptability of the flexible rectosigmoidoscopy was excellent in controls and poor in patients with myocardial infarction (1.0 p. 100 and 26.4 p. 100 of patients respectively refused this procedure). Tolerance, bowel preparation and the length of the explored rectosigmoid were not different. There was no statistically significant difference in the site, number or size of polyps. This study shows a high prevalence of polyps in patients with myocardial infarction and control groups although not statistically different. Consequently, a screening procedure for polyps is not indicated in patients with myocardial infarction.

Adult↗
PubMedDate not supplied

[Polyps of the colon and rectum in childhood. Practical importance of endoscopic examination].

The juvenile polyps are usually benign but there is the possibility of adenomatous degeneration. The authors recall their experience about colon endoscopy. Rectal bleeding was the first symptom that request endoscopy. 23 children were investigated. 10 of them presented with one or more polyps in their colon. All were juvenile polyps. In this article is suggested a diagnostic approach and a follow-up.

Child↗
PubMed1984

Rational management of malignant colon polyps based on long-term follow-up.

We reviewed the long-term results of management of 38 patients with carcinoma in colorectal polyps. Of these, 16 patients demonstrated malignant invasion of the lamina propria but not the muscularis mucosa (group I), and 22 patients showed malignant invasion of the muscularis mucosa (group II). Primary therapy for group I patients consisted of polypectomy in 12, local excision in one, and colonic resection in three. One patient had a subsequent abdominal-perineal resection and was found to have no residual disease and no lymph node involvement. Follow-up of the group I patients showed that 11 were alive and well (mean 5.8 years) and five died of unrelated causes (mean 5.2 years). Of group II patients, 12 underwent polypectomy, six local excision, and four colectomy. Of these 22 patients, 11 underwent further operation, including nine major bowel resections and two local re-excisions. None of these 11 patients had either residual tumor or lymph node metastases. One patient died of complications after abdominal-perineal resection. Follow-up showed that 18/22 group II patients were alive and well 5 to 15 years later (mean 7.5 years); four died of unrelated causes (mean 3.2 years). We then reviewed another group of 220 patients who had undergone resection for invasive colon cancer to relate the presence or absence of lymph node metastases to the depth of malignant invasion in the bowel wall. We found that 44% of this entire group had lymph node involvement. Of 36 patients with tumor confined to the bowel wall, nodal metastases occurred in only 22%. Of eight patients with malignancy superficial to the muscularis propria, only one had nodal involvement. We conclude that colon cancer tends to progress in an orderly fashion and the risk of nodal metastases increases with the depth of invasion. Carcinoma in a polyp represents a very early stage of colon cancer. We therefore recommend polypectomy as primary treatment for pedunculated polyps containing carcinoma either superficial to or invading muscularis mucosa. If histologic review demonstrates incomplete excision, lymphatic invasion, or poor differentiation, patients with lesions invading the muscularis mucosa should undergo formal colonic resection.

Adenocarcinoma↗
PubMed1984

Occult faecal blood loss determined by a 51Cr method and chemical tests in patients referred for colonoscopy.

In 67 patients referred for colonoscopy the faecal blood loss was determined by a 51Cr method and 7 chemical tests. For patients with negative colonoscopy (no. = 10), colorectal polyps (no. = 24), rectal cancer (no. = 8), or colonic cancer (no. = 12), the median 51Cr-determined faecal blood loss was 0.67, 0.74, 1.26, and 2.18 ml/24 h, respectively. For all chemical tests the results were highly influenced by the upper time limit for a positive reaction. Mixing of faecal specimens before testing proved unimportant. Fecatwin sensitive showed more positive tests in delayed compared with immediate analyses (p less than 0.01). Of cases of colorectal polyps, tetramethylbenzidine (TMB) tests including Hemo-Fec Test could detect half, the benzidine test 2 of 5. Fecatwin sensitive and Hemoccult II 1 of 4, and Fecatwin 1 of 24. Of cases of colorectal cancer, TMB tests, the benzidine test, Fecatwin sensitive, Hemoccult, and Fecatwin could detect about 85%, 85%, 85%, 80%, and 45%, respectively. All chemical tests detected faecal blood loss from colorectal lesions more easily than from gastric lesions.

Adult↗
PubMed1997

Consecutive maintenance of human solitary and hereditary colorectal polyps in SCID mice.

Recently, the sequential changes from adenoma to adenocarcinoma have been well studied in human colorectal carcinogenesis. To study the precise clonal changes from colorectal polyps to cancer, we have established an experimental system to maintain human colorectal polyps in severe combined immunodeficient (SCID) mice that have been improved by the selective inbreeding of C.B17-scid/scid homozygous male and female showing undetectable serum IgG and IgM (< 1 microgram/ml). Two of two solitary polyps from two nonhereditary colon polyp patients, four of five colon polyps from two Peutz-Jeghers' syndrome patients and one polypoid lesion from a familial polyposis coli (FAP) patient grew very slowly but steadily, at approximately one-tenth the rate of their malignant form, (i.e., adenocarcinoma), in the improved SCID mice and were maintained for a long period (more than 2 years), over several mouse generations. However, two polyps from FAP and Peutz-Jeghers' syndrome patients could not be transplanted further because of microinfection at the transplanted site due to incomplete sterilization of original human tumors prior to surgical operation (endoscopic polypectomy). Transplanted colon polyps had a semitransparent, soft and sticky appearance, with cells containing large amounts of mucin. Malignant transformation of human colon polyp to adenocarcinoma has not been observed during the maintenance period (about 2 years) in SCID mice. In the consecutively maintained human colon polyps, however, K-ras mutations were detected at codon 12, while these mutations were not found in their original polyps in the patients.

Adenomatous Polyposis Coli↗
PubMed1991

[Determination of cell nuclear DNA content in polyps and cancerous degeneration in the large intestine].

Nuclear DNA content was measured by microspectrophotometry in 40 biopsy specimens from patients with large bowel polyps (10 juvenile polyps and inflammatory polyps, 25 adenoma subdivided into 3 groups with 10 Grade I, 10 Grade II and 5 Grade III, 5 cancerous degeneration), and 5 normal epithelium of large intestine. The mean DNA value increased steadily as follows: normal epithelium of intestine (13.54 +/- 1.76 Au); juvenile polyps and inflammatory polyps (14.89 +/- 0.40 Au); adenoma Grade III (21.96 +/- 0.92 Au); cancerous degeneration (24.47 +/- 1.48 Au). The difference in DNA value in these groups was statistically significant (P less than 0.05-0.01). These results suggest that measurement of nuclear DNA content may serve as an objective quantitative parameter for diagnosis of large bowel carcinomatous change of polyps and classification of polypoid adenomas.

Adenoma↗