MyMedR

Fulltext Outcomes Following Surgery for Distal Rectal Cancers: A Comparison between Laparoscopic and Open Abdomino-Perineal Resection

Tan KK, Chong CS, Tsang CB, Koh DC

Med J Malaysia, 2013 Aug;68(4):348-52.

PMID: 24145265

Oncologic outcomes following laparoscopic abdomino-perineal resection (APR) for distal rectal cancer are infrequently reported. This study aims to compare the long term outcomes between laparoscopic and open APR in distal rectal cancers.

Matched MeSH terms: Rectal Neoplasms*

Meta-analysis of histopathological outcomes of laparoscopic assisted rectal resection (LARR) vs open rectal resection (ORR) for carcinoma

Memon MA, Awaiz A, Yunus RM, Memon B, Khan S

Am J Surg, 2018 11;216(5):1004-1015.

PMID: 29958656 DOI: 10.1016/j.amjsurg.2018.06.012

BACKGROUND: We conducted a meta-analysis of the randomized evidence to determine the relative merits of histopathological outcomes of laparoscopic assisted (LARR) versus open rectal resection (ORR) for rectal cancer.

DATA SOURCES: A search of PubMed and other electronic databases comparing LARR and ORR between Jan 2000 and June 2016 was performed. Histopathological variables analyzed included; location of rectal tumors; complete and incomplete TME; positive and negative circumferential resection margins (+/-CRM); positive distal resected margins (+DRM); distance of tumor from DRM; number of lymph nodes harvested; resected specimen length; tumor size and perforated rectum.

RESULTS: Fourteen RCTs totaling 3843 patients (LARR = 2096, ORR = 1747) were analyzed. Comparable effects were noted for all these histopathological variables except for the variable perforated rectum which favored ORR.

CONCLUSIONS: LARR compares favorably to ORR for rectal cancer treatment. However, there is significantly higher risk of rectal perforation during LARR compared to ORR.

Matched MeSH terms: Rectal Neoplasms/pathology; Rectal Neoplasms/surgery*

Fulltext Adenocarcinoma of rectum metastasizing to penis

Sukumar N, Qureshi A

Med J Malaysia, 2001 Jun;56(2):255-6.

PMID: 11771091

An elderly gentleman with adenocarcinoma of the rectum who had abdominoperineal resection presented with scrotal skin and penile metastasis. Adenocarcinoma of the rectum metastasizing to the groin and penis is very rare and few cases have been reported.

Matched MeSH terms: Rectal Neoplasms/pathology*

Primary anorectal malignant melanoma: A clinical, radiology and pathology correlation

Bohan S, Ramli Hamid MT, Poh KS, Chow TK, Chan WY

Malays J Pathol, 2020 Dec;42(3):461-467.

PMID: 33361730

INTRODUCTION: Primary gastrointestinal melanomas are mucosal malignancies that arise from melanocytes in the oropharynx, rectum, and anus. Anorectal malignant melanoma (ARMM) are exceedingly rare, accounting for less than 1% of all melanomas, 0.1% of all rectal malignancies and 4% of anal malignancies. Diagnosis is frequently delayed as these lesions are often mistaken for haemorrhoids. Histological evaluation with special immunohistochemical stains is often necessary for definitive diagnosis. Due to the aggressive nature, 61% of patients with ARMM would already have lymph node involvement or distant metastases, by the time of diagnosis. Prognosis is usually poor with 5-year survival rate of <20%. We report a case of metastatic ARMM in an elderly lady who presented with symptoms and signs mimicking a haemorrhoid.

CASE REPORT: A 69-year-old lady presented with one year history of intermittent rectal bleed and an anorectal mass that was initially treated as haemorrhoid. Colonoscopy showed a hyperpigmented mass in the anorectal region which was confirmed as malignant melanoma on histopathological examination. Imaging with CT and MRI demonstrated locally advanced tumour with distant metastases to the liver and lung. Patient was referred for palliative management.

CONCLUSION: ARMM is a rare malignancy and often presented with non-specific clinical signs. Diagnosis is frequently delayed without high index of suspicion. MRI pelvis is the imaging of choice to assess local extent of disease. Histologic evaluation with special immunohistochemical stains is often necessary for definitive diagnosis. Prognosis is poor despite surgical and chemotherapeutic interventions.

Matched MeSH terms: Rectal Neoplasms/pathology*

Fulltext Treatment delay in rectal cancer

Law CW, Roslani AC, Ng LL

Med J Malaysia, 2009 Jun;64(2):163-5.

PMID: 20058579 MyJurnal

Early diagnosis of rectal cancer is important for prompt treatment and better outcome. Little data exists for comparison or to set standards. The primary objective of this study is to identify factors resulting in delays in treatment of rectal cancer, the correlation between the disease stage and diagnosis waiting time, treatment waiting time and duration of symptoms. A five year retrospective audit was undertaken in University of Malaya Medical Centre (UMMC). There were 137 patients recruited and the median time to diagnosis was nine days after the first UMMC Surgical Unit consultation with a mean of 18.7 days. Some 11% had to wait more than four weeks for diagnosis. The median time from confirmation of diagnosis to surgery was 11 days with a mean of 18.6 days. Sixty-two percent of patients were operated upon within two weeks of diagnosis and more than 88% by four weeks. However, 10% of them had delayed surgery done four weeks after diagnosis. Long colonoscopy waiting time was the main cause for delay in diagnosis while delay in staging CTs were the main reason for treatment delays.

Matched MeSH terms: Rectal Neoplasms/diagnosis; Rectal Neoplasms/pathology; Rectal Neoplasms/therapy*

Virotherapy: Current Trends and Future Prospects for Treatment of Colon and Rectal Malignancies

Lee CL, Veeramani S, Molouki A, Lim SHE, Thomas W, Chia SL, et al.

Cancer Invest, 2019;37(8):393-414.

PMID: 31502477 DOI: 10.1080/07357907.2019.1660887

Colorectal cancer (CRC) is one of the most common malignancies. In recent decades, early diagnosis and conventional therapies have resulted in a significant reduction in mortality. However, late stage metastatic disease still has very limited effective treatment options. There is a growing interest in using viruses to help target therapies to tumour sites. In recent years the evolution of immunotherapy has emphasised the importance of directing the immune system to eliminate tumour cells; we aim to give a state-of-the-art over-view of the diverse viruses that have been investigated as potential oncolytic agents for the treatment of CRC.

Matched MeSH terms: Rectal Neoplasms/mortality; Rectal Neoplasms/pathology; Rectal Neoplasms/therapy*; Rectal Neoplasms/virology

Fulltext Mucinous adenocarcinoma of the rectum with breast and ocular metastases

Hisham RB, Thuaibah H, Gul YA

Asian J Surg, 2006 Apr;29(2):95-7.

PMID: 16644510

We present the case of a 32-year-old woman who, 10 months after abdominoperineal resection and total mesorectal excision for a locally advanced mucinous adenocarcinoma of the rectum, presented with local recurrence and metastases to the breast, spine, the left eye and orbit. Following surgery, due to the patient's personal reasons, adjuvant chemoradiation was not given. The patient died 2 months later, with disseminated cancer. To the best of our knowledge, breast as well as ocular metastasis in a patient with mucinous adenocarcinoma of the rectum has never been reported and, therefore, needs to be documented.

Matched MeSH terms: Rectal Neoplasms/pathology*

Chylous ascites after anterior resection for rectal carcinoma: a rare but significant incident

Chan KY, Teoh CM, Sukumar N

Asian J Surg, 2006 Jan;29(1):46-8.

PMID: 16428100

Chylous ascites specifically after anterior resection for rectal cancer has not been documented in the literature thus far. All previously reported postoperative chylous ascites developed in other types of malignancies and were diagnosed within a few days of surgery. However, the patient we report had symptoms 2 years after surgery. Intraoperatively, chylous ascites was found with multiple lymph node metastasis in the small bowel mesentery and retroperitoneal region. The rarity of chylous ascites after anterior resection in rectal carcinoma is documented and discussed.

Matched MeSH terms: Rectal Neoplasms/surgery*

Fulltext Isolated metacarpal bone metastasis from advanced rectosigmoid carcinoma

Fadli, A.R., David, O., Azmi, M.N., Zailani, M.H.

International Medical Journal Malaysia, 2012;11(1):59-62.

MyJurnal

Distant metastasis is a common sequelae of stage III colorectal adenocarcinoma. Liver and lungs are the
most common sites for distant metastases, but, metastases to extremities are very rare. We report a case of rectosigmoid adenocarcinoma, which metastasizes to left first metacarpal bone, which is the first occurrence in our experience. The investigations and management of the patient are discussed.

Matched MeSH terms: Rectal Neoplasms

Fulltext Clinical dilemma-management of low rectal cancer in a Jehovah’s Witness

Azhani C., Azmi M.N., David O.

International Medical Journal Malaysia, 2018;17(3):81-84.

MyJurnal

Jehovah’s Witness followers pose a clinical dilemma to the medical practitioners due to their religious belief of an absolute prohibition of blood transfusion under any circumstances. We present a case of Jehovah’s Witness follower who underwent an ultra-low anterior resection for rectal cancer after neo-adjuvant chemo-radiotherapy. The challenges in the perioperative management are highlighted and managed accordingly.

Matched MeSH terms: Rectal Neoplasms

Adjuvant chemotherapy and radiotherapy in the management of colorectal cancer

Lim Kok Hooi A

Gan To Kagaku Ryoho, 1992 Jul;19(8 Suppl):1233-5.

PMID: 1514837

Matched MeSH terms: Rectal Neoplasms/drug therapy; Rectal Neoplasms/radiotherapy*

Fulltext Continent pouch ileostomy

Tay SK, Meah FA, Isa MR, Phang KS

Med J Malaysia, 1994 Sep;49(3):310-4.

PMID: 7845289

Continent pouch ileostomy is fashioned for patients who need a proctocolectomy. It is usually indicated for cases of ulcerative colitis and familial adenomatous polyposis where the anal sphincter can no longer maintain normal function or has to be removed. A case of familial adenomatous polyposis with features of Gardner's syndrome is reported. The patient presented with carcinoma of the rectum. Abdominoperineal resection followed by completion pancolectomy was performed. A continent pouch ileostomy was fashioned for him. He resumed work as a labourer within six months. The pouch was troublefree, needed to emptied four to six times a day and was fully continent of fluid, flatus and faeces until his demise three years later from liver secondaries. Continent pouch ileostomy is a better alternative than permanent end ileostomy. All care should be taken to rule out the existence of Crohn's disease. It is proposed that continent pouch ileostomy should be offered to patients needing permanent ileostomy if the expertise is available.

Matched MeSH terms: Rectal Neoplasms/pathology; Rectal Neoplasms/surgery*

Anorectal melanoma

Jalleh RP, Pathmanathan R, Krishnan MM, Mukherjee A

Postgrad Med J, 1988 Sep;64(755):669-71.

PMID: 3251217

Four cases of anorectal melanoma are presented. The authors believe that this is the first report of the occurrence of this tumour in Malays. Advanced disease at initial presentation accounts for the poor prognosis observed in this series. Surgery remains the principal treatment modality, although controversy exists regarding optimal extent of resection.

Matched MeSH terms: Rectal Neoplasms/ethnology*; Rectal Neoplasms/pathology

Diagnostic conundrum of a perineal tumour: a rectal gastrointestinal stromal tumour mimic

Shi R, Chew MH, Leow WQ

Malays J Pathol, 2017 Dec;39(3):293-296.

PMID: 29279593

Gastrointestinal stromal tumour (GIST) is a common mesenchymal tumour arising in the gastrointestinal tract, but not frequently encountered in the rectum. Herein, we describe a case of a rectal GIST which mimicked histomorphological features of a schwannoma; thus, making intraoperative frozen section evaluation challenging. Although subsequent immunohistochemistry and molecular findings readily confirmed the diagnosis of a GIST, we wish to draw attention to three clues that will help the pathologist steer clear of this potential diagnostic pitfall. One, GISTs are relatively more common than schwannomas in the rectum. Two, schwannomas usually have very little mitoses. Three, rectal GISTs commonly exhibit nuclear palisades. We also discuss the diagnostic, prognostic and therapeutic functions of immunohistochemical and molecular investigations. As the surgical intent for rectal GISTs is for en-bloc excision with wide margins, we surmise that the intraoperative consult should include GIST as a possible differential diagnosis for rectal mesenchymal tumours. In view of the potential for neoadjuvant treatment with imatinib before surgical excision to preserve sphincter function, a multidisciplinary approach is recommended for establishing most effective treatment strategy in these rare complex cases.

Matched MeSH terms: Rectal Neoplasms/diagnosis*; Rectal Neoplasms/pathology

Fulltext The neorectum reservoirs

Wong M.P.K

IIUM Medical Journal Malaysia, 2020;19(1):33-37.

MyJurnal

The incidence of rectal dissection is increasing with the rise of rectal cancer all over the world. This
technique has been used regularly to provide a reasonable quality of life for patients. The concern raised
was the functions of these neorectum to replace the original rectum. Several configurations have been
suggested namely the straight end-to-end coloanal anastomosis, side-to-end coloanal anastomosis, colonic Jpouch and the transverse coloplasty to suit the anatomy of the deep pelvis. Apparently, there was no
difference in terms of functional outcome among all these four types of reconstructions. However, these
configurations have seen the emergence of anterior resection syndrome or a pragmatic defaecatory
dysfunction as their complications. Furthermore, the neorectum functions are affected by many other
factors such as preoperative chemoradiotherapy, septic complications, and others more.

Matched MeSH terms: Rectal Neoplasms

Fulltext Perianal Mucinous Adenocarcinoma Diagnosed by Histological Study of Anorectal Abscess with Fistula

Jee SL, Amin-Tai H, Fathi NQ, Jabar MF

ACG Case Rep J, 2018;5:e21.

PMID: 29577055 DOI: 10.14309/crj.2018.21

Perianal mucinous adenocarcinoma (PMA) is an oncologic rarity that poses a diagnostic and therapeutic dilemma for treating clinicians because there are few reported cases and an absence of definitive guidelines. We report a patient who had been treated with local surgery for recurrent perianal abscess with fistula for 3 years. Biopsy of the indurated tissue overlying his surgical scars revealed PMA. Neoadjuvant concurrent chemoradiotherapy followed by abdominoperineal resection was planned to address the locally advanced disease and ongoing sepsis. Our case is unique in that the fistula preceded carcinoma by only 3 years instead of the typical 10 years.

Matched MeSH terms: Rectal Neoplasms

Fulltext Delayed Bowel Perforation after Routine Distal Loopogram Prior to Ileostomy Closure

Poh KS, Hoh SY, Aziz R, Chong SS, Roslani AC

Open Med (Wars), 2020;15:261-265.

PMID: 32292822 DOI: 10.1515/med-2020-0037

Ultra-low anterior resection for low rectal cancer is usually done with a covering ileostomy as a safety measure to reduce the consequences of distal anastomotic failure. In many centres, distal loopogram is performed routinely, prior to the closure of the loop ileostomy, to assess the integrity of anastomosis. Distal loopogram is generally considered a safe procedure with very low complication rates, especially when water-soluble contrast is used. We report two cases of delayed bowel perforation which led to severe sepsis and generalized peritonitis after distal loopogram prior to ileostomy closure. Our cases highlight the potential dangers of distal loopogram. Therefore, the routine usage of this procedure should be scrutinized and the patient needs to be properly counselled prior to the procedure.

Matched MeSH terms: Rectal Neoplasms

Laryngeal metastasis from a rectal carcinoma

Ramanathan Y, Rajagopalan R, Rahman NA

Ear Nose Throat J, 2007 Nov;86(11):685-6.

PMID: 18225631

Metastases to the larynx from distant primaries are rare. We report a case of a laryngeal metastasis from a rectal carcinoma.

Matched MeSH terms: Rectal Neoplasms/pathology*

Carcinoma of he stomach, colon, and rectum. A survey of 772 surgical biopsies from Malaya

King M, Kutty MK

Br J Surg, 1971 Feb;58(2):123-6.

PMID: 5548502

Matched MeSH terms: Rectal Neoplasms/epidemiology*

Paronychia induced by the epidermal growth factor receptor inhibitor cetuximab

Lee SL, Tan BS, Chan LC

J Oncol Pharm Pract, 2013 Sep;19(3):273-8.

PMID: 23161875 DOI: 10.1177/1078155212461289

While the development of epidermal growth factor receptor inhibitors has been hailed as a remarkable triumph in the field of oncology, it has inherited with it a host of cutaneous side-effects that have been increasingly observed in a substantial number of patients in the recent years. One cutaneous manifestation that may inflict significant pain and affect activities of daily living among some of the patients receiving epidermal growth factor receptor inhibitors is paronychia. A case of paronychia associated with the use of cetuximab in the management of KRAS wild-type midrectal adenocarcinoma along with its management has been described.

Matched MeSH terms: Rectal Neoplasms/drug therapy; Rectal Neoplasms/enzymology

Displaying publications 1 - 20 of 33 in total