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Acta Medica Okayama Aug 2021A 67-year-old woman underwent polypectomy for a tumor at the descending colon. Pathologically, the tumor was diagnosed as adenocarcinoma with an invasion of 2000 μm....
A 67-year-old woman underwent polypectomy for a tumor at the descending colon. Pathologically, the tumor was diagnosed as adenocarcinoma with an invasion of 2000 μm. Computed tomography showed a swollen paracolic lymph node and a mass lesion in the presacral space. Magnetic resonance imaging revealed a multio-cular cystic lesion. On diagnosis of descending colon cancer and tailgut cyst, she underwent synchronous lapa-roscopic resection. Histopathologically, the colon cancer was diagnosed as pT1bN1M0, pStage IIIa. The pre-sacral cystic lesion was diagnosed as a nonmalignant tailgut cyst with negative surgical margin. The patient is currently doing well without recurrence at 28 months.
Topics: Adenocarcinoma; Aged; Colon, Descending; Colorectal Neoplasms; Cysts; Female; Humans
PubMed: 34511622
DOI: 10.18926/AMO/62407 -
European Journal of Surgical Oncology :... Jul 2018Early diagnosis to target minimal volume disease has received increased attention in the management of appendiceal and colorectal peritoneal metastases (PM). This study...
BACKGROUND
Early diagnosis to target minimal volume disease has received increased attention in the management of appendiceal and colorectal peritoneal metastases (PM). This study aimed to identify risk factors for appendiceal, colon and rectal PM.
METHODS
Data were retrieved from the Swedish Colorectal Cancer Registry for all patients undergoing bowel resection of appendiceal and colorectal tumours, in Sweden, 2007-2015. Risk factors for synchronous and metachronous PM were analysed with multivariate logistic and Cox proportional hazard regression models.
RESULTS
Synchronous PM was most common in appendiceal cancer (23.5%), followed by colon (3.1%) and rectal (0.6%) cancer. The 5-year cumulative incidence was 9.0% for appendiceal, 2.5% for right colon, 1.8% for left colon and 1.2% for rectal cancer. In appendiceal cancer (n = 327), T4, N2, mucinous tumour, and non-radical surgery were associated with PM. In colon cancer (n = 24,399), synchronous PM were primarily associated with T4 (OR 18.37, 95% CI 8.12-41.53), T3 and N2 but also with N1, right-sided tumour, mucinous tumour, vascular and perineural invasion, female gender, age <60 and emergency surgery. These factors were also associated with metachronous PM. In rectal cancer (n = 10,394), T4 (OR 19.12, 95% CI 5.52-66.24), proximal tumour and mucinous tumour were associated with synchronous PM and T4 and mucinous tumour with metachronous PM.
CONCLUSIONS
This study shows that appendiceal cancer, right-sided colon cancer, advanced tumour and node stages and mucinous histopathology are the main high-risk features for PM and should increase the awareness of current or future PM.
Topics: Adenocarcinoma; Adenocarcinoma, Mucinous; Age Factors; Aged; Aged, 80 and over; Appendiceal Neoplasms; Colon, Ascending; Colon, Descending; Colonic Neoplasms; Colorectal Neoplasms; Cytoreduction Surgical Procedures; Digestive System Surgical Procedures; Emergencies; Female; Humans; Logistic Models; Lymph Nodes; Male; Middle Aged; Multivariate Analysis; Neoplasm Invasiveness; Neoplasm Staging; Peritoneal Neoplasms; Proportional Hazards Models; Rectal Neoplasms; Registries; Risk Factors; Sex Factors; Sweden
PubMed: 29576463
DOI: 10.1016/j.ejso.2018.02.245 -
Clinical Journal of Gastroenterology Jun 2023A 54-year-old man referred to our hospital for abdominal distension. He had no medical history. On physical examination, he complained lower abdominal distention, and...
A 54-year-old man referred to our hospital for abdominal distension. He had no medical history. On physical examination, he complained lower abdominal distention, and had no spontaneous pain or tenderness. The blood tests showed that CEA and CA19-9 levels were within normal limits. Colonoscopy revealed a submucosal tumor with irregularities and mucosal defects in the descending colon. Computed tomography (CT) showed a 3-cm-diameter mass in the descending colon and ascites. Due to the presence of ascites, laparoscopic examination was performed, which revealed multiple peritoneal seeding of the tumor. Given the presence of peritoneal dissemination, the tumor was determined to be unresectable, and a histological examination was performed from the disseminated nodule. Pathologically, atypical spindle cells were observed and infiltrated into adipose tissue. Additional immunohistochemistry revealed positive expression for Murine double minute 2 (MDM2) and Cyclin-dependent kinase 4 (CDK4), and fluorescence in situ hybridization showed amplification of MDM2. Thus, the tumor was diagnosed with a dedifferentiated liposarcoma of the descending colon. Liposarcoma is a type of soft-tissue sarcoma that arises from soft tissues such as the extremities or retroperitoneum. Here, we report an extremely rare case of a dedifferentiated liposarcoma of the colon.
Topics: Male; Humans; Animals; Mice; Middle Aged; In Situ Hybridization, Fluorescence; Ascites; Colon, Descending; Liposarcoma; Sarcoma
PubMed: 36735203
DOI: 10.1007/s12328-023-01762-5 -
Cell and Tissue Research Sep 2022Our previous studies using immunohistochemistry and serial block-face scanning electron microscopy (SBF-SEM) clarified that fibroblast-like cells (FBLCs) in the rat...
Our previous studies using immunohistochemistry and serial block-face scanning electron microscopy (SBF-SEM) clarified that fibroblast-like cells (FBLCs) in the rat ileal mucosa are classifiable into several subtypes, but their characteristics throughout the large intestine remain unknown. In this study, we investigated the region-specific characteristics of FBLCs in the rat large intestine using histological analysis including SBF-SEM. Immunohistochemistry revealed that CD34CD31 FBLCs were localized in the lamina propria beneath the crypt bases throughout the large intestine and were more abundant in the descending colon than in the other regions. In addition, platelet-derived growth factor receptor α (PDGFRα) FBLCs were ubiquitously present just below the epithelium throughout the large intestine, and those at the crypt base were slightly more abundant in the descending colon than in the other regions. SBF-SEM analysis revealed that there were two types of FBLCs around the crypt base in both the cecum and the descending colon: sub-epithelial FBLCs localizing just beneath the epithelium in the manner of PDGFRα FBLCs, and lamina propria FBLCs localizing farther away from the epithelium than sub-epithelial FBLCs in the manner of CD34CD31 FBLCs. The lamina propria FBLCs were closely apposed to various immune cells in the lamina propria, and their endoplasmic reticulum in the descending colon exhibited various dilatation levels, unlike that in the cecum. These findings indicate that FBLCs, especially around the crypt base, differed in each region of the large intestine with respect to localization, abundance, and ultrastructure, which could lead to the region-specific microenvironment around the crypt base.
Topics: Animals; Fibroblasts; Ileum; Intestinal Mucosa; Intestine, Large; Rats; Receptor, Platelet-Derived Growth Factor alpha
PubMed: 35779135
DOI: 10.1007/s00441-022-03660-7 -
International Journal of Colorectal... Jul 2019The safety and efficacy of laparoscopic surgery for transverse and descending colon cancer remain controversial. This study aimed to evaluate the short- and long-term... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The safety and efficacy of laparoscopic surgery for transverse and descending colon cancer remain controversial. This study aimed to evaluate the short- and long-term outcomes of this procedure.
METHODS
We conducted a single-institutional randomized controlled trial. Patients with transverse or descending colon cancer were randomly allocated to receive laparoscopic surgery (LAC) or conventional open surgery (OC). The primary endpoint was the overall complication rate between the two groups. The secondary endpoints were the length of the postoperative hospital stay, the health-related quality of life (HRQOL) score (at 1, 6, and 12 months after surgery), the 5-year relapse-free survival (RFS), and the 5-year overall survival (OS).
RESULTS
Between August 2008 and October 2012, a total of 66 patients were enrolled (33 in the LAC group and 33 in the OC group). The patient characteristics showed no significant differences between the two groups. The complication rates (≥ grade 3) were 6.1% in the LAC group and 12.1% in the OC group (p = 0.392). The length of postoperative stay was not significantly different between the two groups. Regarding the HRQOL, the physical functioning, role physical, bodily pain, social functioning, mental health, and role component summary at 1 month after surgery and the social functioning and mental health at 6 months after surgery were better in the LAC group than in the OC group. The 5-year RFS and OS rates were similar between the LAC and OC groups (RFS 90.5% and 87.3%, respectively, p = 0.752; OS 93.3% and 100.0%, respectively, p = 0.543).
CONCLUSIONS
The short- and long-term outcomes of laparoscopic surgery for transverse and descending colon cancer are almost equal to those of open surgery. Laparoscopic resection is a better choice than open surgery for managing this cancer with regard to the short- and mid-term QOL.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT01861691 .
Topics: Aged; Colon, Descending; Colonic Neoplasms; Disease-Free Survival; Female; Humans; Laparoscopy; Male; Middle Aged; Neoplasm Recurrence, Local; Quality of Life; Treatment Outcome
PubMed: 31102008
DOI: 10.1007/s00384-019-03305-2 -
Endoscopic Ultrasound 2019The peritoneal cavity is subdivided into supracolic and infracolic compartments by transverse mesocolon, which attaches the colon to the posterior abdominal wall....
The peritoneal cavity is subdivided into supracolic and infracolic compartments by transverse mesocolon, which attaches the colon to the posterior abdominal wall. Infracolic compartment is subdivided into right and left compartment by small bowel mesentery. Left infracolic space freely communicates with pelvic compartment. The infracolic compartment contains the coils of small bowel which is separated from paracolic gutter on either side by ascending and descending colon. Pelvic compartment mainly contains bladder, rectum and genital organ (prostate, seminal vesicle in male and uterus in female). The evaluation of different compartments of peritoneum is gaining importance in multimodality imaging. It has become essential that clinicians and endosonographers thoroughly understand the peritoneal spaces and the ligaments and mesenteries that form their boundaries in order to localize disease to a particular peritoneal/subperitoneal space and formulate a differential diagnosis on the basis of that location. In this article we describe the applied EUS anatomy of peritoneal ligaments, infracolic and pelvic compartments of peritoneum and there technique of imaging from stomach, duodenum, sigmoid colon and rectum. Imaging from stomach images the infracolic compartment through transverse mesocolon, imaging from duodenum images the infracolic compartment through the mesentery and imaging from rectum and sigmoid images the infracolic and pelvic compartments through the sigmoid mesocolon and pelvic peritoneum.
PubMed: 31134898
DOI: 10.4103/eus.eus_25_19 -
Surgical Case Reports Feb 2023Segmental dilatation of the colon (SDC) is a rare disease that is characterized by an abrupt segment of dilated colon between regions of normal-sized colon. We herein...
BACKGROUND
Segmental dilatation of the colon (SDC) is a rare disease that is characterized by an abrupt segment of dilated colon between regions of normal-sized colon. We herein report a case of SDC associated with Hirschsprung's disease (HD).
CASE PRESENTATION
The patient developed abdominal distension soon after birth, and enema examination showed localized intestinal dilatation from the descending colon to the sigmoid colon with significant caliber changes on both the oral and anal sides of the dilated colon. The findings of the rectal mucosal biopsy were consistent with HD. We considered this case to be a combination of HD and SDC and performed laparoscopic-assisted Soave pull-through with resection of the dilated colon when the patient was 7 months old. Resected specimens showed steep caliber changes on the oral and anal sides of the dilated colon. In the pathological examination, no ganglion cells were found in the submucosa on the anal side of the dilated colon. Based on the above findings, we finally made the diagnosis of HD with SDC.
CONCLUSION
In HD with a characteristic dilated colon, the possibility of SDC should be considered.
PubMed: 36788160
DOI: 10.1186/s40792-023-01602-1 -
The Turkish Journal of Gastroenterology... Apr 2021Ischemic colitis (IC) is a common ischemic disorder of the colon caused by insufficient blood supply to the colonic mucosa. This study aimed to identify the clinical...
BACKGROUND
Ischemic colitis (IC) is a common ischemic disorder of the colon caused by insufficient blood supply to the colonic mucosa. This study aimed to identify the clinical characteristics, comorbidities, and risk factors in patients with IC.
METHODS
We performed a retrospective population-based study using electron video-colonoscopy imaging and pathological biopsies from 168 patients diagnosed with IC. A retrospective controlled study was used to analyze differences between a young to middle-aged patient group (78 cases) and an elderly patient group (90 cases) on the basis of clinical characteristics and risk factors.
RESULTS
The primary symptoms in the 168 patients with IC were abdominal pain, diarrhea, and hematochezia. White blood cells (WBC), neutrophilic granulocyte percentage (NEUT%), C-reactive protein (CRP), and D-dimer were significantly elevated in elderly patients. The sigmoid colon and descending colon were the most common lesion locations (57.1% and 33.9%, respectively). Hypertension, cerebral infarction, and coronary heart disease were the most common comorbidities in elderly patients, while smoking history was the most common risk factor in young to middle-aged patients.
CONCLUSION
The sigmoid colon and descending colon are the most affected locations in IC. Hypertension, diabetes mellitus, and cerebral infarction are the most common risk factors and comorbidities.
Topics: Aged; Aged, 80 and over; Biopsy; Capsule Endoscopes; Cerebral Infarction; Colitis, Ischemic; Colon; Colonoscopy; Coronary Disease; Female; Humans; Hypertension; Male; Middle Aged; Retrospective Studies; Risk Factors
PubMed: 34231486
DOI: 10.5152/tjg.2021.20588 -
Case Reports in Pathology 2015A 47-year-old male with a history of left colon cancer, status post left colon resection for 12 years, presented with rectal bleeding. Colonoscopic examination revealed...
A 47-year-old male with a history of left colon cancer, status post left colon resection for 12 years, presented with rectal bleeding. Colonoscopic examination revealed an 8 mm sessile polyp in the proximal descending colon. Microscopic examination showed that the surface of this polyp was covered with a layer of normal colonic mucosa with focal surface erosion. In the submucosal layer, an intimate admixture of multiple cystically dilated glands and prominent lymphoid aggregates with germinal centers was seen. The glands were lined by columnar epithelium. Immunohistochemical staining showed the glands were positive for CK20 and CDX2 and negative for CK7, with a low proliferative index, mostly consistent with reactive colonic glands. The patient remained asymptomatic after one-year follow-up. A review of the literature shows very rare descriptions of similar lesions, but none fits exactly this pattern. We would designate this inverted lymphoglandular polyp and present this case to raise the awareness of recognizing this unusual histological entity.
PubMed: 25767731
DOI: 10.1155/2015/646270