scholarly journals Rectal Cancer With Distally Spreading Intramural Metastasis: A Case Report and Review of the Literature

2019 ◽  
Vol 103 (1-2) ◽  
pp. 21-26
Author(s):  
Kiminori Yanagisawa ◽  
Hidekazu Takahashi ◽  
Norikatsu Miyoshi ◽  
Naotsugu Haraguchi ◽  
Junichi Nishimura ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Primary Tumor ◽  
Case Reports ◽  
Normal Mucosa ◽  
Care Physician ◽  
Primary Adenocarcinoma ◽  
Intramural Metastasis ◽  
Well Differentiated ◽  
Surgical Resection Margin ◽  
Anal Side

Introduction: Intramural metastasis (IM) is common in esophageal cancer, and it is an important factor in determining the resection area and tumor malignancy. However, IM is rare in rectal cancer; therefore, little is known about IM in rectal cancer, and the clinical significance remains unclear. Case Presentation: We describe a case of rectal cancer with distally spreading IM. A 58-year-old man consulted a primary care physician, with a chief complaint of constipation; tests revealed a high carcinoembryonic antigen value. A colonoscopy revealed a type 2, advanced rectal tumor, which covered two-thirds of the circumference of the upper rectum. In addition, 3 protruding lesions were observed under the normal mucosa on the anal side of the primary tumor. A laparoscopic low anterior resection was performed. Pathologic findings showed that the primary tumor was a moderate-to-well-differentiated adenocarcinoma with a cribriform structure. The 3 lesions on the anal side found under normal mucosa were separate from the primary tumor, but morphologically similar to the primary adenocarcinoma; therefore, these were diagnosed as IMs. Based on a review of previous case reports, rectal carcinomas were often accompanied by vascular invasions and lymph-node metastases. Moreover, in rectal cancer, tumors with IMs often show vascular invasion. Therefore, we assumed that IM could be a marker of poor prognosis. Conclusion: This study revealed that, in surgery, detection of a distally spreading IM is an important finding for determining the optimal surgical resection margin.

EXPERIENCE OF THE APPLICATION OF THERMOCHEMIORRADIOTHERAPY IN COMBINED TREATMENT OF DYSTAL CANCER OF DIRECT INTESTINE

2019 ◽  
Vol 65 (1) ◽  
pp. 131-134
Author(s):  
Zhanna Startseva ◽  
Sergey Afanasev ◽  
Dina Plaskeeva
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Primary Tumor ◽  
Advanced Colorectal Cancer ◽  
Combined Treatment ◽  
Locally Advanced ◽  
Chemoradiation Therapy ◽  
Locally Advanced Colorectal Cancer

The article describes the experience of using ther-mochioradiotherapy in the combined treatment of distal locally advanced colorectal cancer, as well as comparing the effectiveness of treatment with chemoradiation therapy. The use of the proposed method as a component of the combined treatment of patients with rectal cancer allowed to increase the percentage of organ-preserving operations. As a result of thermochemotherapy, the prevalence of the primary tumor was significantly reduced, as a result of which the number of sphincter-bearing operations was reduced by almost 2 times (p

scholarly journals Cardio-Pulmonary Sequelae in Recovered COVID-19 Patients: Considerations for Primary Care

2021 ◽  
Vol 12 ◽  
pp. 215013272110237
Author(s):  
Zouina Sarfraz ◽  
Azza Sarfraz ◽  
Alanna Barrios ◽  
Radhika Garimella ◽  
Asimina Dominari ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Infection ◽  
Clinical Laboratory ◽  
Point Of Care ◽  
Case Reports ◽  
Case Series ◽  
Infectious Complications ◽  
Care Physician ◽  
Cross Sectional ◽  
Infection Period

Background: Current literature lacks characterization of the post-recovery sequelae among COVID-19 patients. This review characterizes the course of clinical, laboratory, radiological findings during the primary infection period, and the complications post-recovery. Primary care findings are presented for long-COVID care. Methods: Adhering to PRISMA guidelines, 4 databases were searched (PubMed, Embase, CINAHL Plus, Scopus) through December 5, 2020, using the keywords “COVID-19 and/or recovered and/or cardiovascular and/or long-term and/or sequelae and/or sub-acute and/or complication.” We included published peer-reviewed case reports, case series, and cross-sectional studies providing the clinical course of COVID-19 infection, and cardiopulmonary complications of patients who recovered from COVID-19, while making healthcare considerations for primary care workers. Results: We identified 29 studies across 9 countries including 37.9% Chinese and 24.1% U.S. studies, comprising 655 patients (Mean Age = 45) with various ethnical backgrounds including Asian and European. Based on the WHO COVID-19 severity classification scale, initial disease severity was mild for 377 patients and severe for 52 patients. Treatments during primary infection included corticosteroids, oxygen support, and antivirals. The mean value (in days) for complication onset after acute recovery was 28 days. Complete blood counts and RT-PCR tests were the most common laboratory results described. In 22 of the studies, patients showed signs of clinical improvement and were prescribed medications such as anticoagulants or corticosteroids. Conclusion: Post-recovery infectious complications are common in long-COVID-19 patients ranging from mild infections to life-threatening conditions. International thoracic and cardiovascular societies need to develop guidelines for patients recovering from COVID-19 pneumonia, while focused patient care by the primary care physician is crucial to curb preventable adverse events. Recommendations for real-time and lab-quality diagnostic tests are warranted to establish point-of-care testing, detect early complications, and provide timely treatment.

scholarly journals Patient with Metastatic Process in the Skeleton of Unknown Etiology

2019 ◽  
pp. 135-142
Author(s):  
Majerníková M ◽  
Sedláček J ◽  
Monhart Z
Keyword(s):  
Multiple Myeloma ◽  
Primary Tumor ◽  
Case Reports ◽  
Unknown Etiology ◽  
Primary Process ◽  
Kidney Tumor ◽  
Complex Treatment ◽  
Benign Process ◽  
Metastatic Process

Bearing bone involvement is a possible sign of generalization variety of cancers. In many cases the process of bearing skeletal diagnosed at the time when the primary tumor is not obvious. The task of the physician is quickly to determine whether it is a benign process or not, and diagnosis of the primary process by which then determine the further progress of therapy. The search for causative bearing shell process, alternatively the primary tumor, is often common practice in the hands of internist. Departments of Clinical Oncology do not have to have sufficient capacity for complex treatment all of newly discovered deposits skeleton whose nature does not have to be always initially clear. Therefore, in the opinion of the authors in these cases, the role of internist as a significant diagnosis very important In our article, we introduce six case reports of patients who were bearing the ambiguous process of investigation of the skeleton in our department in 2014. In accordance with the literature data were represented kidney tumor, multiple myeloma, chondrosarcoma, and in one case the origo malignant process was not found.

Combined transabdominal–transanal surgical approach for iatrogenic rectovaginal fistula: two case reports

2021 ◽  
Author(s):  
P Wang ◽  
W Tong ◽  
Q Wang
Keyword(s):  
Rectal Cancer ◽  
Rectovaginal Fistula ◽  
Case Reports ◽  
Rectal Surgery ◽  
Radical Resection ◽  
Scar Tissue ◽  
Vaginal Wall ◽  
Vaginal Repair ◽  
Transanal Resection ◽  
Transanal Approach

Rectovaginal fistula (RVF) is a type of anastomotic leakage that may occur after low anterior resection for rectal cancer. The repair of RVF can be challenging because of the scar tissue stenosis and incomplete obstruction. Two patients presented in our department with vaginal faecal discharge almost 7 months after the radical resection of rectal cancer. On vaginal examination, titanium nails related to the rectal surgery were found in the vaginal wall. The patients were diagnosed with RVF. Considering that RVF positions in the patients were high and might adhere to the pelvic tissue, a combined transabdominal–transanal resection and vaginal repair surgery was performed. About 3 months after surgery, both patients underwent colonic closure surgery, with consequent good recovery. A combined transabdominal–transanal approach may provide distinct advantages in surgical repair of difficult cases of RVF.

scholarly journals Clonal evolution of esophageal squamous cell carcinoma from normal mucosa to primary tumor and metastases

2019 ◽  
Author(s):  
Wenqing Yuan ◽  
Zhen Liu ◽  
Yu Wang ◽  
Mengfei Liu ◽  
Yaqi Pan ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Phylogenetic Analysis ◽  
Lymph Node ◽  
Esophageal Squamous Cell Carcinoma ◽  
Lymph Node Metastases ◽  
Primary Tumor ◽  
Regional Lymph Node ◽  
Clonal Evolution ◽  
Normal Mucosa ◽  
Node Metastases

Abstract The clonal evolution which drives esophageal squamous cell carcinoma (ESCC) from initiation in normal cell to primary carcinoma and metastases is poorly understood. In this study, multi-region whole-exome sequencing (WES) (284X) and whole-genome single nucleotide polymorphism genotyping were performed on a total of 109 samples of ESCC from 10 patients. This included 42 apparently normal samples of esophageal mucosa at increasing distances from the upper or lower boundaries of the primary tumor to the surgical margins of resection, 43 spatially separated tissue samples within primary tumor and 24 regional lymph node metastases. Phylogenetic analysis was performed to reconstruct ancestor–descendant relationships of clones and the clonal composition of multi-region samples. Mutations of cancer-related genes were validated by deep targeted sequencing (1,168X). Both inter- and intra-tumoral genetic heterogeneity were obvious across multi-region samples among ESCC patients. Clones varying in number from one to seven were discovered within each regional tumor or metastatic sample. Phylogenetic analysis demonstrated complex clonal evolution patterns. Regional lymph node metastases had characteristics of early initiation and polyclonal spreading, and could be derived from carcinoma in situ (CIS) directly. TP53 was the only gene harboring non-silent mutations identified across all multi-region tumor samples of all ten patients. Mutations of TP53 were also found in histologically normal mucosa in sites away from primary tumor.

Rectal cancer: can T2WI histogram of the primary tumor help predict the existence of lymph node metastasis?

2019 ◽  
Vol 29 (12) ◽  
pp. 6469-6476 ◽  
Author(s):  
Lanqing Yang ◽  
Dan Liu ◽  
Xin Fang ◽  
Ziqiang Wang ◽  
Yue Xing ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Primary Tumor ◽  
Node Metastasis

Primary Tumor Response to Preoperative Chemoradiation With or Without Oxaliplatin in Locally Advanced Rectal Cancer: Pathologic Results of the STAR-01 Randomized Phase III Trial

2011 ◽  
Vol 29 (20) ◽  
pp. 2773-2780 ◽  
Author(s):  
Carlo Aschele ◽  
Luca Cionini ◽  
Sara Lonardi ◽  
Carmine Pinto ◽  
Stefano Cordio ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Primary Tumor ◽  
Tumor Response ◽  
Locally Advanced ◽  
Muscularis Propria ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Phase Iii ◽  
Preoperative Treatment ◽  
The Impact

Purpose To investigate oxaliplatin combined with fluorouracil-based chemoradiotherapy as preoperative treatment for locally advanced rectal cancer. Patients and Methods Seven hundred forty-seven patients with resectable, locally advanced (cT3-4 and/or cN1-2) adenocarcinoma of the mid-low rectum were randomly assigned to receive pelvic radiation (50.4 Gy in 28 daily fractions) and concomitant infused fluorouracil (225 mg/m2/d) either alone (arm A, n = 379) or combined with oxaliplatin (60 mg/m2 weekly × 6; arm B, n = 368). Overall survival is the primary end point. A protocol-planned analysis of response to preoperative treatment is reported here. Results Grade 3 to 4 adverse events during preoperative treatment were more frequent with oxaliplatin plus fluorouracil and radiation than with radiation and fluorouracil alone (24% v 8% of treated patients; P < .001). In arm B, 83% of the patients treated with oxaliplatin had five or more weekly administrations. Ninety-one percent, compared with 97% in the control arm, received ≥ 45 Gy (P < .001). Ninety-six percent versus 95% of patients underwent surgery with similar rates of abdominoperineal resections (20% v 18%, arm A v arm B). The rate of pathologic complete responses was 16% in both arms (odds ratio = 0.98; 95% CI, 0.66 to 1.44; P = .904). Twenty-six percent versus 29% of patients had pathologically positive lymph nodes (arm A v arm B; P = .447), 46% versus 44% had tumor infiltration beyond the muscularis propria (P = .701), and 7% versus 4% had positive circumferential resection margins (P = .239). Intra-abdominal metastases were found at surgery in 2.9% versus 0.5% of patients (arm A v arm B; P = .014). Conclusion Adding oxaliplatin to fluorouracil-based preoperative chemoradiotherapy significantly increases toxicity without affecting primary tumor response. Longer follow-up is needed to assess the impact on efficacy end points.

scholarly journals Dynamic multi-echo DCE- and DSC-MRI in rectal cancer: Low primary tumor Ktrans and ΔR2* peak are significantly associated with lymph node metastasis

2016 ◽  
Vol 46 (1) ◽  
pp. 194-206 ◽  
Author(s):  
Endre Grøvik ◽  
Kathrine Røe Redalen ◽  
Tryggve Holck Storås ◽  
Anne Negård ◽  
Stein Harald Holmedal ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Primary Tumor ◽  
Node Metastasis ◽  
Dsc Mri

scholarly journals The Rectal Cancer microRNAome – microRNA Expression in Rectal Cancer and Matched Normal Mucosa

2012 ◽  
Vol 18 (18) ◽  
pp. 4919-4930 ◽  
Author(s):  
Jochen Gaedcke ◽  
Marian Grade ◽  
Jordi Camps ◽  
Rolf Søkilde ◽  
Bogumil Kaczkowski ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Normal Mucosa ◽  
Microrna Expression

Well-differentiated liposarcoma arising in the parapharyngeal space: a case report and review of the literature

2015 ◽  
Vol 129 (S2) ◽  
pp. S86-S90 ◽  
Author(s):  
N Kikuchi ◽  
T Nakashima ◽  
J Fukushima ◽  
K Nariyama ◽  
S Komune
Keyword(s):  
Case Report ◽  
Parapharyngeal Space ◽  
Case Reports ◽  
Surgical Margin ◽  
Neck Region ◽  
Surgical Excision ◽  
Curative Therapy ◽  
Long Term Follow Up ◽  
Well Differentiated

AbstractBackground:Liposarcomas rarely occur in the parapharyngeal space and only a few case reports exist. For curative therapy of liposarcoma, surgical excision remains the dominant modality. Although a wide surgical margin is important to prevent local recurrence, wide excision is often difficult in the head and neck region.Case report:We report a case of a 19-year-old female with a well-differentiated liposarcoma arising in the parapharyngeal space. We removed the tumour surgically utilising a cervical–parotid approach. The histological diagnosis was well-differentiated sclerosing liposarcoma. There is no recurrence after five years and nine months of follow up.Conclusion:The patient's age and the tumour site made it difficult for us to make a quantitative diagnosis before the operation. Well-differentiated liposarcoma rarely develop distant metastasis, but often recur locally. The benefit of adjuvant radiotherapy for well-differentiated liposarcoma is still not clear and careful and long-term follow up is necessary.

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