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PubMed1989

Intraperitoneal chemotherapy complicated by erosion of a Tenckhoff catheter into the colon.

Insertion and maintenance of intraperitoneal catheters must be done with meticulous attention to detail. We recommend insertion under direct vision to minimize the incidence of intestinal perforation during catheter placement. Intraperitoneal catheters should not be placed in close proximity to a fresh intestinal anastomosis because this position may promote anastomotic dehiscence. Communication between the catheter and the intestinal lumen necessitates catheter removal.

Catheters, Indwelling↗
PubMed1997

Dermatomyositis in association with tubulovillous adenoma: resolution after resection of adenoma.

Dermatomyositis (DM) has been associated with gastrointestinal malignancy but not with polyps or adenoma. We report a case of villous adenoma associated with DM. An 80-year-old white woman was referred for a rash of 2 months' duration that was suggestive of DM. On examination, Gottron's papules and heliotrope rash were seen. Muscle strength was 4/5 in the proximal upper and lower extremities. Despite normal muscle enzyme values, electromyographic and nerve conduction studies were supportive of the diagnosis of DM. DM was confirmed by deltoid muscle biopsy. Heme-positive stool was seen on rectal examination. Colonoscopy revealed a large tubulovillous adenoma in the cecum, which was resected. The patient was given oral prednisone, 60 mg/day. Within 4 weeks after surgery, steroids were tapered to one third the original dose. Within 9 months, steroid therapy had been discontinued with no evidence of disease activity.

Adenoma, Villous↗
PubMed1997

Perforated cecal adenocarcinoma presenting as a thigh abscess.

Complicated colorectal carcinoma has several symptoms, the most common being bleeding and obstruction. Occasionally it will cause perforation, which carries a worse prognosis. We report a case of perforated adenocarcinoma of the cecum that presented as an abscess of the thigh. We also present a review of the literature on this subject.

Abscess↗
PubMed1998

Carcinoma of the colon: an unusual cause of prolonged fever.

Solid tumors rarely present with fever. Among those that do, carcinoma of the colon has been infrequently reported as a primary cause of fever. This patient had carcinoma of the right colon with prolonged fever, but no evidence of infection or gastrointestinal symptoms. At surgical resection, a caecal adenocarcinoma was found with metastases to the mesentery and 10 of 40 lymph nodes. The patient's fever resolved after 3 days. The patient remained healthy during 8 years of follow-up. Right-sided colon cancer is not often considered in the complete evaluation of fever of undetermined cause.

Adenocarcinoma↗
PubMed1993

Small-cell undifferentiated (neuroendocrine) carcinoma of the cecum in a child with common variable immunodeficiency.

PURPOSE: Patients with primary or secondary immunodeficiencies are known to be at increased risk for the development of malignancies, predominantly of lymphoreticular origin. PATIENTS AND METHODS: We here describe a patient with infant-onset hypogammaglobulinemia due to a common variable immunodeficiency. At the age of 16 a small-cell undifferentiated (neuroendocrine) carcinoma of the cecum (SCUNC) was diagnosed. RESULTS: Neurohormonal analysis showed normal values. CONCLUSIONS: To our knowledge this is the first report in childhood of SCUNC of the gastrointestinal tract, which has also previously not been associated with primary immunodeficiency.

Carcinoma, Small Cell↗
PubMed2002

Adenocarcinoma of the cecum as the first manifestation of ulcerative colitis complicated by primary sclerosing cholangitis and endomyocardial fibrosis.

A 47-year-old male Caucasian patient, with no previous relevant medical history, presented in September 1996 with persistent right lower quadrant abdominal pain. A tumor in the cecum was identified and the patient was submitted to ileocecal resection with ileocolic anastomosis. Histological examination showed a moderately differentiated adenocarcinoma. One year later he developed bloody diarrhea, urgency, and loss of weight. Based on clinical presentation and histology of large bowel biopsies, a diagnosis of ulcerative colitis (UC) was established. The previously resected surgical specimen was reevaluated, and lesions resembling UC were identified in the nonneoplastic mucosa. High levels of alkaline phosphatase and gamma-glutamyl transferase were detected. These alterations could be traced back to 1991. Endoscopic retrograde cholangiopancreatography was performed, showing diagnostic features of primary sclerosing cholangitis (PSC), and the patient was put on ursodeoxycholic acid therapy. In March 1999, he started to have progressive dyspnea and signs of cardiac failure. Endomyocardial biopsy was performed showing extensive lesions of endomyocardial fibrosis. This case illustrates a rather silent course of UC in the presence of PSC, and supports the postulated increased risk in the development of proximally located colorectal carcinoma in these patients. Additionally, the development of endomyocardial fibrosis constituted an unexpected finding, not previously reported in this setting.

Abdominal Pain↗
PubMed1999

Difference in target organs in carcinogenesis with a heterocyclic amine, 2-amino-3,4-dimethylimidazo[4,5-f]quinoline, in different strains of mice.

2-Amino-3,4-dimethylimidazo[4,5-f]quinoline (MeIQ) induces cancers in the forestomach and liver, but not in the colon, of CDF1 male and female mice, which are thought to be resistant to induction of colon cancer by 1,2-dimethylhydrazine. In this study, we examined the carcinogenicity of MeIQ in C57BL/6N female mice, which are susceptible to 1,2-dimethylhydrazine. This strain of mice developed carcinomas of the cecum, colon and liver, but not the forestomach, when given a diet containing 300 ppm of MeIQ. This fact indicates that the target organs of a chemical carcinogen change depending on the strain of a given animal species.

1,2-Dimethylhydrazine↗
PubMed2005

Colorectal cancer in Asians: a demographic and anatomic survey in Malaysian patients undergoing colonoscopy.

BACKGROUND: Colorectal cancer is one of the most common forms of gastrointestinal cancer in the world today. In the Asia-Pacific area, it is the fastest emerging gastrointestinal cancer. AIM: To determine the basic demographic features of patients with colorectal cancer and the anatomic distribution and characteristics of the tumour in a local Asian population. METHODS: We conducted a review of consecutive patients who had undergone colonoscopy from 1999 to 2003 at the University of Malaya Medical Center, Kuala Lumpur, Malaysia. RESULTS: Analysis was carried out on 3404 patients who underwent colonoscopy. A total of 228 patients (7%) were diagnosed with carcinoma. The mean age of diagnosis (+/-s.d.) was 64.4 +/- 13.1 years. The male to female ratio was 1.15. Polyps were noted in 470 patients (14%). Polyps detected concomitantly with a colorectal cancer were noted in 55 patients (2%). Four patients (0.1%) were diagnosed to have familial adenomatous polyposis coli. Of the 228 patients 209 (92%) had tumours at only one site whereas 19 (8%) had synchronous lesions. Tumours were mainly left sided [198 of 248 patients (80%)] with the majority located in the recto-sigmoid region. Detailed records of treatment were available only in 176 patients. A total of 147 of 176 patients (84%) underwent surgery and 50 (28%) also received adjuvant or palliative chemotherapy (28%). Seven of 154 patients (5%) were diagnosed to have stage A cancers, 64 (42%), stage B, 23 (15%), stage C and 60 (39%), stage D. Multivariate analysis using multiple logistic regression analysis showed that age > or =65 years (OR = 1.78; 95% CI: 1.35- 2.36) and Malay (OR = 2.09; 95% CI: 1.30-3.35) and Chinese (OR = 1.77; 95% CI: 1.77-2.69) race were significant independent predictive factors for colorectal cancer. CONCLUSIONS: The demography of colorectal cancer is different from western patients. Tumours were mainly left sided in our patients. However, no differences in anatomic location were found between races, men and women and younger and older age groups. Colorectal cancer presented in an advanced stage in the majority of patients.

Aged↗