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Query: UMLS:C0699790 (colon cancer)
 28,837 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

There is a spectrum of endometrial stromal neoplasms which extends from borderline benign to low-grade malignant. These have a definite tendency to metastasize. Proper diagnosis is important because they have an excellent prognosis with long-term survival even with evidence of recurrence or metastases. Aggressive treatment is mandatory. This represents the first report of the radiographic spectrum of the entity as seen in 7 cases. The patients are usually in middle age and present with vaginal bleeding. Not previously stressed is the presence of diarrhea in many of them. Prior uterine surgery even for "fibroids" should be viewed with suspicion. A pelvic mass was usually seen on plain films, intervenous pyelogram (IVP), or barium enema (BE). Ultrasound showed a mixed cystic configuration of the tumors, whereas computed tomography (CT) demonstrated a definitely solid mass. The lesions simulated primary carcinoma of the colon, retroperitoneal tumor, and pelvic inflammatory disease. Metastases to the lung and the bone were also identified.
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PMID:Endometrial stromal tumors, their varied radiographic patterns. 723 41

Intestinal involvement of endometriosis requiring treatment is 5%, but only 0.7% needs intestinal resection. The authors report two cases of colic endometriosis and illustrate problems in diagnosis and management of this disease. Usually intestinal endometriosis takes the form of asymptomatic superficial serosal implants, encountered incidentally at laparotomy for other diseases, but it can also result in obstruction and occasionally bleeding. Any premenopausal woman with episodic bowel symptoms associated with gynecologic complaints should be suspected of endometriosis of the colon. Diagnosis can be suspected by double-contrast enema examination and colonoscopy with biopsy, although neither is likely to establish the diagnosis with certainty. In fact there are no radiologic or diagnostic imaging findings that are specific for endometriosis and unequivocal diagnosis requires microscopic examination. Differential diagnosis includes primary carcinoma of the colon and other benign diseases (pelvic inflammatory disease, diverticulitis, inflammatory bowel disease, pelvic abscess, polyps, etc.). The treatment of patients with uncomplicated, but symptomatic gastrointestinal endometriosis depends on the age of the patient and her childbearing attitude. Resection of the affected bowel should be done in patient with pain, bleeding, changes in bowel habits and intestinal obstruction and it is necessary to avoid neglecting a malignant tumor. Total abdominal hysterectomy and bilateral oophorectomy is the treatment of choice in the perimenopausal and menopausal women. In symptomatic women desiring children the only resection of involved colon may be appropriate treatment. In these subjects hormonal therapy can be useful.
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PMID:[Endometriosis of the large intestine. A report of 2 clinical cases]. 825 7

Purposes: The Montefiore Medical Center (MMC) experience with Krukenberg tumors (gastrointestinal cancer metastatic to the ovary) was reviewed 1) in order to determine whether it could be used to make clinical management recommendations, eg, differences in treatment based on menopausal status, secondary debulking, prophylactic oophorectomy; 2) to compare the MMC experience to the reported literature, since one of our patients survived 1912 months beyond the generally accepted mean of this rare tumor.Methods: 1) Prospective study from January 1985-April 1996 of 5 patients followed at MMC with a diagnosis of gastrointestinal (GI) cancer metastatic to the ovary; 2) retrospective chart review of all female patients admitted to MMC with a diagnosis of GI cancer during the same time period; 3) computerized literature review from 1966 to 1996.Results: Five patients were followed prospectively. Retrospective chart review identified 1,016 female patients admitted with gastric (231) or colon (785) cancer, 2 additional cases of Krukenberg tumor were identified. Of the 7 patients with Krukenberg tumors the primary tumor was colon in 5 and gastric in 2. The average age at presentation was 49.3 years (range 35-80); 5 were premenopausal, 2 were postmenopausal, and 2 (28.6%) were postpartum. The average survival of these 7 patients was 12.3 months (range 4 days to 26 months). The 5 patients who had ovarian metastases removed at first laparotomy survived an average of 10.8 months. The 1 patient who had a secondary debulking survived longest (26 months). The 1 patient who had no surgery lived 6 months. These numbers are not statistically significant, but do suggest that further study is warranted. Including the prospectively studied patients, 1,021 patients were evaluated. Seven of 1,021 (0.7%) had Krukenberg tumors. Two of 11 (18.2%) premenopausal gastric cancer patients had a Krukenberg tumor, whereas none of the 222 postmenopausal gastric cancer patients did. Similarly, 3 of 41 (7.3%) premenopausal colon cancer patients had a Krukenberg tumor compared to 2 of 747 (0.3%) postmenopausal colon cancer patients. This difference in menopausal status is significant by Fisher's Exact test (P <.001). Nineteen patients underwent oophorectomy at the time of primary colon cancer surgery: 11 had normal or atrophic ovaries, 2 thecomas, 4 simple cysts, and 2 Krukenberg tumors. Three of 19 (15.8%) were premenopausal.Conclusions: Review of the literature has identified a number of diagnostic and management issues that appear to impact on survival. These include timing of definitive diagnosis of Krukenberg tumors, ie, before, after, or at the same time as diagnosis of the GI primary tumor; menopausal status; concurrent pregnancy; role of debulking; prophylactic oophorectomy. The prognosis worsens when the primary tumor is identified after the metastasis to the ovary is discovered. Krukenberg tumor is more common in premenopausal women than in postmenopausal women. The number of patients with Krukenberg tumors discovered postpartum in our study was significantly increased compared to the other series in the literature. The number of patients who received prophylactic oophorectomy or secondary debulking in our study was inadequate to draw conclusions regarding a benefit of these procedures. However, a benefit may be suggested for debulking, as survival appears to be increased. More importantly, there may be a role for prophylactic oophorectomies in both pre- and postmenopausal patients, as this would eliminate the need for a repeat laparotomy. A randomized trial is needed to evaluate the role of prophylactic oophorectomy and debulking. Since the clinical and pathologic details in the literature vary widely, it is extremely difficult to compare studies, particularly the treatment and survival of patients with Krukenberg tumors. Reports should include age, site of GI primary, time from diagnosis of primary to ovarian metastasis, and overall survival as well as survival from the time of diagnosis and treatment of the Krukenberg. We wish to alert the clinician that persistent GI symptoms always warrant investigation. Pelvic inflammatory disease, pregnancy, and postpartum endometritis may mask the GI symptoms. Delays in diagnosis should be avoided. During surgery, the gynecologic surgeon must do a complete upper abdominal exploration, and the general surgeon must do a complete pelvic evaluation. Since Krukenberg tumors are rare, a national registry should be started to gather information on these patients; this might lead to better diagnosis and treatment.
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PMID:Management of Krukenberg tumors: an 11-year experience and review of the literature. 1083 92

Xanthogranulomatous inflammation (XGI) is a well-recognized disease process in the kidney and gallbladder. However, involvement of the colon is extremely rare. On the other hand, it is important to recognize that clinically and radiologically, XGI could be misinterpreted as an infiltrative cancer. Recently the authors encountered a 38-year-old woman who presented with a submucosal mass-like lesion in the sigmoid colon. Radiological imaging had also suggested a possibility of sigmoid colon cancer as well as pelvic inflammatory disease or actinomycosis. Although XGI may rarely occur in the large bowel, it should be considered in patients with a colonic submucosal mass. In addition, it is important to make an intraoperative pathological diagnosis in order to avoid any excessive operative stress.
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PMID:Xanthogranulomatous inflammation presenting as a submucosal mass of the sigmoid colon. 1598 21

Besides the contraceptive effect of the various hormonal contraceptives, it is intended to demonstrate the non-contraceptive health benefits for treatment and prevention of bleeding problems, menstruation-related pain and other disorders, such as premenstrual syndrome and signs of androgenization. The effectiveness can be improved by choosing the proper progestogen with antiandrogenic action. Treatment but also prevention can be achieved with hormonal contraceptives in benign proliferative diseases of women, such as ovarian cysts, endometriosis, adenomyosis, endometrial hyperplasia, myoma and benign breast disease. Furthermore, hormonal contraceptives such as estrogen/progestogen combinations reduce pelvic inflammatory disease, rheumatoid arthritis, asthma symptoms and preserve bone density. In addition, a major impact in oncological prevention seems to be possible for ovarian, endometrial and colon cancer and these positive preventive effects seem to persist also after discontinuation of hormonal contraceptives. In addition, practical concepts for hormonal contraceptive selection will be outlined.
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PMID:Non-contraceptive benefits of hormonal contraceptives. 2082 49

Introduction: Abdominal actinomycosis is a rare granulomatous inflammatory disease caused by a Gram-positive anaerobic bacterium Actinomyces israelii, manifesting as inflammatory mass, or abscess formation. Evolution is slow and steady in inflammatory contiguous extension without limit organ that lends itself to confusion with abdominal malignancies. Methods: We performed a retrospective study on the patients with abdominal actinomycosis operated in the First Surgical Clinic, "St. Spiridon" University Hospital Iasi; between 1980 - 2018 there have been 13 cases (4 men and 9 women) with a mean age 44.07 years admitted for abdominal tumors (7 cases) or pelvic inflammatory disease (6 cases). Results: We identified as predisposing factors: IUD maintained over 10 years (6 cases), foreign bodies 2 cases (a toothpick probably perforated colon, gallstones lost in peritoneum), diabetes (3 cases), immunodepression. All cases were operated by laparotomy (9 cases) or laparoscopic approach (4 cases). We describe five of these cases of actinomycosis that had been mimicking a colon cancer: ileo - cecal - 3 cases, transverse colon - one case and on the greater omentum - one case, followed by specific treatment with penicillin, with good evolution. Conclusions: Abdominal actinomycosis should always be included in the differential diagnosis of abdominal tumors. Preoperative diagnosis, difficult but possible, can avoid surgery. Treatment with antibiotics is necessary for the healing of the disease. Postoperative control is mandatory, with relapses possible.
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PMID:Abdominal Actinomycosis Mimicking Colon Cancer. 3106 Jun 58