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Background mucosal changes of primary advanced large intestinal cancer in patients without familial polyposis coli.

In 337 cases of primary advanced large intestinal cancer in patients without familial polyposis coli, the risk factor for cancer was discussed chiefly from the background mucosa surrounding and apart from the cancers. The following findings were obtained: (1) in the mucosa surrounding cancers, adenoma was seen in 23 cases (6.8 per cent), adenomatous changes of the basal cells in 211 cases (62.6 per cent), and hyperplastic glands in 167 cases (49.6 per cent), (2) in the mucosa at least 10 mm from the cancers, adenoma, adenomatous changes of the basal cells, and hyperplastic glands were seen in 42 cases (12.5 per cent), 129 cases (38.3 per cent), and 40 cases (11.9 per cent), respectively. Therefore, it is suggested that microscopic adenoma and adenomatous changes of the basal cells might be a sign of premalignancy in patients without familial polyposis coli.

Adenocarcinoma↗

Mucinous adenocarcinoma associated with long-standing fistula in the cecal region.

A patient with mucinous adenocarcinoma associated with long-standing chronic fistula in the cecal region is presented. Association of mucinous carcinoma with chronic fistula seems to occur not infrequently in the anal region, but is extremely rare elsewhere in the large intestine. This is the first report of an occurrence in the cecal region.

Adenocarcinoma, Mucinous↗

Colonoscopy: its role in cancer of the colon and rectum.

In order to determine the feasibility, yield, and impact of routine total colonoscopy on the management of large-bowel cancer, 157 cancer patients underwent 175 colonoscopic procedures; 13.6 per cent of the cancers had been missed on double-contrast barium enema examination. Among 92 patients undergoing perioperative colonoscopy, the lesion was reached in 90 per cent and the cecum in 60 per cent; 7.6 per cent demonstrated synchronous cancers, all curable, and all missed on barium-enema examination. Seventy-eight patients underwent colonoscopy at an average of 3.7 years after treatment of the index cancer; 7.7 per cent demonstrated metachronous cancers, all curable, two-thirds of which were missed on barium-enema examination. Benign polyps were noted in 62 per cent of the patients studied; 77 per cent of those polyps, 1 cm or greater in size, were missed on barium-enema examination. Polyps were found proximal to the cancer in 60 per cent of the patients with polyps. Approximately 85 per cent of those with multiple cancers demonstrated benign polyps. Preoperative total colonoscopy with periodic postoperative colonoscopy at an interval of three to five years are essential in the reliable detection of synchronous cancers and for the detection of metachronous cancers at an earlier, more favorable stage.

Cecal Neoplasms↗

The changing distribution of large intestinal cancer.

In recent years, several accounts have reported a proximal migration of colorectal cancer. To determine the experience at the Jewish General Hospital in Montreal, 1044 cases of large-bowel cancer that presented between the years 1955 and 1978 were analyzed. The colon was arbitrarily divided into five anatomic regions, and the distribution of cancer in each region for each of eight three-year periods was calculated. An increase in right-sided lesions occurred from 15.6 per cent in the first three-year period to 37.6 per cent in the final three-year period (P less than 0.01). No significant change occurred in transverse and left-colon lesions. An increase in sigmoid carcinomas occurred from 14 per cent to 35 per cent (P less than 0.01). A dramatic decrease in rectal carcinoma from 53 per cent to 2.1 per cent occurred (p less than 0.001). These findings imply that methods for the early detection and screening of large-bowel carcinoma should be directed at the entire colon rather than the distal 25 cm.

Cecal Neoplasms↗

Experimental model of liver metastases: adhesion and growth of cells on contact with endothelial or hepatocyte cell monolayer cultures.

In a rat colon carcinoma model (DHD/K 12-PROb), two varieties of cells were selected after in vivo passaging: PROb h2, representing a liver-specific variant and PROb Mp1, representing a lung metastatic variant and producing liver and lung metastases after intracecal injection (one out of four). The study of the adhesion and the growth of cells in vitro for contact hepatocytes and/or endothelial cells gave the following results: (1) except for PROb Mp1, tumor cell growth was independent of the cell support; (2) adhesion of PROb Mp1 to endothelial cells was lower between 30 and 120 min, whereas adhesion of PROb h2 to hepatocytes was greater and durable after 60 min (P < or = 0.05). These results suggest that the formation of liver metastases in a dynamic process and that tumor cells have a great ability to adhere to hepatocytes. Improved by serial passaging in vivo, our intracecal model might be useful for studying many aspects of the pathogenesis of colon cancer metastasis, while concurrent in vitro studies of the adhesion and growth ability of cells might be a useful indicator for assessing the in vivo behavior.

Animals↗

Extragenital mixed heterologous tumor of Müllerian type arising in the cecal peritoneum: report of a case.

A mixed heterologous tumor of müllerian type arising in the cecal serosa of an elderly woman is reported. There was no history of endometriosis, and no evidence of the latter was found in the surgical specimen or at autopsy. Evidence of mesothelial origin was found microscopically in the adjacent cecal peritoneum. A review of medical literature on mixed heterologous tumors of müllerian type reveals that heretofore they have originated only in the genital system.

Aged↗

Prophylactic oophorectomy in conjunction with large-bowl resection for cancer: report of two cases.

This report, based on eight cases of our own and a review of the literature, indicates that colonic cancer metastatic to the ovaries has many unusual features and an extremley high mortality rate. Prophylactic bilateral oophorectomy in conjunction with large-bowel resection for cancer in women of all ages is strongly advised to decrease morbidity and improve the quality of survival.

Adenocarcinoma↗

Crohn's disease of the appendix: report of a case and review of the literature.

A case of Crohn's disease of the appendix that simulated a cecal tumor is presented and 27 additional cases are reviewed. Crohn's disease of the appendix most commonly occurs in the younger patient, with 90 per cent in the second and third decades of life. Before operation, appendicitis or an appendiceal abscess is commonly diagnosed. Appendectomy should be performed, if possible; otherwise a limited ileocolectomy should be done. These patients should have a long-term follow-up program because inflammation can develop later in any part of the bowel. Crohn's disease of the appendix should be included in the differential diagnosis of pain or a palpable mass in the right lower quadrant, especially in the young adult patient.

Adult↗

Tuberculosis of the cecum simulating carcinoma.

A case is described of tuberculosis of the cecum mimicking carcinoma so closely that a conventional cancer operation was carried out. Ileocecal tuberculosis, reported in the literature, is briefly reviewed with special attention to its incidence, clinical manifestations, clinical investigation, and treatment.

Cecal Diseases↗

Leiomyoma of the cecum presenting as an acute surgical abdomen: report of a case.

This is a case of a benign leiomyoma of the cecum that perforated the bowel wall and manifested as an acute surgical abdomen. The literature was reviewed and the lesion was found to be uncommon. Clinical pictures may vary, but a colonic mass of this nature should be treated as a cancer, as it is not usually possible to distinguish benign from malignant lesions preoperatively.

Abdomen, Acute↗