Adolescent ; Colon, Ascending ; pathology ; Colonic Neoplasms ; pathology ; surgery ; Colonic Polyps ; pathology ; surgery ; Diagnosis, Differential ; Follow-Up Studies ; Ganglioneuroma ; pathology ; surgery ; Humans ; Male

Lipomas are common benign tumors of mature adipose tissue, enclosed by thin fibrous capsules. They can occur on any part of the body; however, peritoneal lipoma is extremely rare. We encountered a case of a 75-year-old man presenting with intermittent abdominal pain, who had undergone right hemicolectomy due to colon cancer. Abdominal computerized tomography showed a well-defined heterogenous fatty mass measuring 4.5x3.5 cm in size, suggesting fat necrosis located in the abdominal wall. Laparotomy showed a very large soft mass of peritoneum. Pathologically, the tumor was diagnosed as lipoma containing fat necrosis located in parietal peritoneum not fixed to any organs, but with small bowel adhesion. Due to its rare etiologic origin and obscure cause of development, we report on a case of lipoma of parietal peritoneum causing abdominal pain.
*Abdominal Pain ; Aged ; Colonic Neoplasms/surgery ; Humans ; Lipoma/*diagnosis/pathology/surgery ; Male ; Peritoneum/*pathology ; Tomography, X-Ray Computed

Local recurrence after endoscopic piecemeal mucosal resection (EPMR) for colorectal tumors is a crucial issue. However, such recurrence is usually detected within one year and cured with additional endoscopic treatment, which makes EPMR acceptable. Herein, we report a rare case of repeatedly recurrent colon cancer involving the appendiceal orifice after EPMR, which was not cured with additional endoscopic treatments. A 67-year-old man was referred to us for endoscopic treatment of a 25 mm cecal tumor spreading to the appendiceal orifice in May 2002. The tumor was resected with EPMR, showing well differentiated intramucosal adenocarcinoma with a positive lateral cut margin of tubular adenoma. Endoscopic surveillance was conducted and the first local recurrence was detected in August 2006. Although we resected it endoscopically, the second local recurrence was found in September 2007 and we removed it with endoscopic resection again. However, the third local recurrence was detected in March 2008. Although endoscopic resection was performed also for the third recurrence, curative resection was not achieved. In February 2009, laparoscopic assisted colectomy was performed and histopathological examination showed well differentiated adenocarcinoma with deep submucosal invasion. This case is important in considering indication for endoscopic resection in colorectal tumors involving the appendiceal orifice.
Adenocarcinoma/*diagnosis/pathology/surgery ; Aged ; Appendiceal Neoplasms/complications ; Colectomy ; Colonic Neoplasms/*diagnosis/pathology/surgery ; Colonoscopy ; Humans ; Intestinal Mucosa/pathology ; Male ; Neoplasm Recurrence, Local ; Recurrence

Although colorectal granular cell tumors (GCTs) are rare, their incidental finding has increased as the use of diagnostic colonoscopy has become more common. Here we describe the case of a 41-yr-old man with a GCT in the descending colon that was detected after a screening colonoscopy. Endoscopic examination revealed a yellowish submucosal tumor, 13x12 mm in diameter, in the descending colon. Endoscopic mucosal resection (EMR) followed by histological examination revealed that the tumor was composed of plump histiocyte-like cells with an abundant granular eosinophilic cytoplasm and small round nuclei. The tumor cells expressed S-100 protein and stained with periodic acid-Schiff, but were negative for desmin and cytokeratin. The resected tumor was diagnosed as a GCT. Colonoscopists should consider the possibility of GCT in the differential diagnosis of yellowish submucosal tumors of the colon. In such patients, EMR seems to be a feasible and safe approach for diagnosis and treatment.
Adult ; *Colon, Descending/pathology ; Colonic Neoplasms/diagnosis/*pathology/surgery ; Colonoscopy ; Diagnosis, Differential ; Granular Cell Tumor/diagnosis/*pathology/surgery ; Humans ; Male ; S100 Proteins/metabolism

Adenocarcinoma ; complications ; pathology ; surgery ; Aged ; Colectomy ; methods ; Colonic Neoplasms ; complications ; pathology ; Diagnosis, Differential ; Female ; Hepatectomy ; methods ; Humans ; Liver ; pathology ; surgery ; Liver Diseases ; complications ; pathology ; surgery ; Necrosis

Post-polypectomy surveillance has become a major indication for colonoscopy as a result of increased use of screening colonoscopy in Korea. However, because the medical resource is limited, and the first screening colonoscopy produces the greatest effect on reducing the incidence and mortality of colorectal cancer, there is a need to increase the efficiency of postpolypectomy surveillance. In the present report, a careful analytic approach was used to address all available evidences to delineate the predictors for advanced neoplasia at surveillance colonoscopy. Based on the results of review of the evidences, we elucidated the high risk findings of the index colonoscopy as follows: 1) 3 or more adenomas, 2) any adenoma larger than 10 mm, 3) any tubulovillous or villous adenoma, 4) any adenoma with high-grade dysplasia, and 5) any serrated polyps larger than 10 mm. In patients without any high-risk findings at the index colonoscopy, surveillance colonoscopy should be performed five years after index colonoscopy. In patients with one or more high risk findings, surveillance colonoscopy should be performed three years after polypectomy. However, the surveillance interval can be shortened considering the quality of the index colonoscopy, the completeness of polyp removal, the patient's general condition, and family and medical history. This practical guideline cannot totally take the place of clinical judgments made by practitioners and should be revised and supplemented in the future as new evidence becomes available.
Adenoma/*diagnosis/surgery ; Adenoma, Villous/diagnosis/surgery ; Colonic Polyps/pathology/*surgery ; *Colonoscopy ; Colorectal Neoplasms/*diagnosis/surgery ; Databases, Factual ; Humans ; Republic of Korea ; Risk Factors ; Time Factors

Multiple primary malignancy was reported firstly by Billroth in 1889. Recently, multiple primary malignancies are considered to increase due to improved survival rate of cancer patients, advanced diagnostic tools, and increased use of chemotherapy and radiotherapy. In Korea, several cases of triple primary malignancies were reported. However, four primary malignancies in gastro-intestinal tract was rarely reported. Recently, we experienced a 70 year-old male who was diagnosed with metachronous four primary malignancies in rectum, ascending colon, stomach, and ampulla of Vater. We report this rare case of metachronous four primary malignancies with a review of literature.
Adenocarcinoma/*diagnosis/pathology/surgery ; Adenocarcinoma, Mucinous/diagnosis/surgery ; Aged ; Ampulla of Vater/*pathology ; Colonic Neoplasms/diagnosis/surgery ; Common Bile Duct Neoplasms/*diagnosis/pathology/surgery ; Gastrointestinal Neoplasms/*diagnosis/pathology/radiography ; Humans ; Male ; Neoplasms, Second Primary/*diagnosis/pathology ; Rectal Neoplasms/diagnosis/surgery ; Stomach Neoplasms/diagnosis/pathology/surgery ; Tomography, X-Ray Computed

Restorative proctocolectomy with ileal pouch-anal anastomosis is one of the surgical treatments of choice for patients with familial adenomatous polyposis. Although the risk of cancer developing in an ileal pouch is not yet clear, a few cases of adenocarcinoma arising in an ileal pouch have been reported. We report a case of adenocarcinoma in ileal pouch after proctocolectomy with ileal pouch-anal anastomosis. A 56-yr-old woman was diagnosed as having familial adenomatous polyposis. Total colectomy with ileorectal anastomosis was performed. Six years later, she underwent completion-proctectomy with ileal J pouch-anal anastomosis including anorectal mucosectomy for rectal cancer. After 7 yr, she presented with anal spotting. Endoscopic biopsies revealed adenocarcinoma at the ileal pouch. Resection of the ileal pouch and permanent ileostomy were performed. The risk of cancer in an ileal pouch and its prevention with regular surveillance must be emphasized.
Adenocarcinoma/*diagnosis/etiology/pathology ; Adenomatous Polyposis Coli/complications/diagnosis/*surgery ; Colonic Pouches/*pathology ; Colorectal Neoplasms/*diagnosis/etiology/pathology ; Female ; Humans ; Middle Aged ; *Proctocolectomy, Restorative ; Tomography, X-Ray Computed

No abstract available.
Antigens, CD20/metabolism ; Colonic Neoplasms/*diagnosis/pathology/surgery ; Colonoscopy ; Humans ; Lymphoma, B-Cell, Marginal Zone/*diagnosis/pathology/surgery ; Male ; Middle Aged ; Proto-Oncogene Proteins c-bcl-2/metabolism

Metastasis to the primary thyroid carcinoma is extremely rare. We report here a case of colonic adenocarcinoma metastasis to medullary thyroid carcinoma in a 53-yr old man with a history of colon cancer. He showed a nodular lesion, suggesting malignancy in the thyroid gland, in a follow-up examination after colon cancer surgery. Fine needle aspiration biopsy (FNAB) of the thyroid gland showed tumor cell clusters, which was suspected to be medullary thyroid carcinoma (MTC). The patient underwent a total thyroidectomy. Using several specific immunohistochemical stains, the patient was diagnosed with colonic adenocarcinoma metastasis to MTC. To the best of our knowledge, the present patient is the first case of colonic adenocarcinoma metastasizing to MTC. Although tumor-tumor metastasis to primary thyroid carcinoma is very rare, we still should consider metastasis to the thyroid gland, when a patient with a history of other malignancy presents with a new thyroid finding.
Adenocarcinoma/pathology/surgery ; Biopsy, Fine-Needle ; Carcinoma, Medullary/diagnosis/radiography/*secondary ; Colonic Neoplasms/*pathology/surgery ; Humans ; Male ; Middle Aged ; Neoplasms, Second Primary/*diagnosis ; Thyroid Gland/pathology ; Thyroid Neoplasms/diagnosis/radiography/*secondary ; Thyroid Nodule/diagnosis