Generally, colon lipoma is mildly symptomatic or asymptomatic. However, sometimes it may present with symptoms, such as pain, constipation, obstruction, or bleeding and may be the leading point for intussusception, particularly in large size (>20 mm). Giant colon lipoma may warrant the removal to exclude confusion with other lesions that have a malignant potential and to control symptoms. Currently, surgical resection should be considered for giant lipoma more than 20 mm in diameter due to the high risk of perforation or bleeding, especially when the lesion is broadly-based. We report here a case of spontaneous resolution acquired after endoscopic partial resection for the symptomatic giant colon lipoma with broad-base requiring surgery.
Colonic Neoplasms/*diagnosis/surgery/therapy ; Colonoscopy ; Humans ; Lipoma/*diagnosis/surgery/therapy ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Treatment Outcome

Bacterial pericarditis has been recognized as a rare disease since the development of antibiotics. Usually, the disease is associated with underlying conditions or a seeding of infection elsewhere to the pericardium. Here we describe a case of group G streptococcal pericarditis as an initial presentation of colon cancer. A 52-yr-old man was admitted because of dyspnea. An electrocardiogram showed a diffuse ST-segment elevation and a two-dimensional echocardiogram showed a large amount of pericardial effusion. A pericardiocentesis was done and purulent fluid was drained. Group G streptococci was cultured in pericardial fluid. The patient was treated with antibiotics and pericardiostomy with saline irrigation. A colonoscopy revealed a small mass with moderately differentiated adenocarcinoma in rectosigmoid colon. He underwent a mucosectomy and was recovered without any complication.
Adenocarcinoma/complications/*diagnosis/surgery ; Colonic Neoplasms/complications/*diagnosis/surgery ; Echocardiography ; Electrocardiography ; Humans ; Male ; Middle Aged ; Pericardial Effusion ; Pericarditis/complications/drug therapy/*microbiology/surgery ; Streptococcal Infections/complications/drug therapy/*microbiology/surgery ; Streptococcus/*classification

OBJECTIVE: To explore the feasibility of surgical treatment for cancer patients complicated with corona virus disease 2019 (COVID-19). METHODS: The management and clinical outcome of a sigmoid cancer patient with COVID-19 were analyzed. RESULTS: The inflammation indicators and fever of this patient were effectively controlled and the lung lesions remained stable after active anti-viral treatment, then the radical colorectomy was performed after the viral negative conversion for twice. CONCLUSIONS The case indicates that it may feasible to undergo radical tumor surgery for cancer patients with COVID-19 after the virus nucleic acid testing turns negative and more studies are needed to confirm this conclusion.
Antiviral Agents ; therapeutic use ; Betacoronavirus ; Clinical Laboratory Techniques ; Colonic Neoplasms ; complications ; surgery ; virology ; Coronavirus Infections ; complications ; diagnosis ; drug therapy ; Fever ; Humans ; Nucleic Acid Amplification Techniques ; Pandemics ; Pneumonia, Viral ; complications ; diagnosis ; drug therapy

OBJECTIVETo discuss the value of multi-slice CT dynamic enhancement scan in the diagnosis and treatment of colonic lymphomas.

METHODS16 patients with colonic lymphomas underwent multi-slice CT dynamic enhancement scans, images of axial and reconstructive images of VR, MPR and CTVE were analyzed, patients were respectively diagnosed.

RESULTSAppearances of primary colorectal lymphomas were categorized into focal and diffuse lesions. Focal and diffuse lesions were 6 and 10 patients, respectively. The accuracy rate of diagnosis was 87.5%.

CONCLUSIONMSCT dynamic scan has distinctive superiority in diagnosis and treatment of colonic lymphomas.

Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Barium Sulfate ; Child ; Colon ; diagnostic imaging ; drug effects ; surgery ; Colonic Neoplasms ; diagnosis ; drug therapy ; surgery ; Colonoscopy ; Cyclophosphamide ; therapeutic use ; Doxorubicin ; therapeutic use ; Enema ; Female ; Humans ; Lymphoma, B-Cell ; diagnosis ; drug therapy ; surgery ; Male ; Middle Aged ; Prednisone ; therapeutic use ; Radiographic Image Enhancement ; Reproducibility of Results ; Sensitivity and Specificity ; Tomography, Spiral Computed ; methods ; Vincristine ; therapeutic use

There are indirect evidences to suggest that 80% of colorectal cancers (CRC) develop from adenomatous polyps and that, on average, it takes 10 years for a small polyp to transform into invasive CRC. In multiple cohort studies, colonoscopic polypectomy has been shown to significantly reduce the expected incidence of CRC by 76% to 90%. Colonoscopic polypectomy is performed frequently in primary, secondary and tertiary and medical centers in Korea. However, there are no evidence-based, procedural guidelines for the appropriate performance of this procedure, including the technical aspects. For the guideline presented here, Pubmed, Medline, and Cochrane Library literature searches were performed. When little or no data from well-designed prospective trials were available, an emphasis was placed on the results from large series and reports from recognized experts. Thus, these guidelines for colonoscopic polypectomy are based on a critical review of the available data as well as expert consensus. Further controlled clinical studies are needed to clarify aspects of this statement, and revision may be necessary as new data become available. This guideline is intended to be an educational device to provide information that may assist endoscopists in providing care to patients. This guideline is not a rule and should not be construed as a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment. Clinical decisions for any particular case involve a complex analysis of the patient's condition and the available courses of action.
Adenoma/diagnosis/*surgery ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Aspirin/therapeutic use ; Colonic Polyps/pathology/*surgery ; Colonoscopy ; Colorectal Neoplasms/diagnosis/*surgery ; Databases, Factual ; Epinephrine/therapeutic use ; Gastrointestinal Hemorrhage/prevention & control ; Humans ; Lymphatic Metastasis ; Republic of Korea ; Surgical Instruments ; Thrombosis/drug therapy ; Vasoconstrictor Agents/therapeutic use

Hepatocellular carcinoma (HCC) is one of the most common malignant neoplasms occuring worldwide. Although surgical resection still remains the treatment of choice for HCC, radiofrequency ablation (RFA) has emerged as reliable alternatives to resection. It is less invasive and can be repeated after short intervals for sequential ablation in case of multiple lesions. The most common complication of RFA is liver abscess, and bile duct injury such as bile duct stricture has been reported. This is a case report of a rare complication of abscesso-colonic fistula after RFA for HCC. The case was treated by percutaneous abscess drainage and antibiotics and occlusion of abscesso-colonic fistula with n-butyl-2-cyanoacrylate embolization.
Aged ; Anti-Bacterial Agents/therapeutic use ; Carcinoma, Hepatocellular/diagnosis/*surgery ; Catheter Ablation/*adverse effects ; Colonic Diseases/etiology/*therapy ; Drainage ; Embolization, Therapeutic ; Enbucrilate/*therapeutic use ; Humans ; Intestinal Fistula/etiology/*therapy ; Liver Abscess/etiology/ultrasonography ; Liver Neoplasms/diagnosis/*surgery ; Male ; Pseudomonas aeruginosa/isolation & purification ; Tomography, X-Ray Computed

Previous studies reported that oxaliplatin is associated with sinusoidal obstruction syndrome. However few reports on oxaliplatin induced liver fibrosis are found in the literature. Furthermore pathogenesis of liver fibrosis is not well known. We report a case of 45-yr-old Korean man in whom liver fibrosis with splenomegaly developed after 12 cycles of oxaliplatin based adjuvant chemotherapy for colon cancer (T4N2M0). Thorough history taking and serological examination revealed no evidence of chronic liver disease. Restaging CT scans demonstrated a good response to chemotherapy. Five month after chemotherapy, he underwent right hepatectomy due to isolated metastatic lesion. The liver parenchyma showed diffuse sinusoidal dilatation and centrilobular vein fibrosis with necrosis without steatosis. We could conclude that splenomegaly was due to perisinusoidal liver fibrosis and liver cell necrosis induced portal hypertension by oxaliplatin. In addition, to investigate the pathogenesis of liver fibrosis, immunohistochemical stains such as CD31 and alpha-smooth muscle actin (alpha-SMA) were conducted with control group. The immunohistochemical stains for CD31 and alpha-SMA were positive along the sinusoidal space in the patient, while negative in the control group. Chemotherapy with oxaliplatin induces liver fibrosis which should be kept in mind as a serious complication.
Actins/metabolism ; Antigens, CD31/metabolism ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Camptothecin/*analogs & derivatives/therapeutic use ; Chemotherapy, Adjuvant ; Colonic Neoplasms/*drug therapy ; Fluorouracil/therapeutic use ; Humans ; Hypertension, Portal/etiology ; Immunohistochemistry ; Leucovorin/therapeutic use ; Liver Cirrhosis/*diagnosis/etiology/pathology ; Liver Neoplasms/secondary/surgery ; Male ; Middle Aged ; Organoplatinum Compounds/*administration & dosage/adverse effects/therapeutic use ; Splenomegaly/*diagnosis/etiology ; Thrombocytopenia/etiology ; Tomography, X-Ray Computed