A Clinicopathological Correlation of Colorectal and Anal Canal Malignancy

Abstract

BACKGROUND:Colorectal carcinoma is considered a calamity for humanity, but it could have a long survival if it is diagnosed early. The epidemiology of this calamity is also interesting and has always been the subject of investigation in the in the western world. AIMS: 1.To compare the findings in a series of 215 cases studied over a period of 6 years from 2008 to 2013. 2. To study the incidence of colorectal carcinoma in a population with respect to age, sex, religion and diet. 3. To study the occurrence of the carcinoma in a different parts of the colon. 4. To study the different histological and morphological types of carcinoma of colon. 5. To study the stages of carcinoma at the time of presentation by American Joint Commission on Cancer (AJCC) staging system. 6. To study the clinical presentation of colorectal carcinoma. SETTINGS: Lokmanya Tilak Municipal General Hospital, Sion, Mumbai. DESIGN: A retrospective observational study. METHODS AND MATERIAL: The malignant tumor of large bowel and anal canal received in the Surgical Pathology, Department of Pathology, Lokmanya Tilak Medical College and General Hospital in Mumbai in the form of biopsy and resected speciemen were studied after microscopic confirmation of diagnosis over a period of 6 years from 2008 to 2013. A total number of cases studied are 215 cases excluding the superficial biopsy and doubtful cases. RESULTS: Of total 46255 surgical specimen, 6911 were gastrointestinal specimen i.e. 14.9% of all specimens, and 4271 were colorectal specimen. Of 4271 gastrointestinal specimens 497 gastrointestinal malignancy while 215 had colorectal malignancy. The common age group affected is 51-60 years. Rectum (57.74%) is the most common site of colorectal malignancy. Abdominal pain (33.5%) was the most common clinical feature. Ulceroinfilterative is the most common type of gross morphology of tumor in rectum. Hindu and non-vegetarian are most common risk factors. Adenocarcinoma (52.55%) was the most common microscopic type, belonging to AJCC stage IIA (40%). CONCLUSION: The most common site for gastrointestinal malignancy was rectum and anal canal with adenocarcinoma was the most common microscopic type. The above observation implies for a greater emphasis on early recognition of signs and symptoms, to facilitate for early diagnosis so that curative resection can be attempted for the patient to enjoy a better prognosis and better quality of life.

Evaluation of Lower Gastrointestinal Bleeding With Special Reference to Colonoscopy

“…6 In a study by Kantilal MN et al, Adenocarcinoma (52.55%) was the most common microscopic type. 12 In the series of Mahamoud et al, 99 patients (8.5%) presented with colorectal masses, these tumours were benign in 10 cases including 7 inflammatory pseudo-tumours and 3 lipomas while 89 cases proved histopathologically to be malignant (adenocarcinoma in 76 patients (76.7%), 2 cases of malignant melanoma, one case of squamous cell carcinoma of rectum and other malignancies in 10 cases). 11 Thakeb et al group presented with change in bowel habits (75.7%), bleeding per rectum (33.3%), partial or complete intestinal obstruction (16.6%) and/or abdominal mass (13.6%).…”