Takayuki Nakazaki

Anal metastasis from carcinoma of the lung: report of a case.

We report herein the case of a 75-year-old man who developed anal canal metastasis from squamous cell carcinoma of the lung. Initially, he underwent a right middle and lower lobectomy combined with left atrial wall resection under cardiopulmonary bypass. He presented 3 months later with an anal polyp which had prolapsed and bled, for which he underwent a transanal polypectomy. Histologically, the polyp was classified as squamous cell carcinoma and considered to be a metastasis from the primary lung cancer. He is presently well with no signs of recurrence 9 months after his initial operation. To our knowledge, there has been no other case of anal metastasis from lung cancer ever reported.

Significance of Follow-up Total Colonoscopy after Resection for Colorectal Cancer

Abstract: This is a retrospective study of the results of total colonofiberscopy performed on 180 postoperative patients with colorectal cancer. We divided the patients into two groups: “Group A” that had no concurrent polyp and/or synchronous multiple carcinoma besides the main lesion at the time of surgery and “Group B” that had a concurrent polyp and/or synchronous multiple carcinoma besides the main lesion at the time of surgery, and compared them. Colorectal polyps were found in 77 patients (42.8%), recurrent cancers in 9 patients (5.0%). and metachronous cancers in 6 patients (3.3%). respectively. In Group A, no abnormality was found in 65.7% (69/ 105), which was significantly higher compared with 33.3% (25/75) of Group B (p< 0.0001). The detection ratio of polyps in Group B was significantly higher than that of Group A (61.3% versus 29.5%. p<0.0001). The number of detected polyps in Group B was also large. As for the time required to detect the polyps, no difference was found between the two groups. There was no certain tendency for the location in which the polyp developed, and polyps were found in any portion of the residual colon and rectum. The development of metachronous cancer was found in 3 patients (2.8%) in Group A and 3 patients (4.0%) in Group B, which indicated a higher ratio for Group B, but statistically no significant difference was confirmed. In the metachronous cancer group, more than half were in the early stage, and even with the advanced cancers, the diameter of the tumor was small. In all of them, a curative resection were performed, and they were found to be Dukes’A and B in which no spreading was found to the lymphnodes.

Colonic Lipoma Removed by Endoscopic Polypectomy:—A Report of Three Cases—

We report on three cases of colonic lipoma removed by endoscopic polypectomy. Patient 1 was a 46‐year‐old female, Patient 2 a 63‐year‐old male and Patient 3 a 76‐year‐old female, with their afflicted regions being the; ascending colon, ascending colon and transverse colon, respectively. All the three lipomas were pedunculated and smooth on the surface, with the subrnucosal figure presenting yellowish or reddish in color. In Patient 1 and Patient 2, both tumors were totally removed, and in Patient 3, a “half resection” of the polyp was performed by endoscopic polypectomy. The resected specimens were 1.5 cm, 2.6 cm and 1.0 cm, respectively, in size at their maximum diameter and soft tumors with uniformly yellow cut‐surfaces. All were histopathologically diagnosed as being “lipoma”. Because the colonic lipoma is benign, an endoscopic polypectomy should be tried as the treatment of choice in selected patients.

A CASE OF EARLY COLONIC CANCER PRESENTING WITH MASSIVE ANAL BLEEDING

A 63-year-old woman was admitted to the hospital because of massive anal bleeding. Emergency colonoscopy revealed pulsating bleeding from a polyp about 1cm in size in the sigmoid colon. Clliping of the polyp was carried out and the bleeding stopped. Endoscopic polypectomy was performed, but the pathological findings of the specimen showed moderately differentiated adenocarcinoma invaded the submucosa deeply. We thought that radical operation should be done. She underwent a sigmoidectomy. Histological findings demonstrated no residual tumor, but lymph node metastasis was showed. Early colorectal cancer presented with massive anal bleddding is rare. This rare case is reported together with a review of the literature.

CASE REVIEW ON RESECTED CANCER OF THE GASTRIC CARDIA

Among 899 patients who had undergone resection for gastric cancer, excluding remnant or multiple cancer, over the past 14 years in our hospital, 98 patients (10.9%) had cancer localized in the C region. Cancer of the gastric cardia as defined by Nishi et al. was found in 37 out of these 98 patients, amounting to 4.1% of the total number of resected gastric cancers. The characteristics of cancer of the gastric cardia were studied by comparison with other cancers localized in the C region, and the following results were obtained. Cancer of the gastric cardia was most frequently found in males, being 4.3 times as frequent as in females. The macroscopically depressed type, mainly IIc, and histologically differentiated type were predominantly found among early cancers. On the other hand, advanced cancer frequently presented Borrmann type 3 macroscopically and was histologically of the differentiated type, although there was no significant difference in frequency from the undifferentiated type. The five-year survival rate of patients given curative resection was 67.6%.