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]
Patient Stage of renal cell carcinoma at the time of diagnosis Time after initial diagnosis Chemotherapy/immunotherapy prior to presentation with rectal metastasis Symptoms at the time of presentation with rectal metastasis Metastatic status at the time [cureus.com]
Entire Body System
- Fatigue
If the lungs are affected, symptoms may include shortness of breath, difficulty breathing, coughing, pain and/or fatigue. [cancercenter.com]
Side effects include fatigue, nausea, increased risk of infection, anemia, and peripheral neuropathy (tingling or numbness of the fingers and toes). [emedicinehealth.com]
- Perineal Pain
Anal and perineal pain, initially on defecation and later continuous, occurs with low rectal cancer invading the anal sphincters. Sacral pain, sometimes radiating down the legs, results from tumour invasion of the sacrum and sacral nerve plexus. [surgwiki.com]
- 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]
- 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
- 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]
For instance: If the bones are affected, symptoms may include pain, fractures, constipation and/or high calcium levels. If the lungs are affected, symptoms may include shortness of breath, difficulty breathing, coughing, pain and/or fatigue. [cancercenter.com]
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]
Patients undergoing an LAR may experience lower abdominal pain after the operation. Less common complications related to surgery include bleeding, infection and temporary difficulty with emptying the bladder. [texasoncology.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]
- Rectal Bleeding
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]
bleeding Abdominal pain, bloating or cramps A persistent feeling that you cannot completely empty your bowels Rectal cancer symptoms The symptoms of rectal cancer may be similar to those of other bowel diseases, such as ulcerative colitis or Crohn's [cancercenter.com]
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]
- 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]
On digital rectal examination a palpable mass was noted. The colonoscopy confirmed the presence of a partially obstructing ulcerated rectal mass ( Fig 2 ) which was biopsied. The colonoscopy impression was consistent with primary rectal carcinoma. [jgo.amegroups.com]
Hypoechoic rectal mass extending into the muscularis propria. Fig. 3. Enlarged perirectal lymph node. Fig. 4. H&E-stained squamous cell carcinoma arising from the rectal mucosa. Discussion SCC is one of the rarest forms of rectal cancer. [karger.com]
- Nausea
If the liver is affected, symptoms may include nausea, fatigue, swelling of the feet and hands, increased abdominal girth and/or jaundice. [cancercenter.com]
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]
- 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
- Tongue Ulcer
The patient presented with an ulcer in the tongue three years after undergoing an anterior resection for a Dukes C carcinoma of the rectum. [ncbi.nlm.nih.gov]
Neurologic
- 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]
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
- 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
However, no significant differences were observed in the postoperative prognosis for cases with no lymph node metastasis and/or with tumors limited to the muscularis propria between these two groups. [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]
[…] 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]
Etiological agents Environmental & dietary factors Chemical carcinogenesis. [slideshare.net]
"On the etiology of anal squamous carcinoma". Danish Medical Bulletin. 49 (3): 194–209. PMID 12238281. ^ Frisch M, Glimelius B, van den Brule AJ, et al. (November 1997). "Sexually transmitted infection as a cause of anal cancer". N. Engl. J. [en.wikipedia.org]
Epidemiology
METHODS: An analysis of the Surveillance, Epidemiology, and End Results (SEER)-registered database was conducted of patients presenting with mucinous rectal cancer between 2004 and 2011. [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]
Službeni glasnik RS, br. 1106914 Abreu, M.H., Matos, E., Pocas, F.C., Rocha, R., Pinto, J. (2011) Rectal Cancer Epidemiology. u: [ur.] Rectal Cancer - A Multidisciplinary Approach to Management. Dr. [scindeks.ceon.rs]
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]
Can colon cancer be prevented? Colon cancer is preventable. The most important step towards preventing colon cancer is getting a screening test. Any abnormal screening test should be followed by a colonoscopy. [ccrcfw.com]
Statistics BC Canada Can I help to prevent it? Research shows that about 50% of colorectal cancers can be prevented by following a healthy lifestyle. [bccancer.bc.ca]
Accordingly, preventing local recurrence is one of the main treatment goals with rectal cancer. [medicinenet.com]