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Kolorektal Adenokarsinomu Taklit Eden Nonadenokarsinom Tümörlerin Retrospektif Analizi

Yıl 2021, Cilt: 4 Sayı: 1, 8 - 13, 30.04.2021
https://doi.org/10.33713/egetbd.817721

Öz

Amaç: Kolorektal tümör (KRT) nedeniyle ameliyat edilen hastalarda en sık görülen patoloji adenokanserdir. Non-adenokarsinom KRT’ler nadirdir ve bu nedenle adenokarsinom dışı KRT’le ilgili veriler kısıtlıdır. Kliniğimizdeki nonadenokarsinom KRT’le ilgili verileri sunarak literatüre katkı sunmayı amaçlıyoruz. Yöntem: Kliniğimizde 01.01.2010 - 01.01.2020 tarihleri arasında KRT nedeniyle elektif olarak ameliyat edilen hastalar retrospektif olarak tarandı. Histopatolojik olarak adenokarsinom dışı tümör tanısı konan hastalar kaydedildi. Bulgular: KRT nedeniyle elektif olarak ameliyat edilen toplam 798 hasta arasından adenokarsinom dışı patolojik tanısı olan 18 hasta (%2,25) çalışmaya alındı. Dokuz hasta (%50) kadındı ve ortalama yaş 52,8’di (33-70). En sık patolojik tanı, 7 hastada (%38,9) nöroendokrin tümör ve 4 hastada (%22,2) lenfomaydı. İkişer hastada (%11,1) malign melanom ve lipom mevcuttu. Scwannoma, granüler tümör ve endometriozis diğer tanılardı. Hastalarda mortalite gelişmedi. Ortalama yatış süresi 7.44 gündü (3-18). Tümörler en sık rektuma (%33,3) lokalizeydi. On iki hastada (%66,6) 12 ve üzerinde lenf nodu eksize edildi. Tüm hastalarda cerrahi sınırlar salimdi. Ameliyat öncesi histopatolojik tanı sadece 9 hastaya (%50) konabildi. Sonuç: Nonadenokarsinom KRT’ler adenokarsinomlara göre daha genç yaşlarda görülen, erkek dominansı olmayan, ameliyat öncesi tanı oranı düşük nadir tümörlerdir. Kolorektal cerrahlar, ameliyat öncesi tanı konulamayan, atipik özellikleri olan tümöral kitlelerde adenokarsinom dışı tümörleri akılda tutmalıdır. Tanı ve tedavi sürecinde multidisipliner yaklaşım önemlidir.

Destekleyen Kurum

yok

Teşekkür

Patoloji görselleri için S.B.Ü. Tepecik Eğitim ve Araştırma Hastanesi Patoloji Kliniği'nden Sayın Doç.Dr. Emel Ebru PALA'ya teşekkürlerimizi sunarız.

Kaynakça

  • Provenzale D, Gupta S, Ahnen DJ, et al. NCCN Guidelines Insights: Colorectal Cancer Screening, Version 1.2018. J Natl Compr Canc Netw. 2018;16(8):939-949. doi:10.6004/jnccn.2018.0067
  • Türkiye Cumhuriyeti Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. Kalın Bağırsak Kanseri (Kolorektal Kanser) https://hsgm.saglik.gov.tr/tr/haberler/kal%C4%B1n-ba%C4%9F%C4%B1rsak-kanseri-kolorektal-kanser.html. 10 Eylül 2020’de erişildi.
  • Nam S, Kim D, Jung K, Choi YJ, Kang JG. Analysis of the incidence and clinical features of colorectal non-adenocarcinoma in Korea: A National Cancer Registry-based study [published online ahead of print, 2020 May 15]. Ann Coloproctol. 2020;10.3393/ac.2020.05.03. doi:10.3393/ac.2020.05.03
  • Haggar FA, Boushey RP. Colorectal cancer epidemiology: incidence, mortality, survival, and risk factors. Clin Colon Rectal Surg. 2009;22(4):191-197. doi:10.1055/s-0029-1242458
  • Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries [published correction appears in CA Cancer J Clin. 2020 Jul;70(4):313]. CA Cancer J Clin. 2018;68(6):394-424. doi:10.3322/caac.21492
  • Weitz J, Koch M, Debus J, Höhler T, Galle PR, Büchler MW. Colorectal cancer. Lancet. 2005;365(9454):153-165. doi:10.1016/S0140-6736(05)17706-X
  • Firth MJ, Sharples KJ, Hinder VA, et al. Methods of a national colorectal cancer cohort study: the PIPER Project. N Z Med J. 2016;129(1440):25-36. Published 2016 Aug 19.
  • Çalışkan C, Akgün E, Doğanavşargil B, Korkut MA. Rare tumors mimicking colorectal carcinomas. Ege Journal of Medicine 2009;48:101-107.
  • Ellis L, Shale MJ, Coleman MP. Carcinoid tumors of the gastrointestinal tract: trends in incidence in England since 1971. Am J Gastroenterol. 2010;105(12):2563-2569. doi:10.1038/ajg.2010.341
  • Kang H, O'Connell JB, Leonardi MJ, Maggard MA, McGory ML, Ko CY. Rare tumors of the colon and rectum: a national review. Int J Colorectal Dis. 2007;22(2):183-189. doi:10.1007/s00384-006-0145-2
  • Maryański J, Cyran-Chlebicka A, Szczepankiewicz B, Cebulski W, Słodkowski M, Wroński M. Surgical treatment of extra-appendiceal colorectal neuroendocrine tumors. Pol Przegl Chir. 2018;90(3):7-12.
  • Smith JD, Reidy DL, Goodman KA, Shia J, Nash GM. A retrospective review of 126 high-grade neuroendocrine carcinomas of the colon and rectum. Ann Surg Oncol. 2014;21(9):2956-2962. doi:10.1245/s10434-014-3725-3
  • Al Natour RH, Saund MS, Sanchez VM, et al. Tumor size and depth predict rate of lymph node metastasis in colon carcinoids and can be used to select patients for endoscopic resection. J Gastrointest Surg. 2012;16(3):595-602. doi:10.1007/s11605-011-1786-1
  • Gay ND, Chen A, Okada CY. Colorectal Lymphoma: A Review. Clin Colon Rectal Surg. 2018;31(5):309-316. doi:10.1055/s-0038-1642048
  • Iwamuro M, Okada H, Takata K, et al. Colorectal Manifestation of Follicular Lymphoma. Intern Med. 2016;55(1):1-8. doi:10.2169/internalmedicine.55.5393
  • Jaime-Andrade E, Lino-Silva LS, Salcedo-Hernández RA, Zepeda-Najar C. Colorectal lymphoma in Mexico: clinico-pathological and survival analysis. J Gastrointest Oncol. 2018;9(1):90-95. doi:10.21037/jgo.2017.10.08
  • Ünal N , Coşgun G , Korkut M, et al. Ege Üniversitesi Tıp Fakültesi veri tabanındaki kolorektal kanserli olguların epidemiyolojik ve genel sağ kalım özellikleri . Ege Tıp Dergisi.2019;68-77. doi:10.19161/etd.668311)
  • Atak I. Anorectal Malignant Melanoma: Retrospective Analysis of Six Patients and Review of the Literature. Prague Med Rep. 2018;119(2-3):97-106. doi:10.14712/23362936.2018.9
  • Jeong HK, Cho SB, Seo TJ, et al. Autoamputation of a giant colonic lipoma. Gut Liver. 2011;5(3):380-382. doi:10.5009/gnl.2011.5.3.380
  • Bohlok A, El Khoury M, Bormans A, et al. Schwannoma of the colon and rectum: a systematic literature review. World J Surg Oncol. 2018;16(1):125. Published 2018 Jul 3. doi:10.1186/s12957-018-1427-1
  • Sarofim M, Attwell-Heap A, Trautman J, Kwok A, Still A. Unusual case of acute large bowel obstruction: endometriosis mimicking sigmoid malignancy. ANZ J Surg. 2019;89(11):E542-E543. doi:10.1111/ans.14869
  • Ishii M, Yamamoto M, Tanaka K, et al. Intestinal endometriosis combined with colorectal cancer: a case series. J Med Case Rep. 2018;12(1):21. Published 2018 Jan 30. doi:10.1186/s13256-017-1537-3
  • Take I, Shi Q, Qi ZP, et al. Endoscopic resection of colorectal granular cell tumors. World J Gastroenterol. 2015;21(48):13542-13547. doi:10.3748/wjg.v21.i48.13542
  • Huh JW, Oh BR, Kim HR, Kim YJ. Preoperative carcinoembryonic antigen level as an independent prognostic factor in potentially curative colon cancer. J Surg Oncol. 2010;101(5):396-400. doi:10.1002/jso.2149

Retrospective Analysis of Nonadenocarcinoma Tumors Mimicking Colorectal Adenocarcinoma

Yıl 2021, Cilt: 4 Sayı: 1, 8 - 13, 30.04.2021
https://doi.org/10.33713/egetbd.817721

Öz

Objective: Adenocarcinoma is the most common pathology in patients operated on for colorectal tumor (CRT). Non-adenocarcinoma CRTs are rare and therefore data on non-adenocarcinoma CRT are limited. We aim to contribute to the literature by presenting data on non-adenocarcinoma CRT in our clinic. Methods: Patients who underwent elective surgery due to CRC in our clinic between 01.01.2010 and 01.01.2020 were retrospectively screened. Patients who were diagnosed histopathologically as non-adenocarcinoma tumor were recorded. Results: Eighteen patients (2.25%) with a pathological diagnosis other than adenocarcinoma among 798 patients who were operated electively for CRC were included in the study. Nine patients were female (50%) and the average age was 52.8 (33-70). The most common pathological diagnosis was neuroendocrine tumor in 7 patients (38.9%) and lymphoma in 4 patients (22.2%). Two patients (11.1%) had malignant melanoma and lipoma. Scwannoma, granular tumor, and endometriosis were other diagnoses. No mortality developed in the patients. Average hospital stay was 7.44 days (3-18). Tumors were most frequently localized to rectum (%33,3). In 12 patients (66.6%), 12 or more lymph nodes were excised. Surgical margins were safe in all patients. Preoperative histopathological diagnosis could only be made in 9 patients (50%). Conclusion: Non-adenocarcinoma CRC are rare tumors that are seen at younger ages than adenocarcinomas, do not have male dominance and have a low preoperative diagnosis rate. Colorectal surgeons should keep in mind non-adenocarcinoma tumors in tumoral masses with atypical features that cannot be diagnosed before surgery. Multidisciplinary approach is important in the diagnosis and treatment process.

Kaynakça

  • Provenzale D, Gupta S, Ahnen DJ, et al. NCCN Guidelines Insights: Colorectal Cancer Screening, Version 1.2018. J Natl Compr Canc Netw. 2018;16(8):939-949. doi:10.6004/jnccn.2018.0067
  • Türkiye Cumhuriyeti Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. Kalın Bağırsak Kanseri (Kolorektal Kanser) https://hsgm.saglik.gov.tr/tr/haberler/kal%C4%B1n-ba%C4%9F%C4%B1rsak-kanseri-kolorektal-kanser.html. 10 Eylül 2020’de erişildi.
  • Nam S, Kim D, Jung K, Choi YJ, Kang JG. Analysis of the incidence and clinical features of colorectal non-adenocarcinoma in Korea: A National Cancer Registry-based study [published online ahead of print, 2020 May 15]. Ann Coloproctol. 2020;10.3393/ac.2020.05.03. doi:10.3393/ac.2020.05.03
  • Haggar FA, Boushey RP. Colorectal cancer epidemiology: incidence, mortality, survival, and risk factors. Clin Colon Rectal Surg. 2009;22(4):191-197. doi:10.1055/s-0029-1242458
  • Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries [published correction appears in CA Cancer J Clin. 2020 Jul;70(4):313]. CA Cancer J Clin. 2018;68(6):394-424. doi:10.3322/caac.21492
  • Weitz J, Koch M, Debus J, Höhler T, Galle PR, Büchler MW. Colorectal cancer. Lancet. 2005;365(9454):153-165. doi:10.1016/S0140-6736(05)17706-X
  • Firth MJ, Sharples KJ, Hinder VA, et al. Methods of a national colorectal cancer cohort study: the PIPER Project. N Z Med J. 2016;129(1440):25-36. Published 2016 Aug 19.
  • Çalışkan C, Akgün E, Doğanavşargil B, Korkut MA. Rare tumors mimicking colorectal carcinomas. Ege Journal of Medicine 2009;48:101-107.
  • Ellis L, Shale MJ, Coleman MP. Carcinoid tumors of the gastrointestinal tract: trends in incidence in England since 1971. Am J Gastroenterol. 2010;105(12):2563-2569. doi:10.1038/ajg.2010.341
  • Kang H, O'Connell JB, Leonardi MJ, Maggard MA, McGory ML, Ko CY. Rare tumors of the colon and rectum: a national review. Int J Colorectal Dis. 2007;22(2):183-189. doi:10.1007/s00384-006-0145-2
  • Maryański J, Cyran-Chlebicka A, Szczepankiewicz B, Cebulski W, Słodkowski M, Wroński M. Surgical treatment of extra-appendiceal colorectal neuroendocrine tumors. Pol Przegl Chir. 2018;90(3):7-12.
  • Smith JD, Reidy DL, Goodman KA, Shia J, Nash GM. A retrospective review of 126 high-grade neuroendocrine carcinomas of the colon and rectum. Ann Surg Oncol. 2014;21(9):2956-2962. doi:10.1245/s10434-014-3725-3
  • Al Natour RH, Saund MS, Sanchez VM, et al. Tumor size and depth predict rate of lymph node metastasis in colon carcinoids and can be used to select patients for endoscopic resection. J Gastrointest Surg. 2012;16(3):595-602. doi:10.1007/s11605-011-1786-1
  • Gay ND, Chen A, Okada CY. Colorectal Lymphoma: A Review. Clin Colon Rectal Surg. 2018;31(5):309-316. doi:10.1055/s-0038-1642048
  • Iwamuro M, Okada H, Takata K, et al. Colorectal Manifestation of Follicular Lymphoma. Intern Med. 2016;55(1):1-8. doi:10.2169/internalmedicine.55.5393
  • Jaime-Andrade E, Lino-Silva LS, Salcedo-Hernández RA, Zepeda-Najar C. Colorectal lymphoma in Mexico: clinico-pathological and survival analysis. J Gastrointest Oncol. 2018;9(1):90-95. doi:10.21037/jgo.2017.10.08
  • Ünal N , Coşgun G , Korkut M, et al. Ege Üniversitesi Tıp Fakültesi veri tabanındaki kolorektal kanserli olguların epidemiyolojik ve genel sağ kalım özellikleri . Ege Tıp Dergisi.2019;68-77. doi:10.19161/etd.668311)
  • Atak I. Anorectal Malignant Melanoma: Retrospective Analysis of Six Patients and Review of the Literature. Prague Med Rep. 2018;119(2-3):97-106. doi:10.14712/23362936.2018.9
  • Jeong HK, Cho SB, Seo TJ, et al. Autoamputation of a giant colonic lipoma. Gut Liver. 2011;5(3):380-382. doi:10.5009/gnl.2011.5.3.380
  • Bohlok A, El Khoury M, Bormans A, et al. Schwannoma of the colon and rectum: a systematic literature review. World J Surg Oncol. 2018;16(1):125. Published 2018 Jul 3. doi:10.1186/s12957-018-1427-1
  • Sarofim M, Attwell-Heap A, Trautman J, Kwok A, Still A. Unusual case of acute large bowel obstruction: endometriosis mimicking sigmoid malignancy. ANZ J Surg. 2019;89(11):E542-E543. doi:10.1111/ans.14869
  • Ishii M, Yamamoto M, Tanaka K, et al. Intestinal endometriosis combined with colorectal cancer: a case series. J Med Case Rep. 2018;12(1):21. Published 2018 Jan 30. doi:10.1186/s13256-017-1537-3
  • Take I, Shi Q, Qi ZP, et al. Endoscopic resection of colorectal granular cell tumors. World J Gastroenterol. 2015;21(48):13542-13547. doi:10.3748/wjg.v21.i48.13542
  • Huh JW, Oh BR, Kim HR, Kim YJ. Preoperative carcinoembryonic antigen level as an independent prognostic factor in potentially curative colon cancer. J Surg Oncol. 2010;101(5):396-400. doi:10.1002/jso.2149
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Cerrahi
Bölüm Orijinal Araştırma
Yazarlar

Tayfun Kaya 0000-0001-7101-1952

Ayberk Dursun 0000-0001-9187-0463

Yayımlanma Tarihi 30 Nisan 2021
Kabul Tarihi 29 Aralık 2020
Yayımlandığı Sayı Yıl 2021 Cilt: 4 Sayı: 1

Kaynak Göster

EndNote Kaya T, Dursun A (01 Nisan 2021) Kolorektal Adenokarsinomu Taklit Eden Nonadenokarsinom Tümörlerin Retrospektif Analizi. Ege Tıp Bilimleri Dergisi 4 1 8–13.

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