Manifestation Of Colon Cancer Research Articles

Colovesical fistula, as a manifestation of cancer of the left colon: case presentation

Colovesical fistulas are infrequent complications, being those of malignant origin unusual as etiology and often cause problems for their diagnosis. Objective: To present the case of a colovesical fistula of malignant origin which is unusual. Presentation of the case: a patient who entered our service with suspected colovesical fistula, because he had pain in the lower abdomen, pneumatoria and fecaluria, to corroborate said diagnosis by computed tomography, colon by enema with water-soluble contrast and cystography. Discussion: Colovesical fistulas are rare in medical practice, being this unusual as a manifestation of colon cancer. Conclusions: FCV should be suspected in all patients with pneumaturia, fecaluria, lower abdomen pain and palpable suprapubic tumor. Where cytoscopy, tomography and barium enema can give an etiological diagnosis in all cases.

Iron Deficiency Anemia as The Only Manifestation of Colon Cancer in Male Patient: A Case Report

Iron deficiency anemia can be the first manifestation of colon cancer. However, iron deficiency anemia is also common in other benign conditions, which may cause a longer delay for referral decisions to get a definitive diagnosis. This is a case of 40-year-old male patient who had only iron deficiency anemia as a manifestation of colon cancer. Colonoscopy revealed intraluminal mass in transverse colon. After resection of the tumor, histopathology showed well-differentiated mucinous adenocarcinoma, invasion of sub-serous, and one node positive (pT3pN1pM0). After resection, we administered XELOX as adjuvant chemotherapy every 3 weeks for 8 cycles.

Acral injury as the first manifestation of colon cancer: case report

During the diagnosis of the primary CRC, about 20% of patients have already developed metastatic diseases, and the most commons metastatic sites include the liver and lungs. Bone metastasis (BM) is rare and is reported only in 10–15% of patients with CRC. We describe a case of a patient who presented with a bone lesion on his right foot which was later diagnosed as a metastatic lesion from a gastrointestinal cancer.

Correction to: Appendicitis as a manifestation of colon cancer: should we image the colon after appendicectomy in patients over the age of 40years?

The above article originally published with an error present in Table 1 and is now presented correctly in this article.

Appendicitis as a manifestation of colon cancer: should we image the colon after appendicectomy in patients over the age of 40years?

Appendicitis can be secondary to caecal pathology (polyp or cancer). Increasing age is a risk factor for malignancy coexisting with appendicitis. There is an increased coexistence of cancer post-appendicectomy in patients aged 50-54years. This study investigates whether post-appendicectomy patients aged over 40years should receive further colorectal imaging and follow-up. Retrospective data were collected for 1633 patients aged 40years and over who underwent appendicectomy in a 10-year period (1st January 2004-31st December 2014). Data were analysed for patients with histological confirmation of acute appendicitis. Incidental appendicular tumours were excluded. One thousand fifty-five (64%) patients had histological confirmation of acute appendicitis (median age 52years; range 40-96years). Six hundred three patients (57%) were aged 40-54years; 452 patients (43%) were aged 55years or over. Twenty-six (2.5%) patients were investigated post-appendicectomy. Three (11.5%) had caecal pathology: 2 adenocarcinoma, 1 benign caecal polyp. Ten (2.2%) patients aged 55years or over had caecal pathology. Seven (1.6%) were diagnosed with caecal cancer. No patients below age 54years were diagnosed with caecal cancer. The incidence of caecal cancer in the study population was 0.66% (40-54.9years 0%; 55years and over 1.6%). Patients aged 55years or over were more likely to develop caecal pathology than patients aged 40-54years (p = 0.006). The odds ratio of developing caecal pathology was 6.8 times greater (95% CI 1.49-31.29) in people aged 55years and over. Patients aged 55years or over who have undergone appendicectomy should be offered colonoscopy to exclude coexistent caecal pathology.

Colovesical fistula as the initial manifestation of advanced colon cancer: A case report and review of literature

Colovesical fistulas (CVFs) are rare complications of very advanced cancers of the abdominal or pelvic cavity and often cause diagnostic troubles. CVFs are found more often in males, whereas females usually suffer from rectovaginal or vesicovaginal fistulas. This article presents a case of a female patient who was admitted to the hospital because of acute diarrhea, presumably of infectious origin, and with only subtle abnormalities in blood tests and urinalysis. Owing to the ineffectiveness of the performed treatment and progressive intensification of symptoms, diagnostics were extended to include a computed tomography scan, sigmoidoscopy and cystography. The imaging results revealed a large heterogeneous conglomerate of solid and fluid structures in the pelvis, which involved reproductive organs, the bladder and sigmoid colon. The excrement leaking from the digestive tract was urine, and CVF was the first manifestation of colon cancer. Shortly after the final diagnosis, the patient deteriorated and eventually died after an urgent colostomy was performed because of a bowel obstruction.

Gait Disturbance and Dysarthria Presenting as the First Manifestation of Recurrent Colorectal Adenocarcinoma

Purpose: Approximately 20% of patients with colon cancer have metastatic disease at the time of presentation. It usually spreads to regional lymph nodes, liver, lungs, and peritoneum. Initial signs and symptoms might be referable to any of these areas. A 79-year-old man with past medical history of rectal adenocarcinoma diagnosed in 2006, for which he had lower anterior resection and partial colectomy with subsequent chemotherapy and radiotherapy. He presented with a one-week history of gait disturbance, dizziness, slurred speech, and difficulty with his handwriting. He also reported a recent 30-pound weight loss. Brain CT showed a right-sided heterogeneous cerebellar lesion measuring 2.8 x 2.5 cm that was confirmed with MRI. CT of the chest and abdomen showed a right upper lobe lung mass adjacent to the esophagus measuring 3.2 x 2.4 cm, and simple hepatic cysts. EUS was performed, and FNA of the lung mass confirmed the diagnosis of metastatic colon adenocarcinoma that was immunoreactive for CK20 and CDX2. Subsequently, the patient underwent craniotomy and tumor resection, which confirmed the diagnosis of metastatic colon adenocarcinoma to the cerebellum. Neurological symptoms due to brain metastasis could represent the first manifestation of colon cancer even without liver involvement, despite that the liver is considered the most common site of distal metastasis in colorectal adenocarcinoma and lung cancer being the most common source of brain metastasis.FigureFigure

Pityriasis rubra pilaris: Was it the first manifestation of colon cancer in a patient with pre-existing psoriasis?

Pityriasis rubra pilaris: Was it the first manifestation of colon cancer in a patient with pre-existing psoriasis?

Sister mary joseph′s nodule: What lies beneath?

Dear Editor, We recently had a 79-year-old male with no significant medical history who was referred to our hospital for a pulmonary embolism. During examination a 5 cm × 5 cm fungating mass was discovered on his belly [Figure 1]. Patient reported that the mass has been present for months and gradually increasing in size. A computed tomography scan of chest, abdomen and pelvis revealed no other abnormality. The biopsy of mass revealed moderately differentiated adenocarcinoma with stain consistent with tumor of lower gastrointestinal tract. A colonoscopy confirmed adenocarcinoma of transverse colon. Figure 1 A 5 cm ×5 cm fungating mass on patient's periumbilical area This rare manifestation of metastatic disease was recognized by a surgical assistant of Dr. William Mayo, Sister Mary Joseph, whose name has since been used to explain these umbilical nodules.[1] These metastatic lesions are mostly from gastrointestinal (52%) and gynecological neoplasms (28%), most commonly from the stomach (23%), colon (15%), pancreas (10%), and ovary (16%), and less frequently from the uterus, cervix, gallbladder, and small intestine.[2] Metastatic lesions can reach the umbilicus via spread through lymphatic ducts, the venous network, arterial spread, contiguous extension, or even through iatrogenic seeding with laparoscopy. These different pathways may help explain why there is such a wide group of malignant tumors that can produce these nodules.[3] The presence of these lesions is often a poor prognostic factor, as these patients have advanced metastatic disease at the time of initial diagnosis. In several studies, the average survival after the appearance of these nodules was approximately 10-11 months.[4] Sister Mary Joseph nodule is a rare first manifestation of colon cancer. Physicians should be aware of this unusual presentation of colon cancer.

Intracranial metastasis of colon cancer with acute subdural hematoma

Summary We report a case of acute subdural hematoma as the first manifestation of colon cancer and emphasize the need for careful assessment and consideration of clinical and radiological data for patients with nontraumatic subdural hematoma.

Congenital Hypertrophy Retinal Pigment Epithelium as a Manifestation of Colon Cancer

Congenital Hypertrophy Retinal Pigment Epithelium as a Manifestation of Colon Cancer

Congenital Hypertrophy Retinal Pigment Epithelium as a Manifestation of Colon Cancer

Purpose: Congenital hypertrophy of retinal pigment epithelium (CHRPE) is a benign lesion of the optic fundus that is an associated extracolonic manifestation of familial adenomatous polyposis (FAP). However, there are no reports of its association with a solitary colonic neoplasm. To our knowledge, we present the first case of CHRPE in a patient with a solitary colonic neoplasm. A 73-year old female with past medical history of cataracts was following a retina specialist for a routine examination. Upon examination she was found to have acute, multiple CHRPE lesions in both eyes (Figure A). Her previous fundoscopic exam did not show any CHRPE lesions. She was referred to a gastroenterologist for immediate colonoscopy. The patient never had a screening colonoscopy in the past. She had a history of long-term constipation, but no hematochezia, change in bowel habits, or change in bowel caliber. There was no family history of colon cancer or familial adenomatous polyposis (FAP). The colonoscopy showed a fungating non-obstructing mass, 25 mm from the anal verge, encompassing one-third of the circumference of the sigmoid lumen (Figure B). Biopsies were taken, which showed high-grade dysplasia. The patient had an exploratory laparotomy and colon resection with primary end-to-side anastomosis. The pathology confirmed tubular villous adenoma. The margins were free of malignancy with 17 benign lymph nodes. CT scan showed no metastasis. The patient tolerated the procedure well and was discharged 6-days post-op without any need for chemotherapy or radiation. CHRPE is a flat, black, well-defined lesion of the retinal pigment epithelium. This fundoscopic finding is almost always benign, and estimates of its prevalence in the normal population vary widely (0.3%-40%). However, it is a phenotypical extracolonic manifestation of FAP when found acutely and in bilateral retinas. It is thought that since CHRPE is not an age-dependent lesion it could provide a useful marker of patients with a germline APC gene mutation; however, several authors have studied this with inconclusive results. The setting for this case, however, is different than most; to our knowledge, this is the first case of a CHRPE patient who did not have a medical or family history of FAP presenting with a solitary colonic neoplasm.Figure: A: Black arrows point to multiple CHRPE lesions seen on fundoscopic exam. Figure B: Mass seen in sigmoid.

Erythroderma as the First Manifestation of Colon Cancer

Erythroderma as the First Manifestation of Colon Cancer

Rectal Prolapse as Initial Clinical Manifestation of Colon Cancer

Rectal prolapse as the initial clinical manifestation of colorectal cancer is uncommon. We describe the case of a 75-year-old woman who was diagnosed as having adenocarcinoma of the sigmoid colon after presenting with complete rectal prolapse. The tumor caused rectosigmoid intussusception and then it prolapsed out through the anus. She underwent rectosigmoidectomy and rectopexy. The postoperative course was uneventful. The relationship between colorectal cancer and rectal prolapse has not been clearly established. This case report describes an unusual presentation of colorectal cancer. It suggests that rectal prolapse can present as the initial symptom of colorectal cancer and may also be a presenting feature of the occult intra-abdominal pathology. The importance of adequate investigation such as colonoscopy should be emphasized in patients who develop a new onset of rectal prolapse.

Incidence and odds ratio of appendicitis as first manifestation of colon cancer: A retrospective analysis of 1873 patients

Obstruction of the lumen of the appendix is the major cause of appendicitis. Tumors could obstruct this lumen and cause appendicitis in the elderly. The association between appendicitis and colon cancer has not been sufficiently investigated, and this study was designed to clarify this association. This was a retrospective study. Patients diagnosed with acute appendicitis from January 1998 to December 2003 at the Taipei Veterans General Hospital were surveyed. Patients found to have colon cancers immediately or subsequently after appendectomy were included and analyzed. A total of 1873 patients were diagnosed as having appendicitis of whom 16 were found to have colon cancer. The incidence of appendicitis associated with colon cancer was 0.85%. The time from appendectomy to the recognition of colonic cancer was at a median delay of 5.8 months. From the Taiwan Cancer Research Annual Report, the incidence of colon cancer was 31.91/100,000 in the year 2000. The odds ratio of colon cancer incidence had a 38.5-fold increase among patients older than 40 with acute appendicitis. In patients over 40 years who present with symptoms of acute appendicitis the possibility of a coexistent colonic neoplasm should always be kept in mind. These patients should undergo colonoscopy 6 weeks after surgery to exclude the possibility of a coexistent colorectal cancer.