A RARE CASE STUDY OF MEDULLARY CARCINOMA OF DESCENDING COLON REPORTED ON HISTOPATHOLOGY

Medullary carcinoma (MC) of the colon is a rare and unique histologic subtype of colorectal cancer whichcharacterized by poor glandular differentiation and intraepithelial lymphocytic infiltrate. This has now been incorporated as a separate entity in the World Health Organization (WHO) classification of colorectal cancers.It is commonly associated with deficient mismatch repair proteins and has a strong association with Lynch syndrome. Diagnosis is challenging as it does not have the usual immunohistochemical stains on pathology seen in colorectal adenocarcinoma. Here, we discuss an interesting case of MC of the colon that was metastatic on presentation and constituted a diagnostic challenge1. Keywords: medullary carcinoma, colorectal carcinomas (CRC), medullary carcinoma of colon,poorly differentiated adenocarcinoma, undifferentiated adenocarcinoma.

Therapeutic effect of the Indigenous drug modality in the management of Adenocarcinoma of colon – A case report based on cytokines expressions

A clinical study was conducted from May to July 2017 in the outpatient department of Bandaranaike Memorial Ayurvedic Research Institute (BMARI), Navinna, Sri Lanka to test the antitumor activity of the indigenous drug modality which is used to manage the colon cancer. A forty year old colon cancer patient volunteered to the study. Ethical approval has been taken from the Institute of Indigenous Medicine, University of Colombo Sri Lanka. Detailed history, clinical examinations and relevant investigations were conducted at BMARI and the Department of Zoology, Faculty of Science, University of Ruhuna. Three herbal formulations namely SG powder- 5g/day, KY powder -10g/day and A1 powder -10g/day were given for the patient throughout 90 days of study. Serum Interleukin-2 (IL-2), Interleukin-5 (IL-5), Interleukin 17 (IL-17), Interferon (IFN)-ɣ and p53 Upregulated Modulator of Apoptosis (PUMA) were quantified using Enzyme-Linked Immunosorbent Assay (ELISA) before and after the treatments (after 45 and 90 days) as these cytokines play a significant role in tumor growth control. Tumor marker expression and stool samples were tested before and after treatments (after 45 and 90 days). Symptoms of colon cancer were significantly decreased during the treatment along with changes in tumor markers. According to the results of the ELISA, IL-2, IFN-ɣ and IL-17 concentrations were increased significantly after the treatment and expression level increased in all three cytokines over time indicating the possible control of colon cancer growth by the drug modality. Further investigations are required to evaluate the mechanism of effectiveness of this indigenous drug modality in controlling carcinoma of colon.

A Large Invasive Primary Squamous Cell Carcinoma of Colon: A Case Report and Literature Review

Primary squamous cell carcinoma (SCC) of colon is a rare histopathologic type of colon cancers. In this article we report a case of a large invasive primary colon SCC mass proven by pathologic examinations at rectosigmoid level with extensive adhesions to vasculature and hydronephrosis due to pressure effectson ureter. We excised the whole mass and dissected all para-aortic and pelvic lymph nodes. Patient was referred to oncology ward for further treatments.

Colonic Adenocarcinoma at Advanced Stage in Adolescence: Report of 2 Cases

Background. Carcinoma of colon is rare in children and adolescents. The staging criteria of the carcinoma is the same as those for adults. However, the pathogenetic background in pediatric cases is different from adults and usually involves mismatch repair gene mutations or familial polyposis syndromes. Case report. We describe two adolescents diagnosed with advanced stage colon carcinoma and discuss the histological appearance, testing for mismatch repair genes and contrast- it with carcinoma occurring in the setting of familial polyposis syndrome. Conclusion. Colonic carcinoma occurring in pediatric patients should prompt a work-up for mismatch repair gene mutation status. Despite higher stage of presentation, some of the pediatric patients may respond favorably to chemotherapy and surgical resection.

Clinical profile and colonoscopic findings in patients with lower gastrointestinal haemorrhage: a descriptive cross-sectional study

Background: Most of the bleeding in the lower gastrointestinal tract are usually located in the rectum, colon and terminal ileum. Colonoscopy is an invasive procedure used for both diagnostic and therapeutic purposes for detection of lower gastrointestinal (GI) tract pathologies and haemorrhage. Aims and Objective: The purpose of the study was to understand the clinical profile and colonoscopic findings in patients with lower gastrointestinal haemorrhage. Materials and Methods: Seventy-two patients presenting with lower GI haemorrhage were included in the study. All patients underwent colonoscopy after achieving hemodynamic stability and bowel preparation. Clinical profile and colonoscopic findings were studied. Results: The common aetiologies of lower GI haemorrhage were haemorrhoids followed by nonspecific colitis, colorectal polyp and carcinoma of colon. Rectum followed by sigmoid harbored majority of pathologies that presented with lower GI haemorrhage. Conclusions: The diagnosis of the pathological lesion and management of underlying cause not only prevents another episode of lower GI haemorrhage but also help in reducing morbidity and mortality. Colonoscopy or at least sigmoidoscopy is strongly recommended for evaluation, diagnosis and management of lower GI haemorrhage.

Extraskeletal Osteosarcoma of Colon Mimicking Carcinoma of Colon – A Rare Entity

Extraskeletal osteosarcoma is a rare malignant mesenchymal tumor which typically affects elderly patients and the commonly affected sites are extremities, retroperitoneum, mesentery, and trunk. Extraskeletal osteosarcoma arising from colon or retroperitoneum can manifest as a large mass with features of intestinal or urinary tract obstruction. Local recurrence after excision and distant metastasis are common, so regular follow-up and surveillance of such patients are advisable after excision of the primary tumor.