scholarly journals Medullary Carcinoma of the Gastrointestinal Tract: Report on Two Cases with Immunohistochemical and Molecular Features

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1775
Author(s):  
Cristina Colarossi ◽  
Marzia Mare ◽  
Giorgio La Greca ◽  
Marco De Zuanni ◽  
Lorenzo Colarossi ◽  
...  
Keyword(s):  
Older Women ◽  
Specific Treatment ◽  
Medullary Carcinoma ◽  
Good Prognosis ◽  
Right Colon ◽  
Carcinoma Of The Colon ◽  
Molecular Features ◽  
Histological Variant ◽  
Poorly Differentiated ◽  
The Right

Medullary carcinoma of the colon is a rare histological variant characterized by a poorly differentiated morphology, an aberrant immunophenotype, and microsatellite instability. Despite the lack of glandular differentiation, medullary carcinoma is reported to have a good prognosis. It is typically located in the right colon and frequently affects older women. Due to its clinical, histological, biological, and genetic peculiarity, medullary carcinoma requires an accurate diagnosis and the awareness of this diagnostic possibility. We describe the morphological, immunohistochemical, and molecular findings of two interesting cases, the first one in the right colon of a patient and the second one in the terminal ileum of a patient with Crohn’s disease. Deeper knowledge of all the biological and clinical features will allow appropriate and specific treatment of this tumor in the future.

scholarly journals Diffuse Cutaneous Metastases as the Only Sign of Extranodal Tumor Spread in a Patient with Adenocarcinoma of the Colon

ISRN Surgery ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Serenella Civitelli ◽  
Barbara Civitelli ◽  
Jacopo Martellucci ◽  
Gabriello Tanzini
Keyword(s):  
Right Colon ◽  
Cutaneous Metastases ◽  
Tumor Spread ◽  
Site Specific ◽  
Poorly Differentiated Adenocarcinoma ◽  
Anatomical Relationship ◽  
Poorly Differentiated ◽  
Adenocarcinoma Of The Colon ◽  
The Right ◽  
A Site

Cutaneous metastases from large bowel cancer are uncommon and are usually associated with organ involvement. Localization of lesions to the skin is mainly attributed to vascular and anatomical relationship, since most of them are seen in the abdominal wall or in a surgical scar. We report a 73-year-old woman in whom metastatic nodules from a poorly differentiated adenocarcinoma of the right colon developed throughout the skin (buttock, trunk, chest wall, arms, and neck) and remained the only sign of extranodal tumor spread until patient's death, seven months later. This unusual behaviour suggests that localization of neoplastic cells to the skin may be a site-specific process, determined by adhesion molecules and/or by growth factors found at that site.

Lymphoepithelioma-like Carcinoma of the Colon in a Patient With Hereditary Nonpolyposis Colorectal Cancer

1999 ◽  
Vol 123 (8) ◽  
pp. 720-724
Author(s):  
Giovanni De Petris ◽  
Robert Lev ◽  
Daniel M. Quirk ◽  
Paul R. Ferbend ◽  
Janet R. Butmarc ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Nasopharyngeal Carcinoma ◽  
Hereditary Nonpolyposis Colorectal Cancer ◽  
Right Colon ◽  
Carcinoma Of The Colon ◽  
Lymphoid Stroma ◽  
Hereditary Nonpolyposis ◽  
Malignant Lesions ◽  
Well Differentiated ◽  
The Right

Abstract Tumors with features similar to those of nasopharyngeal carcinoma, so-called lymphoepithelioma-like carcinomas, have been described in several organs but are extremely rare in the colon. We describe a patient with a family history consistent with hereditary nonpolyposis colorectal cancer who had 3 malignant lesions in the right colon, namely, a mucinous cancer, a lymphoepithelioma-like carcinoma, and a well-differentiated adenocarcinoma with prominent lymphoid stroma. To the best of our knowledge, lymphoepithelioma-like carcinoma has not been described previously in hereditary nonpolyposis colorectal cancer.

scholarly journals Microsatellite Instability in Medullary Carcinoma of the Colon

Rare Tumors ◽  
2016 ◽  
Vol 9 (1) ◽  
pp. 23-25 ◽  
Author(s):  
Mario Martinotti ◽  
Fernando Cirillo ◽  
Marco Ungari ◽  
Giulia Tanzi ◽  
Giovanni Rolando ◽  
...  
Keyword(s):  
Microsatellite Instability ◽  
Medullary Carcinoma ◽  
Good Health ◽  
Caucasian Woman ◽  
Poorly Differentiated Adenocarcinoma ◽  
Carcinoma Of The Colon ◽  
Stenotic Lesion ◽  
Dna Mismatch ◽  
Poorly Differentiated

Medullary carcinoma (MC) of the large intestine is a relatively new histological type of adenocarcinoma characterized by poor glandular differentiation and an intraepithelial lymphocytic infiltrate. MC can be associated to a defective mechanism for DNA mismatch repair, caused by the so-called microsatellite instability (MSI). We present the case of a 44 years old Caucasian woman, who referred to the Emergency Room with symptoms mimicking an acute appendicitis. Computed tomography and colonoscopy demonstrated an ulcerated and stenotic lesion of the caecum without signs of metastasis and peritoneal carcinosis. Patient underwent a laparoscopic right colectomy. The final pathologic findings provided the diagnosis of medullary carcinoma with MSI. Patient then underwent adjuvant chemotherapy according to the FOLFOX-4 protocol (association of 5-Fluorouracil, Leucovorin, and Oxaliplatin) for twelve cycles. At two-years follow-up, patient is disease free. MC in association with MSI is a non-frequent tumor of the colon characterized by a better prognosis compared to other types of poorly differentiated adenocarcinoma. In the observed case, 24 months after the surgical operation, the patient is in good health and there is no evidence of metastasis or relapse.

scholarly journals Comparison of Nepalese and Swedish Patients with Colorectal Cancer Regarding Tumor Suppressor Methylation in Tumor and Mucosa Samples

2020 ◽  
Vol 42 (1) ◽  
pp. 73
Author(s):  
Bikal Ghimire ◽  
Goran Kurlberg ◽  
Yogendra P Singh ◽  
Yvonne Wettergren
Keyword(s):  
Colorectal Cancer ◽  
Methylation Status ◽  
University Teaching ◽  
University Hospital ◽  
Advanced Stage ◽  
Right Colon ◽  
Younger Adults ◽  
Poorly Differentiated ◽  
Well Differentiated ◽  
The Right

Introduction Colorectal cancer (CRC) is common with wide variation in incidence. However, the incidence in younger adults is showing an increasing trend with rectal preponderance. Such cases appear to present in advanced stage with poorly differentiated histopathology and the trend is stronger in developing countries. The aim of the study was to compare the MLH1 and in matched mucosa and tumor samples obtained from the large gut of Nepalese and Swedish patients with CRC. MethodsPatients diagnosed and operated for CRC at Tribhuvan University Teaching Hospital, Nepal (n=39) matched for age with those operated at Sahlgrenska University Hospital, Sweden (n=39) were included in the study. Demographics and clinicopathological data were compared. The tissue methylation status was compared in the Nepalese and Swedish populations and correlated to clinicopathological data. ResultsThere were 56% men and 44% women in the study. Their mean age was 53 years with a range of 20 to 78 years. Colon cancer amounted to 70% and 60% in the Nepalese and Swedish patients respectively and the majority of lesions were on the right colon. The colorectal cancer was commonly of stage III (52% and 38%) in the Nepalese and Swedish group respectively. Most of the tumors were well differentiated (41%) in the Nepalese population where as in Swedish patients it the differentiation was medium to low (52% and 11%). Methylation of MLH gene, in different CpG sites, when analyzed independently, showed that in about 18-20% of the cases, the degree of methylation is significantly higher in tumor tissue as compared to sites at least 10 cm away from the lesion. ConclusionColon cancer is more common in men in Nepal with predominantly more on the right colon. Most of them present in advanced stage with higher MLH1 methylation.

Correlation of Metabolic Risk Factors with Sessile Serrated Lesions

2020 ◽  
Vol 29 (2) ◽  
pp. 175-179
Author(s):  
Melania Macarie ◽  
Simona Bataga ◽  
Simona Mocan ◽  
Monica Pantea ◽  
Razvan Opaschi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Statistical Significance ◽  
Interval Cancer ◽  
Metabolic Risk Factors ◽  
Control Group ◽  
Anatomical Site ◽  
Metabolic Risk ◽  
Right Colon ◽  
Serrated Lesions ◽  
The Right

Background and Aims: The importance of sessile serrated lesions (SSLs) in the pathogenesis of colorectal carcinoma has been recently established. These are supposed to cause the so-called “interval cancer”, having a rapidly progressive growth and being difficult to detect and to obtain an endoscopic complete resection. We aimed to establish the most important metabolic risk factors for sessile serrated lesions. Methods: We performed a retrospective case-control study, on a series of 2918 consecutive patients who underwent colonoscopy in Gastroenterology and Endoscopy Unit, County Clinical Emergency Hospital, Târgu-Mureș, Romania between 1 st of January 2015-31 th of December 2017. In order to evaluate the metabolic risk factors for polyps’ development, enrolled participants were stratified in two groups, a study group, 33 patients with SSLs lesions, and a control group, 138 patients with adenomatous polyps, selected by systematic sampling for age and anatomical site. Independent variables investigated were: gender, smoking, alcohol consumption, obesity, arterial hypertension, diabetes, hypercholesterolemia, hypertriglyceridemia, hyperuricemia, nonalcoholic liver disease. Results: For SSLs the most common encountered localization was the right colon in 30.55% of cases. By comparative bivariate analysis between SSLs group and control group, it was observed that hypertension (p=0.03, OR 2.33, 95 %CI 1.03-5.24), obesity (p=0.03, OR 2.61, 95 %CI 1.08-6.30), hyperuricemia (p=0.04, OR 2.72, 95 %CI 1.28-7.55), high cholesterol (p=0.002, OR 3.42; 95 %CI 1.48-7.87), and high triglycerides level (p=0.0006, OR 5.75; 95 %CI 1.92-17.2) were statistically associated with SSLs development. By multivariate analysis hypertension and hypertriglyceridemia retained statistical significance. Conclusions: Our study showed that the highest prevalence of SSLs was in the right colon and hypertension and increased triglycerides levels were associated with the risk of SSLs development. These risk factors are easy to detect in clinical practice and may help identifying groups with high risk for colorectal cancer, where screening is recommended.

scholarly journals Thyroid Carcinoma on the Side of the Absent Lobe in a Patient with Thyroid Hemiagenesis

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Hiroki Sato ◽  
Kiyoaki Tsukahara ◽  
Ray Motohashi ◽  
Midori Wakiya ◽  
Hiromi Serizawa ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Papillary Carcinoma ◽  
Thyroid Tissue ◽  
Needle Aspiration ◽  
Left Lobe ◽  
Thyroid Hemiagenesis ◽  
Poorly Differentiated ◽  
Node Metastases ◽  
Right Lobe ◽  
The Right

Background. Thyroid carcinoma complicated by hemiagenesis is very rare, and previous reports have not described this cancer on the side of the absent lobe. Methods and Results. We report the case of a 64-year-old woman in whom left thyroid hemiagenesis was discovered incidentally during investigations of abnormal sensation during swallowing. A tumorous 1.4 cm lesion was also found on the side of the absent lobe, left of the isthmus. Fine-needle aspiration biopsy revealed class V papillary carcinoma, but no lymph node metastases. Total thyroidectomy was performed for stage cT1bN0M0 carcinoma. Histopathology revealed normal thyroid tissues in the right lobe and isthmus, while the left lobe was absent. The mostly papillary carcinoma was adjacent to the truncated thyroid tissue, with a portion histologically consistent with poorly differentiated carcinoma. Conclusions. All previously reported cases of thyroid cancer complicated by hemiagenesis have represented carcinoma occurring within the present lobe. This case is extremely rare.

scholarly journals Impact of second forward-view examination on adenoma detection rate during unsedated colonoscopy: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Keshu Shan ◽  
Hongpeng Lu ◽  
Zhixin Zhang ◽  
Jiarong Xie ◽  
Lu Xu ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Detection Rate ◽  
Controlled Trial ◽  
Lesion Detection ◽  
Adenoma Detection Rate ◽  
Right Colon ◽  
Randomized Controlled ◽  
Adenoma Detection ◽  
Advanced Lesion ◽  
The Right

Abstract Objectives Colorectal cancer on the right side of the colon has been suggested to be harder to detect by colonoscopy. The aim of this study was to evaluate whether a second forward-view examination of the right side of the colon could increase the adenoma detection rate (ADR) and/or polyp detection rate (PDR). Methods This was a single-centre randomized controlled trial. Patients undergoing colonoscopy were recruited and randomly assigned to the second forward-view examination (SFE) group, in which the right side of the colon was examined twice or the traditional colonoscopy (TC) group in which the colonoscopy was performed in a standard manner. The primary outcome was the ADR of right colon. The overall PDR and ADR, PDR of the right colon, per-adenoma miss rate of the right colon, and advanced lesion detection rate were also recorded and compared. Results A total of 392 patients were included in the study (SFE group 197 vs. TC group 195). The ADR and PDR of the right colon in the SFE group were significantly higher than those in the TC group (ADR 10.7% vs. 5.1%; P = 0.042); PDR 17.8% vs. 9.7%, P = 0.021). No significant difference was found in overall PDR/ADR, or advanced lesion detection rate between the two groups. Conclusions This prospective controlled study revealed that a second forward-view examination could modestly increase the ADR and PDR of the right colon during unsedated colonoscopies. This simple, safe and time-effective technique might be recommended for routine unsedated colonoscopy. Trial registration: Clinical Trials.gov, NCT03619122. Registered on 7/8/2018.

scholarly journals Levator palpabrae superioris myositis as an unusual cause of unilateral ptosis—case report

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Ahmed M. Abdrabou
Keyword(s):  
Previous History ◽  
Good Prognosis ◽  
Oculomotor Nerve Palsy ◽  
Ophthalmological Examination ◽  
Bilateral Ptosis ◽  
Mri Findings ◽  
Upper Eyelid ◽  
Unilateral Disease ◽  
The Right ◽  
Mri Study

Abstract Background Ptosis can be a manifestation of a more serious situation. Hence, the analysis of the complaint and the search for etiology are crucial in such cases. Ptosis has many causes; some of them lead to unilateral ptosis while others cause bilateral ptosis. For instance, myasthenia gravis is a cause of bilateral ptosis while oculomotor nerve palsy induces unilateral disease. Proper evaluation of the patient and identification of the cause are important to achieve accurate management and good prognosis. Case presentation A 47-year-old male patient attended the ER complaining of dropping the right eye lid of 2 days’ duration. There was no associated pain or diplopia. On examination, the extraocular muscles’ (EOM) motility was intact, normal pupil and corneal reflexes, and there was swelling of the upper eyelid. Ophthalmological examination revealed normal anterior and posterior chambers as well as the vitreous and retina. The patient had a previous history of traumatic intracranial hemorrhage that was resolved without surgical intervention. He also had diabetes mellitus and hypertension. The patient was transferred to the MRI unit to perform MRI study of the brain and orbit with MRA and IV contrast administration. MRI findings confirmed the diagnosis of LPS myositis, and the patient received medical treatment and improved. Conclusion Proper radiological diagnosis leads to accurate management and achieves rapid recovery and optimal patient care.

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