scholarly journals Thumb metastases in a patient with colorectal cancer

2007 ◽  
Vol 15 (3-4) ◽  
pp. 97-98 ◽  
Author(s):  
Ivan Nikolic ◽  
Aleksandar Patrnogic ◽  
Bratislav Stojiljkovic ◽  
Bogdan Bogdanovic ◽  
Biljana Kukic
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Disease ◽  
Proximal Phalanx ◽  
Lumbar Vertebra ◽  
Palliative Radiotherapy ◽  
Metastatic Colorectal Carcinoma ◽  
Primary Surgery ◽  
History Of ◽  
Histopathologic Analysis ◽  
Hand Radiography

Bone metastases from colorectal cancer are not common and most frequently are manifesting in late history of metastatic disease. We present a 67-old man who had first symptoms of metastatic disease manifested with edema and decreased mobility of thumb of right hand. Radiography showed complete osteolysis of proximal phalanx of thumb, which appeared 30 months after primary surgery for colorectal cancer. Histopathologic analysis of amputated thumb confirmed diagnosis of metastatic colorectal carcinoma and excluded osteolysis of other reasons. Metastatic changes in the first and second lumbar vertebra, which were treated with palliative radiotherapy, were confirmed by additional diagnostics.

Leptomeningeal carcinomatosis in colorectal cancer: The Mayo Clinic experience.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 710-710
Author(s):  
Gretchen E Taylor ◽  
Nina J. Karlin ◽  
Thorvardur Ragnar Halfdanarson ◽  
Kyle Coppola ◽  
Axel Grothey
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Disease ◽  
Mayo Clinic ◽  
Treatment Options ◽  
Palliative Radiotherapy ◽  
Leptomeningeal Metastasis ◽  
Leptomeningeal Carcinomatosis ◽  
Mri Findings ◽  
Lower Extremity Weakness ◽  
Neurologic Symptoms

710 Background: Leptomeningeal metastasis (LM) has been described as a rare form of metastatic disease progression in colorectal cancer (CRC). There remains a paucity of literature with regards to the course and management of LM in CRC. The aim of this study was to estimate the incidence of LM in CRC patients seen at our institution over a 15-year period, and to describe the clinical course and outcome of these cases. Methods: LM in CRC primary cases between 2000 and 2014 were identified in the Mayo Clinic databases. The charts were retrospectively reviewed. Results: Of 17,095 CRC primaries, we identified 10 patients with LM (0.058%) in this 15-year period. Nine cases were included in the analysis. Four had metastatic disease at the time of their initial CRC diagnosis. One patient also had a lung adenocarcinoma diagnosed during initial staging for the CRC primary. Median overall survival after CRC diagnosis was 25.7 months (range 4.7-74.8). Median time to diagnosis of LM after CRC diagnosis was 25.3 months (range 1-68.1). All patients had MRI findings consistent with LM: 3 patients with spinal LM, 5 patients with intracranial LM, 1 with both. One of three CSF analyses at the time of LM workup was positive for malignant cells; all had elevated protein. Neurologic symptoms correlated with site of the lesions, with headache, cranial nerve palsy, lower extremity weakness, and gait disturbance among the most frequently reported. However, not all patients had neurologic findings, with LM lesions found incidentally in two cases. Seven patients (78%) had palliative radiotherapy (RT) for LM. Three patients continued to receive systemic chemotherapy after diagnosis of LM. No patients underwent intrathecal chemotherapy. Median survival after LM diagnosis was 7 weeks (range 2-39). Conclusions: The diagnosis of LM is an exceedingly rare development in the natural course of CRC. It continues to confer an extremely poor prognosis with limited treatment options. At our institution, most patients had their disease addressed by palliative means, with many receiving RT to control their neurologic symptoms. Based on our series, supportive care remains a sensible approach to the management of LM in CRC.

scholarly journals Nasal Cavity Metastasis From Colorectal Cancer Represents End-Stage Disease and Should Be Palliated

2020 ◽  
Vol 36 (2) ◽  
pp. 119-121
Author(s):  
Stephen Hwang ◽  
Dedrick Kok Hong Chan ◽  
Fredrik Petersson ◽  
Ker-Kan Tan
Keyword(s):  
Colorectal Cancer ◽  
Colorectal Carcinoma ◽  
Nasal Cavity ◽  
Metastatic Disease ◽  
Previous History ◽  
Nasal Sinus ◽  
Stage Disease ◽  
History Of ◽  
End Stage ◽  
High Index Of Suspicion

Nasal metastases from colorectal cancer is rare. The presentation of nasal metastases is often very similar to primary nasal sinus adenocarcinoma. A high index of suspicion is required, especially in patients who have had a previous history of colorectal carcinoma. Histology is ultimately required for diagnosis. We describe 2 cases of nasal metastases from colorectal carcinoma, and discuss the presentation, diagnosis and management of the case. Such metastatic disease ultimately represents end-stage malignancy, and patients should be palliated.

Mutations and Allelic Loss of p53 in Primary Tumor DNA From Potentially Cured Patients With Colorectal Carcinoma

2001 ◽  
Vol 19 (11) ◽  
pp. 2829-2836 ◽  
Author(s):  
Ann Forslund ◽  
Christina Lönnroth ◽  
Marianne Andersson ◽  
Hans Brevinge ◽  
Kent Lundholm
Keyword(s):  
Colorectal Cancer ◽  
Colorectal Carcinoma ◽  
Metastatic Disease ◽  
Denaturing Gradient Gel Electrophoresis ◽  
P53 Gene ◽  
Allelic Loss ◽  
P53 Mutations ◽  
Conserved Regions ◽  
Primary Surgery ◽  
Significant Difference

PURPOSE: To compare p53 alterations in survivors and nonsurvivors after surgery for colorectal cancer. PATIENTS AND METHODS: Twenty-nine potentially cured patients with colorectal carcinoma, without recurrent disease for more than 6 years after their primary surgery, were selected to match a group of 41 colorectal cancer patients with early metastatic spread to the liver. All patients were screened for mutations in the p53 gene, exons 5 to 9, by denaturing gradient gel electrophoresis and subsequent sequencing. RESULTS: The frequency of p53 mutations was significantly different in cured patients (60%) compared with patients with early relapse (41%, P < .05). A significant difference was found in the distribution of mutations, indicating that potentially cured patients had a different proportion of mutations in conserved regions of p53 (P = .02). This difference was explained by a significantly different frequency of mutations in exon 8 (40% v 15%, P = .03), which is part of the conserved region V. All mutations in region V were codon 273 mutations in cured patients, whereas three of four mutations were located in codon 273 in patients with metastatic disease. Allelic loss of p53 (loss of heterozygosity [LOH]) was demonstrated in 26% of the cured patients and in 39% of patients with metastatic disease (P = .36). The combination of mutation and LOH of p53 was the same (17%) in both groups. CONCLUSION: A large number of p53 mutations in colorectal cancer do not promote disease progression. Some mutations, particularly within conserved regions, may even counteract negative functional effects of other p53 structural alterations. A complete loss of p53 function was not related to survival or progression after curative operation of colorectal carcinoma.

E-Cadherin and Metalloproteinase-1 and -7 Polymorphisms in Colorectal Cancer

2009 ◽  
Vol 24 (2) ◽  
pp. 99-106 ◽  
Author(s):  
Jacqueline Miranda de Lima ◽  
Lessileia Gomes de Souza ◽  
Ismael Dale Cotrim Guerreiro da Silva ◽  
Nora Manoukian Forones
Keyword(s):  
Colorectal Cancer ◽  
Family History ◽  
Metastatic Disease ◽  
Fragment Length Polymorphism ◽  
Nucleotide Polymorphisms ◽  
Single Nucleotide ◽  
History Of ◽  
Polymerase Chain ◽  
Marginal Risk ◽  
E Cadherin

Purpose E-cadherin (CDH1) and metalloproteinase (MMP) polymorphisms could play a crucial role in cancer invasion. Our aim was to investigate the influence of the -160C/A CDH1, -1607ins/delG MMP-1 and -181A/G MMP-7 polymorphisms on the frequency and progression of colorectal cancer (CRC). Experimental design A total of 130 patients with CRC and 130 noncancer controls were studied. The -160C/A CDH1, -1607ins/delG MMP-1 and -181A/G MMP-7 genotypes were analyzed by polymerase chain reaction-restriction fragment length polymorphism. Results Patients with the 1G allele and a family history of CRC showed a six times higher risk of developing CRC (OR: 6.45, 95%CI: 2.02–20.6, p=0.001). The A/A CDH1 genotype was associated with a higher risk of metastatic disease (OR: 3.43, 95%CI: 1.27–9.27, p=0.023). A higher marginal risk of metastatic disease was observed for MMP-1 genotypes 1G/1G and 1G/2G (OR: 2.97, 95%CI: 0.93–9.47, p=0.098). Conclusions The -160C/A CDH1, -1607ins/delG MMP-1 and -181A/G MMP-7 single nucleotide polymorphisms did not modify the risk of CRC development. Patients with the 1G/1G or 1G/2G genotype and a family history of CRC presented a higher risk of CRC. The AA CDH1 and 1G/1G and 1G/2G MMP-1 genotypes might be associated with advanced metastatic disease, but are not markers of lymphatic metastasis.

Octogenarian patients with colorectal cancer: Characterizing an emerging clinical entity.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 552-552
Author(s):  
Hadar Goldvaser ◽  
Noa Katz Shroitman ◽  
Irit Ben-Aharon ◽  
Ofer Purim ◽  
Yulia Kundel ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Family History ◽  
Elderly Patients ◽  
Metastatic Disease ◽  
Performance Status ◽  
Clinicopathological Characteristics ◽  
Clinical Entity ◽  
Control Group ◽  
Cancer Specific Survival ◽  
History Of

552 Background: Colorectal cancer (CRC) in Octogenarians is an emerging clinical entity. It is currently unclear whether these patients have unique features and whether their treatment should differ from younger patients with CRC. The aim of this study was to better characterize this patients population. Methods: A single-center, retrospective cohort study which included patients diagnosed with CRC at the age of ≥ 80 years between 2008-2013. A control group included consecutive patients younger than 80 years diagnosed with CRC during the same period. Clinicopathological characteristics, treatment and outcome were compared between the groups. Results: The study included 350 patients, followed for a median of 40.2 months (range 1.8-97.5). Several significant differences were noted. Elderly patients had a higher proportion of Ashkenazi ethnicity (p < 0.001), lower rates of family history of any cancer (p < 0.001) and family history of CRC (p = 0.006), and a higher rate of personal history of other malignancies (p = 0.035). CRC diagnosis by screening was less frequent in octogenarians (p < 0.001) and their performance status at presentation was worse. Octogenarians were more likely to have tumors located in the right colon (p = 0.029) and had a lower prevalence of well differentiated histology (p = 0.025). They received less treatment and treatment was less aggressive, both in patients with metastatic and non-metastatic disease, regardless of performance status. Their 5-year cancer specific survival was worse (63.4% vs.77.6%, p = 0.009), both for metastatic (p = 0.03) and for non-metastatic disease (p = 0.028). Conclusions: Elderly patients with CRC presented several differences in clinical and tumor characteristics compared to their younger counterparts. They were less likely to receive treatment and they had worse outcome. Further research is needed to better define this growing patient population and to establish their optimal treatment.

Opportunistic Colorectal Cancer Screening using Colonoscopy. Comparative Results between two Historical Cohorts in Bucharest, Romania

2015 ◽  
Vol 24 (2) ◽  
pp. 171-176 ◽  
Author(s):  
Elena Mirela Ionescu ◽  
Tudor Nicolaie ◽  
Serban Ion Gologan ◽  
Ana Mocanu ◽  
Cristina Ditescu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Screening Program ◽  
Advanced Adenoma ◽  
Detection Rates ◽  
Incidence And Mortality ◽  
Organized Screening Program ◽  
History Of ◽  
Comparative Results ◽  
Asymptomatic Individuals ◽  
Second Period

Background & Aims: Even though Romania has one of the highest incidence and mortality in colorectal cancer (CRC) in Europe, there is currently no organized screening program. We aimed to assess the results of our opportunistic CRC screening using colonoscopy.Methods: A single center retrospective study to include all opportunistic screening colonoscopies performed in two 18 month periods (2007-2008 and 2012-2013) was designed. All asymptomatic individuals without a personal or family history of adenoma or CRC and with complete colonoscopy performed in these two time periods were included.Results: We included 1,807 individuals, 882 in the first period, 925 in the second period. There were 389 individuals aged below 50, 1,351 between 50 and 75 and 67 older than 75 years. There were 956 women (52.9%), with a mean age of 58.5 (median 59, range 23-97). The detection rates were 12.6% for adenomas (6.1% for advanced adenoma) and 3.4% for adenocarcinoma. Adenoma incidence (4.9% in subjects under 50, 14.7% in those aged 50 to 75, and 16.4% in those older than 75, p<0.0001) and size (6.3mm in subjects younger than 50, 9.2mm in those 50 to 75 and 10.8mm in those older than 75, p=0.015) significantly increased with age. Adenoma incidence increased in the second period (14.8% vs. 10.3%, p=0.005), while adenoma size decreased in the second period (8.4mm vs. 10mm, p=0.006). There were no procedure related complications.Conclusions: The neoplasia detection rate was 16% (12.6% adenoma, 3.4% adenocarcinoma). Adenoma incidence and size increased with age in both cohorts. In the second screening period significantly more and smaller adenomas were detected.

scholarly journals When less is more: a daring conservative approach to postpneumonectomy oesophago-pleural fistula

2019 ◽  
Vol 30 (1) ◽  
pp. 146-148
Author(s):  
Lara Girelli ◽  
Elena Prisciandaro ◽  
Niccolò Filippi ◽  
Lorenzo Spaggiari
Keyword(s):  
Clinical Presentation ◽  
Clinical Status ◽  
High Morbidity ◽  
Conservative Approach ◽  
Chronic Fistula ◽  
Less Is More ◽  
Primary Surgery ◽  
History Of ◽  
Uncommon Complication

Abstract Oesophago-pleural fistula is an uncommon complication after pneumonectomy, usually related to high morbidity and mortality. Due to its rarity and heterogeneous clinical presentation, its diagnosis and management are challenging issues. Here, we report the case of a patient with a history of pneumonectomy for a tracheal tumour, who developed an asymptomatic oesophago-pleural fistula 7 years after primary surgery. In consideration of the patient’s good clinical status and after verifying the preservation of respiratory and digestive functions, a bold conservative approach was adopted. Five-year follow-up computed tomography did not disclose any sign of recurrence of disease and showed a stable, chronic fistula.

The Growing Trend of No Primary Surgery in Colorectal Cancer

2021 ◽  
Author(s):  
Thomas Peponis ◽  
Caitlin Stafford ◽  
James Cusack ◽  
Christy Cauley ◽  
Robert Goldstone ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Primary Surgery

Retrospective Review of Multitarget Stool DNA as a Screening Test for Colorectal Cancer

2021 ◽  
pp. 000313482110318
Author(s):  
Thomas K. Kleinschmidt ◽  
Austin Clements ◽  
Mark A. Parker ◽  
Steven D. Scarcliff
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Retrospective Review ◽  
Screening Test ◽  
Hyperplastic Polyps ◽  
Dna Testing ◽  
History Of ◽  
Stool Dna ◽  
Stool Dna Testing ◽  
Advanced Adenomas

Objectives To review the effectiveness of noninvasive multitarget stool DNA testing as a screening test for colorectal cancer. Methods We performed a retrospective review of patients referred to 2 high volume outpatient procedural centers for colonoscopy for positive Cologuard test. Positive findings for colorectal cancer based on pathologic findings and also advanced adenomas were recorded. Positive predictive value (PPV) was assessed. Results Of the 1585 patients evaluated and referred for colonoscopy from January 1, 2018 to November 1, 2019, for ICD-10 codes R19.5 (other fecal abnormalities) and K92.1 (melena), 84 were referred for a positive Cologuard test. Out of the 84, 6 were excluded based on family history of colon cancer in first degree relative or personal history of inflammatory bowel disease. Of the remaining 78 patients, 1 patient (1.3%) had colorectal cancer and 5 (6.4%) had advanced adenomas (>1 cm size, high grade dysplasia or villous). Postive predictive value for colorectal cancer was 1.3% and for precancerous lesions plus colorectal cancer was 7.7%. A total of 53 (68.0%) patients had either totally normal colonoscopy or hyperplastic polyps. Out of the 78 individuals in our study, 70 (89.7%) had normal findings, hyperplastic polyps, or non-advanced adenomas. Conclusions Multitarget stool DNA testing carries an unacceptably low PPV to be utilized as a screening test for colorectal cancer. The study fails to detect both adenomas and colon cancer at a higher rate than screening colonoscopy in selected studies. The advantage of being noninvasive has been noted to increase colorectal cancer screening in otherwise non-compliant Medicare patients.

scholarly journals Clinical, Pathological and Molecular Characteristics of Chilean Patients with Early-, Intermediate- and Late-Onset Colorectal Cancer

Cells ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 631
Author(s):  
Karin Alvarez ◽  
Alessandra Cassana ◽  
Marjorie De La Fuente ◽  
Tamara Canales ◽  
Mario Abedrapo ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Family History ◽  
Age Of Onset ◽  
Late Onset ◽  
Molecular Characteristics ◽  
Family History Of Cancer ◽  
Molecular Features ◽  
Age Of Diagnosis ◽  
History Of ◽  
History Of Cancer

Colorectal cancer (CRC) is the second most frequent neoplasm in Chile and its mortality rate is rising in all ages. However, studies characterizing CRC according to the age of onset are still lacking. This study aimed to identify clinical, pathological, and molecular features of CRC in Chilean patients according to the age of diagnosis: early- (≤50 years; EOCRC), intermediate- (51–69 years; IOCRC), and late-onset (≥70 years; LOCRC). The study included 426 CRC patients from Clinica Las Condes, between 2007 and 2019. A chi-square test was applied to explore associations between age of onset and clinicopathological characteristics. Body Mass Index (BMI) differences according to age of diagnosis was evaluated through t-test. Overall (OS) and cancer-specific survival (CSS) were estimated by the Kaplan–Meier method. We found significant differences between the age of onset, and gender, BMI, family history of cancer, TNM Classification of Malignant Tumors stage, OS, and CSS. EOCRC category was characterized by a family history of cancer, left-sided tumors with a more advanced stage of the disease but better survival at 10 years, and lower microsatellite instability (MSI), with predominant germline mutations. IOCRC has shown clinical similarities with the EOCRC and molecular similarities to the LOCRC, which agrees with other reports.

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