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.

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.

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.

Sp1 contributes to overexpression of stanniocalcin 2 through regulation of promoter activity in colon adenocarcinoma

BACKGROUND Aberrant expression of stanniocalcin 2 (STC2) is implicated in colon adenocarcinoma (COAD). A previous study identified that STC2 functions as a tumor promoter to drive development of some cancers, but the role of its overexpression in the development of COAD remains unclear. AIM To evaluate the regulation mechanism of STC2 overexpression in COAD. METHODS The expression of STC2 in COAD was assessed by TCGA COAD database and GEO (GSE50760). Methylation level of the STC2 promoter was evaluated with beta value in UALCAN platform, and the correlation between STC2 expression and survival rate was investigated with TCGA COAD. Transcription binding site prediction was conducted by TRANSFAC and LASAGNA, and a luciferase reporter system was used to identify STC2 promoter activity in several cell lines, including HEK293T, NCM460, HT29, SW480, and HCT116. Western blotting was performed to evaluate the role of Sp1 on the expression of STC2. RESULTS The central finding of this work is that STC2 is overexpressed in COAD tissues and positively correlated with poor prognosis. Importantly, the binding site of the transcription factor Sp1 is widely located in the promoter region of STC2. A luciferase reporter system was successfully constructed to analyze the transcription activity of STC2, and knocking down the expression of Sp1 significantly inhibited the transcription activity of STC2. Furthermore, inhibition of Sp1 remarkably decreased protein levels of STC2. CONCLUSION Our data provide evidence that the transcription factor Sp1 is essential for the overexpression of STC2 in COAD through activation of promoter activity. Taken together, our finding provides new insights into the mechanism of oncogenic function of COAD by STC2.

Ascending colon adenocarcinoma with tonsillar metastasis:A case report and review of the literature

Metastatic palatine tonsil cancer is extremely rare, with nearly 100 such tumors reported in the English literature. The prognosis of metastatic palatine tonsil cancer is poor. A 53-year-old man presented with painless left palatine tonsillar swelling and a cervical mass following right hemicolectomy for an ascending colon adenocarcinoma. Physical examination showed an ulcerated mass located on the upper pole of the left palatine tonsil. A punch biopsy was taken for histological examination which showed a moderately- differentiated adenocarcinoma. The patient was treated with palliative radiotherapy and chemotherapy. He was still alive when we wrote this paper. Our case shows that immunohistochemical diagnosis of metastatic palatine tonsil cancer is essential.

Relationship between Fas/ FasL expression and apoptosis of colon adenocarcinoma cell lines

INTRODUCTIONFas/ FasL system has been identified as a keymediator of apoptosis in tumor cells[1-4]. Theoccurrence and development of neoplasm are closelyrelated to apoptosis[5-7] Most chemotherapeuticdrugs kill cancer cells mainly by inducingapoptosis[8-14].'

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.

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.

Correlation between clinicopathology and expression of heat shock protein 70 and glucose-regulated protein 94 in human colonic adenocarcinoma

AIM: To investigate the correlation between dinicopathology and expression of heat shock protein 70 (HSP70) and glucose-regulated protein 94 (grp94) in human colonic carcinoma.METHODS: The expression of HSP70 and grp94 was studied in 80 human colonic cancers with or without metastasis as well as in their adjacent mucous membrane by way of immunohistochemistry and pathology photograph analysis.RESULTS: The expression of HSP70 and grp94 was significantly higher in cancer than that in adjacent mucous membrane (92.5%, 85.0% vs 56.3%, 42.5%, P＜0.01).HSP70 and grp94 expressed higher in moderately- and poorly-differentiated colonic cancers than that in their adjacent tissues (93.7%, 87.5%; 100%, 90% vs 56.3%,42.5%; P＜0.01). Dukes C and D stages of colonic cancers showed higher positive rates than Dukes A and B stage groups (97.1%, 91.2%; 100%, 90.9%; vs 80%, 70%;78.6%, 71.4%; P＜0.05). There were definite differences in HSP70 and grp94 expression between metastasis groups and non-metastasis groups (100% vs75%, 100%vs 50%, P＜0.05).CONCLUSION: The HSP70 and grp94 expression rates in colonic cancer groups are significantly higher than that in their adjacent mucous membrane. The HSP70 and grp94expression in poorly-differentiated colonic cancers with metastasis is significantly higher than well-differentiated cancers without metastasis. The overexpression of HSP70and grp94 can be used as diagnostic or prognostic markers for colonic cancer.

Synchronous adenocarcinoma and extranodal natural killer/T-cell lymphoma of the colon:A case report and literature review

Extranodal natural killer/T-cell lymphoma(ENKTL) is a distinct subtype of non-Hodgkin's lymphoma and is rare in the colon.Synchronous adenocarcinoma and ENKTL of the colon has not been reported in the literature.In the present study,we report a 63-year-old male who suffered from intermittent bloody stools for 2 mo.He did not have fever,body weight loss or night sweat.Endoscopic and imaging studies revealed a 4.5-cm ulcerative mass in the ascending colon and a 3.0-cm polypoid,easy bleeding mass in the sigmoid colon,respectively.Thought to have double carcinoma of the colon,he received simultaneous right hemicolectomy and sigmoidectomy.The pathological diagnosis was a synchronous ENKTL(ascending colon) and adenocarcinoma(sigmoid colon).The literature on synchronous adenocarcinoma and malignant lymphoma of the colon was also reviewed.

Growth inhibitory effect of wild-type Kras2 gene on a colonic adenocarcinoma cell line

AIM: To observe the growth inhibitory effect of wild-type Kras2 gene on a colonic adenocarcinoma cell line Caco-2. METHODS: Recombinant plasmid pCI-neo-Kras2 with wild type Kras2 open reading frame was constructed. The Caco-2 cells were transfected with either pCI-neo or pCI-neo-Kras2 using Lipofectamine 2000. The expression of wild type Kras 2 was examined by Northern blot analysis. And the expression of wild type Kras2 protein was examined by Western blot analysis. The effects of wild-type Kras2 on cell proliferation were analyzed by monotetrazolium (MTT) assay, meanwhile analyses of cell cycle and spontaneous apoptosis rate were carried out by flow cytometry (FCM). RESULTS: The plasmid of pCI-neo-Kras 2 was successfully established. The growth rate of cells transfected with pCI-neo-Kras2 was significantly lower than the control cells transfected with the empty pCI-neo vector (P < 0.05). Cell cycle analysis revealed arrest of the pCI-neo-Kras2 transfected cells in G0/G1 phases, decreased DNA synthesis and decreased fractions of cells in S phase. The proliferative index of cells transfected with pCI-neo-Kras2 was decreased compared with the control cells (49.78% vs 64.21%),while the apoptotic rate of Caco-2 cells with stable Kras 2 expression increased (0.30% vs 0.02%). CONCLUSION: The wild-type Kras2 gene effectively inhibits the growth of the colonic adenocarcinoma cell line Caco-2.

Differential expression of nucleolin in colon adenoma and adenocarcinoma

Objective The aim of the study was to investigate the discrepancy in nucleolin expression between colon adenoma and colon adenocarcinoma,explore the role of nucleolin expression in the carcinogenesis of colon adenocarcinoma,and determine the correlation of the nucleolin expression level with histological grade in colon adenocarcinoma.Methods In total,80 cases of colon adenocarcinoma with cancer-adjacent colon mucosa and 60 cases of colon adenomas were examined by immunohistochemistry using an antibody against nucleolin.Nucleolin expression levels in these groups were compared.The correlation between the nucleolin expression level and grade of colon adenocarcinoma was analyzed.Results Nucleolin expression is located in the nuclei of colon adenocarcinoma,colon adenoma,and cancer-adjacent colon mucosa tissues with different intensities.A semiquantitative evaluation using the Allred scoring system showed that the nucleolin immunostaining score in colon adenocarcinoma(7.8 ± 0.1) was significantly higher than those in colon adenoma(6.3 ± 0.2) and cancer-adjacent colon mucosa(5.4 ± 0.1;P < 0.01).The nucleolin immunostaining score in colon adenoma was significantly higher than that in cancer-adjacent colon mucosa(P < 0.01).Nucleolin expression levels in well-differentiated and moderately differentiated adenocarcinoma(6.8 ± 0.2) were significantly lower than those in poorly differentiated adenocarcinoma(8.0 ± 0.1;P < 0.01).Conclusion Increased nucleolin expression may play an important role in the process of malignant transformation of colon adenocarcinoma and predicts a poor prognosis.

Effect of Octreotide on cell-cycle kinetics and serum CEA level in hepatic metastases of colonic adenocarcinoma

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Hepatoid adenocarcinoma of the colon in a patient with inflammatory bowel disease

A case is presented of a 36-year-old male with primary sclerosing cholangitis-associated inflammatory bowel disease(PSC-IBD) and two synchronous stage 1 adenocarcinomata of the colon,who was initially treated with a subtotal colectomy with ileostomy.One year later,the patient presented with extensive intra-abdominal lymphadenopathy and peritoneal carcinomatosis,as well as a markedly elevated serum level of alpha-fetoprotein(AFP).Fine needle aspiration biopsy of a porta hepatis lymph node revealed a metastatic hepatoid adenocarcinoma.Subsequent review of the previous colectomy specimen showed that one of the previously identified adenocarcinomata had features suggestive of a hepatoid colonic adenocarcinoma.The patient was subsequently treated with a cytotoxic regimen of FOLFOX(oxaliplatin,leucovorin,5-fluorouracil) and bevacizumab,with stable results being achieved after six months.This case presents the first known report of PSC-IBD associated with synchronous typical and hepatoid adenocarcinomata of the colon and highlights the importance of considering hepatoid adenocarcinoma as a differential diagnosis in patients with an increasing serum AFP level.

Primary colonic type adenocarcinoma of the cecal appendix presented as obstructive acute abdominal syndrome

We reported a case with an obstructive acute abdomen,and emergency exploratory laparotomy was performed.Ap-pendiceal neoplasm was observed adhered to the ileum,and an ileohemicolectomy was performed.From the histopathological point of view the neoplasm was an infiltrating colonic type adenocarcinoma of the appendix,with extension to the periapendicular adipose tissue and fixation of an adjacent ileal loop secondary to infiltration of the intestinal wall.The tumor produced a moderate luminal stenosis of the intestine,this explained the clinical manifestations of the patient.Post-operative evolution was satisfac-tory and there had been no signs of recurrence in the 5 years since the operation.Based upon the comparison of clinical char-acteristics,pathological behavior(in relation to the growth and dissemination),and therapeutic considerations,possibly colonic type adenocarcinoma of the appendix is a neoplasm similar to the carcinomas of ascending colon.