Association of rectal prolapse with colorectal cancer

Rashid, Zaihan; Basson, Marc D.

doi:10.1016/s0039-6060(96)80213-3

Cited by 35 publications

(34 citation statements)

References 14 publications

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“…In accordance, several case studies reported rectal prolapse when adenocarcinoma of the sigmoid colon was present [44–46]. Patients with rectal prolapse showed a 4.2-fold relative risk for CRC in comparison with a control group [3]. In line with this data, McNicol et al report that the association of rectal prolapse and rectal adenocarcinoma is not that rare.…”

Section: Discussionsupporting

confidence: 56%

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Age and cellular context influence rectal prolapse formation in mice with caecal wall colorectal cancer xenografts

et al. 2016

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In patients with rectal prolapse is the prevalence of colorectal cancer increased, suggesting that a colorectal tumor may induce rectal prolapse. Establishment of tumor xenografts in immunodeficient mice after orthotopic inoculations of human colorectal cancer cells into the caecal wall is a widely used approach for the study of human colorectal cancer progression and preclinical evaluation of therapeutics. Remarkably, 70% of young mice carrying a COLO320DM caecal tumor showed symptoms of intussusception of the large bowel associated with intestinal lumen obstruction and rectal prolapse. The quantity of the COLO320DM bioluminescent signal of the first three weeks post-inoculation predicts prolapse in young mice. Rectal prolapse was not observed in adult mice carrying a COLO320DM caecal tumor or young mice carrying a HT29 caecal tumor. In contrast to HT29 tumors, which showed local invasion and metastasis, COLO320DM tumors demonstrated a non-invasive tumor with pushing borders without presence of metastasis. In conclusion, rectal prolapse can be linked to a non-invasive, space-occupying COLO320DM tumor in the gastrointestinal tract of young immunodeficient mice. These data reveal a model that can clarify the association of patients showing rectal prolapse with colorectal cancer.

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Section: Discussionsupporting

confidence: 56%

“…Interestingly, rectal prolapse can also occur as a symptom of colorectal cancer (CRC). Patients with rectal prolapse are reported to have a 4.2-fold relative risk for CRC in comparison with a control group [3]. This may indicate that rectal prolapse is induced by CRC.…”

Section: Introductionmentioning

confidence: 99%

Age and cellular context influence rectal prolapse formation in mice with caecal wall colorectal cancer xenografts

et al. 2016

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“…A study performed by Rashid and Basson retrospectively identified and investigated the incidence of colorectal cancer in patients with full-thickness rectal prolapse [6]. They concluded that patients with full thickness rectal prolapse had a 4.2-fold relative risk for colorectal cancer when compared with an age-matched asymptomatic comparison group.…”

Section: Dear Editormentioning

confidence: 99%

“…This is the first case with rectal cancer in a prolapsed rectal stump following a Hartmann's procedure. This is more unusual still when one remembers that the original Hartmann's procedure was performed for benign disease.A study performed by Rashid and Basson retrospectively identified and investigated the incidence of colorectal cancer in patients with full-thickness rectal prolapse [6]. They concluded that patients with full thickness rectal prolapse had a 4.2-fold relative risk for colorectal cancer when compared with an age-matched…”

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confidence: 99%

Rectal adenocarcinoma in prolapsed rectal stump following Hartmann’s procedure

Nabi

2014

Int J Colorectal Dis

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Dear Editor:A 77-year-old female with numerous medical comorbidities (predominantly cardiac and respiratory) was referred by her general practitioner to the colorectal outpatient clinic at Fremantle Hospital with a symptomatic full-thickness rectal prolapse. The patient had a Hartmann's procedure performed approximately 35 years prior at a peripheral hospital after an obstetric injury rendered her completely incontinent of faeces. At that time, attempts at sphincter repair unfortunately failed and, consequently, the Hartmann's procedure was performed as a last resort. This procedure had been performed purely for symptomatic relief of her socially debilitating incontinence and no colonic pathology was identified clinically or pathologically.The patient stated that she first noticed prolapse of her rectal stump approximately 5 years prior to her referral to see us in colorectal clinic. At that time, her then general practitioner felt that her medical comorbidities excluded her from having any surgical intervention and, consequently, no referral had been made for specialist review.Examination of the patient's perineum confirmed the presence of a full-thickness rectal stump prolapse, with 15 cm of rectum prolapsing through the patient's anus. Examination of the anus established that the patient had no sphincter tone. Interestingly, a large mass (up to 35-mm diameter) emanating from the rectal mucosa was identified in the distal end of the prolapsing rectal stump-this was clinically suspicious for malignancy. Biopsies of the mass taken in the clinic confirmed the presence of adenocarcinoma.Preoperative staging computer tomography (CT) scanning confirmed that the entire rectal stump had prolapsed from the anus. No disseminated disease or suspicious lymphadenopathy was identified on this CT.Given the patient's numerous medical comorbidities-and subsequent discussions with anaesthetics-a collaborative decision was made to resect the patient's pathology via a perineal approach and avoid any abdominal incisions. This was deemed to be the safest approach given her medical fragility. Consequently, an intersphincteric perineal proctectomy was performed with high ligation of the mesorectum achieved with the use of an energy device through the perineum. The use of the energy device facilitated for a greater lymph node yield with more complete resection of the mesorectum and rectal vessels.The patient recovered well following this novel approach to her highly unusual pathology and no short-term complications were noted at 30 days. The pathology of the resection specimen confirmed the complete resection of a moderately differentiated rectal adenocarcinoma with invasion into the muscularis propria (pT2) and none of the 12 lymph nodes in the specimen involved (pN0).A literature search was performed using PubMed and MEDLINE databases looking for previous cases of colorectal adenocarcinomas in full-thickness rectal prolapse. Only five other cases exist of sigmoid and rectal adenocarcinomas detected in a full-thickness rectal prolapse...

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“…Some authors observed increased incidence of rectal cancer in patients with untreated chronic rectal prolapse probably due to changes in bowel habits, chronic constipation and chronic irritation 9 . Others consider that rectal prolapse could be attributed to chronic constipation exacerbated by colorectal cancer and for that reason rectal prolapse should be considered a symptom of colorectal neoplasm 10 . Altemeier's procedure is a valid surgical option in cases of older patients with rectal prolapse associated with sizable carpeted polypoid lesions of the rectum.…”

Section: Case Presentationmentioning

confidence: 99%