Annals of Coloproctology

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Case Report

Anorectal benign disease

Chronic fistula in ano associated with adenocarcinoma: a case report with a review of the literature: Nalini Kanta Ghosh, Ashok Kumar; Ann Coloproctol. 2024;40(Suppl 1):S1-S5. Published online May 16, 2024; DOI: https://doi.org/10.3393/ac.2022.00752.0107

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The malignant transformation of chronic fistula in ano is rare, accounting for 3% to 11% of all anal canal malignancies. It results from long-standing inflammation and chronic irritation. No guidelines are available for the management of these cases. We herein present a case report of a 55-year-old man who presented with a history of constipation, perianal pain, and discharging fistula in ano of 4-year duration and underwent fistula surgery with recurrence. Biopsy of the fistulous tract revealed adenocarcinoma. He received neoadjuvant chemoradiotherapy, followed by abdominoperineal excision including excision of the fistulous tract. After 18 months of follow-up, he is free of recurrence. We present this case with a review of the literature, highlighting the management strategies.

Citations

Citations to this article as recorded by

A Long-standing Perianal Fistula Hiding an Adenocarcinoma: A Case Report
I-Wei Lin, Ying-Wen Su, Ching-Heng Ting, Ming-Jen Chen
Journal of Cancer Research and Practice.2026;[Epub] CrossRef

Original Article

Malignant disease, Rectal cancer,Prognosis and adjuvant therapy,Minimally invasive surgery

Should transanal total mesorectal excision be implemented in medium-sized colorectal unit? technical and oncological outcome: Man-fung Ho, Dennis Chung-Kei Ng, Janet Fung-yee Lee, Simon Siu-man Ng; Ann Coloproctol. 2022;38(3):207-215. Published online July 28, 2021; DOI: https://doi.org/10.3393/ac.2020.00941.0134

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Abstract PDF

Purpose
This study was performed to evaluate the outcome of implementation of transanal total mesorectal excision (TaTME) for low rectal cancer in a regional hospital and in comparison to laparoscopic (Lap) TME.
Methods
Consecutive patients with low rectal cancer of which the lowest border of the tumour was located beween 1 and 5 cm from the puborectalis who underwent TME at North District Hospital between January 2013 and December 2019 were included. Clinical, operative, and pathologic outcomes were compared between Lap TME and TaTME. The primary end point was complication profile.
Results
Thirty-five patients underwent Lap TME and 45 patients underwent TaTME for low rectal cancer. The conversion rate of the TaTME group was significantly lower than that of the Lap TME group (4.4% vs. 20%, P=0.029), but the operating time was longer (259 minutes vs. 219 minutes, P=0.009). The tumour location was significantly lower in the TaTME group, but the distal resection margins were adequate and not different between both groups. The TaTME group had higher incidence rates of prolonged ileus and urinary tract infection, but the other complications were similar between the two groups. The resection margin positivity rates of the TaTME and Lap TME groups were 2.2% and 5.7%, respectively (P=0.670). At a median follow up of 39 months, no abnormal early recurrence was detected.
Conclusion
It is technically feasible and oncologically safe to perform TaTME in a medium-volume colorectal unit. Patients with difficult pelvic anatomy can benefit by reducing the risk of conversion and margin positivity rate.

Citations

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Transanal versus transabdominal total mesorectal excision for rectal cancer in minimally invasive surgery: meta-analysis
Chun-Kai Liao, Yen-Lin Yu, Ya-Ting Kuo, Yu-Jen Hsu, Yih-Jong Chern, Yueh-Chen Lin, Pao-Shiu Hsieh, Jeng-Fu You, Jy-Ming Chiang
BJS Open.2025;[Epub] CrossRef
Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
Do Laparoscopic Approaches Ensure Oncological Safety and Prognosis for Serosa-Exposed Colon Cancer? A Comparative Study against the Open Approach
Ji-Hyun Seo, In-Ja Park
Cancers.2023; 15(21): 5211. CrossRef

Case Report

Metachronous carcinoma at the colostomy site after abdominoperineal resection of rectal cancer: a case report: Young Sun Choi, Kil-young Lee, Youn Young Park, Hyung Jin Kim, Jaeim Lee; Ann Coloproctol. 2023;39(2):175-177. Published online July 27, 2021; DOI: https://doi.org/10.3393/ac.2020.00185.0026

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Abstract PDF

Metachronous carcinoma at the colostomy site is very rare after abdominoperineal resection. A 53-year-old male patient underwent an abdominoperineal resection 6 years earlier for rectal cancer developed metachronous carcinoma at the site of stoma. A portion of the colon, including the stoma and the surrounding skin, was resected and a new stoma was created in the transverse colon. Although the occurrence of carcinoma at the stoma site is a rare condition, careful observation for the stoma and colonoscopy for surveillance are necessary.

Citations

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Tumor Recurrence at the Colostomy Site: A Rare Case Report and Literature Review
Abdelhak Ettaoussi, Ilias El Azhari, Nassima Fakhiri, Abdessamad Majd, Kamal Khadija, Mounir Bouali, Abdelilah El Bakouri, Khalid Khaleq, Khalid El Hattabi
European Journal of Medical and Health Research.2025; 3(3): 215. CrossRef
A rare case of metastatic carcinoma at the colostomy site after abdominoperineal resection
Dheeraj Manne, Tirou Aroul, Robinson Smile
International Surgery Journal.2025; 12(10): 1849. CrossRef
Colostomy‐site carcinoma with primitive phenotype in a rectal cancer patient after achieving pathological complete response with neoadjuvant chemoradiotherapy
Takayuki Kodama, Maki Kanzawa, Hiroshi Hasegawa, Shuichi Tsukamoto, Mari Nishio, Manabu Shigeoka, Yu‐ichiro Koma, Tomoo Itoh, Hiroshi Yokozaki
Pathology International.2024; 74(1): 33. CrossRef
Metachronous Carcinoma at Colostomy Site Post Abdominoperineal Resection – A Rare Presentation Case Report
Muhammed Huzaifa, Ankita Singh, Vaibhav Aggarwal, Anita Dhar
Clinical Cancer Investigation Journal.2023; 12(2): 1. CrossRef
Peristomal adenocarcinoma 16 years after colorectal adenocarcinoma resection with curative intent
Kayleigh A M van Dam, Thaís T T Tweed, Bart de Vries, Henricus J Belgers
Journal of Surgical Case Reports.2023;[Epub] CrossRef
A Rare Case of Metachronous Carcinoma at the Colostomy Site Following Abdominoperineal Resection – Case Report
Naoki Todayama, Ai Hua Chang, Tomohiro Tabata
Archive of International Journal of Cancer and Allied Science.2023; 3(2): 1. CrossRef

Original Article

Malignant disease, Rectal cancer, Functional outcomes

Early and Late Functional Outcomes of Anal Sphincter-Sparing Procedures With Total Mesorectal Excision for Anorectal Adenocarcinoma: Osama Eldamshety, Sherif Kotb, Ashraf Khater, Sameh Roshdy, Mohamed Elashry, Mohamed S. Zahi, Hend M. Hamdey Rashed Elkalla, Waleed Elnahas, Omar Farouk, Adel Fathi, Ahmed Senbel, Emad-Eldeen Hamed, Khaled Abdelwahab, Islam Abdou Elzahby, Ahmed abdallah, Mahmoud Abdelaziz, Emanuele Lezoche; Ann Coloproctol. 2020;36(3):148-154. Published online April 20, 2020; DOI: https://doi.org/10.3393/ac.2018.07.19

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Abstract PDF

Background
The study aims to assess the functional outcome of anal sphincter sparing procedures (SSP) with TME for anorectal adenocarcinoma.
Methods
In a multicentric, prospective, single-group study in the period between December 2012 and November 2017, 93 patients presented with anorectal adenocarcinoma were included in the study. Sixty-nine patients underwent SSP with TME. SSP included the combined approach of transabdominal TME with intersphincteric resection (ISR) or transanal transabdominal TME (TATA). Using the Per Anal Examination Scoring System (PASS), postoperative anal function was assessed after one year.
Results
Bowel motility time was 50 (±19) hours. The time needed for narcotic analgesia was 54 (±18.8) hours. Mean hospital stay was 15.4 (±10.25) days. Incidence of evident fecal incontinence after ISR is 10.6% (7/67 cases). The Per Anal Examination Scoring System (PASS) findings of 69 cases are as follows: extremely hypotonic 8.6% (6 cases), slightly hypotonic 26.1% (18 cases), normal tone 58% (40 cases), slightly stenotic 3 cases (4.3%), or occluded 2.9% (2 cases). Urinary dysfunction occurred in one case (1.4%). Temporary diversion was performed in 61 patients (87.1%).
Conclusion
Sphincter preservation with TME for anorectal adenocarcinoma helps avoid permanent stoma and provides a reasonable functional outcome. PASS is a new application for postoperative assessment of anal function

Citations

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Transanal Minimally Invasive TME (TaTME) Versus Non-Endoscopic Transanal Intersphincteric Resection of Post-Neoadjuvant Ultralow Rectal Adenocarcinoma: A Multicentric, Matched Case–Control Study
Osama Eldamshety, Mohamed Abdekhalek, Amir M. Zaid, Essam Attia, Mohamed Zuhdy, Emanuel Lezoche, Giovanni Lezoche, Enjy Mosaad, Marwa Abogabal, Islam Elzahby
Indian Journal of Surgery.2025; 87(5): 912. CrossRef
Pathologic Implications of Magnetic Resonance Imaging-detected Extramural Venous Invasion of Rectal Cancer
Hyun Gu Lee, Chan Wook Kim, Jong Keon Jang, Seong Ho Park, Young Il Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Clinical Colorectal Cancer.2023; 22(1): 129. CrossRef
International Society of University Colon and Rectal Surgeons survey of surgeons’ preference on rectal cancer treatment
Audrius Dulskas, Philip F. Caushaj, Domas Grigoravicius, Liu Zheng, Richard Fortunato, Joseph W. Nunoo-Mensah, Narimantas E. Samalavicius
Annals of Coloproctology.2023; 39(4): 307. CrossRef
Multidisciplinary treatment strategy for early rectal cancer
Gyung Mo Son, In Young Lee, Sung Hwan Cho, Byung-Soo Park, Hyun Sung Kim, Su Bum Park, Hyung Wook Kim, Sang Bo Oh, Tae Un Kim, Dong Hoon Shin
Precision and Future Medicine.2022; 6(1): 32. CrossRef
Watch and wait strategies for rectal cancer: A systematic review
In Ja Park
Precision and Future Medicine.2022; 6(2): 91. CrossRef
Current status and role of robotic approach in patients with low-lying rectal cancer
Hyo Seon Ryu, Jin Kim
Annals of Surgical Treatment and Research.2022; 103(1): 1. CrossRef
Robotic surgery for colorectal cancer
Sung Uk Bae
Journal of the Korean Medical Association.2022; 65(9): 577. CrossRef
Update on Diagnosis and Treatment of Colorectal Cancer
Chan Wook Kim
The Ewha Medical Journal.2022;[Epub] CrossRef
Low Anterior Resection Syndrome: Pathophysiology, Risk Factors, and Current Management
Seung Mi Yeo, Gyung Mo Son
The Ewha Medical Journal.2022;[Epub] CrossRef
Current Status and Future of Robotic Surgery for Colorectal Cancer-An English Version
Sung Uk Bae
Journal of the Anus, Rectum and Colon.2022; 6(4): 221. CrossRef
Is It a Refractory Disease?- Fecal Incontinence; beyond Medication
Chungyeop Lee, Jong Lyul Lee
The Ewha Medical Journal.2022;[Epub] CrossRef
Intraoperative neuromonitoring in rectal cancer surgery: a systematic review and meta-analysis
Athina A. Samara, Ioannis Baloyiannis, Konstantinos Perivoliotis, Dimitrios Symeonidis, Alexandros Diamantis, Konstantinos Tepetes
International Journal of Colorectal Disease.2021; 36(7): 1385. CrossRef
Robotic Intersphincteric Resection for Low Rectal Cancer: Technical Controversies and a Systematic Review on the Perioperative, Oncological, and Functional Outcomes
Guglielmo Niccolò Piozzi, Seon Hahn Kim
Annals of Coloproctology.2021; 37(6): 351. CrossRef
Functional outcomes after sphincter-preserving surgeries for low-lying rectal cancer: A review
Eun Jung Park, Seung Hyuk Baik
Precision and Future Medicine.2021; 5(4): 164. CrossRef
Simplification or Accuracy: In Assessing Functional Outcomes After Intersphincteric Resection for Low Rectal Cancer
Kyung Jong Kim
Annals of Coloproctology.2020; 36(3): 129. CrossRef

Case Reports

Malignant disease,Rare disease & stoma

Extensive Resection for Treatment of Locally Advanced Primary Mucinous Adenocarcinoma Arising From Fistula-in-Ano: Jordan Au, Francis M. Hulme-Moir, Andrew Herd, Mathew A. Kozman; Ann Coloproctol. 2021;37(Suppl 1):S7-S10. Published online November 26, 2019; DOI: https://doi.org/10.3393/ac.2019.11.19

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Abstract PDF

We report a case of a 66-year-old male who presented with a locally advanced primary mucinous adenocarcinoma arising from a fistula-in-ano. The presentation was typical for perianal sepsis and fistula-in-ano with anal pain and chronic discharge. Initial treatments with fistula debridement and seton were performed. Subsequent review of histology revealed underlying adenocarcinoma, while magnetic resonance imaging (MRI) showed local invasion into the prostate. The patient received neoadjuvant chemoradiotherapy followed by pelvic exenteration to maximize the chance of achieving cure. Features of this case are discussed together with its implications, including treatment guidelines and typical MRI findings.

Citations

Citations to this article as recorded by

Perianal Mucinous Adenocarcinoma: A Case Report and a Systematic Review of the Literature
Ioannis D. Gkegkes, Vassilis Milionis, Nikolaos Goutas, Ioannis Mantzoros, Antonia A. Bourtzinakou, Apostolos P. Stamatiadis
Journal of Gastrointestinal Cancer.2025;[Epub] CrossRef
A Rare Presentation of Fournier’s Gangrene: Necrotizing Infection Traveling Through a Fistula From the Rectum to the Corpus Cavernosum
Donald Dennis, Michael Gentry
Cureus.2025;[Epub] CrossRef
Perianal Mucinous Adenocarcinoma Found Incidentally From Perianal Mass
Seyed Khalafi, Malini Riddle, Brittany Harper, Vid Fikfak
Cureus.2023;[Epub] CrossRef
Advances in the Treatment of Colorectal Cancer with Peritoneal Metastases: A Focus on Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
Youngbae Jeon, Eun Jung Park
The Ewha Medical Journal.2023;[Epub] CrossRef

Anal Adenocarcinoma Can Masquerade as Chronic Anal Fistula in Asians: Faith Qi-Hui Leong, Dedrick Kok Hong Chan, Ker-Kan Tan; Ann Coloproctol. 2019;35(1):47-49. Published online December 3, 2018; DOI: https://doi.org/10.3393/ac.2018.03.15

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Abstract PDF

Purpose
Perianal adenocarcinoma arising from a chronic anorectal fistula is a rare condition for which the natural history and optimal management are not well established. For that reason, we conducted a retrospective analysis of 5 consecutive patients with a perianal adenocarcinoma arising from a chronic anorectal fistula managed at our institution from January 2014 to December 2015.
Methods
The patients were identified from a prospectively collected colorectal cancer database that included all patients managed for colorectal cancer at our institution.
Results
The median age at diagnosis was 64 years (range, 55–72 years). Magnetic resonance imaging (MRI) was the initial investigation for all patients and showed a hyperintense T2-weighted image. One patient underwent an abdominoperineal resection following neoadjuvant chemoradiotherapy and remained disease free during the 12-month follow-up. Three patients received neoadjuvant therapy with intent for surgery, but did not undergo surgery due to either worsening health or metastatic spread. One patient declined intervention. The median overall survival was 10.5 months (range, 2–19 months).
Conclusion
A high index of suspicion is required to make a clinical diagnosis of an anal adenocarcinoma arising from a chronic fistula. Histologic diagnosis must be achieved to confirm the diagnosis. Multimodal therapy with neoadjuvant chemoradiotherapy followed by abdominoperineal resection is the treatment of choice.

Citations

Citations to this article as recorded by

A Long-standing Perianal Fistula Hiding an Adenocarcinoma: A Case Report
I-Wei Lin, Ying-Wen Su, Ching-Heng Ting, Ming-Jen Chen
Journal of Cancer Research and Practice.2026;[Epub] CrossRef
Chronic fistula in ano associated with adenocarcinoma: a case report with a review of the literature
Nalini Kanta Ghosh, Ashok Kumar
Annals of Coloproctology.2024; 40(Suppl 1): S1. CrossRef
Value of apparent diffusion coefficient on MRI for prediction of histopathological type in anal fistula cancer
Shinji Yamamoto, Keiji Yonezawa, Naoki Fukata, Koji Takeshita, Makoto Kodama, Tetsuro Yamana, Shigeru Kiryu, Yukinori Okada
Medicine.2023; 102(14): e33281. CrossRef
Synchronous anal mucinous adenocarcinoma and anal tuberculosis presenting as chronic anal fistula: Challenging management
Sarah Benammi, Youness Bakali, Mouna Alaoui
Archive of Clinical Cases.2023; 10(2): 74. CrossRef
Non-mucinous adenocarcinomas and squamous cell carcinomas of the anal region masquerading as abscess or fistula: a retrospective analysis and systematic review of literature
Aysun Tekbaş, Henning Mothes, Utz Settmacher, Silke Schuele
Journal of Cancer Research and Clinical Oncology.2022; 148(6): 1509. CrossRef
Management and Outcomes in Anal Canal Adenocarcinomas—A Systematic Review
Vasilis Taliadoros, Henna Rafique, Shahnawaz Rasheed, Paris Tekkis, Christos Kontovounisios
Cancers.2022; 14(15): 3738. CrossRef
Adjuvant chemoradiotherapy does not improve outcomes in patients with fistula-associated anal adenocarcinoma undergoing abdominoperineal resection
Min Wang, Yu Xiang, Yunshan Wang, Jiayi Zhang, Haoran Zhao, Can Wang, Lichao Qiao, Bolin Yang
Frontiers in Oncology.2022;[Epub] CrossRef

Original Articles

Clinical Significance of Signet-Ring-Cell Colorectal Cancer as a Prognostic Factor: Sang-Oh Yun, Yong Beom Cho, Woo Yong Lee, Hee Cheol Kim, Seong Hyeon Yun, Yoon Ah Park, Jung Wook Huh; Ann Coloproctol. 2017;33(6):232-238. Published online December 31, 2017; DOI: https://doi.org/10.3393/ac.2017.33.6.232

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Abstract PDF

Purpose

The aim of this study is to evaluate the prognosis for patients with a signet-ring-cell carcinoma (SRCC) who undergo curative surgery by comparing them to patients with an adenocarcinoma (ADC), excluding a mucinous ADC.

Methods

Between September 1994 and December 2013, 14,110 patients with colorectal cancer underwent surgery and among them, 12,631 patients were enrolled in this study. 71 patients with a SRCC and 12,570 patients with a ADC were identified. We analyzed the disease-free survival and the overall survival rates before and after a 1:2 propensity score matching and evaluated those rates after stage stratification.

Results

The median follow-up durations were 48.5 months for the SRC group and 48.6 months for the ADC group. The disease-free survival rates and the overall survival rates were significantly lower in the SRC group before and after propensity score matching (P < 0.001). After stratification by stage, no differences were observed between the SRC and the ADC groups for the disease-free survival (DFS) and the overall survival (OS) rates for patients with cancer in its early stages (P = 0.913 and P = 0.380 for the DFS and the OS, respectively, in stages 0 and I, and P = 0.223 and P = 0.991 for the DFS and the OS, respectively, in stage II), but those rates were significantly lower in the SRC group for cancer in its later stages (P < 0.001, respectively in stages III and IV).

Conclusion

For cancer in advanced stages, patients with a resectable colorectal SRCC had a poorer prognosis after propensity score matching than those with an ADC did. Therefore, more intensive surveillance and closer observation should be offered to such patients.

Citations

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Racial/Ethnic Disparities in Early-Onset Colorectal Cancer Outcomes
Meng-Han Tsai, Dariush Shahsavari, Jie Chen, Bobak Moazzami, Subbaramia Sridhar
Journal of Racial and Ethnic Health Disparities.2025;[Epub] CrossRef
Breaking Boundaries: An Unusual Case of Rectal Signet Ring Cell Carcinoma Invading the Uterus and Mesentery
Mitali Singh, Vaibhav Mane
Cureus.2025;[Epub] CrossRef
Prognostic implications of T stage in different pathological types of colorectal cancer: an observational study using SEER population-based data
Nan Yao, Wenqiang Li, Jiwei Wang, Hongyuan Chu, Ning Duan, Xinyu Niu, Guoyong Yu, Jun Qu
BMJ Open.2024; 14(2): e076579. CrossRef
Systematic review of risk factors, prognosis, and management of colorectal signet-ring cell carcinoma
Frederiek Nuytens, Vincent Drubay, Clarisse Eveno, Florence Renaud, Guillaume Piessen
World Journal of Gastrointestinal Oncology.2024; 16(5): 2141. CrossRef
Unraveling the complexities of colorectal cancer and its promising therapies – An updated review
Sayan Saha, Shreya Ghosh, Suman Ghosh, Sumit Nandi, Aditi Nayak
International Immunopharmacology.2024; 143: 113325. CrossRef
Case report: Preclinical efficacy of NEDD8 and proteasome inhibitors in patient-derived models of signet ring high-grade mucinous colorectal cancer from a Lynch syndrome patient
Erica Torchiaro, Consalvo Petti, Sabrina Arena, Francesco Sassi, Giorgia Migliardi, Alfredo Mellano, Roberta Porporato, Marco Basiricò, Loretta Gammaitoni, Enrico Berrino, Monica Montone, Giorgio Corti, Giovanni Crisafulli, Caterina Marchiò, Alberto Barde
Frontiers in Oncology.2023;[Epub] CrossRef
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Yasmeen Z. Qwaider, Naomi M. Sell, Caitlin E. Stafford, Chloe Boudreau, Hiroko Kunitake, Robert N. Goldstone, Rocco Ricciardi, Liliana G. Bordeianou, Christy E. Cauley, David L. Berger
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Ashini H. Shah, Amisha J. Gami, Neetal H. Desai, Jahnavi S. Gandhi, Priti P. Trivedi
Indian Journal of Surgical Oncology.2022; 13(3): 459. CrossRef
The Association of Microbiome Dysbiosis With Colorectal Cancer
Artem Artemev, Sheetal Naik, Anastasia Pougno, Prasanna Honnavar, Nandan M Shanbhag
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Tahir Iqbal, Maria Ashraf, Arslan Masood
Inorganic Chemistry Communications.2022; 139: 109322. CrossRef
Predictors of Long-Time Survivors in Nonmetastatic Colorectal Signet Ring Cell Carcinoma: A Large Population-Based Study
Wuguang Zhang, Wenqian Gong, Changhai Wu, Mengting Li, Xiaolong Tu, Stephen Fink
Gastroenterology Research and Practice.2022; 2022: 1. CrossRef
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Liming Wang, Yasumitsu Hirano, Gregory Heng, Toshimasa Ishii, Hiroka Kondo, Kiyoka Hara, Nao Obara, Masahiro Asari, Takuya Kato, Shigeki Yamaguchi
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The Impact of Histologic Subtype on Receipt of Adjuvant Chemotherapy and Overall Survival in Stage III Colon Cancer: a Retrospective Cohort Analysis
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Michael J. Steel, Hussam Bukhari, Laura Gentile, Jennifer Telford, David F. Schaeffer
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Colorectal cancer of the young displays distinct features of aggressive tumor biology: A single-center cohort study
Matteo Mueller, Marcel André Schneider, Barla Deplazes, Daniela Cabalzar-Wondberg, Andreas Rickenbacher, Matthias Turina
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Meena Suthar, Akshay D. Baheti, Suman K. Ankathi, Amit Choudhari, Purvi D. Haria, Reena Engineer, Vikas Ostwal, Mukta S. Ramadwar, Ashwin Desouza, Avanish Saklani
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Jiwei Wang, Song Li, Yanna Liu, Chunquan Zhang, Honglang Li, Bin Lai
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Clinicopathological Characteristics and Mutation Spectrum of Colorectal Adenocarcinoma With Mucinous Component in a Chinese Cohort: Comparison With Classical Adenocarcinoma
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Signet ring cell component in pretreatment biopsy predicts pathological response to preoperative chemoradiotherapy in rectal cancer
Xue Chao, Zixian Wang, Shixun Lu, Yuhua Huang, Shengbing Zang, Peirong Ding, Huizhong Zhang, Jingping Yun
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Outcomes of Definitive Treatment of Signet Ring Cell Carcinoma of the Rectum: Is Minimal Invasive Surgery Detrimental in Signet Ring Rectal Cancers?
S. Raghavan, Deepak Kumar Singh, J. Rohila, A. DeSouza, R. Engineer, A. Ramaswamy, V. Ostwal, A. Saklani
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Aggressive Colorectal Cancer in the Young
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Is the Location of the Tumor Another Prognostic Factor for Patients With Colon Cancer?: Myung-Kyu Jung, Ui Sup Shin, Young-Jun Ki, Yong-Bae Kim, Sun-Mi Moon, Se-Jin Sung; Ann Coloproctol. 2017;33(6):210-218. Published online December 31, 2017; DOI: https://doi.org/10.3393/ac.2017.33.6.210

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Abstract PDF

Purpose

In this study, we investigated both the characteristics of right colon cancer (RTCC) in comparison with those of left colon cancer (LTCC) and the impact of the location of the colon cancer on the prognosis.

Methods

We retrospectively analyzed the cases of 974 patients with nonmetastatic colon cancer who had undergone surgery with a curative intent from January 2001 to December 2011. RTCC was defined as a tumor located proximal to the splenic flexure. The characteristics of RTCC cancer were investigated by using descriptive analyses, and their impacts on the prognosis were assessed by using a Cox multivariate regression.

Results

Compared to LTCC, RTCC showed a female-dominant feature, and an undifferentiated pathology was more frequently observed. The number of lymph nodes retrieved from patients with RTCC was significantly higher than that retrieved from patients with LTCC. During 75 months of follow-up, peritoneal recurrence was more common in patients with RTCC than it was in patients with LTCC, and among the patients with stage III colon cancer, the disease-free and the overall survival rates were significantly worse in patients with RTCC. After adjustments with the other prognostic factors associated with colon cancer had been made, a tumor located at the right colon was found to be independently associated with poor prognosis.

Conclusion

RTCC showed unique clinicopathologic features and was associated with a poorer prognosis.

Citations

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Differences in the expression of CMTM3 and SSTR2 genes in right and left colon tumors: A molecular insight into colorectal cancer
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Association of LCT-13910 C/T Polymorphism and Colorectal Cancer: Genco Gençdal, Esin Salman, Ömer Özütemiz, Ulus S. Akarca; Ann Coloproctol. 2017;33(5):169-172. Published online October 31, 2017; DOI: https://doi.org/10.3393/ac.2017.33.5.169

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Abstract PDF

Purpose

The activity of epithelial lactase (LCT) is associated with a polymorphism 13910 bp upstream in the lactase encoding gene. Because the association between the LCT-13910 polymorphism and the risk for colorectal cancer is not clear, we investigated the role of the LCT-13910 polymorphism as a potential risk factor for colorectal cancer and colorectal polyps in the Turkish population.

Methods

One hundred sixty-six subjects (74 with polyps, 44 with colorectal cancer, 48 controls), who had undergone a total colonoscopy between January 2012 and November 2012 in our endoscopy unit were genotyped for the LCT-13910 polymorphism by using the polymerase chain reaction and minisequencing.

Results

The CC genotype in the lactose gene 13910 locus, which is accepted as the genetic indicator of lactase deficiency, was determined as 83.7%. The CC genotype rate was determined as 89.1% in patients who had a history of lactose intolerance and 81.5% in those without a history of lactose intolerance (P = 0.236). No difference was detected between the patients who had colorectal polyp(s) and/or cancer and the controls with regard to the LCT-13910 polymorphism. No differences were determined between groups when they were compared with regard to the C or the T allele.

Conclusion

No differences were detected between the patients who had colorectal polyp(s) and/or cancer and those with normal colonoscopy findings with regard to lactase gene polymorphisms. No differences were determined between the groups when they were compared with regard to the C or the T allele.

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Genetically Determined Circulating Lactase/Phlorizin Hydrolase Concentrations and Risk of Colorectal Cancer: A Two-Sample Mendelian Randomization Study
Sihao Han, Jiemin Yao, Hajime Yamazaki, Samantha A. Streicher, Jianyu Rao, Roch A. Nianogo, Zuofeng Zhang, Brian Z. Huang
Nutrients.2024; 16(6): 808. CrossRef
The Association of Lactose Intolerance With Colon and Gastric Cancers: Friend or Foe?
Mohammad Maysara Asfari, Osama Hamid, Muhammad Talal Sarmini, Katherine Kendrick, Lakshmi Priyanka Pappoppula, Humberto Sifuentes, Subbaramiah Sridhar
Cureus.2022;[Epub] CrossRef
Genetically proxied milk consumption and risk of colorectal, bladder, breast, and prostate cancer: a two-sample Mendelian randomization study
Susanna C. Larsson, Amy M. Mason, Siddhartha Kar, Mathew Vithayathil, Paul Carter, John A. Baron, Karl Michaëlsson, Stephen Burgess
BMC Medicine.2020;[Epub] CrossRef
Routine disaccharidase testing: are we there yet?
Antone R. Opekun, Bruno P. Chumpitazi, Mustafa M. Abdulsada, Buford L. Nichols
Current Opinion in Gastroenterology.2020; 36(2): 101. CrossRef
Lactose Intolerance and Colorectal Cancer
Jong-Woo Kim
Annals of Coloproctology.2017; 33(5): 157. CrossRef

Anaphase-Promoting Complex 7 is a Prognostic Factor in Human Colorectal Cancer: Ik Yong Kim, Hye Yeon Kwon, Kwang Hwa Park, Dae Sung Kim; Ann Coloproctol. 2017;33(4):139-145. Published online August 31, 2017; DOI: https://doi.org/10.3393/ac.2017.33.4.139

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Abstract PDF

Purpose

The anaphase-promoting complex (APC) is a multiprotein complex with E3 ubiquitin ligase activity and is required for ubiquitination of securin and cyclin-B. Several APC-targeting molecules are reported to be oncogenes. Dysregulation of APC may be associated with tumorigenesis. This study examines the relationship between APC expression and clinicopathological factors and evaluates the possibility of an aberrant APC function in colorectal carcinomas (CRCs).

Methods

To determine whether the loss of APC7 expression is related to tumorigenesis, we used tissue micro-arrays in 114 resected CRCs to scrutinize the expressions of APC7 and Ki-67 immunohistochemistry and to find relations with clinocopathologic parameters. The expression of APC7 was defined as positive for summed scores of staining intensities from 0 to 3+.

Results

Forty-four cases (67.7%) of colon cancer and 38 cases (77.6%) of rectal cancer showed immunopositive reactions to APC. The grade of APC expression was not statistically correlated with tumor location, age, T or TNM stage, or differentiation. However, the expression of APC did correlate with the expression of Ki-67 and to the tumor recurrent. Higher APC expression showed the better 5-year overall survival rate in 74% of grades 2, 3 groups (high expression) than 57% of grades 0, 1 groups (lower expression) respectively (P = 0.042).

Conclusion

Positive APC expression may be a good prognostic factor for patients with CRC, and the loss of APC expression in tumor tissue may be related with the risk for recurrence and a poor survival rate compared to high APC expression. Further study of APC in controlling the cell cycle as aberrant function in CRC is needed.

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Iva Benešová, Ľudmila Křížová, Miloslav Kverka
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Upregulation of anaphase promoting complex (APC) 7 as a prognostic marker for esophageal squamous cell carcinoma: A hospital based study
Eyashin Ali, Manash Jyoti Kalita, Simanta Kalita, Jayasree Talukdar, Ankur Jyoti Deka, Jasmin Sultana, Bikash Narayan Choudhury, Munindra Narayan Baruah, Sahana Bhattacharjee, Subhash Medhi
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Gayatree Mohapatra, Avital Eisenberg-Lerner, Yifat Merbl
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Prognostic Significance of Mucinous Histologic Subtype on Oncologic Outcomes in Patients With Colorectal Cancer: Sare Hosseini, Ali Mohammad Bananzadeh, Roham Salek, Mohammad Zare-Bandamiri, Ali Taghizadeh Kermani, Mohammad Mohammadianpanah; Ann Coloproctol. 2017;33(2):57-63. Published online April 28, 2017; DOI: https://doi.org/10.3393/ac.2017.33.2.57

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Abstract PDF

Purpose

Mucinous adenocarcinomas account for about 10% of all colorectal cancers. This study aimed to investigate the prognostic impact of mucinous histologic subtype on oncologic outcomes in patients with colorectal cancer.

Methods

This retrospective study was performed at two large tertiary university hospitals. We analyzed the characteristics, prognostic factors, and survival of patients with colorectal cancer who were treated and followed up between 2000 and 2013.

Results

Totally, 144 of 1,268 patients with a colorectal adenocarcinoma (11.4%) had mucinous histologic subtype. Statistically significant results found in this research are as follows: Mucinous histologic subtype tended to present in younger patients and to have larger tumor size, higher histologic grade, higher node stage, larger number of positive nodes, and higher rate of perineural invasion compared to nonmucinous histologic subtype. On the univariate analysis, mucinous subtype was a prognostic factor for disease-free and overall survival. On the multivariate analysis, primary tumor location, node stage and lymphatic-vascular invasion were independent prognostic factors for the local control rate. Rectal tumor location, higher disease stage, tumor grade II, and presence of lymphatic-vascular invasion had negative influences on disease-free survival, as did rectal tumor location, higher disease stage and presence of lymphatic-vascular invasion on overall survival.

Conclusion

Mucinous histologic subtype was associated with some adverse pathologic features in patients with colorectal cancer; however, it was not an independent prognostic factor for oncologic outcome.

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Lili Zhu, Chunrun Ling, Tao Xu, Jinglin Zhang, Yujie Zhang, Yingjie Liu, Chao Fang, Lie Yang, Wen Zhuang, Rui Wang, Jie Ping, Mojin Wang
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Chuanwang Yan, Hui Yang, Lili Chen, Ran Liu, Wei Shang, Wenguang Yuan, Fei Yang, Qing Sun, Lijian Xia
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Sare Hosseini, NamPhong Nguyen, Mohammad Mohammadianpanah, Sepideh Mirzaei, Ali Mohammad Bananzadeh
Journal of Gastrointestinal Cancer.2019; 50(4): 716. CrossRef
Impact of histological subtype on the prognosis of patients undergoing surgery for colon cancer
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SCF/c-KIT Signaling Increased Mucin2 Production by Maintaining Atoh1 Expression in Mucinous Colorectal Adenocarcinoma
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Mucinous Subtype in Patients With Colorectal Cancer
Hyung Jin Kim
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Case Report

Synchronous Primary Anorectal Melanoma and Sigmoid Adenocarcinoma: Inju Cho, Kyung Jong Kim, Sung-Chul Lim; Ann Coloproctol. 2016;32(5):190-194. Published online October 31, 2016; DOI: https://doi.org/10.3393/ac.2016.32.5.190

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Abstract PDF

A primary anorectal malignant melanoma is a rare tumor. Moreover, cases involving a synchronous anorectal melanoma and colon adenocarcinoma are extremely rare. The authors report a case of a synchronous anorectal melanoma and sigmoid adenocarcinoma in an 84-year-old man. The regions of the anorectal melanoma showed melanocytic nevi in the adjacent mucosa of the anal canal and rectum. A dysplastic nevus was also identified in the anal mucosa. This case demonstrates that an anorectal melanoma can arise from pre-existing anorectal melanocytic lesions.

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Giovanni Paolino, Antonio Podo Brunetti, Carolina De Rosa, Carmen Cantisani, Franco Rongioletti, Andrea Carugno, Nicola Zerbinati, Mario Valenti, Domenico Mascagni, Giulio Tosti, Santo Raffaele Mercuri, Riccardo Pampena
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Original Articles

Efficacy and Safety of Low-Dose-Rate Endorectal Brachytherapy as a Boost to Neoadjuvant Chemoradiation in the Treatment of Locally Advanced Distal Rectal Cancer: A Phase-II Clinical Trial: Shapour Omidvari, Shadi Zohourinia, Mansour Ansari, Leila Ghahramani, Mohammad Zare-Bandamiri, Ahmad Mosalaei, Niloofar Ahmadloo, Saeedeh Pourahmad, Hamid Nasrolahi, Sayed Hasan Hamedi, Mohammad Mohammadianpanah; Ann Coloproctol. 2015;31(4):123-130. Published online August 31, 2015; DOI: https://doi.org/10.3393/ac.2015.31.4.123

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Abstract PDF

Purpose

Despite advances in rectal cancer treatment over the last decade, local control and risk of late side effects due to external beam radiation therapy (EBRT) remain as concerns. The present study aimed to investigate the efficacy and the safety of low-dose-rate endorectal brachytherapy (LDRBT) as a boost to neoadjuvant chemoradiation for use in treating locally advanced distal rectal adenocarcinomas.

Methods

This phase-II clinical trial included 34 patients (as the study arm) with newly diagnosed, locally advanced (clinical T3-T4 and/or N1/N2, M0) lower rectal cancer. For comparative analysis, 102 matched patients (as the historical control arm) with rectal cancer were also selected. All the patients were treated with LDRBT (15 Gy in 3 fractions) and concurrent chemoradiation (45-50.4 Gy). Concurrent chemotherapy consisted of oxaliplatin 130 mg/m² intravenously on day 1 plus oral capecitabine 825 mg/m² twice daily during LDRBT and EBRT.

Results

The study results revealed a significant differences between the study arm and the control arm in terms in the pathologic tumor size (2.1 cm vs. 3.6 cm, P = 0.001), the pathologic tumor stage (35% T3-4 vs. 65% T3-4, P = 0.003), and the pathologic complete response (29.4% vs. 11.7%, P < 0.028). Moreover, a significantly higher dose of EBRT (P = 0.041) was found in the control arm, and a longer time to surgery was observed in the study arm (P < 0.001). The higher rate of treatment-related toxicities, such as mild proctitis and anemia, in the study arm was tolerable and easily manageable.

Conclusion

A boost of LDRBT can optimize the pathologic complete response, with acceptable toxicities, in patients with distal rectal cancer.

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Mustafa M. Al Balushi, Teresia M. Perkins, Kee-Young Shin, Ivan M. Buzurovic, Simon G. Talbot, Joel E. Goldberg, Desmond A. O’Farrell, Martin T. King, Harvey J. Mamon, Philip M. Devlin
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Roman V. Novikov, Sergey N. Novikov
Koloproktologia.2023; 22(3): 158. CrossRef
Neoadjuvant Radiotherapy Dose Escalation in Locally Advanced Rectal Cancer: a Systematic Review and Meta-analysis of Modern Treatment Approaches and Outcomes
N. Hearn, D. Atwell, K. Cahill, J. Elks, D. Vignarajah, J. Lagopoulos, M. Min
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Zahra Siavashpour, Farzad Taghizadeh-Hesary, Afshin Rakhsha
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F. Roeder, E. Meldolesi, S. Gerum, V. Valentini, C. Rödel
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Predictive Significance of Mucinous Histology on Pathologic Complete Response Rate Following Capecitabine-Based Neoadjuvant Chemoradiation in Rectal Cancer: a Comparative Study
Sare Hosseini, NamPhong Nguyen, Mohammad Mohammadianpanah, Sepideh Mirzaei, Ali Mohammad Bananzadeh
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An-Sofie Verrijssen, Thirza Opbroek, Murillo Bellezzo, Gabriel P. Fonseca, Frank Verhaegen, Jean-Pierre Gerard, Arthur Sun Myint, Evert J. Van Limbergen, Maaike Berbee
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Richard Garfinkle, Sebastian Lachance, Te Vuong, Alexandre Mikhail, Vincent Pelsser, Adrian Gologan, Nancy A. Morin, Carol-Ann Vasilevsky, Marylise Boutros
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Mark T.W. Teo, Lucy McParland, Ane L. Appelt, David Sebag-Montefiore
International Journal of Radiation Oncology*Biology*Physics.2018; 100(1): 146. CrossRef
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Saeedeh Pourahmad, Soudabeh Pourhashemi, Mohammad Mohammadianpanah
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Lentivirus‐mediated shRNA interference of ghrelin receptor blocks proliferation in the colorectal cancer cells
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Colovesical Fistula: Should It Be Considered a Single Disease?: Qamar Hafeez Kiani, Mark L. George, Emin A. Carapeti, Alexis M. P. Schizas, Andrew B. Williams; Ann Coloproctol. 2015;31(2):57-62. Published online April 30, 2015; DOI: https://doi.org/10.3393/ac.2015.31.2.57

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Abstract PDF

Purpose

This research was conducted to compare the management and the outcome of patients with colovesical fistulae of different aetiologies.

Methods

Retrospective data were collected from 2002 to 2012 and analyzed with SPSS ver. 17. Age, gender, aetiology, management, hospital stay, postoperative complications, and mortality were studied and compared among colovesical fistulae of different aetiologies.

Results

A total of 55 patients, 46 males (84%) and 9 females (16%), with a median age of 65 years (interquartile range [IQR], 48-75 years) were studied. Diverticular disease was the most common benign cause and recto-sigmoid cancer the most common malignancy. Anterior resection and bladder repair were the most frequent operations in benign cases, as was total pelvic exenteration in the malignant group. Multiple intestinal loop involvement and subsequent resection were significantly higher in those with Crohn disease than it was in patients of colovesical fistula due to all other causes collectively (60% vs. 6%, P = 0.006). Patients with malignancy had a higher postoperative complication rate than patients who did not (12 [80%] vs. 7 [32%], P = 0.0005). Pelvic collection (11, 22%) was the most frequent early complication (predominantly in the malignant group) whereas incisional hernia (8, 22%) was the most common late complication, with a predominance in the benign group. The median hospital stay was significantly prolonged in the malignant group (32 days; IQR, 17-70 days vs. 16 days; IQR, 11-25 days; P < 0.001).

Conclusion

Despite their having similar clinical presentation, colovesical fistulae of various aetiologies differ significantly in management and outcome.

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Davide Campobasso, Maurizio Zizzo, Federico Biolchini, Carolina Castro-Ruiz, Antonio Frattini, Alessandro Giunta
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Goro Takahashi, Akihisa Matsuda, Takeshi Yamada, Kay Uehara, Seiichi Shinji, Yasuyuki Yokoyama, Takuma Iwai, Kohki Takeda, Sho Kuriyama, Toshimitsu Miyasaka, Shintaro Kanaka, Tai Terayachi, Tetsuya Okino, Hiroshi Yoshida
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Management of colovesical fistula: a systematic review
Maurizio ZIZZO, David TUMIATI, Maria C. BASSI, Magda ZANELLI, Francesca SANGUEDOLCE, Francesco PORPIGLIA, Cristian FIORI, Davide CAMPOBASSO, Carolina CASTRO RUIZ, Franco A. BERGAMASCHI, Umberto V. MAESTRONI, Giuseppe CARRIERI, Luigi CORMIO, Federico BIOLC
Minerva Urology and Nephrology.2022;[Epub] CrossRef
Burden of Colovesical Fistula and Changing Treatment Pathways: A Systematic Literature Review
Caterina Froiio, Daniele Bernardi, Emanuele Asti, Giulia Bonavina, Andrea Conti, Luca Carmignani, Luigi Bonavina
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2022; 32(5): 577. CrossRef
Colovesical Fistulae: The Varying Aetiologies
Mansoor Zafar, Sara Lee, Serena Tieger, William Sacre, Mark Whitehead
Cureus.2021;[Epub] CrossRef
Urinary bladder fistulae and the role of CT cystography: a pictorial review
Daniel F. Fouladi, Shahab Shayesteh, Elliot K. Fishman, Linda C. Chu
Abdominal Radiology.2020; 45(6): 1883. CrossRef
Fístula colovesical: aplicabilidad del abordaje laparoscópico y resultados según su etiología
Noa de la Fuente Hernández, Carmen Martínez Sánchez, Mireia Solans Solerdelcoll, Pilar Hernández Casanovas, Jesús Bollo Rodríguez, Josep María Gaya Sopena, Eduard Targarona Soler
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Colovesical Fistula: Applicability of the Laparoscopic Approach and Results According to Etiology
Noa de la Fuente Hernández, Carmen Martínez Sánchez, Mireia Solans Solerdelcoll, Pilar Hernández Casanovas, Jesús Bollo Rodríguez, Josep María Gaya Sopena, Eduard Targarona Soler
Cirugía Española (English Edition).2020; 98(6): 336. CrossRef
Manejo laparoscópico de fístulas colovesicales de origen benigno, resultados y revisión de la literatura
José Nicolás García Martin del Campo, José Luis Serna Soto, Carolina León Mancilla, Rogelio Romero Pérez, Jorge Alberto Cancino, Betsabé López Vázquez, Julio César Sotelo Estévez
Revista Mexicana de Cirugía Endoscópica.2020; 21(3): 149. CrossRef
Perioperative Management of Patients with Colovesical Fistula
Scott C. Dolejs, Alyssa J. Penning, Michael J. Guzman, Alyssa D. Fajardo, Bryan K. Holcomb, Bruce W. Robb, Joshua A. Waters
Journal of Gastrointestinal Surgery.2019; 23(9): 1867. CrossRef
Laparoscopic approaches to complicated diverticulitis
M. Gachabayov, R. Essani, R. Bergamaschi
Langenbeck's Archives of Surgery.2018; 403(1): 11. CrossRef
A colovesical fistula with a persistent descending mesocolon due to partial situs inversus: A case report
Tetsuya Mochizuki, Hirofumi Tazawa, Yuzo Hirata, Yoshio Kuga, Tomohiro Miwata, Sotaro Fukuhara, Kouki Imaoka, Seiji Fujisaki, Mamoru Takahashi, Saburo Fukuda, Toshihiro Nishida, Hideto Sakimoto
International Journal of Surgery Case Reports.2017; 37: 109. CrossRef
Diagnosis and Treatments for Vesico-Enteric Fistulas: a 2017 Current Review
Justin W. Fincher, Ehab Eltahawy
Current Bladder Dysfunction Reports.2017; 12(3): 212. CrossRef
Incidental adenocarcinoma in patients undergoing surgery for stricturing Crohn's disease
Ivan Kristo, Stefan Riss, Stanislaus Argeny, Svenja Maschke, Praminthra Chitsabesan, Anton Stift
World Journal of Gastroenterology.2017; 23(3): 472. CrossRef
Risk factors associated with postoperative morbidity in over 500 colovesical fistula patients undergoing colorectal surgery: a retrospective cohort study from ACS-NSQIP database
H. Hande Aydinli, Cigdem Benlice, Gokhan Ozuner, Emre Gorgun, Maher A. Abbas
International Journal of Colorectal Disease.2017; 32(4): 469. CrossRef
Different Strategies for Treating a Colovesical Fistula
Moo Jun Baek
Annals of Coloproctology.2015; 31(2): 45. CrossRef
Is laparoscopic surgery the best treatment in fistulas complicating diverticular disease of the sigmoid colon? A systematic review
Roberto Cirocchi, Alberto Arezzo, Claudio Renzi, Giovanni Cochetti, Vito D'Andrea, Abe Fingerhut, Ettore Mearini, Gian Andrea Binda
International Journal of Surgery.2015; 24: 95. CrossRef
Colovesical fistula caused by glucocorticoid therapy for IgG4-related intrapelvic mass
Yohei Yabuuchi
World Journal of Clinical Cases.2015; 3(12): 1000. CrossRef

Clinicopathologic Significance of BRAF Mutation and Extracellular Signal Regulated Kinase 1/2 Expression in Patients With a Colorectal Adenocarcinoma: Hyung Ook Kim, Beom Gyu Kim, Seong Jae Cha, Yong Gum Park, Tae Jin Lee; Ann Coloproctol. 2015;31(1):9-15. Published online February 28, 2015; DOI: https://doi.org/10.3393/ac.2015.31.1.9

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Abstract PDF

Purpose

BRAF mutation and expression of extracellular signal regulated kinase (ERK) are linked with colorectal carcinogenesis through the serrated pathway. BRAF and ERK1/2 play important roles in the activation of mitogen-activated protein (MAP) kinase signaling pathways. The present study investigated the clinicopathologic outcomes of BRAF mutation and ERK1/2 expression in patients with colorectal cancer (CRC) and the possibility of using them as prognostic indicators.

Methods

Dual-priming oligonucleotide-based multiplex polymerase chain reaction for BRAF^V600E mutation and immunohistochemical analysis of ERK1/2 were performed using 65 formalin-fixed, paraffin-embedded samples from patients with CRC. We analyzed the dependences of the clinicopathologic features on BRAF mutation and ERK1/2 expression.

Results

Out of 65 samples from CRC patients, BRAF mutation was detected in 3 (4.6%). The 3 patients with BRAF mutation presented with T3 CRC with lymph node metastasis (stage III) showing moderately or poorly differentiated histology. ERK1 and ERK2 were positively detected in 73.8% and 15.4% of the patients with CRC, respectively. ERK1 expression was significantly correlated with lymph node metastasis (P = 0.049). ERK2 expression was significantly correlated with tumor emboli (P < 0.05), tumor invasion (P = 0.035), lymph node metastasis (P = 0.017), and stage (P = 0.02).

Conclusion

BRAF mutation and ERK1/2 expression may be associated with advanced or more aggressive CRC. These molecular markers might play prognostic roles in CRC developed through the serrated pathway.

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BRAF protein immunoprecipitation, elution, and digestion from cell extract using a microfluidic mixer for mutant BRAF protein quantification by mass spectrometry
Yen-Heng Lin, Heng-Yun Chang, Chia-Chun Wu, Chia-Wei Wu, Kai-Ping Chang, Jau-Song Yu
Analytical and Bioanalytical Chemistry.2019; 411(5): 1085. CrossRef
Combined detection of the expression of Nm23-H1 and p53 is correlated with survival rates of patients with stage II and III colorectal cancer
Yinying Wu, Yi Li, Xiaoai Zhao, Danfeng Dong, Chunhui Tang, Enxiao Li, Qianqian Geng
Oncology Letters.2017; 13(1): 129. CrossRef
Progression inference for somatic mutations in cancer
Leif E. Peterson, Tatiana Kovyrshina
Heliyon.2017; 3(4): e00277. CrossRef
DoesBRAFMutation and Extracellular Signal Regulated Kinase Expression in Patients With Colorectal Cancer Have Any Prognostic Significance?
Moo Jun Baek
Annals of Coloproctology.2015; 31(1): 1. CrossRef

Case Reports

TisN0M1 Sigmoid Colon Cancer: A Case Report: Kyung Ha Lee, Jin Su Kim, Kwang Sik Cheon, In Sang Song, Dae Young Kang, Ji Yeon Kim; Ann Coloproctol. 2014;30(3):141-146. Published online June 23, 2014; DOI: https://doi.org/10.3393/ac.2014.30.3.141

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Abstract PDF

Distant metastasis of a colon carcinoma in situ has not yet been reported. We experienced a case of a sigmoid colon carcinoma in situ with common hepatic lymph node metastasis. After the first operation, we diagnosed dual intramucosal adenocarcinomas of the sigmoid colon without any regional lymph node metastasis. After the second operation, a metastatic adenocarcinoma was found in the common hepatic lymph nodes. We suggest that metastasis in cases of a colonic carcinoma in situ is rare, but possible. The parallel progression model of tumors can explain this early metastasis.

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Lymph node metastasis in a patient with carcinoma in situ rectal cancer: A case report
San-Ha Kim, Gi-Bong Chae, Seung-Koo Lee, Seung-Joo Nam
Molecular and Clinical Oncology.2025; 23(4): 1. CrossRef
Potential for Metastasis and Recurrence in Colorectal Carcinoma In Situ: A Retrospective Analysis of 1069 Patients
Seijong Kim, Jung Kyong Shin, Yoonah Park, Jung Wook Huh, Hee Cheol Kim, Seong Hyeon Yun, Woo Yong Lee, Yong Beom Cho
Clinical Colorectal Cancer.2024; 23(3): 245. CrossRef
Rectal intramucosal carcinoma with lymph node metastasis and tumor deposit
Wenhao Chen, Liang Kang, Yan Huang, Zhao Ding
Asian Journal of Surgery.2022; 45(9): 1719. CrossRef
Presacral lymph node recurrence of rectal intramucosal adenocarcinoma after endoscopic mucosal resection: a case report
Taichi Horino, Yukiharu Hiyoshi, Yuji Miyamoto, Naoya Yoshida, Hideo Baba
Surgical Case Reports.2020;[Epub] CrossRef
Recurrence, death risk, and related factors in patients with stage 0 colorectal cancer
Ming-Hao Hsieh, Pei-Tseng Kung, Wen-Yin Kuo, Tao-Wei Ke, Wen-Chen Tsai
Medicine.2020; 99(36): e21688. CrossRef
Recurrence rate of lateral margin-positive cases after en bloc endoscopic submucosal dissection of colorectal neoplasia
Seohyun Lee, Jihun Kim, Jae Seung Soh, Jungho Bae, Sung Wook Hwang, Sang Hyoung Park, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Dong-Hoon Yang
International Journal of Colorectal Disease.2018; 33(6): 735. CrossRef
Unusual Local Recurrence with Distant Metastasis after Successful Endoscopic Submucosal Dissection for Colorectal Mucosal Cancer
Hyo Jeong Lee, Byong Duk Ye, Jeong-Sik Byeon, Jihun Kim, Young Soo Park, Yong Sang Hong, Yong Sik Yoon, Dong-Hoon Yang
Clinical Endoscopy.2017; 50(1): 91. CrossRef
Lymph node pooling: a feasible and efficient method of lymph node molecular staging in colorectal carcinoma
Natalia Rakislova, Carla Montironi, Iban Aldecoa, Eva Fernandez, Josep Antoni Bombi, Mireya Jimeno, Francesc Balaguer, Maria Pellise, Antoni Castells, Miriam Cuatrecasas
Journal of Translational Medicine.2017;[Epub] CrossRef
Inter- and intra-tumor profiling of multi-regional colon cancer and metastasis
Akihiro Kogita, Yasumasa Yoshioka, Kazuko Sakai, Yosuke Togashi, Shunsuke Sogabe, Takuya Nakai, Kiyotaka Okuno, Kazuto Nishio
Biochemical and Biophysical Research Communications.2015; 458(1): 52. CrossRef

A Case of a Mucinous Adenocarcinoma Arising from a Rectal Diverticulum: Jang Hoon Kwon, Koon Hee Han, Woo-Sung Chang, Ki-Ho Nam, Myoung Sik Han, Jae Hong Ahn, Sang Hak Han, Gab Jin Cheon; J Korean Soc Coloproctol. 2012;28(4):222-224. Published online August 31, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.4.222

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Abstract PDF

The occurrence of an adenocarcinoma arising from a rectal diverticulum that causes mechanical ileus is very rare. Recently, we diagnosed a case of a mucinous adenocarcinoma in a rectal diverticulum after an emergent abdominal perineal resection and permanent colostomy by laparotomy. Here, we present a case report and a review of the literature.

Citations

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Solitary rectal diverticulum: A rare entity mimicking contained perforation – Imaging and surgical correlation
Kassandra G. Tulenko, Samantha H. Epstein, Brett R. Kurpiel, Rachita Khot
Case Reports in Clinical Radiology.2025; 0: 1. CrossRef
A Novel Method of Treating Rectal Diverticulum Using Transanal Minimally Invasive Surgery (TAMIS)
Yui Kaneko, Neil Strugnell
World Journal of Colorectal Surgery.2024; 13(2): 46. CrossRef
A case of solitary rectal diverticulum presenting with a large retrorectal abscess
Stefanos Gorgoraptis, Sofia Xenaki, Elias Athanasakis, Anna Daskalaki, Konstantinos Lasithiotakis, Evangelia Chrysou, Emmanuel Chrysos
Annals of Medicine and Surgery.2020; 49: 57. CrossRef
Mucinous Adenocarcinoma Arising within a Colonic Diverticulum Mimicking a Diverticular Abscess: A Case Report
Goun Choi, Jiyoung Hwang, Seong Sook Hong, Jae Joon Kim, In Ho Choi
Journal of the Korean Society of Radiology.2018; 79(1): 40. CrossRef
Divertículo rectal sintomático
Alvaro Andres Gomez Venegas
Revista Colombiana de Gastroenterología.2018; 33(4): 469. CrossRef
Rectal pseudodiverticulum
Saurabh Singh, Louis Savage
BMJ Case Reports.2014; 2014: bcr2013201888. CrossRef
Rectal Diverticulum after Stapled Transanal Procedures: Surgery Encouraged
Gianluca Pellino
The American Surgeon™.2013; 79(12): 1320. CrossRef

Concurrent Large Cell Neuroendocrine Carcinoma and Adenocarcinoma of the Ascending Colon: A Case Report: Yo Na Kim, Ho Sung Park, Kyu Yun Jang, Woo Sung Moon, Dong Geun Lee, Ho Lee, Min Ro Lee, Kyung Ryoul Kim; J Korean Soc Coloproctol. 2011;27(3):157-161. Published online June 30, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.3.157

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Abstract PDF

Large cell neuroendocrine carcinomas of the colon are rare and represent only a small percentage of all colonic endocrine tumors. Here, we report a case of a colonic large cell neuroendocrine carcinomas concurrent with a colonic adenocarcinoma. A 70-year-old man presented with acute abdominal pain. A spiral computed tomography scan of the abdomen revealed eccentric wall thickening on the ascending colon. An explorative laparotomy and a right hemicolectomy were performed. Grossly, two separated masses were observed in the proximal ascending colon. One was a 7.4 × 5.1 cm ulcerative fungating lesion, and the other was a 2.8 × 1.9 cm polypoid lesion. Microscopically, the ulcerative fungating lesion showed a well-differentiated neuroendocrine morphology with necrosis and increased mitosis. Most of the tumor cells had large, vesicular nuclei with eosinophilic nucleoli, variable amounts of eosinophilic cytoplasm, and immunoreactivity for chromogranin A and synaptophysin. The polypoid lesion was a well-differentiated adenocarcinoma that had invaded the submucosa. We diagnosed these lesions as a concurrent large cell neuroendocrine carcinoma and an adenocarcinoma of the ascending colon.

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Large cell neuroendocrine tumor of the gastrointestinal tract with concurrent tubular adenomas
Inayat GILL, Christienne SHAMS, Elisa QUIROZ, Subhashree M. KRISHNAN, Susanna GAIKAZIAN
Gazzetta Medica Italiana Archivio per le Scienze Mediche.2021;[Epub] CrossRef
Large cell neuroendocrine carcinoma of the colon with brain metastasis
Ali Allouch, Mohamad K. Moussa, Ali Dirany, Zahraa Barek, Mohammad Makke, Nizar Bitar
International Journal of Surgery Case Reports.2020; 76(C): 421. CrossRef
A case of colorectal large cell neuroendocrine carcinoma accompanied by disseminated peritoneal leiomyomatosis
Kunihiko Suga, Hiroomi Ogawa, Makoto Sohda, Chika Katayama, Naoya Ozawa, Katsuya Osone, Takuhisa Okada, Takuya Shiraishi, Ryuji Katoh, Akihiko Sano, Makoto Sakai, Takehiko Yokobori, Ken Shirabe, Hiroshi Saeki
Surgical Case Reports.2020;[Epub] CrossRef
Colorectal neuroendocrine carcinoma: A case report and review of the literature
Tomoaki Yoshida, Kenya Kamimura, Kazunori Hosaka, Koji Doumori, Hiromitsu Oka, Akito Sato, Yasuo Fukuhara, Shoji Watanabe, Tomomi Sato, Akira Yoshikawa, Takashi Tomidokoro, Shuji Terai
World Journal of Clinical Cases.2019; 7(14): 1865. CrossRef
Neuroendocrine tumor mixed with adenoma in rectum: a case report and literature review
Jiancong Hu, Xiaochuan Chen, Dezheng Lin, Zhaoliang Yu, Juan Li, Xuefeng Guo
International Journal of Surgery Oncology.2019; 4(6): e79. CrossRef
Large Cell Neuroendocrine Carcinoma of the Rectum with Long Recurrence-free Survival after Radical Surgery and Adjuvant Chemotherapy
Kukiko SAKIHAMA, Kinuko NAGAYOSHI, Hayato FUJITA, Shuntaro NAGAI, Yoshinao ODA, Masafumi NAKAMURA
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association).2018; 79(12): 2463. CrossRef
Synchronous Small Cell Neuroendocrine Carcinoma and Adenocarcinoma of the Colon: A Link for Common Stem Cell Origin?
Seth Lipka, Jorge Hurtado-Cordovi, Boris Avezbakiyev, Lester Freedman, Toshimasa Clark, Kaleem Rizvon, Paul Mustacchia
ACG Case Reports Journal.2014; 1(2): 96. CrossRef
Simultaneous Neuroendocrine Carcinoma and Adenocarcinoma of the Colon
Donggeum Shin, Youngsook Park, Soojung Gong, Seonghwan Kim, Yunju Jo, Sangbong Ahn, Joonkil Han, Eunkyung Kim
Intestinal Research.2013; 11(2): 137. CrossRef
Synchronous Occurrence of Advanced Neuroendocrine Carcinoma and Tubular Adenocarcinoma of the Rectum
Yoshifumi Nakayama, Takayuki Torigoe, Noritaka Minagawa, Toshihito Uehara, Koji Yamaguchi
Case Reports in Gastroenterology.2013; 7(1): 117. CrossRef

Laparoscopic Treatment of Adult Sigmoidorectal Intussusception Caused by a Mucinous Adenocarcinoma of the Sigmoid Colon: A Case Report: Seok Youn Lee, Won Cheol Park, Jeong Kyun Lee, Dong Baek Kang, Young Kim, Ki Jung Yun; J Korean Soc Coloproctol. 2011;27(1):44-49. Published online February 28, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.1.44

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Intussusception is a rare cause of intestinal obstruction in adult patients, but is common in children. In fact, it accounts for an estimated 1% of all cases of bowel obstruction in adults, although adult intussusception of the large intestine is rare. Sigmoidorectal intussusception, however, is a rare variety with few cases reported in the literature. A mucinous adenocarcinoma, a subtype of adenocarcinoma, is characterized by extracellular mucin production and accounts for between 5% and 15% of the neoplasms of the colon and rectum. Despite the general consensus supporting surgical resections for adult intussuceptions, controversy remains over whether intussuceptions should be reduced before resection. Most cases of colon intussusception should not be reduced before resection because they most likely represent a primary adenocarcinoma. However, prior reduction followed by a resection can be considered for the sigmoidorectal intussusception to avoid inadvertent low rectal cancer sugery. We experienced one case of sigmoidorectal intussusception caused by a mucinous adenocarcinoma of the sigmoid colon in a 79-year-old woman. Abdominal computed tomography demonstrated a sigmoidorectal intussusception. After the end-to-end anastomosis-dilator-assisted reduction, the patient underwent a laparoscopic oncological anterior resection under the impression that a sigmoidorectal intussusception existed. We report a successful laparoscopic anterior resection in a patient with an intussusception caused by a sigmoid malignant tumor.

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Laparoscopic Reduction of Sigmoidorectal Intussusception by a Modified Hutchinson’s Maneuver
Haruna Onoyama, Takashi Nakamura, Yuka Ahiko, Naoki Sakuyama, Susumu Aikou, Dai Shida
Indian Journal of Surgery.2024; 86(2): 428. CrossRef
Strangulated appendiceal intussusception caused by isolated endometriosis
Seokyoun Lee, Junhee Lee, Keunyoung Kim
Clinical and Experimental Emergency Medicine.2021; 8(3): 246. CrossRef
Unusual causes of large bowel obstruction
Nicholas G. Farkas, Ted Joseph P. Welman, Talisa Ross, Sarah Brown, Jason J. Smith, Nikhil Pawa
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Original Article

Relation of the Expression of Cyclooxygenase-2 in Colorectal Adenomas and Adenocarcinomas to Angiogenesis and Prognosis: Yoon Dae Han, Young Ki Hong, Jung Gu Kang, Yoon Jung Choi, Chan Heun Park; J Korean Soc Coloproctol. 2010;26(5):339-346. Published online October 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.5.339

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Abstract PDF

Purpose

Recent studies have shown that cyclooxygenase (COX)-2 may be involved in tumor growth, invasion and apoptosis in various carcinomas. Vascular endothelial growth factor (VEGF) has a potent angiogenic activity, and COX-2 promotes angiogenesis by modulating angiogenic factors, including VEGF. Endothelial growth factor receptor (EGFR) is considered as a factor of cell growth, maturation and cell death. The current study was designed to investigate the possible roles of COX-2 in colorectal tumor progression and angiogenesis.

Methods

Fifty colorectal adenomas and forty adenocarcinomas were investigated by using immunohistochemical staining for COX-2, VEGF and EGFR. The correlations of COX-2, VEGF and EGFR with the grade of dysplasia, the size of the adenoma, and various clinicopathologic factors were studied.

Results

The expressions of COX-2, VEGF and EGFR were each significantly correlated with carcinomatous transformation, and the expressions of COX-2 and VEGF were significantly correlated. COX-2 and EGFR showed correlations with adenomas rather than adenocarcinomas. However, no correlations of COX-2, VEGF and EGFR expression to other clinicopathologic factors, except tumor size in EGFR expression, were detected.

Conclusion

These results suggest that COX-2 may play an important role in carcinogenesis through interaction with VEGF and EGFR in human colorectal cancer.

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In Vitro Anticancer Effects of Unitein and Deep Seawater Salt Minerals on HT-29 Human Colon Carcinoma Cells
Kyunghwa Lee, WoonSeo Song, YeonJun Lee, Yanni Pan, Suk-Chan Hahm, Kun-Young Park
Journal of the Korean Society of Food Science and Nutrition.2023; 52(1): 8. CrossRef
Ocoxin® oral solution slows down tumor growth in an experimental model of colorectal cancer metastasis to the liver in Balb/c mice
JOANA MÁRQUEZ, JORGE MENA, IERA HERNANDEZ-UNZUETA, AITOR BENEDICTO, EDUARDO SANZ, BEATRIZ ARTETA, ELVIRA OLASO
Oncology Reports.2016; 35(3): 1265. CrossRef
In vivo molecular imaging of epidermal growth factor receptor in patients with colorectal neoplasia using confocal laser endomicroscopy
Jun Liu, Xiuli Zuo, Changqing Li, Tao Yu, Xiaomeng Gu, Chengjun Zhou, Zhen Li, Martin Goetz, Ralf Kiesslich, Yanqing Li
Cancer Letters.2013; 330(2): 200. CrossRef
Imunoexpressão das proteínas COX-2, p53 e caspase-3 em adenoma colorretal e mucosa não neoplásica
Renan Brito Nogueira, Andréa Rodrigues Cordovil Pires, Thélia Maria Santos Soares, Simone Rabello de Souza Rodrigues, Mariane Antonieta Menino Campos, Giovanna Canato Toloi, Jaques Waisberg
Einstein (São Paulo).2013; 11(4): 456. CrossRef
Oldhamianoside II, a New Triterpenoid Saponin, Prevents Tumor Growth via Inducing Cell Apoptosis and Inhibiting Angiogenesis
Feng-Ling Wang, Jing-Yong Sun, Yan Wang, Yan-Ling Mu, Yu-Ji Liang, Zhao-Zhong Chong, San-Hai Qin, Qing-Qiang Yao
Oncology Research Featuring Preclinical and Clinical Cancer Therapeutics.2013; 20(8): 369. CrossRef
Effects of Resveratrol on Migration and Proliferation in HT-29 Colon Cancer Cells
Sol Hwa Lee, Song Yi Park, In-Seop Kim, Ock Jin Park, Young Min Kim
KSBB Journal.2012; 27(5): 289. CrossRef
Anti-Proliferative Effects of Selenium in HT-29 Colon Cancer Cells via Inhibition of Akt
Song-Yi Park, In-Seop Kim, Se-Hee Lee, Sol-Hwa Lee, Da-Woon Jung, Ock-Jin Park, Young-Min Kim
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Case Report

Synchronous Multiple Colorectal Cancer Occurring in Polyposis.: Ham, Young Chan , Kim, Il Myung , Yun, Jin , Park, Sang Soo , Shin, Dong Gue , Kang, Seong Ku; J Korean Soc Coloproctol. 2010;26(1):80-84.; DOI: https://doi.org/10.3393/jksc.2010.26.1.80

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Abstract PDF: The frequencies of multiple synchronous carcinomas of the colon and the rectum have been reported to range from 2.1 to 6.3%. Currently, the frequency is higher in colorectal cancer patients, and the diagnosis is better due to the many diagnostic tools that have been developed. There are a few reported cases of five cancers in a patient at the same time. We report here on the case of five synchronous cancers arising from the colon and the rectum in a patient without a familial history of colon cancer or of genetic predisposing factor. The patient was a 62-yr-old woman who presented with frequently loose stool for six months and intermittent abdominal pain for two months. Colonoscopic examination revealed two adenocarcinomas, one each at the sigmoid colon and the rectum; the cancer in the sigmoid colon was obstructed at nearly 40 cm above the anal verge. Computed tomographic colonoscopy revealed many other polyps and masses in the colon and a metastatic mass at segment 8 in the liver. A total proctocolectomy and ileostomy were performed. Histologic evaluation revealed the five lesions to be adenocarcinomas invading the pericolic fat; 1 out of 30 lymph nodes was invaded by the cancer cells.

Original Articles

Immunohistochemical Studies of Fascin, MMP-9 Overexpression, and Proliferating Index as Prognostic Factors in Cases of a Colon Adenocarcinoma.: Kim, Beom Gyu , Ha, Kyung Won , Park, Jun Suk , Yoo, Jae Hyung; J Korean Soc Coloproctol. 2009;25(6):393-400.; DOI: https://doi.org/10.3393/jksc.2009.25.6.393

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Abstract PDF

PURPOSE
The malignant conversion of epithelial cells involves alterations in the expression and the function of cell-matrix and cell-cell adhesive systems that enable a switch to a migratory phenotype in tumor invasion and metastasis. Here, the author studies the prevalence and the potential clinical significance of fascin and Matrix metalloproteinase-9 (MMP-9) expression in relation to the progression of colon adenocarcinoma and of tumor cell proliferation as measured by using the topoisomerase II-alpha (Topo II-alpha) index. METHODS: Relatively well-preserved paraffin-embedded tissues of 120 cases of colon adenocarcinomas were immunohistochemically stained for fascin, MMP-9, and Topo II-alpha expression. A reaction was determined as being positive when more than 10% of the cells were positive for fascin, and/or MMP-9. The Topo II-alpha index is defined as the positive number of tumor cells divided by the total number of tumor cells counted times 100. At least 1,000 cells were counted for this analysis. A chi-square test, by using Epi info 2000, for Fascin and/or MMP-9 and a two-sided test for the Topo II-alpha index were employed with a significance of P<0.05. RESULTS: Positive reactions for fascin and MMP-9 in colon adenocarcinomas were 44.2% and 56.7%, respectively. In clinically annotated tumors, fascin immunoreactivity was more common in tumors located in the right colon (P=0.014) and was associated with older age (>65 yr, P=0.028), tumor grading (P=0.009), and lymph node metastases (P=0.005). However, MMP-9 immunoreactivity was not statistically associated with age, gender, tumor stage, or lymph node metastases. Fascin expression was statistically associated with MMP-9 expression, especially for left colon adenocarcinomas (P=0.0032). Although the topo II-alpha proliferating index was associated with lymph node metastasis (P<0.01), this result was not statistically associated with Fascin or MMP-9 expression. CONCLUSION: Fascin expression may be closely linked with tumor grading and lymph node metastasis of more aggressive colon adenocarcinomas and partly associated with MMP-9 expression in tumor invasion. However, further studies of fascin expression as an independent prognostic factor are required for the determination of significant relationships with other clinicopathologic indices.

Citations

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Association of fascin-1 with mortality, disease progression and metastasis in carcinomas: a systematic review and meta-analysis
Vanessa Y Tan, Sarah J Lewis, Josephine C Adams, Richard M Martin
BMC Medicine.2013;[Epub] CrossRef

Malignancy Associated with Inflammatory Bowel Disease.: Shin, Ui Sup , Yu, Chang Sik , Kim, Chan Wook , Park, Jin Seok , Jeong, Kwang Yong , Yoon, Sang Nam , Lim, Seok Byung , Song, Joon Seon , Kim, Jin Cheon; J Korean Soc Coloproctol. 2009;25(3):150-156.; DOI: https://doi.org/10.3393/jksc.2009.25.3.150

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Abstract PDF

PURPOSE
As the number of patients with inflammatory bowel disease (IBD) has steadily increased in Korea, IBD-associated cancers are expected to increase in number. This study investigated the clinical features of intestinal cancer in patients with IBD.
METHODS
One hundred five patients with ulcerative colitis (UC) and 270 patients with Crohn's disease (CD) under the care of the Department of Colon and Rectal Surgery, Asan Medical Center, between December 1989 and January 2009 were reviewed retrospectively.
RESULTS
Ten patients of the 105 with UC and 5 patients of the 270 with CD were found to have intestinal cancer. The mean age was 45 yr (+/-8.8), and the mean duration of IBD at the time of diagnosis of the cancer was 12.6 yr (+/-6.0). Six of the 15 cancer patients had no history of treatment for IBD of more than 3 mo before diagnosis of the cancer. Eleven cancers were located in the rectum (7 in UC, 4 in CD), including 1 case of synchronous cancer. One case of small bowel cancer was found in a patient with small bowel CD. Four cases involved a mucinous adenocarcinoma. Eight of the 12 cases of an adenocarcinoma of the colon and rectum were advanced stage.
CONCLUSION
IBD-associated intestinal cancers were found at a relatively young age, were diagnosed at an advanced stage, and had a higher proportion of mucinous adenocarcinomas than in sporadic cancer. Considering the increasing incidence of IBD and the expected increase in the number of IBD-associated cancer in Korea, every effort should be made to prevent intestinal cancer in patients with IBD and to detect it early.

Citations

Citations to this article as recorded by

Rectal Squamous Cell Carcinoma in a Patient with Familial Adenomatous Polyposis
Hye Min Jo, Hyun Jung Kim, Jina Youn, Seong Kyu Park, Dae Sik Hong, A Reum Chun, Hee Kyung Kim
Korean Journal of Medicine.2015; 88(3): 335. CrossRef
Primary Squamous Cell Carcinoma of the Ascending Colon: Report of a Case and Korean Literature Review
Dong-Keun Cho, Sang-Hun Kim, Sung-Bum Cho, Wan-Sik Lee, Young-Eun Joo
The Korean Journal of Gastroenterology.2014; 64(2): 98. CrossRef
Clinical Characteristics of Lower Gastrointestinal Cancer in Crohn's Disease: Case Series of 5 Patients
Ji Min Choi, Changhyun Lee, Yoo Min Han, Minjong Lee, Dong Kee Jang, Jeehye Kwon, Jong Pil Im, Sang Gyun Kim, Joo Sung Kim, Hyun Chae Jung
Intestinal Research.2013; 11(2): 127. CrossRef
A Case of Squamous Cell Carcinoma of the Breast in a Patient with Crohn's Disease Taking Azathioprine
Kyoung Chan Park, Dong Uk Ju, Seong Wook Heo, Jung Il Ryu, Ju Youn Cho, Eui Jung Kim, Hoon Kyu Oh, Eun Young Kim
The Korean Journal of Gastroenterology.2012; 60(6): 373. CrossRef
Squamous Cell Carcinoma of the Rectum: Report of Two Cases
Na Rae Kim, Dong Hae Chung, Jeong Heum Baek, Yeon Ho Park, Hee Eun Kyung, Mi Sook Roh, Seung-Yeon Ha
Intestinal Research.2010; 8(2): 172. CrossRef

Case Report

Adenocarcinoma of the Rectum with Choriocarcinomatous Differentiation: A case report.: Jeong, Jae Hong , Cho, Yong Bum , Park, Chi Min , Yun, Hae Ran , Lee, Won Suk , Suh, Yeon Lim , Yun, Seong Hyeon , Lee, Woo Yong , Chun, Ho Kyung; J Korean Soc Coloproctol. 2007;23(4):274-278.; DOI: https://doi.org/10.3393/jksc.2007.23.4.274

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Abstract PDF

A choriocarcinoma of the rectum is extremely rare and has a very poor prognosis. Its rarity and the obscurity of its histogenesis make the entity of disease hard to define. We report a case of a choriocarcinoma of the rectum which showed synchronous liver and lung metastasis. A 52-year- old male patient presented with tenesmus, hematochezia and pain on defecation for 4 months. The preoperative colonoscopy revealed a mass at the rectum, 3 cm proximal to the anal verge. The biopsy revealed a poorly differentiated adenocarcinoma. An abdominoperineal resection was performed, and the pathologic examination confirmed a choriocarcinoma arising from an adenocarcinoma. Immunostain for beta-human chorionic gonadotropin (hCG) was strongly positive for the choriocarcinoma component. Serum hCG checked postoperatively was as high as 4,222 IU/L, but the serum carcinoembryonic antigen (CEA) was normal. Although chemotherapy was begun at the 5th week after the operation, the patient died on the 47th day after the operation. A choriocarcinoma of the colon or the rectum is very rare and is aggressive. Although radical resection and chemotherapy are performed, the clinical outcome is very disappointing. Even though a choriocarcinoma of the colon or the rectum is very rare, it should be included on the list for differential diagnosis of a colorectal carcinoma.

Citations

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Primary Rectal Tumor With Extensive Choriocarcinoma Differentiation in a Woman With Lung, Liver and Disseminated Peritoneal Disease: A Primary Rectal Adenocarcinoma With Extensive Choriocarcinoma Differentiation or Primary Rectal Choriocarcinoma?
Isidro Machado, María del Carmen Martínez La Piedra, Fernando Martínez de Juan, Fernanda-Maia de Alcántara, Reyes Claramunt, José Antonio López-Guerrero, Ana Marhuenda, Marcos Melian
International Journal of Surgical Pathology.2024; 32(5): 976. CrossRef
Histologic transformation of rectal adenocarcinoma to choriocarcinoma after surgery and chemotherapy: A rare case report and review of the literature
Juan Zhong, Lei Yang
International Journal of Surgery Case Reports.2024; 117: 109478. CrossRef
Primary colon adenocarcinoma with choriocarcinoma differentiation: a case report and review of the literature
Jessica Boyce, Karine Tawagi, John T. Cole
Journal of Medical Case Reports.2020;[Epub] CrossRef
A Case of Ascending Colon Choriocarcinoma with Multiple Liver Metastases
Koya YASUKAWA, Shinji NAKATA, Syusei SANO, Kei KUSAMA, Akihito NISHIO, Harutsugu SODEYAMA
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association).2020; 81(8): 1563. CrossRef
Rare histologic types of rectal cancer: A monocentric cases series report
A. Vallard, P. Diao, M.-A. Garcia, G. Pigné, N. Vial, F. Forest, M. Peoc’h, J. Langrand-Escure, N. Magné
Cancer/Radiothérapie.2019; 23(1): 17. CrossRef
Primary Adenocarcinoma with Focal Choriocarcinomatous Differentiation in the Sigmoid Colon
Sook Kyoung Oh, Hyung Wook Kim, Dae Hwan Kang, Cheol Woong Choi, Yu Yi Choi, Hong Kyu Lim, Ja Jun Goo, Sung Yeol Choi
The Korean Journal of Gastroenterology.2015; 66(5): 291. CrossRef

Original Articles

Mucinous Adenocarcinoma of the Colon and Rectum.: Kim, Kab Choong , Kim, Duck Woo , Park, Hyung Chul , Park, Jae Gahb; J Korean Soc Coloproctol. 2007;23(1):60-64.; DOI: https://doi.org/10.3393/jksc.2007.23.1.60

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Abstract PDF

PURPOSE
This study was to evaluate and compare the clinical characteristics of a mucinous adenocarcinoma with those of a non-mucinous adenocarcinoma in colorectal cancer patients.
METHODS
Data were retrospectively reviewed on 3,232 colorectal cancer patients, including 221 mucinous adenocarcinoma patients (6.1%), who received surgery between 1990 and 2003.
RESULTS
The mean tumor size (6.5 cm) of the mucinous adenocarcinomas was bigger than that (5.2 cm) of the non-mucinous adenocarcinomas. The locations of the mucinous adenocarcinomas were 95 (48.2%) in the proximal colon, 35 (17.8%) in the distal colon, and 67 (34.0%) in the rectum whereas those of the non-mucinous adenocarcinomas were 559 (18.9%) in the proximal colon, 861 (29.2%) in the distal colon, and 1,533 (51.9%) in the rectum. Stage distribution was as follows: In mucinous adenocarcinomas, 7 stage A (3.3%), 84 stage B (39.3%), 76 stage C (35.5%), and 47 stage D (21.9%). In non-mucinous adenocarcinomas, 447 stage A (15.2%), 1,036 stage B (35.1%), 997 stage C (33.8%), and 469 stage D (15.9%). In the univariate analysis, the overall 5-year survival rate of patients with a mucinous adenocarcinoma was lower than that of patients with a non-mucinous adenocarcinoma (60% vs. 65%, P=0.016), but survival rates for each stage were not significantly different. The difference in recurrence rates was not statistically significant (33.3% vs. 24.2%, P=0.258). A multivariate analysis showed that the mucinous histologic type was not useful as an independent prognostic factor.
CONCLUSIONS
Mucinous colorectal adenocarcinomas tend to be large, exist in a proximal location, have an advanced stage at diagnosis. The difference in survival rates for each stage was not statistically significant. A mucinous histologic type was not an independent prognostic factor.

Citations

Citations to this article as recorded by

Analysis of Prognosis in Colorectal Mucinous Adenocarcinoma: A Retrospective Analysis with Peritoneal Fluid
Seung Bong Choi, In Kyu Lee, Dae Youn Won, Yoon Suk Lee, Yoon Si, Sang Chul Lee, Won Kyung Kang, Jong Kyung Park, Chang Hyeok Ahn, Jun-Gi Kim, Seong Taek Oh
Journal of the Korean Surgical Society.2010; 79(6): 474. CrossRef

Small Flat Adenocarcinoma of the Colon Arising From Familial Adenomatous Polyposis Patient: Suggesting de novo Origin.: Park, Dong Kook , Lee, Min Chol , Jun, Ho Jin , Lee, Chan Young , Kim, Jung Tak , Jung, Min , Park, Jong Kwon , Ryu, Jin Woo; J Korean Soc Coloproctol. 1998;14(3):655-660.

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Abstract PDF: Most adenocarcinomas of the colorectum arise in a visible benign precursor lesion, the adenoma, which is a monoclonal proliferation of dysplastic nonmalignant epithelial cells. Adenoma-adenocarcinoma sequence has been represented as the predominat pathogenetic pathway. But a small flat depressed colon cancer is characterized by non-polypoid growth pattem with no association of adenomatous tissues, which has tendency to early submucosal invasion and lymph node metastasis even in very small lesion (<10 mm). It supports de novo carcinogenesis of colorectal cancer, although most colorectal cancerarise in pre-existing adenoma. We report a case of small float colon adenocarcinoma arising in normal colonic epithelium rather than adenomatous polyp in familial adenomatous polyposis syndrome.

Case Report

A Case of Perianal Adenocarcinoma Developing in Chronic Tuberculous Anal Fistula.: Kim, Joon Ho , Lee, Seok Hwan , Ko, Young Gwan , Yoon, Choong , Lim, Sung Jig , Yang, Moon Ho , Yoo, Jung Joon , Lee, Kee Hyung; J Korean Soc Coloproctol. 1998;14(3):611-616.

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Abstract PDF: Mucinous adenocarcinomas of the anal region constitute only 2% of anal cancer and adenocarcinoma developing in a chronic tuberculous anal fistula is extremely rare. In most cases, its origin is difficult to ascertain because the primary sites have already been destroyed before any diagnosis of malignancy is made. We experienced a case of perianal adcnocarcinoma developing in chronic tuberculous anal fistula, which was treated by abdominoperineal resection with preoperative chemo-irradiation. We reported a case and reviewed the related literatures.

Original Articles

Adenocarcinoma Associated with Anal Fistula.: Kang, Sung Bum , Heo, Seung Chul , Jung, Seung Yong , Choi, Hyo Seong , Park, Kyu Joo , Park, Jae Gahb; J Korean Soc Coloproctol. 2002;18(2):115-120.

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Abstract PDF: PURPOSE
Although adenocarcinoma associated with anal fistula is rare, missed diagnosis may result in progression of the tumor and poor outcome. This study is aimed to determine the clinical features of adenocarcinoma associated with anal fistula.
METHODS
The medical records of 8 (0.4%) cases associated with anal fistula, out of 1978 anorectal adenocarcinoma treated at Seoul National University Hospital between 1979 and 2000, were reviewed.
RESULTS
The median age at diagnosis of cancer was 57 years (range, 39 to 62 years) and sex ratio was 7 to 1 with male predominance. The median duration of anal fistula before diagnosis of cancer was 8.5 years (range, 4 to 30 years). Major symptoms at diagnosis of cancer were perianal pain (38%) and discharge (38%). Perianal mass was palpable in all patients. All patients except for one case, in which palliative T-colostomy was performed due to extensive invasion despite preoperative radiation therapy, were treated with abdominoperineal resection: 4 in curative resection and 3 in palliative rsection. There were 4 (50%) in stage IV, 3 (38%) in stage III, and 1 (12%) in stage II. On median follow-up of 16 months (range, 3 to 72 months), systemic recurrences of 2 cases at lung or intraperitoneal cavity and 1 local recurrence at posterior vaginal wall were developed after curative resection.
CONCLUSIONS
Adenocarcinoma associated with anal fistula had the history of long-standing anal fistula and perianal mass on physical examination. These tumors were detected at advanced stage and their outcomes were poor. Therefore, in the anal fistula combined with long-standing history or perianal mass, a high index of suspicion for malignancy is necessary and a generous biopsy of fistulous tract should be performed to rule out concomitant adenocarcinoma.

Expression of a Novel 90 kDa Heat Shock Protein in Colorectal Tumor.: Choi, Dae Hwa , Cho, Hong Rae , Ko, Byung Kyun , Nah, Yang Won , Nam, Chang Woo , Kim, Gyu Yeol , Im, Young Cheol , Park, Kun Choon , Kim, Do Ha , Park, Jae Hoo , Min, Young Joo , Suh, Fae Hee , Park, Jeong Woo; J Korean Soc Coloproctol. 2002;18(1):1-6.

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Abstract PDF: PURPOSE
When cells are subjected to a wide variety of stressful stimuli, they respond by increasing the synthesis of specific stress proteins. Stresses include heat shock, nutrient deprivation, oxygen radicals, toxic metal and viral infection. Major stress proteins are Hsp 27, Hsp 60, Hsp 70 (9), Hsp 90 (3) and Hsp 100 (1). Previously a novel 90 kDa stress protein has been reported to be induced in fish cells by virus infection. The novel 90 kDa stress protein is different from well-known major stress protein in size, antigenicity, cellular localization. The novel 90 kDa stress protein was found to be present in various kinds of cells including human cells and its expression was increased in human carcinomas. The purpose of this study is to evaluate the expression of the novel 90 kDa stress protein in human colonic mucosa of normal tissue, adenoma and adenocarcinoma using immunohistochemical method.
METHODS
85 colon tissues were screened for the expression of the novel 90 kDa stress protein; 85 normal colonic mucosa, 20 colonic adenoma and 65 colonic adenocarcinoma. The tissues were stained with monoclonal antibody against the novel 90 kDa stress protein. In scoring system, tissue sections with immunostained area above 10 % were decided to be positive and, among the positive, the tissue sections were divided into three score, 1, 2, and 3, based on the staining intensity and positive area proportion. The tissue sections with immunostained area below 10% were decided to be negative and grouped into 0 score. Correlation of immunohistochemical expression was analysed by using SPSS version 10.0 statistically.
RESULTS
The expression of the 90 kDa stress protein was significantly different among normal colonic mucosa, colonic adenoma, and colonic adenocarcinoma and the percentage of positive samples were 14.1%, 80.5%, and 95.4% respectively. This result suggests that the expression level of the novel 90 kDa stress protein was extremely low in normal tissue but increased significantly in adenocarcinomatous tissues.
CONCLUSIONS
The expression of the novel 90 kDa stress protein was increased significantly with transformation of the normal colon tissue to malignancy. This suggests the possibility that this novel 90 kDa stress protein play some role in cancerous transformation of colon tissue.

Expression of p27 Protein in Adenoma and Adenocarcinoma of the Colorectum.: Son, Hyun Jin , Kang, Myoung Jae; J Korean Soc Coloproctol. 2001;17(5):251-258.

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Abstract PDF: PURPOSE
The cyclin-dependent kinase inhibitor p27kip1 protein is a negative regulator of the cell division cycle, and its degradation is required for entry into the S phase. Loss of p27(kip1) protein expression has been reported to be associated with aggressive behavior in a variety of tumors of epithelial and lymphoid origin. The purpose of this study was to determine the expression of p27 protein in adenoma and adenocarcinoma of the colorectum and to assess the prognostic significance.
METHODS
We performed immunohistochemical staining for expression of p27 protein in adenomas (20 cases) and adenocarcinomas (30 cases) of the colorectum. The data (p27 protein labeling index (LI, mean+/-standard deviation)) were analyzed in association with clinicopathologic parameters.
RESULTS
p27 protein LI of normal mucosa (10 cases), adenoma, and adenocarcinoma were 93.3+/-4.5, 65.4+/-17.5, and 28.2+/- 14.5, respectively (p<0.0001). p27 protein LI of well differentiated adenocarcinoma was slightly higher than those of moderately and/or poorly differentiated adenocarcinoma, but did not show any significant difference among these groups (p=0.19). Also p27 protein expression did not show any significant relationship to other prognostic facters such as age, invasion depth, and operative staging.
CONCLUSIONS
The results suggested that reduced expression of p27 protein may play an important role in the malignant transformation process of colorectal cancer.

Case Report

A Case Report of Intussusception of the Vermiform Appendix with Adenocarcinoma.: Yoon, Dae Sung , Lee, Jae Jung , Park, Chul Jae , Kim, Duck Hwan; J Korean Soc Coloproctol. 1998;14(1):143-148.

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Abstract PDF: The authors present a case of intussusception of the vermiform appendix with ade nocarcinoma. A 35-year-old male with lower abdominal pain and anemia was found to have an intussusception of the appendix associated with an adenocarcino-ma. The preoperative diagnosis was cecal cancer but we detected the iutussuscept-ion of the appendix with an adenocarcinoma during operation. Patient was managed with right hemicolectomy and has been followed up.

Original Article

Expression of MUC2 and MUC6 in Colorectal Adenomas and Adenocarcinomas.: Park, Ho Sung , Kong, Tae Shik , Jang, Kyu Yun , Chung, Myoung Ja , Moon, Woo Sung , Lee, Dong Geun , Kang, Myoung Jae; J Korean Soc Coloproctol. 2005;21(4):193-200.

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Abstract PDF: PURPOSE
Although the expression of MUC2 is seen in colorectal tumors, there have been few reports about the expression of MUC6 in colorectal tumors. The aim of this study was to investigate the expressions of MUC2 and MUC6 in normal colorectal tissues and in tumors, as well as the association of MUC2 and MUC6 expressions with prognostic factors.
METHODS
Twenty (20) cases of colorectal adenomas treated by using a endoscopic polypectomy and 30 cases of colorectal carcinomas treated by using a resection were collected. Ten (10) normal tissue samples were obtained apart from the carcinomas. Sections were used for MUC2 and MUC6 immunostaining. The expressions of MUC2 and MUC6 were scored by using the sum of the percentages of the stained cells and the intensity of staining.
RESULTS
All of the ten normal colorectal tissues expressed MUC2 and MUC6. Of the 20 adenomas, 19 cases (95%) were MUC2 positive, and 17 cases (85%) were MUC6 positive. Adenomas with severe atypia tended to express lower levels of MUC2 and MUC6 than those with mild or moderate atypia. Of the 30 carcinomas, 28 cases (93%) were MUC2 positive and 19 cases (63.3%) were MUC6 positive. Colorectal mucinous carcinomas differed significantly from non-mucinous carcinomas in strong MUC6 expression. MUC2 expression showed a significant association with lymph-node metastasis.
CONCLUSIONS
The results suggest that MUC6 is expressed in normal colorectal tissues and tumors, that MUC6 expression is especially strong in mucinous carcinomas, and that MUC2 expression is associated with lymph-node metastasis, among the prognostic factors.

Case Report

Perianal Extramammary Paget's Disease Associated with an Anal Duct Adenocarcinoma: A Case Report.: Lee, Kang Youn , Yun, Min Young , Choi, Sun Keun , Hur, Yun Suk , Lee, Kun Young , Kim, Sei Joong , Cho, Young Up , Ahn, Seung Ick , Hong, Kee Chun , Shin, Suk Hwan , Kim, Kyung Rae , Woo, Ze Hong; J Korean Soc Coloproctol. 2005;21(3):174-177.

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Abstract PDF: Extramammary Paget's disease occurs commonly on the external female genitalia and rarely occurs in the perianal region. Recently, we experienced a case of perianal extramammary Paget's disease associated with an anal duct adenocarcinoma. The patient was a 60-year-old man. The perianal skin lesion was eczematous and encircled the anus. A wide-excision, split-thickness skin graft and temporal T-loop colostomy were performed. Histopathologically, the tumor was a well-differentiated anal duct adenocarcinoma. There was a prominent pagetoid spread of about 6x4 cm. The tumor cell was positive for carcinoembryonic antigen, but the paget cell was negative. The patient was treated with radiation therapy and with single 5-FU chemotherapy six times. Five months later, the perianal region was nearly normal.

Original Article

The Role of CD24 in Colonic Adenocarcinoma.: Lee, Seog Ki , Lim, Sung Chul , Kim, Kyung Jong; J Korean Soc Coloproctol. 2005;21(1):13-18.

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Abstract PDF: PURPOSE
CD24 is a small, heavily glycosylated glycosylphosphatidylinositol-linked cell surface protein that is expressed in hematologic malignancies and in a large variety of solid tumors. It appears to function as a ligand of P-selectin, an adhesion molecule that is present in activated platelets and endothelial cells. We aimed to evaluate CD24 protein expression in adenomas and adenocarcinomas of the colon and to correlate it to clinicopathological data.
METHODS
Adenomas and adenocarcinomas of the colon were stained for CD24 immunohistochemically. For statistical analysis, the staining was categorized according to stainability (negative, weakly, moderately, strongly positive) and staining patterns (membranous vs. intracytoplasmic).
RESULTS
The present study clearly demonstrated that CD24 was much more abundantly expressed for adenocarcinomas than for adenomas in the colon (P <0.05). A higher significant association of cytoplasmic CD24 expression was observed with adenocarcinomas of the colon than with adenomas of the colon (P <0.05) and with positive nodal status of the colonic adenocarcinoma than with negative nodal status of the colonic adenocarcinoma (P <0.001).
CONCLUSIONS
The stainability and the staining pattern of CD24 is an important molecular marker for colonic epithelial neoplasms and may help to define malignant transformation and to predict lymph-node metastasis.

Case Report

Appendiceal Mucinous Adenocarcinoma with Pseudomyxoma Peritonei.: Park, Tae Jin , Jeong, Chi Young , Jung, Eun Jung , Lee, Young Joon , Hong, Soon Chan , Choi, Sang Kyung , Ha, Woo Song , Park, Soon Tae; J Korean Soc Coloproctol. 2004;20(6):420-423.

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Abstract PDF: Pseudomyxoma peritonei is a relatively rare and poorly understood condition in which mucus accumulate within the peritoneal cavity. The presence of cells in the mucin, either inflammatory or neoplastic, distinguishes it from simple acellular mucus ascites caused by mucinous spillage. There are widespread seedings on the peritoneal and omental surfaces with a heavy cancerous glaze. This is principally a complication of borderline or malignant neoplasm of the ovary and/or appendix. We report one female case with pseudomyxoma peritonei from mucinous adenocarcinoma of appendix which was diagnosed incidentally during laparoscopic cholecystectomy.

Original Articles

Clinicopathologic Analysis on Mucinous Adenocarcinoma of Colon & Rectum.: Shin, Dong Woo , Kim, Nam Kyu , Min, Jin Sik , Kim, Ho Keun , Yang, Woo Ik; J Korean Soc Coloproctol. 1997;13(3):325-332.

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Abstract PDF: We have performed a retrospective analysis of 59 patients with mucinous colorectal carcinomas who were operated at the department of surgery, College of Medicine, Yonsei University Hospital between 1993 and 1996. Among the total 914 patients who had been treated by surgery due to colon & rectal cancers during the same period, 62 were diagnosed as mucinous adenocarcinomas(MC) of colon & rectum. Of these 62 patients, we have analyzed 59 patients of colorectal MCs'comparing with another 59 patients of non-mucinous adenocarcinomas(NMC) who were randomly selected during the same period. Mean age of MCs' was 54.6(25-84) and that of NMCs'was 58.2(30-76). The sex ratio was 1.1:1 and 1.6:1 respectively. The age distribution showed peak incidences at 50s' for MCs' and at 60s' for NMCs'. The tumor locations were more proximal in MCs'. Preoperative CEA levels were similar but postoperative serum CEA levels were more reduced in NMCs' than in MCs'. There were more frequent perineural and vascular invasions in MCs' The distribution according to Modified Dukes'stages showed more frequences of NMC's in stage A and there were more frequent synchronous metastases in MCs'. 110 patients out of 118 were followed up. The mean fellow-up periods were 17.9 months in MCs' and 17.6 months in NMCs'. During the period of follow-ups, 12 patients were detected for recurrence in MCs', and 8 patients in NMCs'. Although there was no statistical significance, mucinous carcinoma showed more high incidences of local & systemic recurrences. The three-year survival in groups of Dukes' stage C was poorer in mucinous group. Despite short follow-up period and limited number of patients, our results showed more aggressiveness of mucinous carcinoma.

Characteristic Clinical Behaviors of and Prognosis for Mucinous Adenocarcinomas in the Colon and Rectum.: Yu, Yeun Sik , Kim, Hee Cheol , Park, Sang Jun , Yu, Jang Hak , Kim, Jung Sun , Lee, Gang Hong , Yu, Chang Sik , Kim, Jin Cheon; J Korean Soc Coloproctol. 2003;19(6):379-385.

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Abstract PDF: PURPOSE
The clinical significance of a mucinous-type colorectal adenocarcinoma is still controversial. Mucinous colorectal adenocarcinomas have been suggested to have distinct clinicopathologic features, i.e., early-onset, right-side dominancy, and poor prognosis. We aimed to verify the biological behaviors of and survivals for mucinous adenocarcinomas compared with non-mucinous adenocarcinomas.
METHODS
Using a database of colorectal cancers at Asan Medical Center between 1989 and 2000, we enrolled 121 mucinous adenocarcinoma and 2,289 non-mucinous adenocarcinoma patients in this study. Clinical, pathological characteristics of and prognoses for mucinous adenocarcinomas were analyzed and compared with those for non-mucinous adenocarcinomas, retrospectively. The median follow-up period was 24 (0~113) months for mucinous adenocarcinomas and 32 (0~130) months for non-mucinous adenocarcinoma.
RESULTS
Compared to non-mucinous adenocarcinomas, mucinous adenocarcinomas showed distinctive clinicopathologic features of early-onset (P<0.001), frequent family history (P<0.001), right-side dominancy (P=0.010), advanced stage at diagnosis (P<0.001), and common peritoneal seeding at diagnosis (P<0.001). The recurrence rate in the mucinous adenocarcinoma group was 45.2% during the follow-up period: 21.6% distant metastasis, 14.3% peritoneal dissemination, 5.7% local recurrence, and 3.6% simultaneous local recurrence and distant metastasis. The five-year survival rates in stages II and III were 70% and 48.7%, respectively, for mucinous adenocarcinomas and 92% and 50.2%, respectively, for non-mucinous adenocarcinomas. This difference was statistically significant.
CONCLUSIONS
Mucinous adenocarcinomas seem to have distinct biologic behaviors with different clinicopathologic features and poor prognosis. A surgical approach with a follow-up schedule considering the characteristics of mucinous adenocarcinomas is needed.

Case Reports

A Case of Synchronous Triple Primary Adenocarcinomas Occurring at the Duodenum, Right Colon and Sigmoid Colon.: Kim, Young Wan , Kim, Nam Kyu , Lee, Jae Kil , Kim, Won ho , Kim, Ju Hang , Min, Jin Sik; J Korean Soc Coloproctol. 1999;15(4):351-356.

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Abstract PDF: It is rare to find three separate primary cancers in one individual. But, multiple primary cancers have been increasing because of improved methods of diagnosis and treatment and greater longevity of the population. We experienced a 52-year old male patient with synchronous triple primary adenocarcinomas occurring at the duodenum, right colon and sigmoid colon, who complained of abdominal pain and hematochezia for 2 months. The patient underwent pancreaticoduodenectomy, right hemicolectomy, and anterior resection, and was recovered uneventfully. After surgery, postoperative adjuvant chemotherapy (5-FU and Leucovorin) is currently being administered.

A Case of Jejunal Adenocarcinoma in a 13-Year-Old Girl.: Baek, Moo Jung , Lim, Hoon , Kim, Sung Yong; J Korean Soc Coloproctol. 1999;15(3):237-241.

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Abstract PDF: The incidence of carcinoma of the small intestine is very low in children, and it is also known that the prognosis of this tumor in children is very poor. A case of adenocarcinoma in a 13-year-old girl arising in the jejunum is herein reported. The girl underwent a curative resection and is free of recurrence or metastasis 12 months after operation. This particular case is reported here with a review of the literature.

A Case of Linitis Plastica Type of Appendiceal Adenocarcinoma.: Kim, Jeong Soo , Jeon, Hae Myung , Lee, Eun Jung , Kim, Jae Sung; J Korean Soc Coloproctol. 1999;15(2):141-144.

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Abstract PDF: Primary tumor of the appendix is a rare disease entity of gastrointestinal malignancy. Most of them are discovered unexpectedly in an acute situation. The diagnosis of adenocarcinoma of the appendix is hardly made preoperatively. An unsuspected finding of appendiceal tumor during operation can cause confusion about appropriate management of the lesion. The prognosis of adenocarcinoma of appendix can be determined by Dukes' stage and is similar, stage for stage, to that of colorectal carcinoma. We experienced a patient with linitis plastica type of primary adenocarcinoma of the appendix, who complained right lower quadrant pain for twenty days. The patient underwent appendectomy only. The second curative operation could not be performed due to patient's condition.

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