Adenocarcinoma Of Sigmoid Colon Research Articles

Synchronous Appearance of a High-Grade Neuroendocrine Carcinoma of the Ampulla Vater and Sigmoid Colon Adenocarcinoma

Neuroendocrine carcinoma is a relatively rare tumor and its coexistence with other primary cancers is very exceptional. We present a case of a 63-year-old woman with biliary obstruction due to a high-grade neuroendocrine carcinoma located in ampulla of Vater who was found to have a synchronous sigmoid colon adenocarcinoma while undergoing staging laparotomy and pancreas head resection. Medical history was significant only for basal cell skin cancer. Immunohistochemical examination revealed the concurrence of histologically proved neuroendocrine carcinoma (chromogranin A, synaptophysin, and CD56 were positive) and Stage II (T3, N0, and M0) according to the TNM staging classification of colorectal cancer. The coexistence of neuroendocrine tumors with either synchronous or metachronous unrelated cancer is increasingly recognized. The patients with neuroendocrine carcinoma should be evaluated for secondary primary malignancies.

Synchronous adenocarcinomas of the colon presenting as synchronous colocolic intussusceptions in an adult

Intussusception is uncommon in adults. To our knowledge, synchronous colocolic intussusceptions have never been reported in the literature. Here we described the case of a 59-year-old female of synchronous colocolic intussusceptions presenting as acute abdomen that was diagnosed by CT preoperatively. Laparotomy with radical right hemicolectomy and sigmoidectomy was undertaken without reduction of the invagination due to a significant risk of associated malignancy. The final diagnosis was synchronous adenocarcinoma of proximal transverse colon and sigmoid colon without lymph nodes or distant metastasis. The patient had an uneventful recovery. The case also emphasizes the importance of thorough exploration during surgery for bowel invagination since synchronous events may occur.

Non-Hodgkin lymphoma as a cause of acute intestinal obstruction/perforation in patients with adenocarcinoma of the sigmoidcolon: a case report

Report of a rare case of an 83-year-old patient with lymphoma of the terminal ileum causing obstructive/perforated acute abdomen synchronous with sigmoid colon adenocarcinoma and review of literature data about small bowel malignancies, particularly lymphomas. It seems to correspond to a rare disease (2% of all bowel cancers), more prevalent in elderly and immunocompromised patients, whose symptoms are vague and early diagnosis is difficult, often making it impossible to establish the correct therapy.

Sarcomatous carcinoma with osteosarcomatoid differentiation of the bladder with simultaneous sigmoid colon adenocarcinoma.

Sarcomatoid carcinoma is a rare tumor of the urinary bladder and accounts for approximately 0.3% of all bladder malignancies. In these tumors, histogenesis and biological behaviour remains controversial. Herein, we report a case of sarcomatoid carcinoma with osteosarcomatoid differentiation of the urinary bladder with simulataneous sigmoid colon adenocarcinoma.

Colonic perforation resulting from ingested chicken bone revealing previously undiagnosed colonic adenocarcinoma: report of a case and review of literature

An 86 year old male with a four-day history of nonspecific gastrointestinal symptoms was found on colonoscopy to have evidence of sigmoid colon obstruction and possible perforation. Emergent operative exploration revealed diffuse peritonitis, sigmoid perforation, adjacent dense adhesions, and a foreign body protruding through the perforated area. Pathologic examination showed the foreign body to be a sliver of bone consistent with chicken bone and the sigmoid subacute perforation to be associated distally with a circumferential ulcerated obstructing mass, microscopically seen to be transmurally infiltrating adenocarcinoma, signet-ring cell type. There was extensive acute and organizing peritonitis, 100% Escherichia coli was cultured from peritoneal fluid, and the patient died two days postoperatively with sepsis and hypotension. This appears to be the fifth reported case of colonic perforation resulting from foreign body perforation due to previously undiagnosed adenocarcinoma. The four previously reported cases were all deeply invasive adenocarcinoma of sigmoid colon, and the foreign bodies included three chicken/poultry bones and a metallic staple. These five cases are highly unusual examples of a potentially lethal malignant neoplasm being clinically revealed by a usually (but not always) innocuous event, the ingestion of a small foreign body.

Arterial Injury Complicating Subclavian Central Venous Catheter Insertion

n i a a g n c INADEQUATE PLACEMENT of a subclavian venous catheter in the subclavian artery is a well-known complication.1,2 Three cases of accidental arterial puncture occurred with the implantation of subclavian venous catheters, 2 of which involved the subclavian artery leading to percutaneous treatment; and the other involved the aortic arch, resulting in surgical management, are described.

A Long-Term Survivor of Sigmoid Colon Adenocarcinoma with Neuroendocrine Differentiation Who Received CPT-11+CDDP Therapy Following Non-curative Resection

症例は61歳の男性で，下部消化管内視鏡検査でS状結腸に2型腫瘍を指摘され，術前生検では中分化腺癌であった．術前造影CTにて腎静脈下縁尾側のNo216リンパ節転移陽性と診断した．肝硬変を併存しており根治手術は困難と判断し，ハルトマン手術，D2郭清，根治度C（遺残病変はNo216リンパ節のみ）を施行．病理組織学的検査において，原発巣および転移リンパ節にはそれぞれ腺癌細胞と約20%，約30%の内分泌細胞癌成分の混在を認めた．遺残病変に対し，肺小細胞癌に準じてCPT-11＋CDDP療法を施行した．2コース終了後にNo216リンパ節腫大は著明に縮小し，その後4コース追加し化学療法を中止，以後経過観察のみを行っている．化学療法終了後4年6か月間Complete Responseを維持しており，術後5年1か月現在生存中である．

A Case of Adenocarcinoma of the Sigmoid Colon with Pelvic Arteriovenous Malformation

症例は60歳代の男性で2008年11月に下血を主訴に近医を受診し，精査でS状結腸癌の診断となり，同月当科入院となった．高血圧の既往あり．下部消化管内視鏡検査で肛門縁より30cmのS状結腸に全周性の2型腫瘍を認めた．生検では高分化腺癌であった．CTではS状結腸に全周性の壁肥厚像を認めた．また両側の総腸骨から内腸骨動静脈にかけ，直腸を圧排する巨大な骨盤内動静脈奇形が存在した．心臓カテーテル検査で，動静脈奇形にともなう高度の僧帽弁閉鎖不全症（MRIII度）と肺動脈高血圧症（PAP：50mmHg）と診断された．2008年12月S状結腸部分切除術をおこなった．骨盤内動静脈奇形に，下腸間膜動静脈も関連していたため，血流の変更をともなわないように，部分切除となった．骨盤内動静脈奇形を合併したS状結腸癌の1例を報告した．

Carcinoma colon presenting as cutaneous metastasis to an old operative scar of hysterectomy

Cutaneous metastases from asymptomatic colonic carcinoma have been documented rarely in the literature. But cutaneous metastasis to an already present operative scar as the mode of presentation of otherwise asymptomatic colon cancer is an extremely rare phenomenon which has been described only thrice till now. We report such a case of adenocarcinoma of sigmoid colon which presented as a large subcutaneous metastasis to an already existing scar of hysterectomy.

Rhinocerebral Mucormycosis Complicated by Diabetes Insipidus

Abstract Rhinocerebral mucormycosis (RCM) is an increasingly common infection in immunocompromised subjects. We report a case of RCM in an immunosuppressed gentleman known to suffer from sigmoid colon adenocarcinoma stage D and presenting with diabetic ketoacidosis, complete ptosis, and orbital cellulitis. During his hospital stay, the patient developed cranial diabetes insipidus. In spite of extensive surgical debridement and high-dose liposomal amphotericin, the disease had a fatal outcome. This case emphasizes the need for increased awareness of mucormycosis as a potentially lethal fungal infection requiring a high index of suspicion in subjects at risk. The case also illustrates a rare complication of RCM, namely diabetes insipidus.

Gingival and submandibular lymph node metastasis of sigmoid colon adenocarcinoma

Introduction: Metastatic tumors of oral and maxillofacial region compromise 1% of all malignant oral neoplasms. Most commonly affect the jaw bone and less commonly intraoral soft tissues. They originate mainly from primary tumors of lung, breast, colon-rectum, prostate and kidney. Case report: a 77 years old man with history of sigmoid colon adenocarcinoma and liver metastasis. Two years later of being free of disease, he presented with submandibular lymphadenopathy and a gingival mass in right upper jaw. Fine needle aspiration of the node and biopsy of the gingival mass were performed. The cytological smears showed cohesive cell groups on a necrotic background. Biopsy examination showed subepithelial infiltration by neoplasm of glandular pattern with immunoreactivity for keratin 20 and carcinoembryonic antigen. A definitive diagnosis of node and oral metastases of colon adenocar cinoma was made. Discussion: Metastases in the oral and maxillofacial region are very uncommon and usually represent an advanced stage and disseminated disease. They present non specific radiologic and clinical features so it is imperative to reach a definitive diagnosis the cytological/histological examination. Because of its rarity, the diagnosis of metastases in the oral region are a challenging, both to the clinician and to the pathologist, in recognising that a lesion is metastasic and in determining the site of origin.

Single-Port Access Laparoscopic Radical Left Colectomy in Humans

Transumbilical single-port access (SPA) surgery is a rapidly evolving field that combines in part the cosmetic advantage of natural orifice transluminal endoscopic surgery (NOTES) with the ability to perform the operation with standard laparoscopic instruments. We report our experience with the first transumbilical single-port access radical left colectomy conforming to surgical oncologic principle and minimally invasive colectomy technique. Umbilical single-port access (embryonic natural orifice transluminal endoscopic surgery) left colectomy was performed in a patient with sigmoid colon adenocarcinoma in situ. During the same procedure, a single-port access cholecystectomy was performed for chronic cholecystitis. Transumbilical single-port access radical left colectomy was feasible with conventional laparoscopic instruments. A 39-cm pathologic specimen with sufficient surgical margins and lymph nodes (34) was resected. Final diagnosis revealed an adenocarcinoma in situ. Operative time for left colectomy and cholecystectomy was 213 minutes. No intraoperative or postoperative complications were recorded. Single-port access radical left colectomy is feasible when performed by experienced laparoscopic surgeons. Carcinologic surgical principles can be respected using this colectomy technique. Single-port access left colectomy may have a clinical advantage over natural orifice transluminal endoscopic surgery in offering the safety of laparoscopic colectomy. It has yet to be determined whether or not this approach would offer patient benefits, except in cosmesis, compared with standard laparoscopic left colectomy.

Aortic, Celiac Axis, and Superior Mesenteric Artery Thrombosis Associated With Sigmoid Colon Adenocarcinoma and Hypercoagulable State

A patient with sigmoid colon adenocarcinoma and hypercoagulable state developed acute visceral ischemia secondary to thrombus involving the suprarenal aorta, celiac axis and superior mesenteric artery. A large, laminated fibrin thrombus was removed via supraceliac aortotomy. Attempts to clear thrombus from branches of the celiac axis and superior mesenteric artery by open and catheter-based techniques were of limited success. Extensive visceral infarction ensued and the patient died.

Synchronous ileal carcinoid and primary colonic neoplasms: a case report

Primary colonic tumours with synchronous ileal carcinoid tumours are rare in occurrence and are mainly found incidentally on autopsies or pathological examination of resected surgical specimens. This article describes a case of adenomatous colonic polyps, adenocarcinoma of sigmoid colon and concurrent malignant carcinoid tumour of ileocaecal junction, detected on colonoscopic examination. The radiological staging investigations revealed no distant spread of disease. The patient was effectively treated with subtotal colectomy, resection of terminal ileum, excision of locoregional lymph nodes and the bowel continuity was restored with stapled ileo-rectal anastomosis. This article is as an example of concomitant presence of two types of malignant tumours, effectively managed surgically.

Metastasis to the Sinonasal Tract from Sigmoid Colon Adenocarcinoma

Metastatic adenocarcinoma from the gastrointestinal tract to the sinonasal tract is rare. The histological morphology of this lesion is indistinguishable from the colonic variant of primary sinus adenocarcinoma or intestinal-type adenocarcinoma (ITAC). This is a report of a case of metastatic adenocarcinoma of colorectal origin to the paranasal sinuses in a 52-year-old female who was previously treated for adenocarcinoma of the sigmoid colon. A histologic study of the surgical specimen from the sinonasal cavity demonstrated a tumour identical to the patient's prior primary tumour of the colon. The sinonasal neoplastic tissue showed marked positivity for carcinoembryonic antigen and expressed cytokeratin 20, which differentiates metastatic colonic adenocarcinoma from ITAC. The patient received palliative radiation but died 3 months after the diagnosis. Distinguishing metastatic adenocarcinoma from gastrointestinal tract from ITAC can be difficult. In view of the resemblance, immunohistochemical staining can help in differentiating them. It is important to recognise these as metastatic lesions as the treatment is mainly palliative.

Necrotizing Fasciitis After Laparoscopic Colonic Surgery

A 67-year-old woman, with a past medical history of diabetes mellitus and hypertension, underwent an elective laparoscopic anterior resection for sigmoid colon adenocarcinoma. She was readmitted on the tenth postoperative day with complaints of abdominal pain and a foul smelling discharge from her abdominal wound. She was later diagnosed with necrotizing fasciitis (NF) over the extraction wound. To our knowledge there has only been one other case of NF after laparoscopic colonic surgery reported in the literature. We reviewed the literature on NF after laparoscopic surgery, and discussed the clinical diagnosis; diagnostic adjuncts such as magnetic resonance imaging, bedside exploration under local anesthesia, frozen section of deep incisional biopsies, and laboratory tests; and management principles of NF. Although there is a low incidence of wound infections associated with laparoscopic colonic surgery, necrotizing infections although rare, are a very real possibility.

Laryngeal metastasis from sigmoid colon adenocarcinoma followed by peristomal recurrence

Considering clinical evidence,<2% of laryngeal malignancies are distant metastases. Cutaneous melanomas are the preponderant primaries metastasizing to the larynx, followed by renal cell carcinomas, breast and lung carcinomas. Colonic adenocarcinoma metastases to the larynx are extremely rare: only 13 cases have been described since 1972. We present the first case of sigmoid colon adenocarcinoma metastasis to the larynx in a patient who developed peristomal malignancy recurrence after total laryngectomy. Patients with metastasis of colonic adenocarcinoma to the larynx usually present with disseminated disease: in view of the poor chances of long-term survival of these patients conservative palliative laryngeal treatments should be carried out to improve the quality of life. Curative treatment should be considered only in isolated laryngeal metastasis.

Signet ring cell infiltration in tubular adenoma of ascending colon

We present a case of signet ring cell infiltration in an adenomatous polyp of the ascending colon and review the literature. The patient had undergone resection of a mucin-producing adenocarcinoma of the proximal sigmoid colon seven months before the findings were reported. We presume that the signet ring cell aggregates are of metastatic origin.

びまん浸潤型を呈したＳ状結腸高分化腺癌の１例

著明な炎症性細胞浸潤と瘻孔様構造を伴うびまん浸潤型を呈したS状結腸の高分化腺癌の1例を経験した.症例は55歳,男性.主訴は便秘で,下部消化管の精査にてS状結腸に約7cmの全周性の狭窄を認めた.術前の生検では癌の組織診断は得られなかったが,狭窄が高度で悪性腫瘍が否定できないため,S状結腸切除術を施行した.切除標本では狭窄部の腸管壁は全周性に肥厚し,いわゆるびまん浸潤型を呈する腫瘍を認めた.組織学的に腫瘍は固有筋層まで浸潤する高分化腺癌で,粘膜下層を中心に高度の炎症性細胞浸潤を広範に認めた.病変部の粘膜面には正常粘膜が不連続に残存し,粘膜下浸潤部にも正常粘膜を認めた.本症例に類似したびまん浸潤型を呈する分化型大腸癌は過去に7例が報告されており,本症例はその発育様式について極めて示唆に富む症例であると考えられたので,文献的考察を加えて報告する.

Metastatic carcinoma in follicular adenoma of the thyroid gland

We report here two autopsy cases of carcinoma that metastasized to a thyroid follicular adenoma. The first was an 82-year-old man with sigmoid colon adenocarcinoma. Three years after a colectomy he died of multiple metastases. Autopsy revealed that the metastatic colonic carcinoma was located in a thyroid follicular adenoma. The second case was a 51-year-old man with primary lung adenocarcinoma. At the time of admission, he was inoperable because of multiple organ metastasis. He died 14 months after admission due to the carcinoma. Autopsy revealed a metastatic lung adenocarcinoma also located in a follicular adenoma, as in the first case. The phenomenon of tumor-to-tumor metastasis is rare. The mechanism is still unknown, and to our knowledge, only five cases of carcinoma metastatic to thyroid follicular adenoma have been documented in the literature.