BACKGROUND Distant metastasis of colorectal cancer to the anus is very rare,with only 30 related cases published in PubMed thus far.Therefore,recurrence of colorectal cancer derived anus metastases is rarely seen and ...BACKGROUND Distant metastasis of colorectal cancer to the anus is very rare,with only 30 related cases published in PubMed thus far.Therefore,recurrence of colorectal cancer derived anus metastases is rarely seen and less presented.CASE SUMMARY Here we report an 80-year-old male patient who underwent radical resection for sigmoid colon cancer in January 2010 and another surgery for anal fistula resection in December 2010.Postoperative pathology of the anal fistula revealed a metastatic moderately differentiated adenocarcinoma.The patient subsequently received chemotherapy and radiotherapy.In May 2020,after the patient reported symptoms of anal swelling and pain,computed tomography and magnetic resonance imaging revealed a perianal abscess.Perianal mass biopsy was performed,and the postoperative pathological diagnosis was metastatic moderately differentiated adenocarcinoma.CONCLUSION This case highlights that there is a risk of recurrence of anal metastasis of colorectal cancer even after 10 years of follow-up.We also reviewed the literature and discuss potential mechanisms for anal metastasis of colorectal cancer,thus providing some suggestions for treatment of these cases.展开更多
Background: Complete resection of locally advanced sigmoid colon cancer(LASCC) is sometimes difficult. Patients with LASCC have a dismal prognosis and poor quality of life, which has encouraged the evaluation of alter...Background: Complete resection of locally advanced sigmoid colon cancer(LASCC) is sometimes difficult. Patients with LASCC have a dismal prognosis and poor quality of life, which has encouraged the evaluation of alternative multimodality treatments. This prospective study aimed to assess the feasibility and efficacy of neoadjuvant chemora?diotherapy(neo CRT) followed by surgery as treatment of selected patients with unresectable LASCC.Methods: We studied the patients with unresectable LASCC who received neo CRT followed by surgery between October 2010 and December 2012. The neoadjuvant regimen consisted of external?beam radiotherapy to 50 Gy and capecitabine?based chemotherapy every 3 weeks. Surgery was scheduled 6–8 weeks after radiotherapy.Results: Twenty?one patients were included in this study. The median follow?up was 42 months(range, 17–57 months). All patients completed neo CRT and surgery. Resection with microscopically negative margins(R0 resection) was achieved in 20 patients(95.2%). Pathologic complete response was observed in 8 patients(38.1%). Multivisceral resection was necessary in only 7 patients(33.3%). Two patients(9.5%) experienced grade 2 postopera?tive complications. No patients died within 30 days after surgery. For 18 patients with pathologic M0(yp M0) disease, the cumulative probability of 3?year local recurrence?free survival, disease?free survival and overall survival was 100.0%, 88.9% and 100.0%, respectively. For all 21 patients, the cumulative probability of 3?year overall survival was 95.2% and bladder function was well preserved.Conclusion: For patients with unresectable LASCC, preoperative chemoradiotherapy and surgery can be performed safely and may result in an increased survival rate.展开更多
BACKGROUND The R-on-T phenomenon is a malignant arrhythmia associated with potentially catastrophic consequences.It may initiate ventricular tachycardia or ventricular fibrillation,which can result in syncope or sudde...BACKGROUND The R-on-T phenomenon is a malignant arrhythmia associated with potentially catastrophic consequences.It may initiate ventricular tachycardia or ventricular fibrillation,which can result in syncope or sudden cardiac death.This manifestation poses a great challenge for anesthesiologists.However,it is rarely encountered in the perioperative setting.CASE SUMMARY We herein present a case in which the R-on-T phenomenon was incidentally revealed by 24-h Holter monitoring in a patient diagnosed with sigmoid colon cancer.Careful evaluation and treatment with mexiletine were carried out preoperatively under consultation with a cardiovascular specialist,and surgery was uneventfully performed under general anesthesia after thorough preparation.CONCLUSION Physicians should be vigilant about this infrequent but potentially fatal arrhythmia.Our experience suggests that the anesthetic process can be greatly optimized with careful preparation.展开更多
BACKGROUND Polyethylene glycol(PEG)is widely used as an additive because of its hydrophilic and chemically inert properties.However,there are been increasing reports of PEG allergies,including anaphylaxis,although the...BACKGROUND Polyethylene glycol(PEG)is widely used as an additive because of its hydrophilic and chemically inert properties.However,there are been increasing reports of PEG allergies,including anaphylaxis,although they are still rare.This case report aims to raise awareness,that the commonly used bowel cleansing agent containing PEG can cause serious allergic reactions.CASE SUMMARY Prior to surgery for sigmoid colon cancer,a 63-year-old man was prescribed a bowel cleansing agent containing PEG.Within 30 min of ingestion,he developed symptoms of anaphylactic shock and did not respond to initial intramuscular epinephrine injection.Under diagnosis of anaphylaxis to PEG,he was stabilized with fluid hydration and continuous norepinephrine infusion.CONCLUSION While allergic reactions to PEG are rare,they can be life-threatening.Therefore,it is crucial for clinicians to be aware of this possibility and to diagnose and resuscitate patients immediately.展开更多
基金Supported by Nanjing Municipal Health Bureau,No.NWQR-201702Nanjing Translational Medicine Base of Chinese Medicine,No.ZHZD201802.
文摘BACKGROUND Distant metastasis of colorectal cancer to the anus is very rare,with only 30 related cases published in PubMed thus far.Therefore,recurrence of colorectal cancer derived anus metastases is rarely seen and less presented.CASE SUMMARY Here we report an 80-year-old male patient who underwent radical resection for sigmoid colon cancer in January 2010 and another surgery for anal fistula resection in December 2010.Postoperative pathology of the anal fistula revealed a metastatic moderately differentiated adenocarcinoma.The patient subsequently received chemotherapy and radiotherapy.In May 2020,after the patient reported symptoms of anal swelling and pain,computed tomography and magnetic resonance imaging revealed a perianal abscess.Perianal mass biopsy was performed,and the postoperative pathological diagnosis was metastatic moderately differentiated adenocarcinoma.CONCLUSION This case highlights that there is a risk of recurrence of anal metastasis of colorectal cancer even after 10 years of follow-up.We also reviewed the literature and discuss potential mechanisms for anal metastasis of colorectal cancer,thus providing some suggestions for treatment of these cases.
基金supported by the Grants from National Natural Science Funding of China (No.81071891)Guangdong Provincial Science and Technology Funding (No.2010B080701)
文摘Background: Complete resection of locally advanced sigmoid colon cancer(LASCC) is sometimes difficult. Patients with LASCC have a dismal prognosis and poor quality of life, which has encouraged the evaluation of alternative multimodality treatments. This prospective study aimed to assess the feasibility and efficacy of neoadjuvant chemora?diotherapy(neo CRT) followed by surgery as treatment of selected patients with unresectable LASCC.Methods: We studied the patients with unresectable LASCC who received neo CRT followed by surgery between October 2010 and December 2012. The neoadjuvant regimen consisted of external?beam radiotherapy to 50 Gy and capecitabine?based chemotherapy every 3 weeks. Surgery was scheduled 6–8 weeks after radiotherapy.Results: Twenty?one patients were included in this study. The median follow?up was 42 months(range, 17–57 months). All patients completed neo CRT and surgery. Resection with microscopically negative margins(R0 resection) was achieved in 20 patients(95.2%). Pathologic complete response was observed in 8 patients(38.1%). Multivisceral resection was necessary in only 7 patients(33.3%). Two patients(9.5%) experienced grade 2 postopera?tive complications. No patients died within 30 days after surgery. For 18 patients with pathologic M0(yp M0) disease, the cumulative probability of 3?year local recurrence?free survival, disease?free survival and overall survival was 100.0%, 88.9% and 100.0%, respectively. For all 21 patients, the cumulative probability of 3?year overall survival was 95.2% and bladder function was well preserved.Conclusion: For patients with unresectable LASCC, preoperative chemoradiotherapy and surgery can be performed safely and may result in an increased survival rate.
文摘BACKGROUND The R-on-T phenomenon is a malignant arrhythmia associated with potentially catastrophic consequences.It may initiate ventricular tachycardia or ventricular fibrillation,which can result in syncope or sudden cardiac death.This manifestation poses a great challenge for anesthesiologists.However,it is rarely encountered in the perioperative setting.CASE SUMMARY We herein present a case in which the R-on-T phenomenon was incidentally revealed by 24-h Holter monitoring in a patient diagnosed with sigmoid colon cancer.Careful evaluation and treatment with mexiletine were carried out preoperatively under consultation with a cardiovascular specialist,and surgery was uneventfully performed under general anesthesia after thorough preparation.CONCLUSION Physicians should be vigilant about this infrequent but potentially fatal arrhythmia.Our experience suggests that the anesthetic process can be greatly optimized with careful preparation.
文摘BACKGROUND Polyethylene glycol(PEG)is widely used as an additive because of its hydrophilic and chemically inert properties.However,there are been increasing reports of PEG allergies,including anaphylaxis,although they are still rare.This case report aims to raise awareness,that the commonly used bowel cleansing agent containing PEG can cause serious allergic reactions.CASE SUMMARY Prior to surgery for sigmoid colon cancer,a 63-year-old man was prescribed a bowel cleansing agent containing PEG.Within 30 min of ingestion,he developed symptoms of anaphylactic shock and did not respond to initial intramuscular epinephrine injection.Under diagnosis of anaphylaxis to PEG,he was stabilized with fluid hydration and continuous norepinephrine infusion.CONCLUSION While allergic reactions to PEG are rare,they can be life-threatening.Therefore,it is crucial for clinicians to be aware of this possibility and to diagnose and resuscitate patients immediately.
