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A case of intestinal obstruction due to ingested "foreign body" (a patient's tooth) is described in an elderly man with cancer of the ascending colon, at that time, without clinical symptoms.
A benign colonic polyp with epithelial dysplasia developed in a young male at the site of ureteral implantation in the sigmoid colon following ureterosigmoidostomy for urinary incontinence. Patients with ureterosigmoidostomy represent a high-risk cancer group, and a review of the literature suggests the necessity of a life-long follow-up in these patients. A follow-up plan with Hemoccult test each year and a sigmoidoscopy every 3rd year is proposed.
Twenty two patients (13 males), whose ages ranged between 25 and 94 years, were subjected to surgical treatment for perforative carcinoma of the colon in a period of 10 years. Seventy three percent of tumors were localized in rectum and sigmoid colon. The perforation lied within the tumor in half of the patients and proximal to the tumor, specially in the cecum, in the rest. The perforation produced a local abscess in 5 patients and a diffuse peritonitis in 17 patients. Fifteen patients were subjected to segmental resections with a 40% operative mortality rate and 5 to a fecal diversion procedure with a 57% operative mortality. Tumor staging was similar to that of patients subjected to elective surgery. Crude 5 year survival was 18% and, excluding operative mortality, 57%.
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Carcinoembryonic antigen, as measured by radioimmunoassay, is present in two different human colonic tumors that have been serially transplanted and maintained in the cheek pouches of unconditioned, adult golden hamsters. This finding shows that a human tumor-associated antigen can be produced in an animal host.
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A benign reactive polyp developed at each ureteral implantation in the sigmoid colon following bilateral ureterosigmoidostomy for exstrophy of the bladder. The first polyp was discovered 23 years after the operation. The second polyp occurred 4 years later at the other ureteral orifice. Each polyp contained benign cystic glandular epithelium within the submucosa and the stalk. These submucosal cysts resembled colitis cystica profunda, except that they were confined to the pedunculated polyps. A complete review of the literature of neoplasms complicating ureterosigmoidostomy is presented. It is concluded that a benign or a malignant colonic tumor may develop at the site of the ureterocolic anastomosis many years later. Therefore, patients who undergo this operation should be followed for the rest of their lives.
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OBJECTIVE: Intercellular adhesion molecule-1 (ICAM-1) is important in ulcerative colitis (UC) by mediating the arrest and further migration of neutrophils. In vitro studies have shown that colonocytes from chronically inflamed colon and cultured colon cancer cells are capable of expressing ICAM-1. The aim of this study was to assess the ICAM-1 expression in human colonic tissue representing UC, Crohn's disease (CD), adenomas, and adenocarcinomas, with special attention to the epithelium. MATERIAL AND METHODS: Formalin-fixed and paraffin-embedded tissue from the archives of the Department of Pathology of Rigshospitalet University of Copenhagen was examined. Colonic tissue from 10 patients with UC, 10 with CD, 32 adenomas, 27 adenocarcinomas, and 10 lymph node metastases were included. The expression of ICAM-1 was assessed by using the EnVision(+)technique (DakoCytomation). RESULTS: Endothelial ICAM-1 was up-regulated in areas with dense lymphocyte infiltration and near crypt abscesses and ulcerations. Ulcerations were covered by a continuous layer of macrophages and epithelial cells expressing ICAM-1. Similar observations were made in the case of adenomas and adenocarcinomas, but in adenocarcinomas the epithelial ICAM-1 was more diffuse and not related solely to sites of surface destruction. CONCLUSIONS: In the colon, endothelial cells, macrophages, and epithelial cells are in certain conditions capable of expressing ICAM-1. Although the ICAM-1 expression was related to both the degree and the nature of inflammation, the data indicate increased susceptibility of cancer cells to express ICAM-1. Epithelial and macrophage ICAM-1 might be involved in the immune surveillance and the first-line defense of the diseased colon.
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