Colonic ductal adenocarcinoma case report: New entity or rare ectopic degeneration?

BACKGROUND Ectopic pancreatic tissue is a congenital anomaly where a part of pancreatic tissue is located outside of the pancreas and lacks vascular or anatomical communication with it but shows the same histological features.Currently,the literature reports only two anecdotal cases of malignant transformation of colonic ectopic pancreas.CASE SUMMARY We present a case of an 81-year-old patient presenting with anemia,with right colonic neoplasia and carbohydrate antigen 19-9 above the normal values.She underwent laparoscopic right hemicolectomy.The final histology was consistent with a primitive adenocarcinoma with ductal morphology and solid-predominant growth pattern.Benign ectopic pancreatic tissue was absent in the surgical specimen.CONCLUSION The case describes a very rare complete degeneration of a colonic ectopic pancreatic tissue.However,the absence of benign ectopic pancreatic tissue in the surgical specimen is suggestive of the first description of a primitive ductal adenocarcinoma of the colon.

Cetuximab combined with chemotherapy for simultaneous esophageal squamous cell carcinoma and colon adenocarcinoma:A case report

BACKGROUND Multiple primary carcinomas(MPCs)are defined as two or more independent primary cancers that occur simultaneously or sequentially in the same individual.Synchronous MPCs are rarer than solitary cancers or metachronous MPCs.Accurate diagnoses of synchronous MPCs and the choice of treatment are critical for successful outcomes in these cases.CASE SUMMARY A 64-year-old patient presented with dysphagia,without obvious cause.A diagnosis of synchronous esophageal squamous cell carcinoma and colon adenocarcinoma with liver metastasis was confirmed based on examination and laboratory results.After multi-disciplinary consultations,combination chemotherapy(a 3-wk cycle with oxaliplatin 212 mg administered on day 1 and capecitabine 1.5 g twice daily on days 1-14)and esophageal cancer radiotherapy were initiated.Based on the results of genetic testing,we switched to a regimen of leucovorin+fluorouracil+oxaliplatin and cetuximab regimen for 8 cycles.Subsequently,capecitabine and bevacizumab were administered until the most recent follow-up,at which the tumor remained stable.CONCLUSION Successful cetuximab chemotherapy treatment provides a reference for the nonoperative and homogeneous treatment of different pathological types of synchronous MCPs.

Colon Adenocarcinoma in a Retrograde Intussusception: A Case Report and Literature Review

Background: Intussusception is defined as a telescoping of a proximal gastrointestinal segment with its mesentery to a distal one, only 5% occur in adults and in colon the probability that it is caused by a malignant disease is up to 65%. Only 1% occurs in a retrograde manner, the rest occur in an anterograde manner. Aim: Describe the clinical presentation of an intussusception in the adult patient as well as its most frequent causes and possible complications that influence decision making for a definitive treatment. Case Presentation: A 66-year-old woman diagnosed with colon adenocarcinoma who underwent elective transverse colectomy and colonic anastomosis with an incidental finding of a transverse colon tumor in a retrograde intussusception was studied. Conclusion: In any adult patient with an intussusception especially in colon a neoplasia should be suspected and the affected segment should be resected without being reduced due to the risk of perforation and tumor dissemination.

Prognostic significance of CDKN2A expression in colon adenocarcinoma: insights from TCGA analysis

Background:The cyclin-dependent kinase inhibitor 2a(CDKN2A)gene,identified as the multiple tumor suppressor gene,functions as a regulatory gene implicated in cancer pathogenesis.Its significance lies in its pivotal involvement in the genesis of various tumors;notwithstanding,the precise connection between CDKN2A and c olon adenocarcinoma(COAD)remains undisclosed.Methods:The objective of this research was to assess the predictive importance of CDKN2A in COAD by analyzing data from The Cancer Genome Atlas database.Logistic regression,signed rank test,Wilcoxon test,and Kruskal-Wallis test were used to examine CDKN2A expression levels and clinicopathological features.Univariate and multivariate Cox r egression analyses and Kaplan-Meier analysis found prognostic variables.Additionally,gene set enrichment analysis identified key CDKN2A expression pathways.The study additionally examined CDKN2A expression with tumor immune infiltration using The Cancer Genome Atlas data and single sample gene set enrichment analysis.Results:The results of this investigation indicated a substantial connection between higher CDKN2A expression and negative outcomes in terms of overall survival and disease-related survival among COAD patients.Gene set enrichment analysis indicated a tight link between CDKN2A and both the cell cycle and hedgehog signaling pathways.Subsequent evaluation employing single sample gene set enrichment analysis demonstrated a positive link between CDKN2A expression with infiltration by iDCs,whereas a negative correlation was detected with infiltration by helper T cells.Conclusion:In conclusion,the present study gives strong data supporting the predictive value of CDKN2A and its possible usefulness as a biomarker for COAD.Additionally,our results show a reasonable link between CDKN2A expression and immune influx in COAD,putting light on the role of CDKN2A in the control of the tumor microenvironment.Nevertheless,additional studies are needed to confirm the underlying mechanisms of these relationships and to discover the therapeutic possibilities of targeting CDKN2A in the treatment of COAD.

GINS1 as a Novel Biomarker of Survival in Colon Adenocarcinoma Patients-A Secondary Publication

The study focused on elaborating the role of GINS1 expression and its regulatory mechanisms in colon adenocarcinoma (COAD). Using the UALCAN informational index, GINS1 expression assessment unveiled a critical up- regulation in malignant cells that stood out from normal controls, suggesting its contribution to COAD expansion. Further dismantling GINS1 expression across various boundaries revealed unsurprising up-regulation in different malignant development stages, racial groups, genders, and age classes in COAD patients, characteristics for its imperative role in cancer progression. Moreover, this study investigated the promoter methylation status of GINS1, uncovering a critical uniqueness between COAD samples and normal controls. Analyzing promoter methylation across various clinical boundaries uncovered powerful variations, with particular methylation patterns seen across cancer stages, race groups, genders, and age groups. Survival analysis using the Kaplan-Meier (KM) plotter tool showed a colossal connection between GINS1 expression levels and overall survival (OS) in COAD patients, with low GINS1 expression interfacing with higher OS. Additionally, mutational examination using the cBioPortal stage revealed that no critical change was found in COAD. Overall, these findings revealed the complex contribution of GINS1 in COAD pathogenesis, underlining its actual limit as a prognostic biomarker and supportive therapeutic agent in COAD management.

Prognostic implications of ferroptosis-associated gene signature in colon adenocarcinoma

BACKGROUND Colon adenocarcinoma(COAD)is one of the most common and fatal malignant tumors,which increases the difficulty of prognostic predictions.Thus,new biomarkers for the diagnosis and prognosis of COAD should be explored.Ferroptosis is a recently identified programmed cell death process that has the characteristics of iron-dependent lipid peroxide accumulation.However,the predictive value of ferroptosis-related genes(FRGs)for COAD still needs to be further clarified.AIM To identify some critical FRGs and construct a COAD patient prognostic signature for clinical utilization.METHODS The Cancer Genome Atlas database(TCGA)and Gene Expression Omnibus databases were the data sources for mRNA expression and corresponding COAD patient clinical information.Differentially expressed FRGs were recognized using R and Perl software.We constructed a multi-FRG signature of the TCGA-COAD cohort by performing a univariate Cox regression and least absolute shrinkage and selection operator Cox regression analysis.COAD patients from the Gene Expression Omnibus cohort were utilized for verification.RESULTS Our research showed that most of the FRGs(85%)were differentially expressed between the corresponding adjacent normal tissues and cancer tissues in the TCGA-COAD cohort.Seven FRGs were related to overall survival(OS)in the univariate Cox analysis(all P<0.05).A model with five FRGs(AKR1C1,AKR1C3,ALOX12,CRYAB,and FDFT1)was constructed to divide patients into high-and low-risk groups.The OS of patients in the high-risk group was significantly lower than that of the low-risk group(all P<0.01 in the TCGA and Gene Expression Omnibus cohorts).The risk score was an independent prognosticator of OS in the multivariate Cox analysis(hazard ratio>1,P<0.01).The predictive capacity of the model was verified by a receiver operating characteristic curve analysis.In addition,a nomogram based on the expression of five hub FRGs and risk score can precisely predict the OS of individual COAD cancer patients.Immune correlation analysis and functional enrichment analysis results revealed that immunology-related pathways were abundant,and the immune states of the high-risk group and the low-risk group were different.CONCLUSION In conclusion,a novel five FRG model can be utilized for predicting prognosis in COAD.Targeting ferroptosis may be a treatment option for COAD.

IN VIVO NEAR-INFRAREDFLUORESCENCEIMAGING OF HUMANCOLONADENOCARCINOMABY SPECIFIC IMMUNOTARGETINGOFA TUMOR-ASSOCIATEDMUCIN

Background and Aims: Accurate endoscopic detection of premalignant lesions and earlycancers in the colon is essential for cure, since prognosis is closely related to lesion size andstage. Although it has great clinical potential, autofluorescence endoscopy has limited tumorto-normal tissue image contrast for detecting small preneoplastic lesions. We have developed amolecularly specific, near-infrared fluorescent monoclonal antibody (CC49) bioconjugate whichtargets tumor-associated glycoprotein 72 (TAG72), as a contrast agent to improve fluorescencebased endoscopy of colon cancer. Methods: The fluorescent anti-TAG72 conjugate was evaluated in vitro and in vivo in athymic nude mice bearing human colon adenocarcinoma (LS174T)subcutaneous tumors. Autofluorescence, a fluorescent but irrelevant antibody and the free fluorescent dye served as controls. Fluorescent agents were injected intravenously, and in vivowhole body fluorescence imaging was performed at various time points to determine pharmacokinetics, followed by ex vivo tissue analysis by confocal fluorescence microscopy and histology Results: Fluorescence microscopy and histology confirmed specific LS174T cell membrane targeting of labeled CC49 in vitro and ex vivo. In vivo fluorescence imaging demonstrated significant tumor-to-normal tissue contrast enhancement with labeled-CC49 at three hours postinjection, with maximum contrast after 48 h. Accumulation of tumor fluorescence demonstratedthat modification of CC49 antibodies did not alter their specific tumor-localizing properties, andwas antibody-dependent since controls did not produce detectable tumor fluorescence. Conclusions: These results show proof-of-principle that our near-infrared fluorescent-antibody probetargeting a tumor-associated mucin detects colonic tumors at the molecular level in real time,and offer a basis for future improvement of image contrast during clinical fluorescence endoscopy.

CHANGES OF NUCLEAR MATRIX PROTEIN AND ITS RELATIONSHIP WITH c-erbB-2 IN HUMAN COLON ADENOCARCINOMA

Objective： Nuclear matrix protein is tissue, cell-type specific, and tumor-relative. It plays an important role in the regulation of intranuclear processes. Some researches also showed that a c-erbB-2 promoter-specific DNA-binding nuclear matrix protein is present only in malignant human breast tissues and induces mitogenesis and cell surface expression of the c-erbB-2 protein in resting NIH/3T3 cells. But it is not clear that how it in colon adenocarcinomas. Methods： Two-dimensional gel electrophoretic method was used for NMP identification and immunohistochemistry was used for c-erbB-2 detection in 12 cases of colon adenocarcinomas and matched adjacent normal colon tissues. Results： 5 different nuclear matrix proteins （named C1-C5） were identified in 12 colon adenocarcinoma specimens, but not in the matched adjacent normal colon tissues; 3 nuclear matrix proteins （named N1-N3） were identified in all 12 matched adjacent normal colon tissues, but not in colon adenocarcinoma specimens. A nuclear matrix protein （named N4） was detected in all of 9 moderated-well differentiated adenocarcinomas and all 12 matched adjacent normal colon tissues, but not in 3 poor-differentiated adenocarcinomas. All of the 10 colon adenocarcinomas which had the nuclear matrix protein C4 were c-erbB-2 expression positive. Conclusion： The data suggest that there are specific nuclear matrix proteins in colon adenocarcinomas and its subtypes, which maybe valuable to serve as markers of colon adenocarcinomas in future. Nuclear matrix protein C4 probably is a c-erbB-2 promotor-specific nuclear matrix protein in colon adenocarcinomas, and may induce the expression of c-erbB-2.

Metachronous isolated penile metastasis from sigmoid colon adenocarcinoma:A case report

BACKGROUND Sigmoid colon adenocarcinoma has a high incidence among gastrointestinal tumors,and it very rarely metastasizes to the penis.The literature reports that the prognosis after penile metastasis is generally poor,with a median survival of about 9 mo.Metachronous isolated metastasis to the penis originating from sigmoid colon adenocarcinoma has not been reported so far.Here,we report a case of sigmoid colon adenocarcinoma with isolated penile metastasis occurring 2 years after surgery.The mass was pathologically confirmed as metastatic adenocarcinoma,and oral chemotherapy with capecitabine was given after surgery.The tumor did not recur during the 2-year follow-up period.CASE SUMMARY A 79-year-old man presented to the urology department with"a mass located at the root of the penis since 1 mo".Enhanced computed tomography(CT)examination suggested a 12 mm×10 mm×9 mm nodule at the root of the right penile corpus cavernosum.Cranial,pulmonary,and abdominal CT;and bone scan did not show any tumorigenic lesions.The carcinoembryonic antigen(CEA)level was slightly elevated(6.01 ng/mL,reference value 0-5 ng/mL).The patient had undergone laparoscopic radical sigmoidectomy for sigmoid colon cancer 2 years ago.The postoperative pathology showed moderately differentiated adenocarcinoma of the sigmoid colon,and the stage was PT2N0M0.The penile mass was removed under general anesthesia.The postoperative pathology showed adenocarcinoma,and immunohistochemistry showed CDX2(+),CK20(+),and Villin(+).Based on the medical history,he was diagnosed with penile metastasis from sigmoid colon adenocarcinoma.The CEA level returned to normal(3.34 ng/mL)4 d after surgery.Oral chemotherapy with capecitabine was given subsequently,and tumor recurrence was not found during the 2-year follow-up period.CONCLUSION To our knowledge,this is a rare case of metachronous isolated penile metastasis from sigmoid colon adenocarcinoma.The penis is a potential site of metastasis of colon adenocarcinoma,and the possibility of metastasis should be considered in patients with a history of colon cancer who present with a penile mass.Solitary penile metastasis can be removed surgically,in combination with chemotherapy,and it may have good long-term outcomes.

Autophagy-related lncRNA and its related mechanism in colon adenocarcinoma

Objective Colon cancer is a type of cancer with high morbidity and mortality,of which adenocarcinoma is the most common type.Numerous studies have found that long noncoding RNAs(lncRNAs)are related to the occurrence and development of colon cancer.Autophagy is a key metabolic process in the human body and has a role in affecting cancer growth.In this study,our aim was to explore the correlation between lncRNAs and colon adenocarcinoma(COAD)from the perspective of autophagy.Methods A series of bioinformatics methods were used to explore the correlation between lncRNA and COAD from the perspective of autophagy.Results Four autophagy-related lncRNAs related to the prognosis of COAD were identified:EB1-AS1,LINC02381,AC011462.4,and AC016876.1.These four lncRNAs may act as oncogenes involved in the occurrence and development of COAD.The prognostic model was established,and the accuracy of the model was verified by the receiver operating characteristic curve.The risk score of the model could independently predict the prognosis of patients and was preferable to other clinical indicators,with higher values indicating a worse prognosis of the patients.Gene Set Enrichment Analysis was performed for these four lncRNAs,which showed that the high expression group of these were enriched in the basal cell carcinoma pathway.To make it more convenient for clinicians to use,we constructed a nomogram based on age and risk score,which can be used to evaluate the one-,three-,and five-year survival rates of patients.Conclusion These results can help us understand the mechanism of action of lncRNA on COAD from the perspective of autophagy and may provide new directions for the diagnosis and treatment of COAD.The EB1-AS1 gene in this study is a potential candidate biological target for COAD treatment in the future.

Unusual Spreading of Colon Adenocarcinoma into the Right Hip Area: A Case Report

Adenocarcinoma is the most common colon cancer type. This form of colonic neoplasms usually metastasizes initially to regional lymphatic system and through the blood circulation to the lungs and liver, while other forms of expansion and involvement of other organ systems are less common. Extraluminal carcinoma is very rare. Only a few authors describe the direct spread of cancer to adjacent structures and organs. In this paper we present a case of a 76-year old patient with tumor mass extending from the colon to the right hip area “per continuitatem”. The patient had no symptoms and signs that would indicate the presence of neoplastic process in the colon. Only a discomfort in right leg was present and finally tumor mass was visualized. Biopsy and patohistology findings confirmed final diagnosis and type of tumor in the right hip region. Pathohistologicaly tumor was adenocarcinoma.

THE THERAPEUTIC EFFECT OF INTRATUMORAL INJECTION OF GM-CSF GENE-MODIFIED ALLOGENIC MACROPHAGES ON TUMOR-BEARING MICE

Both the antigen presenting ability and the cytotoxicity of macrophages can be enhanced by GMCSF gene transfer. In the present study, the therapeutic effect of intratumoral injection with GMCSF genemodified allogenic macrophages on tumorbearing mice observed. The peritoneal macrophages of C57BL/6 mice were transfected with GMCSF gene mediated by recombinant adenovirus and the subcutaneous CT26 colon adenocarcinomabearing BALB/c mice were treated by intratumoral injection of the above macrophages. The survival time of the tumorbearing mice were prolonged significantly and some tumor mass disappeared completely. The necroses of the tumor cells and massive infiltration of inflammatory cells were observed 6 days after treatment. 30 days after treatment, only the leftover of tumor cells and the inflammatory cells remained. The data indicated that introtumoral injection of GMCSF genemodified allogenic macrophages displayed more potent therapeutic effect on the preestablished tumorbearing mice.

HETEROTOPIC OSSIFICATION IN ADENOCARCINOMA OF THE COLON

Heterotopic ossification occurring in large-bowel carcinoma and/or its metastasis is a rare entity. There had been only 33 cases reported in the literature by 1992. Isolated wound recurrence after surgery for colorectal carcinomas is also relatively uncommon. Hughes et al studied the surgery results of 1 603 patients with large-bowel cancer and found 11 patients (0.7%) having recurrent tumor in the abdominal wall scar. The finding of malignant epithelial cells and benign bone trabeculae in adenocarcinoma of the colon and its incisional recurrence is an exceedingly rare phenomenon. Herein, an unusual case of colonic carcinoma with an isolated abdominal wall scar recurrence was presented, in which heterotopic ossification was associated with primary and metastatic adenocarcinomas.

Colon carcinoma treated with oxaliplatin and capecitabine in a 12-year-old child

Background:XELOX(oxaliplatin 130mg/m^(2)iv,capecitabine 1000mg/m^(2)bid oral d1–14,q3w)chemotherapy has never been used in children.In this report,we present a case of a 12-year-old girl with colon adenocarcinoma,treated with surgery and XELOX chemotherapy.Methods:On admission,the girl complained of abdominal pain and intestinal obstruction.Physical examination revealed a distended abdomen with tenderness on the left upper quadrant.Barium enema revealed a stenotic lesion at the distal end of the transverse colon,and abdominal computed tomography showed acute obstruction and a colonic mass.Laparotomy was performed after the failure of conservative treatment.Results:The mass was originated from the transverse colon.Frozen sections of the specimens revealed an adenocarcinoma.Transverse colectomy was performed and regional lymph nodes were removed.Pathological examination confirmed that the mass was a poorly differentiated adenocarcinoma,and XELOX chemotherapy was used.No evidence of recurrent or metastatic tumor was found after 18 months.Conclusion:Although complete resection is the most effective treatment,XELOX chemotherapy is beneficial to the improvement of clinical outcome of patients with colon adenocarcinoma.