Cases reported "Colonic Neoplasms"

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1/15. Phlebosclerotic colitis coincident with carcinoma in adenoma.

    Phlebosclerosis of the colon is a rare disease characterized by a thickening of the wall of the colon with fibrosis, hyalinization and calcification to the affected veins. These symptoms result in a type of ischemic colitis known as phlebosclerotic colitis. A case of phlebosclerotic colitis coincident with carcinoma in adenoma is reported. A 74-year-old Japanese woman was admitted to hospital because of a mass in her right lower abdomen. Abdominal computed tomography examination revealed linear calcifications in the wall of the cecum and the ascending colon. colonoscopy revealed dark purple mucosa with multiple ulcers in the cecum and the ascending colon. biopsy specimens showed a marked hyalinous thickening of the wall of small blood vessels in the mucosa. Phlebosclerotic colitis was suspected because of negative results with amyloid stain. Alternative ileocolic angiography showed the serpentine of the peripheral nature blood vessels and pooling at the late venous phase. Microscopic examination of the surgically resected colon revealed mucosal and submucosal fibrosis, and a thickening of the venous wall with fibrosis, hyalinization and calcification from the mucosa to the serosa, which caused a marked luminal narrowing. A small polypoid lesion was also found in the affected region and was diagnosed histologically as carcinoma in adenoma. To our knowledge, this is the first reported case of phlebosclerotic colitis complicated by carcinoma.
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2/15. Primary non-Hodgkin's lymphoma of the transverse colon presenting as dermatomyositis: case presentation and literature review.

    Primary extranodal non-Hodgkin's lymphoma of the transverse colon is a rare presentation of non-Hodgkin's lymphoma or colonic neoplasm. dermatomyositis is an autoimmune condition of the skin, muscle, and blood vessels that when associated with malignancy is a true paraneoplastic syndrome but is rarely associated with non-Hodgkin's lymphoma. We present a case of primary non-Hodgkin's lymphoma of the transverse colon diagnosed after the presentation of dermatomyositis and review the literature on dermatomyositis and hematologic neoplasm.
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3/15. Combined leiomyomatosis of the small intestine and colon.

    We report a case of leiomyomatosis that involved the small intestine and colon. On gross examination, the bowel wall was irregularly thickened at various levels. Histologically, the lesions were characterized by multifocal, diffuse tumor masses that were present in the muscular layers. These masses consisted of proliferating smooth-muscle cells that often surrounded prominent blood vessels. Cytologic atypia was not observed, and the mitotic count was low, illustrating the benign nature of the tumors. Findings from immunohistochemical analysis of the lesions were essentially negative; vimentin, cytokeratin, actin, desmin, and S100 stains showed no reactivity in the tumor cells, despite positive internal controls. By reviewing the literature, we found several reports on related lesions that occurred in the gastrointestinal tract; diffuse leiomyomatosis of the esophagus and the colon have been reported. We did not find any report on the small intestinal variant of the disease; therefore, it seemed useful to term this new localization as leiomyomatosis of the small intestine and colon.
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4/15. Regional lymph node metastasis from port site implants after laparoscopic surgery.

    Although overall incidence of laparoscopic port site implants is decreasing, it remains problematic in patients with occult intraabdominal malignancy. Port-site metastases may themselves become the source of new metastases. A 42-year-old man underwent a laparoscopic cholecystectomy for cholelithiasis. One month later, he was diagnosed with a right colon cancer, for which a right colectomy was performed. Eleven months later, a CT scan showed nodules in the umbilicus (one of the original laparoscopic port sites) and behind the right rectus abdominis muscle, adjacent to the deep epigastric vessels. These sites were resected, and histopathology confirmed metastatic adenocarcinoma. The right deep epigastric nodule was reported to be lymph node-positive for metastatic adenocarcinoma. It is probable that dissemination of cancer cells to this lymph node occurred from the port site implants. Presence of metastasis in the lymph nodes draining the abdominal wall should be examined in all patients with port site implants.
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5/15. A case of idiopathic colonic varices: a rare cause of hematochezia misconceived as tumor.

    Colonic varices are a very rare cause of lower gastrointestinal bleeding. Fewer than 100 cases of colonic varices, and 30 cases of idiopathic colonic varices (ICV) have been reported in the English literature. Among these 30 cases of ICV, 19 cases were diagnosed by angiography, and 7 operated cases were diagnosed later as ileocecal vein deficit, hemangioma, and idiopathic in 1, 1, 5 cases, respectively. We report the case of a 24-year-old man who suffered from multiple episodes of hematochezia of varying degree at the age of 11 years. He had severe anemia with hemoglobin of 21 g/L. On colonoscopy, tortuously dilated submucosal vein and friable ulceration covered with dark necrotic tissues especially at the rectosigmoid region were seen from the rectum up to the distal descending colon. It initially appeared to be carcinoma with varices. Mesenteric angiographic study suggested a colonic hemangioma. Low anterior resection was done due to medically intractable and recurrent hematochezia. Other bowel and mesenteric vascular structures appeared normal. Microscopic examination revealed normal colonic mucosa with dilated veins throughout the submucosa and serosa without representing new vessel growth. Taken all of these findings together, the patient was diagnosed as ICV. His postoperative course was uneventful.
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6/15. Cerebrovascular complications of mucinous cancers.

    Six patients with mucinous cancer (2 colonic, 2 pancreatic, and 2 pulmonary origin) had necropsy evidence of thrombosis of large and small systemic, extracranial, and intracranial arteries and veins, and multiple cerebral infarcts and small hemorrhages. On microscopic examination, we found small infarcts and hemorrhages within the brain and mucin within vessels, macrophages, and in areas of infarction. The clinical picture included strokes and encephalopathy. Mucin-producing cancers can be associated with a coagulopathy that causes extensive occlusive vascular disease.
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7/15. The response of neoplastic intestinal vessels to prostaglandin F2 alpha: angiographic observations with emphasis on therapeutic applications.

    The effects of prostaglandin (PG) F2 alpha in 16 patients with vascular malignant intestinal tumors were analyzed by angiography. It was found that PGF2 alpha reduced tumor vascular flow selectively in all but one patient, a rectal carcinoma case. Among the remaining group, a case of intestinal choriocarcinoma complicated by massive gastrointestinal hemorrhage was successfully controlled with intraarterial infusion of PGF2 alpha into the superior mesenteric artery. Owing to the reduced blood flow in tumors, PGF2 alpha is expected to be used extensively as a vasoconstrictor to control bleeding from tumors of the alimentary tract.
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8/15. Ischemic enterocolitis without arterio-occlusive lesion.

    Four cases of ischemic enterocolitis without arterio-occlusive lesion were described. Three cases were associated with sigmoid colon carcinomas. Ischemic lesions developed anal to the carcinomas in two cases, and oral to sigmoidostomy to relieve intestinal obstruction by carcinoma in one case. One other case was associated with inguinal hernia. Grossly, ischemic lesions involved relatively short intestinal segments, and the ischemic colonic lesions were not related to teniae coli. Extensive veno-occlusive lesions were discovered in a case of ischemic stricture of the ileum, which had been incarcerated in the right inguinal hernia. Reversible mechanical occlusion of the intestinal vessels caused by transient or recurrent intestinal strangulation is the most probable cause of these ischemic lesions.
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9/15. Resection of the abdominal aorta for recurrent colon cancers. 18 year survival.

    (1) An 18 year survival after resection of a recurrent colon cancer involving the aortic bifurcation is reported. (2) Involvement of major intraabdominal vessels by malignant tumors should not categorically be considered a contraindication to curative resection. (3) After extended radical resections for colonic cancer, 40 to 100 percent of the adhesions will contain malignant cells. Curative en bloc resection of these primary tumors together with their organs and tissues, particularly if the adhesions are dense, can achieve 5 year survival in 34 percent of cases. (4) Colonic tumors recur locally in 4 to 28 percent of patients who are resected for cure; recurrence at the primary site may be the sole evidence of recurrent disease in 28 to 60 percent of these cases. These patients may be candidates for exploratory laparotomy and 30 to 40 percent may be amenable to reresection for cure with an anticipated 5 year survival rate of 23 percent.
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10/15. indocyanine green videoangiographic findings in choroidal metastatic tumor.

    BACKGROUND: indocyanine green videoangiography (ICGV) has recently advanced and become widely available as a clinical tool. We tested the efficacy of ICGV in evaluating metastatic choroidal tumors. methods: ICGV using Topcon 50-IA was performed in five patients with clinically diagnosed choroidal metastatic tumors. The findings were compared with those of conventional fluorescein angiography (FAG). RESULTS: Compared with FAG, ICGV demonstrated more smooth and regular hypofluorescent lesions, precisely indicating the exact size of the tumor. In all cases, no tumor vessels were found. The choroidal vascular integrity around the tumors was observed. FAG, however, was more sensitive in detecting the tumor development than ICGV when the extent of the hypofluorescent lesion could be seen clearly in the early phase. FAG provided more information regarding retinal pigment epithelial dysfunction in the outer blood retinal barrier overlying the tumor. CONCLUSION: Since ICGV enables visualization of tumors through the retina, it is very useful, particularly in cases of associated secondary retinal detachment around the tumors. ICGV combined with FAG provides more precise assessment of the tumors themselves and their response to treatment than FAG alone.
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