scholarly journals COEXISTENCE OF TUBERCULOSIS AND ADENOCARCINOMA OF THE COLON

2003 ◽  
Vol 42 (145) ◽  
pp. 39-41
Author(s):  
Yogendra Singh ◽  
G Sayami ◽  
M Khakurel

ABSTRACTA 60-years-old, male patient presented with a-tender swelling in the right iliac fossa with right hip flexiondeformity suggesting of psoas abscess. Following emergency drainage of faeculant pus, the general conditionof the patient improved. The barium enema showed leaking ascending colonic ulcer and colonoscopicexamination revealed nonspecific ulcerative lesion in the ascending colon. Repeat investigations were alsonon-conclusive except there was a stricture at the ascending colon on colonoscopy. A second operationshowed that there was a huge mass of terminal ileum, cecum and ascending colon and perforation of ascendingcolonic ulcer most likely carcinoma. Right hemicolectomy was performed with uneventful postoperativeperiod. Histopathological examination revealed well differentiated adenocarcinoma limited to the musclelayer of the ascending colon and features suggestive of colonic tuberculosis at the same site. Antituberculartreatment was completed with regular follow-up and monitoring on CEA level. Patient has been doing well3 years postoperatively. Although rare, the coexistence of colonic tuberculosis with carcinoma may occur. Adefinitive diagnosis can be established only by histological examination.Key Words: Colonic tuberculosis, Adenocarcinoma, Histology.

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Nicolas Macagno ◽  
Stéphane Fuentes ◽  
Gonzague de Pinieux ◽  
André Maues de Paula ◽  
Sébastien Salas ◽  
...  

Despite being one of the most frequent soft-tissue sarcomas, well-differentiated liposarcoma has never been reported near the spine. The authors present the case of a 67-year-old man with progressive history of back pain. Physical examination revealed a mass located within the right paravertebral muscles. MR and CT imaging showed a heavily ossified central mass surrounded by a peripheral fatty component. No connection with the underlying bone was detected on imagery and during surgery. After surgical resection, histopathological examination revealed a tumor harboring combined features of well-differentiated liposarcoma and low-grade osteosarcoma. Tumor cells displayed overexpression of MDM2, CDK4, and P16 by immunohistochemistry and CGH revealed amplification of 12q13-15 as the only genetic imbalance. MDM2 FISH analysis was performed but was inconclusive. The pathological, immunohistochemical, and genetic features, the differential diagnoses, and the therapeutic management of this unusual tumor are discussed. No complementary treatment was performed initially. Following first treatment, two recurrences occurred 6 and 9 years later, both displaying histological features similar to the first occurrence. Radiotherapy was started after the second recurrence. Follow-up shows no evidence of disease 11 years after initial diagnosis. This case was unusual due to the paravertebral location of the tumor and its divergent differentiation.


2017 ◽  
Vol 4 (10) ◽  
pp. 3292
Author(s):  
Anita Samraj ◽  
Sanjay Prakash J. ◽  
Muthukumaran G.

Background: Patients with mass in the right iliac fossa may confront the surgeon, pediatrician or gynecologist. Thus, thorough understandings of the anatomy and pathological process that may occur within the abdomen are essential for an accurate diagnosis and plan of treatment. The objective of this study was to interpret aetiopathology, clinical presentation, differential diagnosis and management of mass in the right iliac fossa.Methods: A total of 60 cases with mass in the right iliac fossa (RIF) were included in the study. Investigations like colonoscopy and CT scan were done. All the cases underwent right hemicolectomy followed by chemotheraphy. Other cases like psoas abscess, non-hodgkins lymphoma, Meckels diverticulum and intussusception were diagnosed and treated.Results: During this study period, a total number of 36 cases of appendicular mass and 10 cases of appendicular abscess were encountered. In this study 10 cases of appendicular abscess were encountered and treated by extraperitoneal drainage, 4 cases of ileocaecal kochs were encountered. Patients presented with constitutional symptoms like pain, fever, weight loss etc. Right hemicolectomy was done, specimens after operative procedures were examined microscopically and histopathological diagnosis. 3 cases of carcinoma caecum and 3 cases of carcinoma ascending colon were seen. Contrast enema was done which showed filling defect and mucosal irregularities.Conclusions: This study showed that appendicular mass is the commonest pathology in right iliac fossa amongst all and conservative treatment followed by interval appendicectomy is the best mode of treatment. Carcinoma of the colon and ileocaecal tuberculosis is the other two common causes for mass in the right iliac fossa. These cases also carry a good prognosis, if properly diagnosed and treated. The other rare causes of mass in the right iliac fossa are intussusception, psoas abscess and Non Hodgkins lymphoma.


2002 ◽  
Vol 30 (4) ◽  
pp. 452-456 ◽  
Author(s):  
A Nakao ◽  
S Sato ◽  
A Nakashima ◽  
A Nabeyama ◽  
N Tanaka

We report a novel case of cystadenocarcinoma forming an appendiceal mucocele with development of a skin fistula. The patient was a 75-year-old Japanese woman who originally presented with a skin ulcer on the right flank (inferior to the ribs and superior to the iliac bone) with mucus discharge. The serum concentration of carcinoembryonal antigen was elevated (57.4 ng/ml). Ultrasonography and computed tomography demonstrated a cystic mass with septations in the right iliac fossa. Fistulography from the skin ulceration showed a communication via the fistula to the caecum. A right hemicolectomy and enbloc resection of the skin fistula was performed. The histological findings revealed a well-differentiated mucinous cystadenocarcinoma of the appendix. The patient has been alive for 7 years following surgery without any sign of recurrence. This report is of interest as it demonstrates that tumour rupture to the extraperitoneal space could result in a good outcome by preventing the development of pseudomyxoma peritonei.


Author(s):  
Hage Ampu ◽  
Tanya Singh ◽  
Sunil Kumar ◽  
H. P. Singh ◽  
Shalini Bhalla

AbstractIn this case report we describe a rare case of chondrosarcoma of the Temporomandibular joint in a 70 years old female who presented with a right preauricular swelling, trismus and neuralgic pain. On examination, firm and tender swelling was noted in the right preauricular region. CT Scan revealed 3.48 × 3.0 cm size mass lesion in the region of mandibular condyle and extending into the right temporomandibular joint space. The cytopathological report was suggestive of chondroid malignancy. The tumor was excised and histopathological examination showed large sheets of atypical tumor cells with cartilaginous matrix and diagnosis of a well differentiated Chondrosarcoma was confirmed. Post-surgical resection, patient remains disease free at 15 months follow up.


2021 ◽  
pp. 386-387
Author(s):  
Arnab Gupta ◽  
Subrata Kumar Sahu ◽  
Samir Bhattacharya ◽  
Sudip Haldar

Malrotation of the gut is a rare congenital anomaly that mostly presents in the 1st month of life. Very rarely, it is found during adulthood either as an asymptomatic incidental finding or at autopsy. Presenting in adulthood with colon cancers is extremely rare. Here, we present the case of a middle-aged male patient with unexplained anemia which on investigation was found to have adenocarcinoma at the hepatic flexure of the colon. The staging computed tomography scan of the abdomen showed the growth at the hepatic flexure with malrotation of the gut. During the laparoscopic assessment, the cecum and ascending colon were found on the left side, and hence, a formal midline incision was made. Cecum was found on the left of the midline along with Ladd’s band. Extended right hemicolectomy was performed, dividing the Ladd’s band, taking care of the anomalous position of superior mesenteric vessels. The post-operative period was uneventful. Histopathological examination revealed this to be well-differentiated adenocarcinoma (pT3N1b). He thereafter received adjuvant chemotherapy and remains well after 5 years of follow-up. Presentation of malrotation of the gut in adulthood is seen in only 10–15% of cases as an incidental finding or at autopsy. Cancers in the colon in these patients are extremely rare. The treatment for colon cancer remains the same although one has to be careful about the vascular anomaly during the resection.


2020 ◽  
Vol 102 (2) ◽  
pp. e39-e41
Author(s):  
M Sammut ◽  
C Barben

Approximately 5% of intestinal obstruction cases are caused by internal herniation. Caecal herniation through the foramen of Winslow is considered a rare event. The management of caecal herniation remains challenging due to the lack of literature highlighting this pathology. A 66-year-old woman was admitted with a 24-hour history of epigastric pain radiating to the back. The pain was associated with nausea and vomiting of gastric contents. On examination, the abdomen was soft with mild tenderness but no signs of peritonism or distension. The abdominal x-ray and a computed tomography were in keeping with caecal volvulus and confirmed that the caecum was not in the right iliac fossa. In a midline laparotomy procedure, the ileum, caecum and ascending colon were noted to be herniating into the foramen of Winslow. A right hemicolectomy with a handsewn anastomosis was performed. The foramen of Winslow was not closed. No postoperative complications occurred. A literature review showed a lack of similar cases with no agreed management consensus. The laparotomy approach is comparable to the laparoscopic approach and no caecal herniation recurrence after open/laparoscopic surgical procedures were identified. Awareness of caecal herniation allows early diagnosis and timely surgical management is needed in prevent patient morbidity and mortality.


2011 ◽  
Vol 1 ◽  
pp. 57 ◽  
Author(s):  
Ahmet Pergel ◽  
Ahmet Fikret Yucel ◽  
Ibrahim Aydin ◽  
Dursun Ali Sahin ◽  
Hasan Gucer ◽  
...  

Spermatic cord liposarcoma is an uncommon paratesticular tumor. Patients usually present with a painless scrotal or inguinal mass, mimicking inguinal hernia. Clinical examination suggested an inguinal hernia. Computed tomography demonstrated a fat-containing mass in the right inguinal region. The mass was surgically removed, along with the right testis and spermatic cord. Histopathological examination revealed a well-differentiated liposarcoma. No evidence of recurrence or metastases has been noted during the two-year follow-up with postoperative adjuvant therapy.


Author(s):  
Sneha R Adidam ◽  
◽  
Seenath M ◽  
Chalapathi R Adidam Venkata ◽  
◽  
...  

Inflammatory Myoglandular polyps (IMGPs) are rare intestinal polyps that occur frequently in the left colon and may present with hematochezia. Only a small number of cases have been reported in the right colon (2%). We present a case of IMGP in the proximal ascending colon. A 46-year-old woman of mixed ethnicity presented with a history of abdomino-pelvic pain and constipation. CT scan suggested possibility of malignancy. On colonoscopy, a non- obstructive polyp in proximal ascending colon was biopsied followed by right hemicolectomy. Patient also underwent total abdominal hysterectomy at the same time for fibroids. The colonic polyp revealed features of IMGP with focal adenomatous changes. The polyp was characterized by epithelial erosion, inflamed granulation tissue, hyperplastic and dilated glands, and proliferating smooth muscle. IMGP needs to be distinguished from other non-neoplastic colonic polyps, which includes Peutz-Jeghers polyps, inflammatory pseudopolyps, juvenile polyps, and inflammatory fibroid polyps. We report a large sized inflammatory myoglandular polyp with suspicious imaging findings and presence of adenomatous changes that mimicked malignancy that requires comprehensive evaluation and follow up.


2019 ◽  
Vol 6 (3) ◽  
pp. 85-89
Author(s):  
Elena Neștian ◽  
M A Șoitu ◽  
Rodica Birla ◽  
Daniela Dinu ◽  
Cristina Iosif ◽  
...  

Introduction: Tumors of ileo-caecal valve are most clinically manifested either through transit disorders or anemic syndrome. The 88-year-old patient is admitted for abdominal pain in the left flank, vomiting, asthenia and lack of intestinal transit for faeces, with a progressive onset of one week. Clinical examination: generalized affected state, wide abdomen, painful left flank and hypochondrium, lack of intestinal transit and pallor. Paraclinic: severe hypochromic microchrome anemia (hemoglobin: 5.8 g / dl). Plain radiography: hydro-aeric levels in the left hypochondrium. Abdominal CT: ileo-colic intussusception that completely occupies the ascending colon to the hepatic flexure, with no visible tumoral lesions. After hydroelectrolytic and hemodynamic balancing with restoration of intestinal transit, colonoscopy is performed: 5 cm ulcer-vegetative tumor formation at the ileo-caecal valve level - biopsy with histopathological examination: moderately differentiated adenocarcinoma. Patient refuses surgery. After 3 weeks, the patient returns to the clinic for the recurrence of digestive symptoms and emergency surgery is performed: laparotomy by median suprasubombilical incision, finding: ileo-ceco-appendico-colic invagination up to the middle third of the transverse colon, defective attachment of ascending colon, ileum dilated with thick wall. The invagination is reduced, the tumor formation is discovered. Right hemicolectomy with ileotransversoanastomosis is performed. Postoperatively, the patient shows a simple evolution with discharge of the 9th postoperative day. Conclusions: The ileocolic invagination in adults is most often the appearance of a tumor located on mobile segments of the intestine. The right colon invagination is possible when there is a defect of acolation, anatomical peculiarity encountered in the presented case.


2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098668
Author(s):  
Bo Pang ◽  
Cong Hu ◽  
Qian Liu ◽  
Jinyu Yu ◽  
Zhentong Wei ◽  
...  

Well-differentiated papillary mesothelioma (WDPM) is an uncommon mesothelial tumor. The lesions may be single or multiple and usually behave in a benign or indolent fashion, sometimes persisting for many years. In the present case, a 37-year-old woman had experienced primary infertility for 12 years, and a diagnostic laparoscopy was performed. Approximately 200 mL of dark red, free fluid in the pelvis and more than 10 yellow-white nodules on the surface of the right round ligament, sacrum ligament, right fallopian tube, and both sides of the uterus were found. A lesionectomy was performed and immunohistochemical markers indicated WDPM with adenomatoid tumor. The patient was monitored by computed tomography and serum CA125 (cancer antigen 125) levels for 49 months with no recurrence. WDPM and adenomatoid tumor are both benign tumors of mesothelial origin. Because of the lack of effective radical treatment, regular follow-up is sufficient. However, the effects of estrogen and progesterone on WDPM and adenomatoid tumors during ovulation or pregnancy remains unclear. Although WDPM is not life threatening, a strategy to fulfill the fertility requirements of women with this condition is a new challenge for infertility doctors.


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