To date healthy male, 51, was admitted to hospital for abdominal pain and body weight loss of 10 kilograms within 6 weeks. Soon after admittance the patient's condition deteriorated and he was operated on for ileus. The Hartman's resection of sigmoid colon was the option for obstructive tumour. First signs of stoma complications were being reported from day 16 on and soon overt multiple fistula formation was diagnosed. Systemic and site treatment was involved (5-ASA, steroids). Nevertheless, the patient's condition was not improving within following 8 months, which led to succeeding hospitalisations, finally, infliximab therapy was the successful one. On patient's demand the hind-gut reconstruction was performed. Partial resection of involved bowel and stoma followed by end-to-end hind-gut reconstruction was the option. Up to now (i.e. 8 months after the reconstruction) the patient remains in good condition.
The study presented a rare case of inflammatory myofibroblastic tumor (IMT) in a 57-year old male patient who presented with recurrent abdominal pain. He was diagnosed to have a tumor of the small intestine within ileal intussusception, demonstrated by CT enterography. The patient underwent surgery to remove the tumor with a margin of healthy tissue. Histopathological and immunohistochemical examination results enabled to diagnose IMT. IMT is a rare tumor that occurs mainly in children and young adults. Its etiology remains to be fully understood. Due to the differentiated histology it can be found in many organs and soft tissues, being responsible for different, non-specific clinical and radiological symptoms. Due to the rarity of this tumor a clear treatment protocol has not yet been established. However, given the tendency to recur with possible distant metastases an important element of treatment consists in long-term clinical patient observation.
Patients with colorectal carcinoma showed statistically significant lower values of transferrin saturation, total iron binding capacity and serum iron level as compared with control group, while the level of ferritin and the size of labile iron pool in carcinoma patients were higher, although this difference was not statistically significant. Our observations are in favour of the hypothesis which suggests that changes in iron metabolism restrict iron availability for tumour cells and as consequence, slow their growth.
There is always a certain rate of recurrence after radical treatment for cancer and to get on it an early detection of disease set back is crucial.Material and methods. Medical data of patients operated on for primarily detected colorectal cancer in years 1993-2002 was retrospectively reviewed. Usefulness of follow-up means such as physical examination, or CEA and endoscopic surveillance was analyzed. All mentioned above were applied to scheduled follow-up (in 3, 6 and 12 month intervals following an operation and annually after that by the year 5).Results. Complete and reliable data was obtained from 340 out of 502 follow-up intended subjects (67.7%). Elevated CEA was the most frequent predictor of recurrence within non-symptomatic subjects meeting follow-up appointments (60%). The cancer set back diagnosed by means of either physical or endoscopic examinations was the case only in one out of five patients (20.75% and 18.87% respectively). Clinical onset of recurrence making patients meet an unscheduled appointment was found increasing relative risk of nothing-but-palliative option either for them with local set back, or meta-static spread. Relative risk of onset of meta-chronous colonic cancer was significantly higher in patients being affected by synchronous advanced adenoma at time of surgery compared to those with one-fold changes.Conclusions. CEA scheduled follow-up after treatment for colorectal cancer CRC seems adequate to provide a good outcome of treatment for recurrent tumors. CRC patients presenting with synchronous advanced adenomas at time of surgery are probably to be under more intensive endoscopic surveillance.
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