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Splenic Site Abscess as a Symptom of Colorectal Carcinoma - Case Report

100%
Murawa D., Nowaczyk P., Murawa P.
Polish Journal of Surgery
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2007
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vol. 79
|
issue 12
779-784
EN
Splenic abscess occurs only rarely. However, in recent years its frequency has been growing, which is related not only to the improvement in diagnostics but also to the increasingly common problem of immunosuppression caused by multiple factors and the occurrence of diabetes in the population. This paper presents a case of splenic flexure carcinoma, which was manifested clinically by a splenic site abscess and earlier probably by splenic abscess. Its aetiology was not specified after splenectomy had been carried out at the local hospital; only symptomatic treatment was applied. Due to the low occurrence of splenic abscess and non-specific clinical symptoms, doctors must show a great deal of prudence and alertness to make the right diagnosis. Furthermore, knowing that the presence of such lesions in the spleen is a consequence of other local or distant pathogenic processes, appropriate management and treatment of such patients requires investigating the cause and specifying the aetiology of the abscess. Failure to do so exposes the patient to the danger of serious consequences, frequently making early and successful treatment of many diseases, including neoplasms in the abdominal cavity, impossible.
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Determination of the Activity of CD134 (OX-40) and CD137 (4-1BB) Adhesive Nolecules by Means of Flow Cytometry in Patients with Colorectal Cancer Metastases to the Liver

86%
Cepowicz D., Zaręba K., Gryko M., Stasiak-Bermuta A., Kędra B.
Polish Journal of Surgery
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2011
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vol. 83
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issue 8
424-429
EN
Colorectal carcinoma (CRC) is one of the most common reasons of mortality in patients diagnosed with neoplasms. In nearly 20% of patients with colorectal carcinoma metastatic lesions are diagnosed. In general, survival of patients with metastatic lesions to the liver and other organs is poor. Conventional therapy of colorectal carcinoma is based on the surgical excision of the tumor, chemotherapy, and radiotherapy.The aim of the study was to determine the expression of CD134 and CD137 molecules inside the tumor, at the border of the tumor, in the healthy tissue, and peripheral blood, considering patients with colorectal carcinoma metastases to the liver.Material and methods. The study group comprised 39 patients subject to surgical treatment at the Department of General and Gastroenterological Surgery, due to colorectal carcinoma with liver metastases. CD134 and CD137 adhesive molecule levels were determined inside the tumor, at the border of the tumor, and in the healthy margins of the surgical incision. Additionally, the authors evaluated the peripheral blood level of the above-mentioned molecules on the day of the surgical procedure, and 10 days, thereafter.Results. The mean CD134 levels were the highest inside the tumor, significantly decreasing towards the direction of healthy tissues. The average peripheral blood molecule levels were four-fold higher on the day of the surgical procedure, as compared to values obtained on the tenth postoperative day. This dependency also concerned the remaining statistical measures.The mean CD137 levels showed no significant difference, regardless their location. The authors observed significant, peripheral blood, CD137 level differences, considering the day of the surgical procedure and tenth postoperative period. The mean CD137 peripheral blood level was several times higher on the day of the surgical procedure, as compared to the postoperative period.Conclusions. The determination of the activity of CD134 and CD137 molecules might create opportunities to plan treatment and predict prognosis in case of colorectal carcinoma. Proper immuno-therapeutic management which is based on the expression of the above-mentioned molecules might help determine the risk of metastases, preventing from their development. In advanced cases treatment of liver metastases might be possible.
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