المؤلفون: Kota, Yamamoto, Miyuki, Atarashi, Takahiro, Terashima, Shunji, Kawamoto, Norimitsu, Kurogi

المصدر: Gan to kagaku ryoho. Cancerchemotherapy. 49(11)

مصطلحات موضوعية: Colon, Ascending, Positron Emission Tomography Computed Tomography, Colonic Neoplasms, Humans, Lymph Node Excision, Female, Lymph Nodes, Middle Aged

الوصف: We report a rare case of postoperative ascending colon cancer metastasis to the right external iliac lymph nodes. A 57- year-old woman underwent a laparoscopic right colectomy and D3 lymph node dissection. Pathological findings indicated a Stage Ⅲb, pT4aN1bM0 cancer. Because side effects were observed on adjuvant chemotherapy with FOLFOX, she was switched to S-1 administration every other week. Sixteen months postoperatively, right inguinal pain and elevated CEA values were noted. CT revealed two swollen right external iliac nodes with high FDG uptake on PET-CT. With the diagnosis of lymph node metastasis, an open celiotomy was performed to remove the lymph nodes. Pathological findings confirmed lymph node recurrence of ascending colon cancer. Postoperatively, her CEA values were normal and no recurrence was noted. This rare occurrence highlights the importance of examining adjacent lymph nodes for possible tumor recurrence. We report this case with the necessary literature review.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=pmid________::a48d22f3d798fc907a36af6655767203Test
https://pubmed.ncbi.nlm.nih.gov/36412031Test

المؤلفون: Atsushi, Toyofuku, Rina, Torii, Masaru, Idei, Kazuma, Ito, Akiko, Sakurai, Kohei, Yoshida, Shinji, Yotsumoto, Aiichiro, Higure, Naoki, Nagata

المصدر: Journal of UOEH. 43:433-443

مصطلحات موضوعية: Colon, Ascending, Colonic Neoplasms, Skull, Public Health, Environmental and Occupational Health, Humans, Female, General Medicine, Adenocarcinoma, Middle Aged, Neck

الوصف: A 55-year-old woman became aware of a tumor on the left side of the head in July, 2020 and was referred to our hospital in September because of its rapid growth. A head CT showed a neoplastic lesion of the skull. A CT from the neck to the pelvis revealed an ascending colon tumor and multiple lesions in the liver, which was suspected as metastasis. A colonoscopy also showed a type 2 like lesion in the ascending colon, and a biopsy showed adenocarcinoma. A pedunculated polyp had been pointed out in the ascending colon at another hospital four years previously, and the pathological result was an adenoma, but endoscopic mucosal resection was not performed. It is considered that the adenoma became advanced colon cancer with metastasis through the mechanism of multistage carcinogenesis. Metastatic lesions of the ascending colon cancer was suspected with regard to the skull lesion. In addition to the rapid growth, surgical removal was desirable from the viewpoint of cosmetology, and surgery was performed in November. The postoperative pathological diagnosis was a metastatic skull tumor derived from ascending colon cancer. The diagnosis was Stage IVb according to the Japanese Classification of Colorectal, Appendiceal, and Anal Carcinoma (9

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::771e2a1bdbe0239b1ed000ca5bb4dc32Test
https://doi.org/10.7888/juoeh.43.433Test

المؤلفون: Takeshi Nagayasu, Shinji Okano, Masaaki Moriyama, Tetsuro Tominaga, Shosaburo Oyama, Mitsutoshi Ishii, Takashi Nonaka, Terumitsu Sawai, Akiko Fukuda

المصدر: Clinical Journal of Gastroenterology. 15:134-139

مصطلحات موضوعية: Male, medicine.medical_specialty, Colorectal cancer, Pembrolizumab, Antibodies, Monoclonal, Humanized, Colon, Ascending, Biopsy, medicine, Humans, Stage (cooking), Lymph node, FOLFOXIRI, medicine.diagnostic_test, business.industry, Gastroenterology, General Medicine, Middle Aged, Swollen lymph nodes, medicine.disease, medicine.anatomical_structure, Colonic Neoplasms, Adenocarcinoma, Microsatellite Instability, Radiology, medicine.symptom, business

الوصف: Pembrolizumab is a novel immune-checkpoint inhibitor used for treatment of microsatellite instability-high (MSI-H) colorectal cancer. Several studies have reported clinical complete response (CR) after treatment with pembrolizumab, but none has confirmed pathological CR. Here we provide the first description of pathological CR with R0 resection after immune-checkpoint therapy. A 45-year-old man presented at our hospital with abdominal distention and highly elevated tumor markers. Contrast-enhanced abdominal CT showed a 110 × 75 mm bulky mass with markedly swollen lymph nodes and an isolated peritoneal metastasis in the pelvic space. Biopsy revealed poorly differentiated adenocarcinoma. We diagnosed ascending colon cancer cT4aN2bM1c Stage IVc. A biopsy specimen obtained during systemic chemotherapy (FOLFOXIRI) was confirmed pathologically as MSI-H, after which the treatment was changed to pembrolizumab. The tumor markers rapidly decreased to within normal ranges after three courses of treatment. After twenty courses, CT revealed shrinkage of the main tumor, lymph node metastases, and the peritoneal metastasis, and we performed extended right hemi-colectomy with dissection of the peritoneal metastasis. No residual tumor cells were found histologically. The patient achieved pathological CR and the postoperative course was uneventful. An accurate diagnosis and appropriate follow up are crucial for obtaining sufficient therapeutic effect of pembrolizumab.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ce5e9026bfc9e8d2717731fcb61eaae2Test
https://doi.org/10.1007/s12328-021-01543-yTest

المؤلفون: Zachary J. Naser, Shawna Morrissey

المصدر: The American journal of case reports. 23

مصطلحات موضوعية: Colon, Ascending, Carcinosarcoma, Carcinoma, Humans, Cellulitis, Female, General Medicine, Abdominal Pain, Aged, Anti-Bacterial Agents

الوصف: BACKGROUND Sarcomatoid carcinoma is a rare tumor that can occur in different organs and anatomical locations. Colonic sarcomatoid carcinoma, also known as carcinosarcoma, is an extremely rare tumor, with only 32 cases reported world-wide. The pathogenesis and guidelines for treatment are poorly understood due to the rarity and invasiveness of the disease. CASE REPORT A 77-year-old woman presented with worsening lower abdominal pain and associated fever after having initially been diagnosed with stump appendicitis and associated phlegmon 3 weeks prior, which was treated with antibiotics. Repeat imaging revealed an extraluminal versus perforated colonic mass with associated phlegmon. The patient's condition continued to worsen, with development of obstructive-like symptoms, resulting in operative intervention involving a R2 right hemicolectomy, stapled ileo-colostomy, and partial omentectomy. The patient had an uneventful remainder of her hospitalization other than continued lower abdominal pain. After initial discharge, the patient presented to an outside hospital due to continued deterioration of health, with findings of an additional mass, likely secondary to the previous lymphadenopathy. Ultimately, goals of care were discussed, and the decision was made to provide palliative care, and the patient died due to her illness 32 days after the initial procedure. CONCLUSIONS Carcinosarcoma is an extremely rare tumor with scant research guiding treatment guidelines. Current guidelines gathered from previous case reports suggest treating colorectal carcinosarcoma as adenocarcinoma. Additional research and studies are needed to establish appropriate therapeutic guidelines for carcinosarcoma.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2fe7c9e4f901b3df1b90daabd8379a32Test
https://pubmed.ncbi.nlm.nih.gov/36176184Test

المؤلفون: Rajesh N. Keswani, Dyanna L. Gregory, Tonya Kaltenbach, Andrew J. Gawron, Mark E. Benson, Anna Duloy, Rena Yadlapati, Charles J. Kahi

المصدر: BMC Gastroenterology, Vol 21, Iss 1, Pp 1-5 (2021)
BMC Gastroenterology

مصطلحات موضوعية: Adenoma, medicine.medical_specialty, medicine.medical_treatment, Colonic Polyps, Colonoscopy, Withdrawal time, RC799-869, Routine practice, Poor quality, Colon, Ascending, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Ascending colon, 030212 general & internal medicine, Cecum, Retroflexion, medicine.diagnostic_test, business.industry, Gastroenterology, General Medicine, Hepatology, Diseases of the digestive system. Gastroenterology, medicine.disease, Quality, Polypectomy, Colon polyps, 030211 gastroenterology & hepatology, Radiology, business, Right colon, Research Article

الوصف: Background As right colon polyps are challenging to detect, a retroflexed view of right colon (RV) may be useful. However, cecal retroflexion (CR) without a RV to the hepatic flexure (HF) is inadequate. We aimed to determine the frequency of CR and quality of the RV in routine practice. Methods This prospective observational study performed at an academic medical center assessed colonoscopy inspection technique of endoscopists who had performed ≥ 100 annual screening colonoscopies. We video recorded ≥ 28 screening/surveillance colonoscopies per endoscopist and randomly evaluated 7 videos per endoscopist. Six gastroenterologists blindly reviewed the videos to determine if CR was performed and HF withdrawal time (cecum to HF time, excluding ileal/polypectomy time). Results Reviewers assessed 119 colonoscopies performed by 17 endoscopists. The median HF withdrawal time was 3 min and 46 s. CR was performed in 31% of colonoscopies. CR frequency varied between endoscopists with 9 never performing CR and 2 performing CR in all colonoscopies. When performed, nearly half (43%) of RVs did not extend to the HF with median RV duration of 16 s (IQR 9–30 s). Three polyps were identified in the RV (polyp detection rate of 8.1%), all identified prior to a forward view. Conclusions CR is performed infrequently in routine practice. When CR is performed, the RV is of low quality with a very short inspection duration and insufficient ascending colon examination. Further education is required to educate endoscopists in optimal technique to improve overall colonoscopy quality.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::891e3d54987c638a2d3e26853a8d414fTest
https://doaj.org/article/a579825c5b6e44d59678677ead235660Test

المؤلفون: Wei Gong, Fang Wang, Guili Xia, Yan Zhou, Wei Hu, Jianguo Xu, Ying Zhu

المصدر: Arab Journal of Gastroenterology. 22:127-132

مصطلحات موضوعية: Adenoma, Colorectal cancer, Rectum, Colon, Ascending, 03 medical and health sciences, 0302 clinical medicine, Tubular adenoma, medicine, Humans, Ascending colon, medicine.diagnostic_test, business.industry, Lasers, Gastroenterology, Transverse colon, Colonoscopy, medicine.disease, Endoscopy, medicine.anatomical_structure, Hyperplastic Polyp, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Colorectal Neoplasms, Nuclear medicine, business

الوصف: BACKGROUND AND STUDY AIMS Non-pedunculated lesions are easily missed on endoscopy, and histopathological examination shows that some of these lesions are adenomas. Adenoma is a precursor of colorectal cancer, a common tumor of the digestive tract. This study was conducted to compare the detection efficacy of non-pedunculated lesions in the same patient under different modes of blue laser endoscopy and to determine whether the surface pattern of the sample was consistent with its histopathological results. PATIENTS AND METHODS A total of 91 patients with non-pedunculated lesions diagnosed at our hospital between April 2018 and March 2019 were included in this study. White light imaging (WLI), linked color imaging (LCI), and blue laser imaging (BLI) modes were used to record the location, number, and Hiroshima classification of the surface patterns of the non-pedunculated lesions. The lesions were removed by different endoscopic excision methods for histopathological examination; the histopathological results were compared with the surface patterns. RESULTS A total of 105, 198, and 223 lesions were detected using the WLI, BLI, and LCI modes, respectively. The Wilcoxon signed rank test revealed a significant difference in the number of lesions detected using each observation mode (p

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::860c4ad3efd18b1d6a5ea8344d3295ceTest
https://doi.org/10.1016/j.ajg.2020.12.002Test

المؤلفون: Hiroki Akamatsu, Junichi Hasegawa, Masahisa Ohtsuka, Yozo Suzuki, Mitsuyoshi Tei, Toshinori Sueda, Mitsunobu Imasato, Yukihiro Yoshiwaka

المصدر: Surgical Endoscopy. 35:5359-5364

مصطلحات موضوعية: medicine.medical_specialty, Hepatic Flexure, Colon, Ascending, 03 medical and health sciences, Cecum, 0302 clinical medicine, medicine.artery, medicine, Humans, Retroperitoneal space, Superior mesenteric artery, Superior mesenteric vein, Mesentery, Ligation, Colectomy, business.industry, Surgery, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Colonic Neoplasms, Duodenum, Lymph Node Excision, Laparoscopy, 030211 gastroenterology & hepatology, business, Pancreas, Mesocolon

الوصف: Single-port laparoscopic extended right hemicolectomy with complete mesocolic excision and central vascular ligation is technically challenging, and a standardized procedure is needed to minimize technical hazards. As a first step, the hepatic flexure is mobilized from the duodenum, and the third part of the duodenum and pancreatic head was exposed. Next, the ileocecal vessels are divided at the root using a medial-to-lateral approach, and the cecum is separated from the retroperitoneal space. This process completes the mobilization of the right colon. In the second step, the omental bursa is opened, and the inferior border of the pancreas is exposed. The mobilized right colon is turned around to the left of the superior mesenteric vein, continuing to separate the mesentery from right to left side, and the right colic vessels are divided at the roots. The inverted right colon is restored to its original position, and the mesenteric fat is dissected along the left edge of the superior mesenteric artery to the inferior border of the pancreas. A total of 57 consecutive patients with advanced hepatic flexure colon cancer (n = 24) and transverse colon cancer (n = 33) underwent S-ERHC. The conversion rate to open surgery was 5.3%. Operative time, blood loss, and number of harvested lymph nodes were 232 min (interquartile range [IQR], 184–277 min), 5 mL (IQR, 5–66 mL), and 30 (IQR, 22–38), respectively. According to the Clavien–Dindo classification, the grade ≥ 2 complication rate was 10.5%. Median duration of hospitalization was 9 days (IQR, 7–13 days). Single-port laparoscopic extended right hemicolectomy using a right colon rotation technique is safe, feasible, and useful. This technique of repeating the inversion and restoration of the right colon may help avoid bleeding and damage to other organs and facilitate reliable lymph node dissection.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7ef57c7b3de567f01c48cb242135805eTest
https://doi.org/10.1007/s00464-021-08500-3Test

المؤلفون: Saghi Esfandiarifard, Syed Mehdi, Wissam Kiwan, Nada Al Masalmeh, Anthony F. Shields, Ibrahim Azar, Gurjiwan Virk, Philip A. Philip

المصدر: Cancer Medicine
Cancer Medicine, Vol 10, Iss 9, Pp 2987-2995 (2021)

مصطلحات موضوعية: 0301 basic medicine, Oncology, Male, Cancer Research, Response to therapy, Colorectal cancer, primary tumor sidedness, medicine.disease_cause, right‐sided colon cancer, 0302 clinical medicine, Retrospective analysis, Medicine, Registries, Stage (cooking), RC254-282, Early onset, Original Research, Veterans, education.field_of_study, Incidence (epidemiology), Incidence, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Middle Aged, Prognosis, Primary tumor, Colon, Descending, medicine.anatomical_structure, colon cancer, 030220 oncology & carcinogenesis, laterality, Colonic Neoplasms, Female, KRAS, Colorectal Neoplasms, Colon, Transverse, Adult, medicine.medical_specialty, Population, Rectum, colorectal cancer, 03 medical and health sciences, Colon, Ascending, Internal medicine, Humans, Radiology, Nuclear Medicine and imaging, education, neoplasms, Veterans Affairs, Aged, Neoplasm Staging, Retrospective Studies, Splenic flexure, business.industry, Rectal Neoplasms, early‐onset colorectal cancer, Cancer, Clinical Cancer Research, medicine.disease, United States, left‐sided colon cancer, 030104 developmental biology, business

الوصف: Background The incidence of early‐onset colorectal cancer (EOCRC) is rising. Left‐sided colorectal cancer (LCC) is associated with better survival compared to right‐sided colon cancer (RCC) in metastatic disease. NCCN guidelines recommend the addition of EGFR inhibitors to KRAS/NRAS WT metastatic CRC originating from the left only. Whether laterality impacts survival in locoregional disease and EOCRC is of interest. Methods 65,940 CRC cases from the National VA Cancer Cube Registry (2001–2015) were studied. EOCRC (2096 cases) was defined as CRC diagnosed at
In EOCRC patients, LCC is associated with better OS than RCC only in patients with metastatic disease. In the overall population, LCC is associated with better OS in all stages except stage II, which might be due to the high incidence of MMRd tumors in this subpopulation.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2b31d23bdf581ea6c3da87a1084e3851Test
http://europepmc.org/articles/PMC8085929Test

المؤلفون: Mari Igasaki, Masaki Yoshizawa, Tomohiro Kumagae, Izumi Kitagawa, Takaaki Murata, Ryohei Ono

المصدر: Journal of Medical Case Reports, Vol 15, Iss 1, Pp 1-12 (2021)
Journal of Medical Case Reports

مصطلحات موضوعية: myalgia, Male, medicine.medical_specialty, lcsh:Medicine, Case Report, Malignancy, Gastroenterology, Dermatomyositis, 030207 dermatology & venereal diseases, 03 medical and health sciences, Colon, Ascending, 0302 clinical medicine, Surgical oncology, Internal medicine, Neoplasms, Cancer screening, medicine, Humans, Autoantibodies, Cancer, Muscle biopsy, Mediation Analysis, medicine.diagnostic_test, business.industry, lcsh:R, General Medicine, Middle Aged, medicine.disease, 030220 oncology & carcinogenesis, Prednisolone, medicine.symptom, business, Anti-TIF1γ antibody, Biomarkers, Anti-transcription intermediary factor 1 gamma, medicine.drug

الوصف: BackgroundAnti-transcriptional intermediary factor 1 gamma (TIF1γ) antibody is a marker for predicting cancer association in patients with dermatomyositis (DM). The overall survival rate in DM patients with cancer was reported to be considerably worse than that in DM patients without cancer. However, the treatment for cancer-associated DM remains controversial, because the treatment priority between surgical resection for the tumor and internal treatments, including glucocorticoids, immunosuppressive agents, and intravenous immune globulin, has not been established.Case presentationWe report the case of a 57-year-old Japanese man diagnosed with anti-TIF1γ antibody-positive DM associated with ascending colon cancer. His clinical symptoms included facial and brachial edema, muscle weakness, dysphagia, myalgia, and rash. Physical examination revealed periorbital edema and Gottron's papules over his knuckles with brachial edema, and tenderness and weakness of the proximal limb muscles. The findings of hyperintense muscles in T2-weighted sequences of brachial contrast-enhanced magnetic resonance imaging and the infiltration of lymphocytic cells and CD4-positive lymphocytes from muscle biopsy were compatible with the diagnostic criteria for dermatomyositis. Anti-TIF1γ antibody was positive by immunoprecipitation assay. He first started internal treatment including intravenous immunoglobulin, steroid pulse, prednisolone, and azathioprine, followed by surgical resection for the tumor because of the elevation of creatine kinase and progression of dysphagia. However, clinical symptoms did not improve, and the patient died 6 months later.ConclusionsWe faced difficulties in determining the treatment priority between surgical resection and internal treatment for our case; therefore, this case would be educational for readers. We searched PubMed to identify English-language case reports of anti-TIF1γ antibody-positive dermatomyositis with malignancy and found 21 reported cases. We herein review and summarize previously reported cases of anti-TIF1γ antibody-positive DM with malignancy. Cancer screening is essential in patients with anti-TIF1γ antibody-positive dermatomyositis because it is associated with a high prevalence of malignancies. Our review revealed that initial surgical treatment should be recommended for better prognosis if the general condition allows.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5855c1470453070a589100fc96c3d803Test
https://doaj.org/article/fd369311aa904b0aba52de6cd7aff70aTest

المؤلفون: Jungheum Cho, Young Hoon Kim, Hae Young Kim, Won Chang, Ji Hoon Park

المصدر: Abdominal radiology (New York). 47(11)

مصطلحات موضوعية: Male, Radiological and Ultrasound Technology, Rectal Neoplasms, Urology, Gastroenterology, Prognosis, Adenocarcinoma, Mucinous, Magnetic Resonance Imaging, Colon, Ascending, Colonic Neoplasms, Humans, Radiology, Nuclear Medicine and imaging, Neoplasm Invasiveness, Tomography, X-Ray Computed, Aged, Neoplasm Staging, Retrospective Studies

الوصف: This study evaluates the prognostic significance of EMVI and DEMI on preoperative CT in patients with ascending colon cancer.This retrospective study included consecutive patients with T3 ascending colon cancer from January 2012 to December 2016 in a tertiary center. Two radiologists independently reviewed EMVI, DEMI, and nodal status on preoperative CT. We assessed the association of age, sex, mucinous adenocarcinoma, EMVI, and DEMI with metastasis on preoperative CT using univariable and multivariable analysis. We also compared disease-free survival (DFS) with and without variables (age, sex, mucinous adenocarcinoma, EMVI, DEMI and adjuvant chemotherapy) using Cox's proportional hazards models. We assessed interobserver agreements on imaging features using the Cohen's weighted kappa.Of 237 patients [107 men; mean (standard deviation) age, 66 (13) years], 24 had metastases on preoperative CT. Positive EMVI was associated with metastasis (odds ratio 16.9; P 0.001) on multivariable analysis. Of 194 patients [83 men; 65 (13) years] included for DFS analysis, recurrence was observed in 31 (16%) with median follow-up of 53 months. Positive EMVI [hazard ratio (HR) 4.8; P 0.001] and DEMI 5 mm (HR 5.5; P 0.001) were associated with worse DFS. Interobserver agreements were good (kappa = 0.64-0.67).Positive EMVI and DEMI 5 mm on preoperative CT were associated with a worse T3 ascending colon cancer prognosis. Thus, these CT findings could be used as imaging biomarkers for T3 ascending colon cancer risk stratification.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::335aef62930b5641c1ad9e62fc41c7b0Test
https://pubmed.ncbi.nlm.nih.gov/36066635Test