Presentation
The authors present the case of a 17-year-old girl with tuberous sclerosis (TS) who presented with symptoms of intussusception. [ncbi.nlm.nih.gov]
Entire Body System
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Weight Loss
We describe a 13-year-old girl with short stature and delayed puberty who presented with hematochezia and recurrent abdominal pain for 1 year, and progressive weight loss for 6 months. Per rectal examination was suggestive of a rectal mass. [ncbi.nlm.nih.gov]
As the cancer grows, it may spread, producing systemic symptoms that affect your whole body, such as fatigue and weight loss. [cancercenter.com]
Unexplained weight loss. Causes No cancer grows overnight. Carcinoma rectum is also a slow process. In its initial stage or the precancerous stage, it is known as polyps. [medanta.org]
If there are symptoms, the following may indicate colon cancer: Abdominal pain and tenderness in the lower abdomen Blood in the stool Diarrhea, constipation, or other change in bowel habits Narrow stools Weight loss with no known reason Exams and Tests [owensborohealthse3.adam.com]
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Fatigue
If the lungs are affected, symptoms may include shortness of breath, difficulty breathing, coughing, pain and/or fatigue. [cancercenter.com]
There were significant differences in favor of SC for grade 3 AE: radiation dermatitis (0% vs 5.6%, P 0.003), proctitis (0% vs 3.7% P 0.016), nausea (0% vs 3.1%, P 0.029), fatigue (0% vs 3.7%, P 0.016) and grade 3/4 diarrhea rates (1.3% vs 14.2% P 0.001 [ncbi.nlm.nih.gov]
Anemia, fatigue, and at times loss of breath. Incomplete secretion of stool. Unexplained weight loss. Causes No cancer grows overnight. Carcinoma rectum is also a slow process. In its initial stage or the precancerous stage, it is known as polyps. [medanta.org]
The rectal cancer symptoms that may require attention are fatigue from anaemia and the feeling of tenesmus (wanting to open the bowels when there is no stool there can be particularly distressing, especially when it is painful). [myvmc.com]
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Pallor
Symptoms and Types In addition to the black, tarry appearance of the feces, ferrets with melena may demonstrate some of the following: Anorexia Dehydration Weight loss Hypersalivation Vomiting Regurgitation Pallor of the mucous membranes Poor haircoat [petmd.com]
She had marked pallor and she was obese. On per-abdomen examination, the abdomen was soft and a Pfannenstiel scar of previous surgery was seen. On per vaginal examination (PV), a fixed mass on the posterior portion of the vault was noted. [ispub.com]
Signs Pallor Abdominal mass PR mass Jaundice Nodular liver Ascites Rectal metastasis travel along portal drainage to liver via superior rectal vein as well as systemic drainage to lung via middle inferior rectal veins. 12. [de.slideshare.net]
The hydration status of the patient was adequate, she had mild pallor and abdominal examination was essentially normal. [wjso.biomedcentral.com]
Gastrointestinal
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Constipation
A 36-year-old female presented with a 1-year history of constipation and bleeding per rectum. Colonoscopy revealed an ulcerated mass 2 cm above the anal verge. After multiple biopsies an abdomino-perineal resection was performed for the rectal mass. [ncbi.nlm.nih.gov]
Her complaints on application were epigastric pain, burning, and constipation. [hindawi.com]
Common local symptoms include: Constipation Diarrhea Alternating diarrhea and constipation, or other changes in bowel habits Rectal bleeding or blood in the stool Abdominal bloating, cramps or discomfort A feeling that the bowel doesn't empty completely [cancercenter.com]
The symptoms of rectal cancer to watch out for include any change in bowel habits such as constipation, narrowing of the stools or diarrhea and any blood in the stools. [annapoliscolon.com]
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Hematochezia
We describe a 13-year-old girl with short stature and delayed puberty who presented with hematochezia and recurrent abdominal pain for 1 year, and progressive weight loss for 6 months. Per rectal examination was suggestive of a rectal mass. [ncbi.nlm.nih.gov]
Clinical signs consist of tenesmus, hematochezia, dyschezia, rectal bleeding unassociated with defecation, and polyp prolapse. Also vomiting, diarrhea and weight loss can occur. Leiomyoma is the second most common benign tumor. [vin.com]
The presence of hematochezia is six-times greater in a LGIB than with a UGIB.[5] Occasionally, a person with a LGIB will not present with any signs of internal bleeding, especially if there is a chronic bleed with ongoing low levels of blood loss. [en.wikipedia.org]
Herein, we report a case of an 82-year-old female who presented with a 2-month history of worsening abdominal pain, hematochezia, and bilateral inguinal lymphadenopathy with right-sided purulent discharge. [karger.com]
The patient applied because of rectal prolapsus and hematochezia to our hospital’s emergency unit and as the examination revealed a prolapsed rectal tumor, an urgent Computerized Tomography (CT) was performed. [digestive-diseases.imedpub.com]
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Blood in Stool
Some changes in bowels habits that may be considered colon cancer signs include: Change in frequency of bowel movements Constipation Change in consistency of stool (loose or watery stools) Blood in stools (either as bright red spots or dark tar-like stools [cancercenter.com]
Some new stool tests look for genetic material from a cancer rather than for blood. Genetic stool tests are done every 3 years. [msdmanuals.com]
Mayo Clinic's approach to rectal cancer care Symptoms Common symptoms include: A change in your bowel habits, such as diarrhea, constipation or more-frequent bowel movements Dark or red blood in stool Mucus in stool Narrow stool Abdominal pain Painful [mayoclinic.org]
As the disease progresses, which can take years, symptoms of rectal cancer include: Blood in stool: This is often bright red versus blood in the stool that's related to cancers that are higher in the colon. [verywellhealth.com]
stools Colicky abdominal pain due to obstruction Rectum (50%) and sigmoid (30%) Hematochezia Stool caliber (pencil-shaped stool) Rectal pain Tenesmus Flatulence with involuntary stool loss Symptoms according to stage of disease Colorectal cancer must [amboss.com]
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Fecal Incontinence
A study on 74 dogs documented a 78% complication rate: permanent fecal incontinence (55%), diarrhea (43%), tenesmus (31%), stricture (22%) and rectal bleeding (11%) were the most common. [vin.com]
WHAT IS FECAL INCONTINENCE? Fecal incontinence (also called anal or bowel incontinence) is the impaired ability to control the passage of gas or stool. This is a common problem, but often not discussed due to embarrassment. [fascrs.org]
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Dyschezia
Clinical signs consist of tenesmus, hematochezia, dyschezia, rectal bleeding unassociated with defecation, and polyp prolapse. Also vomiting, diarrhea and weight loss can occur. Leiomyoma is the second most common benign tumor. [vin.com]
Neurologic
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Neglect
Conclusions: The rarity of RSCLN metastases in ovarian cancer might incline clinicians to neglect the presence of RSCLN enlargement during examinations. [liebertpub.com]
This difference is not surprising given that local excision neglects the substantial risk of spread to regional lymph nodes by T1 rectal cancers. [ncbi.nlm.nih.gov]
Workup
Following pathology confirmation of colorectal cancer as biopsied endoscopically, a metastatic workup is undertaken. [bccancer.bc.ca]
Patients with biopsy proven rectal cancer were included in this study after a workup consisting of sigmoidoscopy/colonoscopy and a contrast enhanced computed tomography (CT) of the abdomen and pelvis. [jgo.amegroups.com]
CT scan Part of routine workup of patients Useful in identifying enlarged pelvic lymph-nodes and metastasis outside the pelvis than the extent or stage of primary tumor Limited utility in small primary cancer Sensitivity 50-80% Specificity 30-80% Ability [de.slideshare.net]
The image below depicts the staging and workup of rectal cancer. Diagnostics. Staging and workup of rectal cancer patients. Signs and symptoms Bleeding is the most common symptom of rectal cancer, occurring in 60% of patients. [emedicine.medscape.com]
X-Ray
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Multiple Colonic Polyps
Although endoscopically diagnosed with multiple colonic polyps, presumed to be hamartomas, and an invasive rectal adenocarcinoma, postoperative pathology findings confirmed the rectal cancer and showed multiple colonic adenomas. [ncbi.nlm.nih.gov]
Proctoscopy
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Rectal Ulcer
Karanjia ND, Rutter KRP (1994) Solitary rectal ulcer and rectal prolapse. Curr Pract Surg 6: 59-64. [digestive-diseases.imedpub.com]
HLA Type
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HLA-A2
Adenocarcinoma Of The Rectum Terminated NCT00081224 Phase 2 capecitabine;celecoxib 48 A Trial Of Vaccination With The Carcinoembryonic Antigen (CEA) Peptide Cap 1-6D With Montanide ISA 51 Adjuvant Or Granulocyte-Macrophage Colony Stimulating Factor (GM-CSF) In HLA-A2 [malacards.org]
Treatment
The increased use of multimodal therapy for the treatment of Stage II and III disease continues. [ncbi.nlm.nih.gov]
Prognosis
The prognosis of IIIA approaches that of IIB etc. This is not yet in widespread use). The advent of the newer chemotherapy agents has made a significant impact on rectal cancer prognosis. [myvmc.com]
Adenocarcinoma of the colon is a virulent disease in children and has a poor prognosis. The reasons for this are explored, and a literature review is included. [ncbi.nlm.nih.gov]
Etiology
This article describes a patient with a large squamous carcinoma of the anus along with a large adenocarcinoma of the rectum, and also discusses a current review of the etiology and treatment of squamous carcinoma of the anus. [ncbi.nlm.nih.gov]
[…] the anal canal (not rectal adenocarcinomas with downward spread) Terminology Also known as perianal adenocarcinoma or perianal gland adenocarcinoma Epidemiology 5% of anorectal malignancies Usually diagnosed in the seventh decade; more common in men Etiology [pathologyoutlines.com]
[…] and chronic cough may also play a role in the etiology [2]. [digestive-diseases.imedpub.com]
Though its etiology and pathogenesis remains unclear, it has been associated with chronic inflammation and infections. [karger.com]
Etiology Predisposing factors Colorectal adenomas (see colonic polyps) Family history Hereditary syndromes Familial adenomatous polyposis: 100% risk by age 40 Hereditary nonpolyposis colorectal cancer (HNPCC): 80% progress to CRC. [amboss.com]
Epidemiology
LIMITATIONS: The study was limited by its retrospective nature and the information available in the Surveillance, Epidemiology, and End Results database. [ncbi.nlm.nih.gov]
[6] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]
Pinto, J. (2011) Rectal Cancer Epidemiology. u: [ur.] Rectal Cancer - A Multidisciplinary Approach to Management. Dr. [scindeks.ceon.rs]
Increasing incidence of rectal cancer in patients aged younger than 40 years: an analysis of the surveillance, epidemiology, and end results database. Cancer 2010; 116: 4354-9. 4. [jpma.org.pk]
Definition / general Rare adenocarcinoma that primarily involves the anal canal (not rectal adenocarcinomas with downward spread) Terminology Also known as perianal adenocarcinoma or perianal gland adenocarcinoma Epidemiology 5% of anorectal malignancies [pathologyoutlines.com]
Pathophysiology
Collision tumors have an idiopathic pathophysiology and in fact "accidental meeting" is accepted by many authors. [ncbi.nlm.nih.gov]
The kidney: Physiology and pathophysiology, New York: Ravan Press, 1491-1525 [ PM ] [ EČ ][ GS ] Kraut, J.A., Madias, N.E. (2010) Metabolic acidosis: pathophysiology, diagnosis and management. Nature reviews. [scindeks.ceon.rs]
Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 126. National Cancer Institute website. [owensborohealthse3.adam.com]
Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 126. Lawler M, Johnston B, Van Schaeybroeck S, et al. Colorectal cancer. [medlineplus.gov]
Prevention
The mucin, in turn, creates a barrier that may, in fact, prevent chemotherapy medications from effectively penetrating cancer cells. In short, the chemo may not be able to get where it needs to be. [verywellhealth.com]
[…] undergoing colorectal surgery despite routine efforts to prevent them. [centerwatch.com]
CAN RECTAL CANCER BE PREVENTED? Rectal cancer is preventable. Nearly all rectal cancer develops from rectal polyps, which are benign growths on the rectal wall. [fascrs.org]
Prevention If there is a family history of developing such cancer, one should get regular screening tests to protect themselves from the disease. Other prevention measures include: Quitting smoking. Limiting alcohol consumption. [medanta.org]