![]() Pathologic stage currently remains the main prognostic factor, although it cannot fully predict the clinical outcome by itself. The diagnosis of this cancer is often late, in an advanced stage of illness, mainly with an obstructive clinical presentation 4. It is relatively rare and represent only 1–8% of all colon cancers 2, 3. Splenic flexure cancer (SFC) is defined as a colon cancer situated in the distal third of the transverse colon, or in the left colonic corner, or in the proximal descending colon within 10 cm from the flexure 1. It is our opinion that the extended surgery is seldomly indicated to cure splenic flexure cancer. According to our results, the partial resection of splenic flexure was not associated with a worse prognosis and it was leading for a satisfactory oncological outcome. There was no difference in overall and progression free survival among the three different surgical treatments. After a median follow-up of 42 months, 30 recurrences and 19 deaths occurred (12 for tumor progression). ![]() In all groups no differences were found in the total number of harvested lymphnodes. No significant differences in complications were found among the three groups. The tumor infiltrated near organs (T4) in 5 patients. Out of 103 selected cases an extended right hemicolectomy was performed in 22 (21.4%) patients, an extended left hemicolectomy in 24 (23.3%) patients, a segmental resection of the splenic flexure in 57 (55.3%) patients the combined resection of adjacent organs showing tumor adherence was carried out in 11 (10.7%) patients. We evaluated the clinicopathological findings and outcomes of all patients and associated them to the different surgical treatment. Between January 2006 and May 2016, 103 patients with splenic flexure colon cancer were enrolled in the study. Extended resection (including distal pancreasectomy and/or splenectomy), has been often indicated for the treatment for the splenic flexure cancer, because the lymphatic drainage at this site is poorly defined and assumed as heterogeneous. These findings are consistent with a histopathological diagnosis of IFP.Īrgon plasma coagulation Endoclipping Inflammatory fibroid polyp Polypectomy.Extended right or left hemicolectomy are the most common surgical treatments for splenic flexure colon cancer. The spindle cells were positive for CD34 and S100 but negative for c-kit and muscle markers. Proliferation of spindle cells and infiltration of inflammatory cells such as plasma cells and eosinophils were observed. Histologically the polyp was located in the submucosa of the gastrointestinal tract. After these measures we were able to resect the stalk and the polyp was retrieved. We placed an endoclip at the base of the stalk and then applied argon plasma coagulation at 1.0 l/min and 40 W. ![]() However the polyp stalk was extremely difficult to resect despite several attempts with the hot snare. After saline injection, we attempted to remove the polyp with a hot snare. ![]() A 12-mm pedunculated polyp was found at the hepatic flexure of the colon. A 74-year-old asymptomatic female underwent a screening colonoscopy in our hospital. We present a rare case of a pedunculated IFP in the hepatic flexure of the colon treated successfully with a combination of argon plasma coagulation, endoclipping and polypectomy. Histologically IFP is characterized by a mixture of numerous small vessels, fibroblasts and edematous connective tissue associated with marked inflammatory infiltration by eosinophils. Most IFPs occur in the stomach and colonic occurrence is very rare. Inflammatory fibroid polyp (IFP) is a rare benign polypoid lesion of the gastrointestinal tract.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |