Colorectal Carcinoma

Colorectal carcinoma: is second most common cause of death from neoplastic diseases, with peak incidence in 60-79 years of age, and rare under the age of 40.

Risk factors:

• High fat, high protein, low fibre diets

• Presence of multiple sporadic adenomatous polyps

• Ulcerative colitis

• Familial adenomatous polyposis

Morphology:

Distribution is as follows….

• Caecum/ ascending colon (38%)

• Transverse colon (8%)

• Descending colon (8%)

• Rectosigmoid (35%)

• Multiple sites at presentation (1%)

Presentation may be:

• Polypoid, fungating masses; especially in capacious caecum and right (ascending) colon

• Annular, encircling masses with napkin-ring obstruction; characteristic of distal colorectum

Both forms penetrate bowel wall over years (diffuse infiltrative)

Clinical finding:

Colorectal carcinoma is asymptomatic for years, though:

• Fatigue

• Weakness

• Iron deficiency anaemia

• Abdominal discomfort

• Progressive bowel obstruction

• Liver enlargement (metastases)

Eventually occur.

Five-year survival depends on the depth of penetration and lymph node involvement and ranges from 100% for lesions limited to the mucosa to 25% for extensively invasive tumours. Surgery is the only hope for cure.

Category: Gastroenterology Notes