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Abstract
Cutaneous metastasis portends a poor prognosis. Therefore, a high clinical index of suspicion is necessary so that a clinician knows how to recognize the presentation of a cutaneous metastasis, while the pathologist must know the appropriate stains to order. In this review, the authors summarize the common and uncommon ways that these tumors will present. Frequently a metastatic cancer will present as a firm red nodule or as a plaque, ulcer, or papule. Less commonly they will present with a clinical clue that can alert a clinician to a likely diagnosis; these manifestations include alopecic, vesicular, blue color, sclerodermoid, acrochordon-, or pellagra-like.
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Affiliation(s)
- Evan Alexander Choate
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Alexander Nobori
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
| | - Scott Worswick
- Department of Dermatology, Keck School of Medicine, University of Southern California, 1441 Eastlake Avenue, Ezralow Tower, Suite 5301, Los Angeles, CA 90033-9174, USA.
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Steinhagen E, Colwell J, Cannon LM. Intestinal Stomas-Postoperative Stoma Care and Peristomal Skin Complications. Clin Colon Rectal Surg 2017; 30:184-192. [PMID: 28684936 DOI: 10.1055/s-0037-1598159] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Intestinal stomas are necessary for several colon and rectal conditions and represent a major change in the new ostomate's daily life. Though dehydration is the most frequent etiology requiring readmission, irritant contact dermatitis and a host of other peristomal skin conditions are more common complications for ostomates. Wound, ostomy, and continence nurses are invaluable resources to both ostomy patients and providers. A few simple interventions can prevent or resolve most common peristomal complications. Good stoma care is possible in a resource-poor environment.
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Affiliation(s)
- Emily Steinhagen
- Division of Colon and Rectal Surgery, Department of Surgery, University Hospitals Case Medical Center, Cleveland, Ohio
| | - Janice Colwell
- Section of Colon and Rectal Surgery, Department of General Surgery, University of Chicago Medicine, Chicago, Illinois
| | - Lisa M Cannon
- Section of Colon and Rectal Surgery, Department of General Surgery, University of Chicago Medicine, Chicago, Illinois
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Maeda C, Hidaka E, Shimada M, Shimada S, Nakahara K, Takayanagi D, Takehara Y, Mukai S, Sawada N, Ishida F, Kudo SE. Transverse colon cancer occurring at a colostomy site 35 years after colostomy: a case report. World J Surg Oncol 2015; 13:171. [PMID: 25943390 PMCID: PMC4426552 DOI: 10.1186/s12957-015-0593-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Accepted: 04/24/2015] [Indexed: 11/17/2022] Open
Abstract
Background Carcinomas occurring at colostomy sites are rare, and most of these are metachronous colorectal cancers. The median time between colostomy and development of a carcinoma at a colostomy site is 22 years, which exceeds the length of the recommended follow-up period. We report a rare case of a carcinoma of the transverse colon occurring at a colostomy site in a patient without a history of colorectal cancer. Case report An 89-year-old woman presented with a tumor occurring at a colostomy site. Thirty-five years previously, she had undergone a transverse loop colostomy for an iatrogenic colon perforation that occurred during left ureteral lithotomy. Upon physical examination, the patient had a hard nodule measuring 3 cm at the colostomy site. A biopsy of the nodule suggested adenocarcinoma, and the preoperative diagnosis was transverse colon cancer. A laparotomy was performed via a peristomal incision with 5-mm skin margins, and the tumor was covered by a surgical glove to avoid any tumor seeding. The colon was separated from the tumor by 5-cm margins, and the specimen was removed en bloc. An end colostomy was constructed to a new site on the right side of the abdomen. The deficit in the abdominal wall was repaired, and the skin was closed via a purse-string suture. The final diagnosis of the stoma tumor was transverse colon cancer (T2, N0, M0, stage I). One year and five months after surgery, there was no evidence of recurrence. Conclusions The occurrence of carcinomas at colostomy sites in patients without a history of colorectal cancer is rare. It is important to train ostomates to monitor the stoma for possible tumor recurrence.
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Affiliation(s)
- Chiyo Maeda
- Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan.
| | - Eiji Hidaka
- Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan.
| | - Mari Shimada
- Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan.
| | - Shoji Shimada
- Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan.
| | - Kenta Nakahara
- Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan.
| | - Daisuke Takayanagi
- Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan.
| | - Yusuke Takehara
- Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan.
| | - Shumpei Mukai
- Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan.
| | - Naruhiko Sawada
- Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan.
| | - Fumio Ishida
- Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan.
| | - Shin-ei Kudo
- Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan.
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Liang R, Chen TX, Wang ZQ, Jin KW, Zhang LY, Yan QN, Zhang HH, Wang WP. A retrospective analysis of the clinicopathological characteristics of large cell carcinoma of the lung. Exp Ther Med 2014; 9:197-202. [PMID: 25452802 PMCID: PMC4247287 DOI: 10.3892/etm.2014.2075] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 09/04/2014] [Indexed: 12/30/2022] Open
Abstract
The aim of the present study was to analyze and summarize the clinicopathological characteristics of large-cell lung carcinoma (LCLC) of the lung, in order to improve the definite diagnosis rate of LCLC. Clinicopathological data of 174 patients with LCLC, confirmed pathologically, were retrospectively reviewed. The 174 cases of LCLC accounted for 5.7% of the total lung cancer cases during the corresponding time period at the Affiliated Cancer Hospital of Tianjin Medical University (Tianjin, China), among which there were 131 males and 43 females with an average age of 61.4 years. The postoperative pathological diagnosis of the 174 cases showed 80 cases of classic LCLC, 64 cases of large cell neuroendocrine carcinoma (LCNEC), six cases of combined LCNEC, 19 cases of basaloid carcinoma, three cases of clear cell carcinoma and two cases of lymphoepithelioma-like carcinoma. Of the total 174 LCLC cases, 96 patients exhibited lymph node metastasis. LCLC is a highly aggressive malignancy with a high tendency of invasion and metastasis, although the incidence rate is low. A definite diagnosis of LCLC primarily relies on the pathological diagnosis. Each subtype of LCLC has its own pathomorphological and immunohistochemical characteristics.
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Affiliation(s)
- Rui Liang
- Department of Pathology, The First People's Hospital of Yunnan Province, Kunming, Yunnan 650032, P.R. China
| | - Tian-Xing Chen
- Department of Pathology, The First People's Hospital of Yunnan Province, Kunming, Yunnan 650032, P.R. China
| | - Zhi-Qiang Wang
- Department of Oncology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, P.R. China
| | - Ke-Wei Jin
- Department of Pathology, Kunming Medical University, Kunming, Yunnan 650031, P.R. China
| | - Lian-Yu Zhang
- Department of Pathology, The Affiliated Cancer Hospital of Tianjin Medical University, Tianjin 300060, P.R. China
| | - Qing-Na Yan
- Department of Pathology, The Affiliated Cancer Hospital of Tianjin Medical University, Tianjin 300060, P.R. China
| | - Hui-Hua Zhang
- Department of Pathology, The First People's Hospital of Yunnan Province, Kunming, Yunnan 650032, P.R. China
| | - Wan-Pu Wang
- Department of Pathology, The First People's Hospital of Yunnan Province, Kunming, Yunnan 650032, P.R. China
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Mourra N, Bataillon G, Lesurtel M. Fungating mass occurring at a colostomy site 50 years after colectomy for inflammatory condition. Gastroenterology 2014; 146:e1-2. [PMID: 24361429 DOI: 10.1053/j.gastro.2013.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 09/03/2013] [Indexed: 12/02/2022]
Affiliation(s)
- Najat Mourra
- Department of Pathology, Hôpital Saint-Antoine, AP-HP, Paris-France
| | | | - Mickael Lesurtel
- Department of Surgery, Swiss Hepato-Pancreato-Biliary Center, Zürich, Switzerland
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