Large bowel carcinoma

Laurie JA, Moertel CG, Fleming TR, et al. Surgical adjuvant therapy of large bowel carcinoma an evaluation of levamisole and the combination of levamisole and 5-fluorouracil. J Clin Oncol 1989 7 1447-1456. 

Rosenberg, L., Louik, C., and Shapiro, S., Nonsteroidal antiinflammatory drug use and reduced risk of large bowel carcinoma. Cancer, 82, 2326-2333, 1998. 

Mesalazine caused apoptosis and reduced cell proliferation in the colorectal mucosa in 17 patients with sporadic polyps of the large bowel (3). This may be clinically relevant in lowering the rate of polyp recurrence after polypectomy, thereby contributing to chemoprevention of sporadic colonic carcinoma. 

Tumors of the large bowel in humans are of three types—adenocarcinoma, carcinoid, and squamous cell carcinoma. Of these, adenocarcinoma is the most common and can be either the fungating exophytic type or the flat infiltrative type. Opinions vary regarding the histogenesis of... 

D. Roy, Fecal bile acid concentrations of patients with carcinoma or increased risk of carcinoma in the large bowel. Gut, 21 587 (1980). 

A 63-year-old hjrpertensive woman, who had a carcinoma of the distal esophagus resected 19 months earlier, developed chronic diarrhea. Clostridium difficile toxin was identified in her stools and the diarrhea resolved after treatment with metronidazole. Enalapril was added to her antihypertensive treatment, and 3 months later the diarrhea recurred. Stool examination was negative and there was no Clostridium difficile toxin. Her condition worsened and she lost 5 kg in weight She had marked eosinophiha (2.4 x 10 /1), and a small bowel biopsy showed mild chronic inflammation and edema, partial villous atrophy, and large clusters of eosinophils in the lamina propria with some focal infiltration of the epithelium. She stopped taking enalapril and her diarrhea promptly abated and the eosinophil count fell to 0.5 X 10 /1 at 3 weeks and 0.1 x 10 /1 at 2 months. 

Untreated CD is associated with significant morbidity and increased mortality, largely related to the development of enteropathy-associated T-cell lymphomas (EATL). Other less common complications include refractory sprue, carcinomas of the oropharynx, oesophagus and small bowel, and ulcerative jejuno-ileitis and its collagenous variant (Logan et al. 1989 Holmes et al. 1976 Catassi et al. 2005). 

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