Case Of Rectal Tumor Research Articles

A case of rectal tumor in which the shape altered with regression in short period

BackgroundHistological regression of solid tumors in adults receiving no treatment is rare. Specifically, spontaneous partial and complete regression of colorectal cancers account for less than 2% of such cases and those without metastasis are exceedingly rare.Case presentationA 60-year-old male underwent total colonoscopy following a positive fecal occult blood test at the referring hospital. A flat elevated lesion with central reddish depression, 10 mm in diameter, was detected in the lower rectum. Biopsy results from the referring hospital showed a well-differentiated adenocarcinoma and the patient was referred to our hospital for diagnosis and treatment. Preoperative colonoscopy was performed to determine the therapeutic strategy; however, we found only scar tissue and there were no endoscopic features to suggest malignancy. Biopsy from the scar revealed normal rectal mucosa and we performed diagnostic endoscopic submucosal resection with a ligation device (ESMR-L) one week later. The resected specimen showed a 1 mm well-differentiated adenocarcinoma with low-grade atypia and no lymphovascular invasion. The macroscopic type was 0-IIb, the depth of invasion was intramucosal, and the vertical and lateral margins were negative. There has been no evidence of recurrence for 18 months following treatment.ConclusionWe report a case of a rectal tumor showing regression over a short period without treatment. Spontaneous regression of malignant tumors is a rare and unexplained phenomenon. Further research and understanding of the mechanism holds the key for treatment and prevention of cancer in the future.

Les tumeurs stromales gastro-intestinales : profil épidémiologique, clinique et thérapeutique au CHU de Marrakech

Les tumeurs stromales gastro-intestinales ou GIST sont des tumeurs mésenchymateuses rares (1 à 3 % des tumeurs malignes gastro-intestinales). Elles font l’objet de multiples controverses. Nous rapportons une étude rétrospective portant sur 17 cas de tumeurs stromales gastro-intestinales confirmées histologiquement et à l’immunohistochimie, colligés au CHU Mohammed VI. L’âge moyen des patients était de 59 ans (de 29 à 80 ans). La symptomatologie révélatrice était une douleur abdominale dans la majorité des cas (49 %), une masse abdominale retrouvée chez 35 % des patients et une hépatomégalie dans 2 cas. Il s’agissait de 6 cas de tumeurs gastriques, 4 cas de tumeurs mésentériques, 4 cas de tumeurs jéjunales, et 3 cas de tumeurs rectales. Quinze patients ont été traités par exérèse chirurgicale complète. A l’histologie, l’expression du marqueur C KIT à était présente dans 100 % des cas. Dans 13 cas, il s’agissait de tumeurs localisées, deux patients présentaient d’emblée des tumeurs localement avancées et deux autres avaient des métastases hépatiques au moment du diagnostic. Un traitement médicamenteux à base d’Imatinib était entrepris dans les tumeurs classées de haut grade de malignité, dans 6 cas en adjuvant, et dans 2 cas en néoadjuvant. Sur un recul moyen de 3 ans, la survie moyenne était de 88 % à 3 ans et on notait 8 cas de rémission complète, 3 cas de rémission partielle, 2 cas de récidive tumorale et 2 cas de décès.

Comparison of intrarectal filling with water and idling in rubber sheath with water in endoluminal ultrasonography for preoperative staging of rectal tumors

Objective To compare the value of intrarectal filling with water and filling in rubber sheath with water in endoluminal uhrasonography for preoperative staging of rectal tumors. Methods 215 cases of rectal tumors were divided into two groups. 120 cases using the method of filling in rubber sheath with water and 95 cases using intrarectal filling with water were diagnosed with uhrasonography. The results were compared with corresponding pathologic results for the judgment of their accuracy. Results The accuracy for the diagnosis of infiltration depth was 60.0 % in the first group and was 73.7 % in the second. The difference was statistically significant (P 0.50). Conclusion Intrarectai filling with water is better than filling in rubber sheath with water in the diagnosis of infiltration depth of rectal tumors, while there is no difference in the diagnosis of metastasis of perirectal lymph nodes. Key words: Rectal neoplasms; Endosonography; Intrarectal filling with water; Filling in rubber sheath with water