Presentation
Abstract The early and precise diagnosis of linitis plastica-type tumours of the rectum and anal canal is difficult because of their insidious presentation and anaplastic nature. [ncbi.nlm.nih.gov]
Entire Body System
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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]
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]
Side effects include fatigue, nausea, increased risk of infection, anemia, and peripheral neuropathy (tingling or numbness of the fingers and toes). [emedicinehealth.com]
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Perineal Pain
Severe pelvic and perineal pain may be improved by a variety of nerve block procedures. Locally advanced colorectal carcinoma En bloc resection of the cancer with adherent viscera and portions of the abdominal wall is performed. [surgwiki.com]
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Lymphedema of the Lower Extremity
We report a case of a patient with adenocarcinoma of the rectum with inflammatory metastases to the skin who was treated with radiation therapy and subsequently developed lymphatic obstruction with resultant extensive lymphedema of the lower extremities [ncbi.nlm.nih.gov]
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Hyperthermia
PURPOSE: The aim of this study is to evaluate long-term results of preoperative hyperthermia combined with chemotherapy and irradiation (HCR therapy) in patients with carcinoma of the rectum. [ncbi.nlm.nih.gov]
Gastrointestinal
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Abdominal Pain
Herein, we report a 15-year-old boy who presented with rectal bleeding, lower abdominal pain, and diarrhea. His physical examination revealed tender abdomen with hepatomegaly. A hard mass was palpated by digital rectal examination. [ncbi.nlm.nih.gov]
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 main clinical manifestations of disease include changes in bowel habits (diarrhea or constipation), abdominal pain, blood in the stool, anemia and weight loss. [www2.keelpno.gr]
pain Unexplained weight loss Although these symptoms may be caused by other, less serious conditions, such as hemorrhoids, ulcers and Crohn's disease, they should be discussed with a doctor. [cancercenter.com]
pain or a cramping pain in your lower stomach Bloating or full feeling Change in appetite Weight loss without dieting Fatigue These symptoms do not always mean you have rectal cancer. [mdanderson.org]
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Rectal Bleeding
This case highlights the need for awareness of colorectal carcinomas and their invasive nature in the differential diagnosis of rectal bleeding and diarrhea in adolescents. [ncbi.nlm.nih.gov]
It is moreover one of the varieties to which a great deal of attention has been devoted in an attempt to control cancer, since a change in bowel habit and rectal bleeding have been emphasized repeatedly in the past decade as the prime warning symptoms [nejm.org]
If early-stage colorectal cancer does cause symptoms, they most often include: Rectal bleeding, either bright or dark red in color Narrow stools Tenesmus, which is the feeling that you have to empty your bowel but nothing passes Anemia caused by iron [cancercenter.com]
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Rectal Mass
The lesions appeared as indurated, ulcerated rectal masses that resembled carcinoma on endoscopic examination. Deep mucosal biopsy results demonstrated no malignancy and barium sulfate crystals in tissue macrophages. [ncbi.nlm.nih.gov]
Figure 1 Rectal contrast was extravasating outside the bowel lumen and filling the teratoma consistent with a fistulous communication Figure 2 Colonoscopy view of the rectal mass eroding into the lumen Figure 3 Colonoscopy view of the rectal mass eroding [jgo.amegroups.com]
Abdominal CT scan showed an irregular rectal mass with bulky pelvic and retroperitoneal adenopathy. Colonoscopy revealed one large circumferential nonobstructing lesion in the rectum. [karger.com]
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Nausea
Patient 5 A 67-year-old man with a history of stage-3 left-sided RCC who had undergone left nephrectomy 9 years earlier presented with acute onset of abdominal distention, nausea, vomiting, and hematochezia. [cureus.com]
Symptoms of bowel obstruction - nausea, vomiting. Weight loss. Pathogenesis - see pathogenesis of colorectal carcinoma. Clinical - serum: CEA elevated. [1] CA19-9 elevated. [librepathology.org]
If the liver is affected, symptoms may include nausea, fatigue, swelling of the feet and hands, increased abdominal girth and/or jaundice. [cancercenter.com]
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Hematochezia
[…] and acute anemia None [2] 3 Not defined 28 years Immunotherapy with interleukin-2 and interferon alpha Hematochezia and acute anemia Brain, duodenum, lungs [3] 4 Stage 3 7 years None Anal mass Lung, small bowel mesentery [4] 5 Stage 3 9 years None Hematochezia [cureus.com]
A 40-year-old woman with hematochezia and change in bowel habits was studied. The main laboratory finding was a mild anemia. A barium enema and a proctoscopy revealed a rectal neoplasm at eight cm from the anal verge. [ncbi.nlm.nih.gov]
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]
She had a three month history of pelvic pain, hematochezia and difficulty defecating. A CT scan revealed a necrotic colorectal mass most consistent with malignancy, which was seen eroding into a large teratoma within the pelvis. [jgo.amegroups.com]
The symptoms gradually worsened and the patient experienced hematochezia, anorexia and weight loss of 10% body weight. The patient had a history of smoking and alcohol consumption. [spandidos-publications.com]
Jaw & Teeth
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Tongue Ulcer
Other asymptomatic metastatic lesions were discovered only after the histology report suggested that the tongue ulcer biopsy was metastatic in origin. [ncbi.nlm.nih.gov]
Musculoskeletal
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Decrease in Height
Major LARS increased significantly with decreasing tumour height from one fifth in sigmoid carcinoma to 90% in low rectum carcinoma. [ncbi.nlm.nih.gov]
Neurologic
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Meningism
The case is described of a middle-aged man whose rectal carcinoma presented with meningitis, due to a fistula into the spinal theca. [ncbi.nlm.nih.gov]
Workup
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 [slideshare.net]
Eleven patients had no further workup aside from the routine evaluation. Fifty-six patients were treated with curative intent. [jamanetwork.com]
One (8.3%) of the patients had defaulted treatment and not completed full metastasis workup. The most common site of metastasis was bone (five patients). It is the same with adults [17]. [ejo.eg.net]
Also, these data may allow flexibility in clinical workup and molecular analysis by potentially using DNA samples from primary and/or metastatic sites in rectal adenocarcinoma. [archivesofpathology.org]
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]
Microbiology
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Listeria Monocytogenes
A 26-year-old male homosexual initially presented with Listeria monocytogenes sepsis and a small cell carcinoma of the rectum. [ncbi.nlm.nih.gov]
Read EJ, Orenstein JM, Chorba TL, Schwartz AM, Simon GL, et al. (1985) Listeria monocytogenes sepsis and small cell carcinoma of the rectum: an unusual presentation of the acquired immunodeficiency syndrome. Am J Clin Pathol 83:385–389. [colorectal-cancer.imedpub.com]
Treatment
Local treatment seems a much more desirable form of therapy. [ncbi.nlm.nih.gov]
Prognosis
Rectal neuroendocrine carcinoma is rare with poor prognosis. [ncbi.nlm.nih.gov]
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]
Etiology
Though its etiology and pathogenesis remains unclear, it has been associated with chronic inflammation and infections. [karger.com]
The etiology of colorectal SCC is still unclear; however, chronic inflammation (infectious or autoimmune) may play a pivotal role. [jgo.amegroups.com]
Etiological agents Environmental & dietary factors Chemical carcinogenesis. [slideshare.net]
Discussion The etiology of extrapulmonary small cell carcinoma remains unknown. [spandidos-publications.com]
[…] hepatocellular carcinoma irrespective of the baseline ECOG performance status (0-2), tumor burden (w/ or without macrovascular invasion &/or extrahepatic spread), presence or absence of either lung or lymph node metastasis, tumor stage, prior therapy & disease etiology [specialty.mims.com]
Epidemiology
A weaker association between S japonicum infection and colorectal neoplasia has been proposed, although reports are limited to case reports, a case series, and epidemiologic studies. [ncbi.nlm.nih.gov]
The objective of this study is to compare the overall survival (OS), cancer specific survival (CSS) and prognostic factors of RSCC to those of rectal adenocarcinoma (RAC) using the Surveillance, Epidemiology, and End Results (SEER) registry. [ascopubs.org]
The data extrapolated from Survey of Epidemiology and End Results (SEER) reported several patient characteristics associated with colorectal NEC (1367 patients) as compared to colorectal adenocarcinoma. [colorectal-cancer.imedpub.com]
Pathophysiology
Although rectal SCC is a well-established entity, the pathophysiology and risk factors remain largely unknown. Diagnostic criteria are based on the widely-accepted Williams exclusion criteria. [jgo.amegroups.com]
Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 126. National Cancer Institute website. [mountsinai.org]
Almost four different pathophysiological theories regarding the origin of squamous cell carcinoma of the colorectum have been proposed in the literature so far. [jmedicalcasereports.biomedcentral.com]
Univariate sub-group analyses showed that the treatment effect for surgery alone vs preoperative radiotherapy plus surgery was not significant in patients whose cancer (TNM stage I to IV) was located between 10.1 cm and 15 cm from the anal verge. [5] Pathophysiology [emedicine.medscape.com]
Prevention
CONCLUSION: The present results suggested that pre-operative intermediate-dose radiotherapy is effective in preventing pelvic recurrence in rectal cancer patients with acceptable toxicities. [ncbi.nlm.nih.gov]
Prevention The guidelines for the prevention and early detection of the disease in the general population include colonoscopy from the age of 50 years and thereafter every 10 years, or sigmoidoscopy every 5 years. [www2.keelpno.gr]
We believe that more multicentric studies are needed to develop a screening tool for the prevention of SCC of the colon. Statement of Ethics The authors have no ethical disclosures. Disclosure Statement There are no conflicts of interest. [karger.com]