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Case Reports
Multiple Myeloma Mimics Bone Metastasis From a Rectal Adenocarcinoma
Im-Kyung Kim, Jeonghyun Kang, Yu Ri Kim, Tae Joo Jeon, Seung Hyuk Baik, Seung-Kook Sohn
Ann Coloproctol. 2017;33(2):70-73.   Published online April 28, 2017
DOI: https://doi.org/10.3393/ac.2017.33.2.70
  • 4,308 View
  • 37 Download
  • 1 Citations
AbstractAbstract PDF

A presumptive diagnosis of bone metastasis can be easily made when a patient with a history of colorectal cancer develops bone lesions that are seen on follow-up imaging. In this case report, we describe a patient whose multiple bone lesions were wrongly attributed to a recurrence of rectal cancer rather than being identified as multiple myeloma lesions. When clinicians detect new, abnormal, bony lesions in a patient with a previous history of cancer, they should consider diseases such as multiple myeloma in their differential diagnosis.

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  • Capecitabine/fluorouracil/oxaliplatin

    Reactions Weekly.2017; 1661(1): 71.     CrossRef
Incidentally Solitary, Synchronous, Metastatic Left Adrenal Mass From Colon Cancer
Mina Alvandipour, Mohammad Yasin Karami, Mehdi Khalvati, Hamed Khodabakhsh
Ann Coloproctol. 2016;32(2):79-82.   Published online April 30, 2016
DOI: https://doi.org/10.3393/ac.2016.32.2.79
  • 5,752 View
  • 47 Download
  • 2 Web of Science
  • 4 Citations
AbstractAbstract PDF

The authors report the case of a 63-year-old man who underwent an open adrenalectomy for a synchronous, malignant, metastatic left adrenal tumor and a total colectomy for T3N0M1 (stage 4) primary, malignant colon cancer. Two polypoid lesions, one measuring 40 mm × 30 mm × 30 mm and the other measuring 20 mm × 10 mm × 10 mm, were found in the ascending colon and rectosigmoid (RS) junction, respectively, and a synchronous, malignant, left adrenal gland lesion measuring 70 mm × 50 mm × 30 mm was incidentally found on abdominal computed tomography scan. Histological examination revealed a metastatic, necrotic adenocarcinoma of the left adrenal mass, an adenocarcinoma of the cecal mass, and an adenomatous polyp (tubulovillous type) of the smallest polypoid lesion in RS junction that had invaded deeply into the submucosal layer. The patient recovered uneventfully, and his condition is now stable, with no evidence of local recurrence or metastatic disease, 2 years after the surgery. To the best of our knowledge, only 25 cases of an adrenalectomy for treating metastatic adrenal gland tumors have been reported to date; physicians should be aware of the possibility of this event.

Citations

Citations to this article as recorded by  
  • Surgical resection of adrenal metastasis from colorectal cancers: a systematic review
    Thi Ai Van Terresa Nguyen, Sze Ling Wong, Zi Qin Ng
    ANZ Journal of Surgery.2024; 94(4): 545.     CrossRef
  • An Adrenal Incidentaloma After Colon/Rectal Cancer Surgery: A Primer Lesion or Metastasis—A Case Report
    Adalet Daş, İbrahim Ethem Cakcak, Derya Karabulut, Dicle Tamer Türk
    SN Comprehensive Clinical Medicine.2024;[Epub]     CrossRef
  • Solitary metastasis of colorectal cancer in the left adrenal gland 4 years after surgery on the primary tumor. Case report
    Marina D. Budurova, Vladimir S. Trifanov, Vladimir V. Kopylov, Olga S. Kuznetsova, Maria A. Chernichenko, Sergey I. Poluektov
    Journal of Modern Oncology.2023; 25(3): 401.     CrossRef
  • Synchronous contralateral adrenal metastasis of colorectal cancer: case report
    Micaela Raices, Luis Boccalatte, Gustavo Rossi, Fernando Wright
    Journal of Surgical Case Reports.2017;[Epub]     CrossRef
Multiple Glomus Tumors of the Omentum
Won Beom Jung, In Ja Park, Joon Seon Song, Kyung-Ja Cho, Jin Cheon Kim
Ann Coloproctol. 2015;31(4):153-156.   Published online August 31, 2015
DOI: https://doi.org/10.3393/ac.2015.31.4.153
  • 3,444 View
  • 42 Download
AbstractAbstract PDF

A glomus tumor is a very rare neoplasm consisting of cells that resemble the modified smooth muscle cells of normal glomus bodies. Here, we report a case of a 39-year-old male with multiple omental glomus tumors. The patient underwent a complete resection of the glomus tumors. This is a rare case of omental glomus tumors, and to our knowledge, this patient is the first with multiple omental glomus tumors to be described.

Original Article
Clinical Characteristics of Colorectal Cancer Patients With a Second Primary Cancer
Jin Woo Lee, Jong Woo Kim, Nam Keun Kim
Ann Coloproctol. 2014;30(1):18-22.   Published online February 28, 2014
DOI: https://doi.org/10.3393/ac.2014.30.1.18
  • 3,744 View
  • 44 Download
  • 19 Web of Science
  • 16 Citations
AbstractAbstract PDF
Purpose

The incidence of colorectal cancer is increasing due to a westernized dietary lifestyle, and improvements in treatment and diagnostic tools have resulted in more patients being confirmed of having multiple primary cancers. However, studies regarding multiple primary cancers are insufficient. In this study, the clinical aspects of patients with primary multiple cancers, including colorectal cancers, were investigated, and the results were compared to those of patients with primary colorectal cancer only.

Methods

Seven hundred eighteen patients who received surgery for colorectal cancer between March 2003 and September 2012 in CHA Medical Center were enrolled. A retrograde cohort was done for comparison of the two groups: those with and those without multiple primary cancer. The analysis was done according to sex, age, tumor location, tumor size, metastatic regional lymph-node number, vascular/lymphatic microinvasion, staging, tumor markers, microsatellite instability, and C/T subgroup of polymorphism in methylenetetrahydrofolate reductase.

Results

Of the 718 subjects, 33 (4.6%) had multiple primary cancers: 12 (36.4%) synchronous and 21 (63.6%) metachronous. The malignancy most frequently accompanying colorectal cancer was gastric cancer, followed by thyroid, prostate, and esophageal malignancies in that order. In the comparison between groups, mean age, tumor location, and microsatellite instability showed statistically significant differences; others parameters did not.

Conclusion

The incidence of multiple primary cancers, including colorectal cancer, is increasing. Therefore, defining the characteristics of patients with multiple primary cancers is crucial, and those characteristics need to be acknowledged in the follow-up of colorectal cancer patients.

Citations

Citations to this article as recorded by  
  • Synchronous Papillary Thyroid Cancer and Colorectal Cancer in a Young Patient with a CHEK2 Mutation
    Sydney Brooke Hoskins, Leslie Torgerson
    Case Reports in Oncology.2024; 17(1): 524.     CrossRef
  • Risk of Gynaecological Cancers as Second Primary in Non-gynaecological Cancer Survivors: A Retrospective Cohort Study
    N. R. Sindhu, Dhanya Susan Thomas, Ajit Sebastian, Anitha Thomas, Rachel Chandy, Sherin Daniel, Vinotha Thomas
    The Journal of Obstetrics and Gynecology of India.2024;[Epub]     CrossRef
  • Influence factors of the survival in colorectal cancer patients with second primary malignancy after surgery: A SEER database analysis
    Liyu Liu, Bolin Chen
    Medicine.2023; 102(40): e35286.     CrossRef
  • A synopsis of modern - day colorectal cancer: Where we stand
    Ranmali Ranasinghe, Michael Mathai, Anthony Zulli
    Biochimica et Biophysica Acta (BBA) - Reviews on Cancer.2022; 1877(2): 188699.     CrossRef
  • A Single-Center Study of Patients With Synchronous Primary Malignancy: A Case Series
    Abeer I Alsulaimani, Layla M Alkhaldi, Sheikha A AlTawairqi, Arif Khurshid, Hamma A Abdulaziz, Abdulrahman G Alotaibi, Haifa O Alotaibi
    Cureus.2022;[Epub]     CrossRef
  • MicroRNAs expression analysis shows key affirmation of Synaptopodin-2 as a novel prognostic and therapeutic biomarker for colorectal and cervical cancers
    Md. Shahadat Hossain, Mahafujul Islam Quadery Tonmoy, Md. Nur Islam, Md. Sajedul Islam, Ibrahim Khalil Afif, Arpita Singha Roy, Atqiya Fariha, Hasan Al Reza, Newaz Mohammed Bahadur, Md. Mizanur Rahaman
    Heliyon.2021; 7(6): e07347.     CrossRef
  • Multiple Metachronous Malignancies: One Patient with Five Primary Malignancies
    Sung Yun Lee, Byung Ik Kim, Hong Ju Kim, Kwan Joong Joo, Sang Hyuk Lee, Chang Hak Yoo, Dong Hoon Kim
    The Korean Journal of Medicine.2019; 94(1): 114.     CrossRef
  • Synchronous Hodgkin lymphoma and gastric adenocarcinoma
    Hongying Wu, Liyan Wei, Lumei Hao, Xuemei Li, Lei Wang, Chenglu Yuan
    Medicine.2018; 97(3): e9484.     CrossRef
  • Secondary Breast, Ovarian, and Uterine Cancers After Colorectal Cancer: A Nationwide Population-Based Cohort Study in Korea
    Dong Woo Shin, Yoon Jin Choi, Hyun Soo Kim, Kyung-Do Han, Hyuk Yoon, Young Soo Park, Nayoung Kim, Dong Ho Lee
    Diseases of the Colon & Rectum.2018; 61(11): 1250.     CrossRef
  • Clinical characteristics and survival of lung cancer patients associated with multiple primary malignancies
    Shan Shan, Jun She, Zhi-qiang Xue, Chun-xia Su, Shen-xiang Ren, Feng-ying Wu, Rafael Rosell
    PLOS ONE.2017; 12(9): e0185485.     CrossRef
  • Liver resection for hepatocellular carcinoma in patients with hematological malignancies
    Hui-Chen Lin, Yang-Shen Yang, Chieh-Lin Jerry Teng, Ching-Hui Shen, Yee-Gee Jan, Shao-Bin Cheng, Cheng-Chung Wu, Yi-Ling Lin, Chu-Chun Huang, Fang-Ku P’eng
    World Journal of Surgical Oncology.2017;[Epub]     CrossRef
  • Multiple Primary Malignancies in Patients With Hepatocellular Carcinoma
    Wei Xu, Wenjun Liao, Penglei Ge, Jinjun Ren, Haifeng Xu, Huayu Yang, Xinting Sang, Xin Lu, Yilei Mao
    Medicine.2016; 95(17): e3491.     CrossRef
  • Lessons Learned From a Case of Gastric Cancer After Liver Transplantation for Hepatocellular Carcinoma
    Kun Yang, Hong Zhu, Chong-Cheng Chen, Tian-Fu Wen, Wei-Han Zhang, Kai Liu, Xin-Zu Chen, Dong-Jiao Guo, Zong-Guang Zhou, Jian-Kun Hu
    Medicine.2016; 95(7): e2666.     CrossRef
  • An Uncommon Presentation of a Metachronous Primary Gastric Tumor in a Patient with a Resected Colorectal Carcinoma: Case Report and Review of the Literature
    Michalis Galanopoulos, Elisavet Nikolaidou, Christos Liatsos
    Journal of Gastrointestinal Cancer.2015; 46(1): 85.     CrossRef
  • Gastric cancer following a liver transplantation for glycogen storage disease type Ia (von Gierke disease): A case report
    HUA XIAO, JIANMIN BIAN, LEI ZHANG, ZHAOMING WANG, AIXING DING
    Oncology Letters.2014; 8(6): 2803.     CrossRef
  • Second Primary Cancers Following Colorectal Cancer
    Jung Wook Huh
    Annals of Coloproctology.2014; 30(1): 2.     CrossRef
Case Reports
Multiple Presacral Teratomas in an 18-year-old Girl: A Case Report
Young Jin Park
J Korean Soc Coloproctol. 2011;27(2):90-93.   Published online April 30, 2011
DOI: https://doi.org/10.3393/jksc.2011.27.2.90
  • 3,757 View
  • 17 Download
  • 7 Citations
AbstractAbstract PDF

Although the sacrococcygeal area is the most common site for a teratoma in infants, it is a rare site for a teratoma in older patients. Most of the teratomas found in this area in adults are single mass, but in a few cases, multiple masses have been reported. The author reports on the case of an 18-year-old female patient with 3 presacral teratomas. The tumors were surgically removed via a transabdominal approach and were pathologically diagnosed as mature cystic teratomas. This case report indicates that an adult presacral teratoma can appear as multiple tumors, although it is very unusual.

Citations

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  • Differential diagnostics of pilonidal cysts
    Denis A. Zvonkov, Natalya M. Stepanova, Vladimir A. Novozhilov, Ivan S. Sharapov, Marina I. Stupina, Julia A. Naryshkina, Margarita N. Ludwig
    Russian Journal of Pediatric Surgery.2024; 28(6): 594.     CrossRef
  • Perirectal epidermoid cyst in a patient with sacrococcygeal scoliosis and anal sinus: A case report
    Zhou-Xin Ji, Song Yan, Xu-Can Gao, Li-Fen Lin, Qiang Li, Qi Yao, Dong Wang
    World Journal of Clinical Cases.2022; 10(30): 11139.     CrossRef
  • Adult sacrococcygeal teratoma: A review
    Jia-Xing Guo, Jian-Guo Zhao, Ying-Na Bao
    Medicine.2022; 101(52): e32410.     CrossRef
  • A Rare Case of Sacrococcygeal Teratoma in Adult
    Abhilasha Goyal, Praveen S Rathod, Pallavi V Reddihalli, Shobha Krishnappa, S. K. Rajshekar, Yamini Kansal, Sravanthi Nuthalapati, Amarinder Singh, Tejas Vanakudri, S. D. S. Karthik
    Indian Journal of Surgical Oncology.2020; 11(S1): 102.     CrossRef
  • Currarino syndrome with two synchronous presacral teratomas
    Timothy A. Little, Kathryn E. Compson, Katherine Hall, M. Jean Murdoch, Katherine R. Neas, Diane Kenwright, Mark D. Stringer
    Journal of Pediatric Surgery Case Reports.2018; 36: 16.     CrossRef
  • Giant Type II Sacroccocygial Teratoma: A Senegalese Case
    Balla Diop, Dia Aliou Amadou, Sow Oumar, Ba Abdoulaye Pape, Dial Chérif, A. Phiri, Youhanidou Wane, Sarre Mamadou Serigne
    Journal of Gynecologic Surgery.2017; 33(6): 264.     CrossRef
  • Sacrococcygeal teratoma – case report and review of the literature
    Krzysztof Szyllo, Natalia Lesnik
    American Journal of Case Reports.2013; 14: 1.     CrossRef
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
  • 1,480 View
  • 12 Download
AbstractAbstract 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
Synchronous Colorectal Cancer.
Lee, Hui Song , Park, Jun Ho , Lee, Ru Ji , Cho, Yong Kwon , Yun, Hae Ran , Cho, Yong Beom , Yun, Seong Hyeon , Kim, Hee Cheol , Lee, Woo Yong , Chun, Ho Kyung
J Korean Soc Coloproctol. 2009;25(4):234-240.
DOI: https://doi.org/10.3393/jksc.2009.25.4.234
  • 1,696 View
  • 8 Download
  • 2 Citations
AbstractAbstract PDF
PURPOSE
Synchronous colorectal cancer is clinically significant because there is a chance to miss concurrent lesions. The aim of this study is to investigate the clinical features of synchronous colorectal cancer. METHODS: Retrospectively, the records of 4,494 colorectal cancer patients who underwent a potentially curative resection for colorectal cancer from September 1994 to December 2005 were reviewed. Synchronous colorectal cancer was defined according to the following two criteria: 1) two or more colorectal cancers had to be found simultaneously in the same patient and 2) each of the tumors had to be distinctly separated by an intact bowel wall. RESULTS: Synchronous colorectal cancer was diagnosed in 114 patients (2.5%). Synchronous colorectal cancer shows different features compared with single colorectal cancer. Synchronous colorectal cancer occurs at a older age, occurs more frequently in the colon, has a bigger size, and has more polyps. There was no difference of stage based on survival rate between synchronous and single colorectal cancer patients. The preoperative diagnosis rate of synchronous colorectal cancer was 74.6%. Eleven (9.6%) synchronous colorectal cancer patients underwent a total colectomy, and there were no significant differences in survival or complications compared with the other group. CONCLUSION: Synchronous colorectal cancer is difficult to diagnose preoperatively. Early postoperative examination for synchronous colorectal cancer is required, especially in patients who did not have a complete preoperative evaluation.

Citations

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  • Computed tomography has low sensitivity for the diagnosis of early colon cancer
    I‐H. Lao, H. Chao, Y.‐J. Wang, C.‐W. Mak, W.‐S. Tzeng, R.‐H. Wu, S.‐T. Chang, J.‐L. Fang
    Colorectal Disease.2013; 15(7): 807.     CrossRef
  • Barium Zirconium Titanate Powders Prepared by Sol–Gel Method
    Xiao Ling Deng, Dong Jiao Guo, Wei Cai, Chun Lin Fu
    Advanced Materials Research.2011; 412: 86.     CrossRef
Treatment of Multiple Colorectal Cancers.
Paek, Ok Joo , Oh, Seung Yeop , Suh, Kwang Wook
J Korean Soc Coloproctol. 2009;25(1):34-40.
DOI: https://doi.org/10.3393/jksc.2009.25.1.34
  • 1,510 View
  • 12 Download
AbstractAbstract PDF
PURPOSE
The detection of synchronous and metachronous colon cancer is important for the surgical treatment. The aim of this study is to review the clinicopathological characteristics of multiple colon cancers.
METHODS
A retrospective analysis was performed with 43 patients with multiple colon cancers who underwent surgical treatment from June 1996 to May 2008. Patients with familial adenomatous polyposis and cancer from inflammatory bowel disease were excluded.
RESULTS
There were 43 cases of multiple colon cancers. Synchronous colon cancers were present in 30 patients and metachronous colon cancers were present in 18 patients. The mean age was 61.33+/-11.44, and the male-to-female ratio was 23:20. The index cancer and the second cancers in synchronous colon cancers, as well as the first colon cancer in metachronous colon cancers showed, significantly more distal tumor locations. However, the second cancers in metachronous colon cancers showed no significant differences in tumor location. As for stage, a more advanced stage was noted in the index cancer than in the second cancers in synchronous cancer. However, an early stage was noted for the first colon cancer in metachronous cancers. Seventeen patients with synchronous cancer and 14 patients with metachronous colon cancer underwent a total or a subtotal colectomy.
CONCLUSION
Detection of synchronous colon cancer was important for deciding the extent of surgical resection. Patients with colon cancer should be considered for frequent colonoscopy follow-up for early detection of metachronous colon cancer.
Multiple Primary Cancers Including Colorectal Cancer.
Kim, Soo Hong , Kim, Hyung Jin , Lee, Jae Im , Lee, Yoon Suk , Kang, Won Kyung , Park, Jong Kyung , Oh, Seong Taek
J Korean Soc Coloproctol. 2008;24(6):467-472.
DOI: https://doi.org/10.3393/jksc.2008.24.6.467
  • 2,215 View
  • 5 Download
  • 3 Citations
AbstractAbstract PDF
PURPOSE
With advance in diagnostic techniques and treatment modalities, it has been increasing that the patients with colorectal cancer experience another primary malignancies. Understanding the characteristics of multiple primary malignancies is important to establish an effective surveillance program for the early detection of second cancer.
METHODS
The database of 2,709 patients diagnosed with colorectal cancer between 1985 and 2007 in Kangnam St. Mary's Hospital was analyzed retrospectively.
RESULTS
Out of 2,709 patients, 102 (3.76%) of them were found to have multiple malignancies. Among them, 37 patients had synchronous cancers and 65 patients had metachronous cancers. The most common site of multiple primary malignancies was the stomach, followed by kidney, thyroid and breast.
CONCLUSIONS
In the patients with colorectal cancer, it should be considered to evaluate multiple primary malignancies, especially stomach, during the routine follow up. And the most frequent multiple primary cancer before colorectal cancer was also stomach cancer. Careful attention should be paid to the colorectal cancer in stomach cancer patients.

Citations

Citations to this article as recorded by  
  • An Uncommon Presentation of a Metachronous Primary Gastric Tumor in a Patient with a Resected Colorectal Carcinoma: Case Report and Review of the Literature
    Michalis Galanopoulos, Elisavet Nikolaidou, Christos Liatsos
    Journal of Gastrointestinal Cancer.2015; 46(1): 85.     CrossRef
  • Clinical Characteristics of Colorectal Cancer Patients With a Second Primary Cancer
    Jin Woo Lee, Jong Woo Kim, Nam Keun Kim
    Annals of Coloproctology.2014; 30(1): 18.     CrossRef
  • Triple Synchronous Primary Cancers of Rectum, Thyroid, and Uterine Cervix Detected during the Workup for Hematochezia
    Jun Sik Lee, Won Moon, Seun Ja Park, Moo In Park, Kyu Jong Kim, Lee La Jang, Mi Jung Park, Bong Kwuen Chun
    Internal Medicine.2010; 49(16): 1745.     CrossRef
Outcomes after a Hepatic Resection for Multiple Hepatic Metastases from Colorectal Cancer.
Choi, Pyong Wha , Kim, Hee Cheol , Jung, Sang Hun , Kim, Dae Dong , Park, In Ja , Yu, Chang Sik , Kim, Jin Cheon
J Korean Soc Coloproctol. 2008;24(2):100-106.
DOI: https://doi.org/10.3393/jksc.2008.24.2.100
  • 1,884 View
  • 9 Download
  • 2 Citations
AbstractAbstract PDF
PURPOSE
Surgical resection is still considered as the gold standard in patients with hepatic metastases from colorectal cancer. The impact of the number of hepatic metastases is a controversial issue. We aimed to evaluate the outcomes and the prognostic factors after hepatic resection in multiple hepatic metastases from colorectal cancer. METHODS: Between June 1989 and October 2005, 42 patients underwent hepatic resections for three or more hepatic metastases from colorectal cancer. Disease-free survival analyses were performed on patients grouped as a function of the following factors: age, sex, preoperative serum CEA level, primary tumor site, nodal status, intrahepatic distribution, diameter of the liver lesion, their number, and the resection margin. RESULTS: Of the 42 patients, 29 (69.0%) developed recurrence (16 in the liver alone, 5 in the liver and another distant site, 8 in a distant site alone) during a median follow-up of 24 months. The overall 1-, 2-, and 5-year survival rates were 89.1%, 58.6%, and 31.8%, respectively. The 1-year and 2-year disease-free survival rates were 38.1 and 29.4%, respectively. There was no postoperative mortality and the morbidity rate was 11.9%. The disease-free survival rate was independently associated with the resection margin of the metastatic tumor (P=0.017). The 1-year disease- free survival rates in patients with more than a 5-mm resection margin and with less than a 5-mm resection margin were 72.7%, and 25.8%, respectively.
CONCLUSIONS
If technically feasible, an aggressive hepatic resection should be performed for the treatment of multiple hepatic metastases from colorectal cancer. The surgical resection margin may govern the outcomes in patients with surgically curable hepatic metastases from colorectal cancer.

Citations

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  • Scoring of prognostic factors that influence long-term survival in patients with hepatic metastasis of colorectal cancer
    Sung Woo Ahn, Ahn Soo Na, Jae Do Yang, Hong Pil Hwang, Hee Chul Yu, Baik Hwan Cho
    Korean Journal of Hepato-Biliary-Pancreatic Surgery.2011; 15(3): 146.     CrossRef
  • Impact of Resection for Primary Colorectal Cancer on Outcomes in Patients with Synchronous Colorectal Liver Metastases
    Jung Wook Huh, Chol  Kyoon Cho, Hyeong Rok Kim, Young Jin Kim
    Journal of Gastrointestinal Surgery.2010; 14(8): 1258.     CrossRef
Clinical Characteristics of Synchronous Multiple Colorectal Cancer.
Kang, Jung Gu , Kim, Dong Hyun , Kim, Chang Hee , Lee, Sang Hyuk , Choi, Yun Jung
J Korean Soc Coloproctol. 2006;22(6):418-423.
  • 914 View
  • 4 Download
AbstractAbstract PDF
PURPOSE
Colorectal cancer might have a synchronous cancer or polyps. Diagnosis of synchronous cancer is important for surgical treatment. The purpose of this study is to review the clinicopathological characteristics of synchronous multiple colorectal cancers.
METHODS
A retrospective analysis was performed with 16 patients with synchronous multiple colon cancer out of 625 colorectal cancer patients who underwent surgical treatment from March 2000 to December 2005.
RESULTS
The incidence of synchronous multiple colon cancer was 2.6%, and 1.9% in case of exception of Tis. The incidence of synchronous polyp was 62.5% in synchronous multiple colorectal caner and higher than 29.6% in single colorectal cancer. Numbers of the lesions were from 2 to 4, and total number of lesions were 35. Preoperative diagnostic rate of multiple colorectal cancers was 46.7% with colonoscopic examination. 18.8% of synchronous cancers were detected during intraoperative examination. Microscopically, ulcerative type was most common (62.9%), moderately differentiated type was common (84.8%). In TNM stage, advanced stage was common and stage III was 43.8%. T3 was the most common lesion in T stage among all lesions in synchronous cancer. Relatively small lesions of less than 2 cm were common (48.3%). Synchronous cancers were common in distal part of colorectum. Operations were carried out from segmental resection, to total or subtotal colectomy in case of multiple involvement of colon by cancer. During the follow up, one case was died postoperative 22 months due to cerebrovascular attack.
CONCLUSIONS
Synchronous multiple colon cancer was important for decision of extent of surgical resection. In this study, preoperative diagnostic rate of multiple colorectal cancers was 42.9%. So, index of suspicion about synchronous multiple colorectal cancers in preoperative and intraoperative stage is major key to improve the detection rate of synchronous lesion and appropriate resection.
Genetic Instability and Mutations of Mismatch Repair (MMR) and p53 Gene in Colorectal Cancers with Multiple Polyps and Sporadic Colorectal Cancers.
Chun, Sung Won , Chang, Suk Kyun
J Korean Soc Coloproctol. 2002;18(6):353-362.
  • 1,223 View
  • 16 Download
AbstractAbstract PDF
PURPOSE
General conceptions of carcinogenic mechanisms by recent reports are ras-p53 gene pathway in sporadic colorectal cancers (SCC), MMR gene pathway in hereditary nonpolyposis colorectal cancer (HNPCC) and APC gene in familial adenomatous polyposis (FAP). But in the colorectal cancer with multiple polyps (CCMP), the carcinogenic pathway is not still defined exactly. In order to find out the which carcinogenic pathway control the CCMP and SCC, genetic instability were studied in CCMP and SCC.
METHODS
In this study, genetic instability on D2S123, D3S1029, D5S107, D6S87 and AP delta3 foci and gene mutations of hMLH1 (exon 2, 16, 19), hMSH2 (exon 11, 12, 13, 14) gene of MMR gene, p53 gene (exon 5, 6, 7, 8, 9) were studied on the 60 DNA samples of CCMP (30 cases) and SCC (30 cases).
RESULTS
1. Observed positive genetic instability was higher in CCMP (30%) than SCC (20%), and was higher in right colon cancers (33%) than left colon cancers (23%) or rectal cancers (17%), but not significant statisitically. And observed positive genetic instability was lower in moderate differentiated cancers (16%) than well (67%) or poorly (60%) differentiated cancers (P=0.005). 2. Any mutations of hMLH1 and hMSH2 gene of MMR gene were not observed in both of CCMP and SCC, but 3 cases (2 CCMPs and 1 SCC) point mutations of intron of hMSH2 gene, which were higher in positive genetic instability than negative (P=0.002). 3. This 3 cases point mutations were C for T which were on 6th bases upstream from codon 669. 4. From the results of SSCP for nucleotide sequencing of p53 gene, the abnormal bands were observed in 30% (9 of 30) of CCMP and SCC. Also the abnormal bands were observed in both of positive or negative genetic instability without differences.
CONCLUSIONS
With above results the authors suggested that the mechanism of genetic instability and mutations of p53 gene strongly affect the mechanism of carcinogenesis in SCC and CCMP. And there are relationship between genetic instability and point mutation at intron region of hMSH2 gene. However further evaluation and research is needed to establish relation between APC gene and other different kind of MMR gene.
Clinicopathological Characteristics of Multiple Primary Colorectal Cancer.
Kim, Yong Jin , Kim, Nam Kyu , Lee, Kang Young , Sohn, Seung Kook , Min, Jin Sik
J Korean Soc Coloproctol. 2002;18(5):343-348.
  • 1,204 View
  • 22 Download
AbstractAbstract PDF
PURPOSE
Through studying the clinical manifestation and prognosis of multiple colorectal cancer in comparison to those of solitary primary colorectal cancer, we expect this study to help establish a strategy for the diagnosis and treatment of it.
METHODS
2,302 patients with colorectal cancer, operated at the department of surgery, Yonsei university college of medicine, between Jan. 1989 and Dec. 1999 were evaluated for multiple colorectal cancer. Synchronous cancer was defined as distinct lesions separated by a distance of greater than 4 cm with the invasion of the tumor below the muscularis mucosa at the time of diagnosis. Metachronous cancer was defined as the development of colon cancer more than 6 months after the initial treatment without evidence of recurrence or metastasis from the primary tumor.
RESULTS
The incidence of multiple cancer was 2.1% (49 patients). Among them, 1.8% were synchronous and 0.3% were metachronous. The average age was 59.7 years old, similar to the solitary colorectal cancer group whose mean age was 57.1 years old. The median follow up period was 44 months and average follow up period was 53 months. The frequency of cancer increased as it got closer to the rectum. The most frequent location was the rectum (43%) and the sigmoid colon (24%). The average time interval until the development of metachronous cancer was 46 months after initial operation. Adenomatous polyps were identified in 11 patients (43%) out of 49 patients with multiple colorectal cancer, whereas 538 patients (24%) out of 2,253 patients with solitary colorectal cancer were discovered with ademomatous polyps. The survival rate of multiple colorectal cancer was 59%, lower than that of solitary colorectal cancer (64%). But the difference was not statistically significant (P>0.05).
CONCLUSIONS
The diagnosis of multiple colorectal cancer is very important in view of curative radical surgery and prognosis. This emphasizes the need for detection of early stage cancer by developing genetic markers and using advanced radiological diagnostic tools.
Multiple Primary Colorectal Cancer.
Lim, Yong Seok , Lee, Seok Hwan , Hong, Sung Wha , Yoon, Choong , Joo, Hoong Zae , Lee, Kee Hyung
J Korean Soc Coloproctol. 1998;14(1):27-34.
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AbstractAbstract PDF
To assess the clinico-pathological characteristics of patients with multiple primary colorectal cancer, 458 patients who underwent curative surgery and being followed-up at our institution between Jan. 1987 and Dec. 1993 were evaluated in this study. The median follow-up period was 42 months. Synchronous cancer was defined as distinct lesions separated by a distance of greater than 4cm with the invasion of the tumor below the muscularis mucosa at the time of diagnosis or within 6 months after initial treatment, and metachronous cancer was defined as the development of colon cancers more than 6 months after the initial treatment without evidence of the recurrence or metastases from primary tumor. There were 29 cases of multiple primary colorectal cancer(6.3%). Eighteen cases(3.9%) of them were synchronous, 11 cases(2.4%) were metachronous cancers. Seven cases(1.5%) were related to 5 hereditary non-polyposis colorectal cancer(HNPCC) families. During the follow-up period, 11 patients(2.4%) developed cancers in other organs. Adenomatous polyps were identified 14 cases of 29 patients with multiple primary colorectal cancers(48.3%), compared to 43 cases(10%) in 429 patients with solitary colorectal cancer(p<0.01). After initial curative surgery, there were 8 recurrences in 29 patients with multiple primary colorectal cancers(23.6%), compared to 100 recurrences in 429 patients with solitary primary colorectal cancer(23.3%)(p>0.05). In aspect of family history, there was close-relationship with this regarding in the group of multiple primary colorectal cancers. However, authors were unable to make analysis this regarding in the group of solitary primaries because of lack of the information. Conclusively, authors guess the frequent association of the adenomatous polyps in multiple primary colorectal cancers as the evidence of the adenoma-carcinoma sequence. In addition, authors emphasized the importance of the total colonoscopic examinations in pre-and post-operation in order to make diagnosis of the multiple primary colorectal cancers and paying attention as to the family history of colorectal cancer patients because we have good therapeutic results after operation of early stage in synchronous cancers and co-existent adenomatous polyps.
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