Synchronous Cancers, Familial Adenomatous Polyposis

Video Endoscopic Sequence 1 of 36.

Synchronous Colon Cancers, Familial Adenomatous Polyposis

Prolapsed Adenocarcinoma of the rectum and
adenocarcinoma of the transverse colon.

This is the case of a 48, year-old female, referred to us to evaluate a rectal prolapsed mass, one brother died due to a colon cancer and two brothers died due to rectal hemorrhage at 11 and 12 years.

For more endoscopic details download the video clips by clicking on the endoscopic images, wait to be downloaded complete then press Alt and Enter; thus you can observe the video in full screen.

All endoscopic images shown in this Atlas contain
video clips.

 

 

 

 

Synchronous Cancers, Familial Adenomatous Polyposis

Video Endoscopic Sequence 2 of 36.

Synchronous Cancers, Familial Adenomatous Polyposis

The image as well as display a large and irregular mass
in the transverse colon that was proven by histopathology
to be an adenocarcinoma.

Synchronous carcinomas of the colon and rectum are of considerable clinical significance because of their frequency, the number of extra tumours missed and the difficulty of preoperative diagnosis.

Most patients with FAP are asymptomatic until they develop cancer. As a result, diagnosing presymptomatic patients is essential.

 

Synchronous Cancers, Familial Adenomatous Polyposis

Video Endoscopic Sequence 3 of 36.

Synchronous Cancers, Familial Adenomatous Polyposis

The patient has several flat adenomas in the rectum.

The genetic defect in FAP is a germline mutation in the adenomatous polyposis coli (APC) gene. Syndromes once thought to be distinct from FAP are now recognized to be, in reality, part of the phenotypic spectrum of FAP.

 

Multiple Adenomas in the Sigmoid are displayed. Colonoscopy revealed hundreds of polyps throughout the colon.

Video Endoscopic Sequence 4 of 36.

Synchronous Colon Cancers, Familial Adenomatous Polyposis

Multiple Adenomas in the Sigmoid are displayed. Colonoscopy revealed hundreds of polyps throughout the colon.

The principal cause of mortality is colorectal cancer, which develops in all patients unless they are treated. The mean age at which colorectal cancer develops in patients with classic FAP is 39 years. Patients with adenomatous polyposis itself often are asymptomatic.

 

Synchronous Colon Cancers, Familial Adenomatous Polyposis

Video Endoscopic Sequence 5 of 36.

Synchronous Colon Cancers, Familial Adenomatous Polyposis

More Adenomas in the Descending Colon

The second reported lethal complication of FAP is diffuse mesenteric fibromatosis and is referred to as a desmoid tumor. It involves intra-abdominal organs and vessels, causing gastrointestinal obstruction and constriction of veins, arteries, and ureters. Desmoid tumors are reported in 4-32% of patients. Even after the appropriate surgical treatment of FAP, 20% of patients may develop desmoid tumors after colectomy. Studies have not found a correlation between specific APC mutation sites and desmoid tumor development.

 

Synchronous Colon Cancers, Familial Adenomatous Polyposis 

The two most common inherited forms of colorectal cancer are familial adenomatous polyposis and hereditary non -polyposis colorectal cancer.


The second most common malignancy in patients with FAP is adenocarcinoma of the duodenum and the papilla of Vater. It affects as many as 12% of patients.

Video Endoscopic Sequence 6 of 36.

Synchronous Colon Cancers, Familial Adenomatous Polyposis

The two most common inherited forms of colorectal cancer are familial adenomatous polyposis and hereditary non -polyposis colorectal cancer.

The second most common malignancy in patients with FAP is adenocarcinoma of the duodenum and the papilla of Vater. It affects as many as 12% of patients.

 

Synchronous Colon Cancers, Familial Adenomatous Polyposis

Video Endoscopic Sequence 7 of 36.

A large Ulcerated Adenoma is seen at the Splenic Flexure. The ulcer displayed it may be due to the biopsies taken 19 days in a previous colonoscopy.

Synchronous Colon Cancers, Familial Adenomatous Polyposis

Video Endoscopic Sequence 8 of 36.

Synchronous Colon Cancers, Familial Adenomatous Polyposis

This unusual finding is an artery that feed two polyps.

Rarer cancers associated with FAP include medulloblastomas (Turcot syndrome), hepatoblastoma, thyroid cancer, gastric cancer, pancreatic cancer, and adrenal cancer.

 

Again more images and video clip of the Adenocarcinoma of the transverse colon.

Video Endoscopic Sequence 9 of 36.

Synchronous Colon Cancers, Familial Adenomatous Polyposis

Again more images and video clip of the Adenocarcinoma of the transverse colon.

 

Synchronous Colon Cancers, Familial Adenomatous Polyposis, The hole of the apendix is surrounded by adenomatous tissue.

Video Endoscopic Sequence 10 of 36.

Synchronous Colon Cancers, Familial Adenomatous Polyposis

The hole of the apendix is surrounded by adenomatous tissue.

 

Synchronous Colon Cancers, Familial Adenomatous Polyposis. Cecum, the terminal Ileum was unremarkable.

Video Endoscopic Sequence 11 of 36.

Synchronous Colon Cancers, Familial Adenomatous Polyposis

Cecum, the terminal Ileum was unremarkable.

 

 

 

 

Synchronous Colon Cancers, Familial Adenomatous Polyposis. A large pediculated mass is displayed at ascending colon.

Video Endoscopic Sequence 12 of 36.

Synchronous Colon Cancers, Familial Adenomatous Polyposis.

A large pediculated mass is displayed at ascending colon.

 

Florid polyposis, usually with over 100 polyps in the colon and often several thousand

Video Endoscopic Sequence 13 of 36.

Synchronous Colon Cancers, Familial Adenomatous Polyposis

Florid polyposis, usually with over 100 polyps in the colon and often several thousand.

This image and the video clip shown multiple polyps and the adenocarcinoma of the transverse colon.

 

Synchronous Colon Cancers, Familial Adenomatous Polyposis

Video Endoscopic Sequence 14 of 36.

Synchronous Colon Cancers, Familial Adenomatous Polyposis

The video clip displays the biopsy of the cancer of the transverse colon.

 

Endoscopy of Synchronous Colon Cancers, Familial Adenomatous Polyposis

Video Endoscopic Sequence 15 of 36.

Endoscopy of Synchronous Colon Cancers, Familial Adenomatous Polyposis

Splenic Flexure.

 

Endoscopy of Synchronous Colon Cancers, Familial Adenomatous Polyposis

Video Endoscopic Sequence 16 of 36.

Endoscopy of Synchronous Colon Cancers, Familial Adenomatous Polyposis

In FAP the male-to-female ratio is 1:1.

 

 

 

 

The average age of onset of polyposis in FAP is 16 years. The average age of onset for colorectal cancer is 39 years. The average age of onset for polyps in AAPC is 36 years, and the average age of onset for cancer in AAPC is 54 years. These patients have fewer polyps (approximately 30 polyps) compared to patients with FAP. Most patients with FAP are asymptomatic until they develop cancer. As a result, diagnosing presymptomatic patients is essential. Of patients with FAP, 75-80% have a family history of polyps and/or colorectal cancer at age 40 years or younger.

Video Endoscopic Sequence 17 of 36.

Synchronous Colon Cancers, Familial Adenomatous Polyposis

The average age of onset of polyposis in FAP is 16 years.

The average age of onset for colorectal cancer is 39 years.

The average age of onset for polyps in AAPC is 36 years, and the average age of onset for cancer in AAPC is 54 years. These patients have fewer polyps (approximately 30 polyps) compared to patients with FAP.

Most patients with FAP are asymptomatic until they develop cancer. As a result, diagnosing presymptomatic patients is essential.

Of patients with FAP, 75-80% have a family history of polyps and/or colorectal cancer at age 40 years or younger.

 

The image and the video clip displays the adenocarcinoma of the rectum.

Video Endoscopic Sequence 18 of 36.

The image and the video clip displays the adenocarcinoma of the rectum.

A gastroenterologist familiar with familial adenomatous polyposis (FAP) should direct the overall care. In addition, a geneticist is part of the medical team involved in therapy for FAP.

Treatment frequently involves the input of a surgeon who is familiar with FAP.

Other problems to be considered

Other conditions that should be considered in the differential diagnosis of familial adenomatous polyposis include the following:

Bannayan-Riley-Ruvalcaba syndrome
Juvenile polyposis syndrome
Hereditary nonpolyposis colon cancer
Hyperplastic polyposis
Nodular lymphoid hyperplasia
Lymphomatous polyposis
Inflammatory polyposis
MYH-associated polyposis


Differential Diagnoses


Cowden Disease (Multiple Hamartoma Syndrome)
Cronkhite-Canada Syndrome
Neurofibromatosis Type 1
Peutz-Jeghers Syndrome

The image and the video clip display, that some biopsies are taken of an irregular flat adenoma of the rectum.

Video Endoscopic Sequence 19 of 36.

Synchronous Colon Cancers, Familial Adenomatous Polyposis

The image and the video clip display, that some biopsies are taken of an irregular flat adenoma of the rectum.

Dental and skull x-ray films are recommended in patients thought to have a Gardner variant of FAP. The films help to detect osteomas and dental abnormalities.

 

Nonspecific symptoms, such as unexplained rectal bleeding (hematochezia), diarrhea, or abdominal pain, in young patients may be suggestive of FAP.

Video Endoscopic Sequence 20 of 36.

Synchronous Colon Cancers, Familial Adenomatous Polyposis

Nonspecific symptoms, such as unexplained rectal bleeding (hematochezia), diarrhea, or abdominal pain, in young patients may be suggestive of FAP.

Congenital hypertrophy of the retinal pigment epithelium is highly specific for FAP and is best seen by slit-lamp examination.

 

The rectum has several flat polyps.

Video Endoscopic Sequence 21 of 36.

Synchronous Colon Cancers, Familial Adenomatous Polyposis

The rectum has several flat polyps.

 

The rectum has several flat polyps.

Video Endoscopic Sequence 22 of 36.

Synchronous Colon Cancers, Familial Adenomatous Polyposis

Again a flat polyp of the rectum.

 

Retroflexed image of the rectal adenocarcinoma.

Video Endoscopic Sequence 23 of 36.

Synchronous Colon Cancers, Familial Adenomatous Polyposis

Retroflexed image of the rectal adenocarcinoma.

 

Synchronous Colon Cancers, Familial Adenomatous Polyposis

Video Endoscopic Sequence 24 of 36.

Synchronous Colon Cancers, Familial Adenomatous Polyposis

Again, retroflexed image displayed a retum adenocarcinoma.

 

Synchronous Colon Cancers, Familial Adenomatous Polyposis

Video Endoscopic Sequence 25 of 36.

Synchronous Colon Cancers, Familial Adenomatous Polyposis

Prolapsed adenocarcinoma.

 

Synchronous Colon Cancers, Familial Adenomatous Polyposis

Video Endoscopic Sequence 26 of 36.

Synchronous Colon Cancers, Familial Adenomatous Polyposis

More images and video clip.

 

Surgical specimen of the colon after total colectomy with

Video Endoscopic Sequence 27 of 36.

Synchronous Colon Cancers, Familial Adenomatous Polyposis

Surgical Specimen

Surgical specimen of the colon after total colectomy with
ileostomy. Note the carpetlike appearance of the mucosa
covered with polyps.

The surgical specimen showed besides of multiple colon
carcinoma a large number of adenomas of which many
contained areas with high grade dysplasia.

 

Macroscopic Specimen of Familial adenomatous polyposis (FAP), Familial polyposis coli: the entire colonic mucosa is carpeted with a close crop of polyps.

Video Endoscopic Sequence 28 of 36.

Synchronous Colon Cancers, Familial Adenomatous Polyposis

Macroscopic Specimen of Familial adenomatous polyposis (FAP), Familial polyposis coli: the entire colonic mucosa is carpeted with a close crop of polyps.

 

Macroscopic Specimen of Familial adenomatous polyposis (FAP).

Video Endoscopic Sequence 29 of 36.

Macroscopic Specimen of Familial adenomatous polyposis (FAP).

Familial adenomatous polyposis colon is an
autozomal dominant most commonly caused by a
mutation in the APC gene at chromosome 5q21. it is
characterised by early onset of numerous colonic
adenomas with an inevitable progression to
colorectal carcinoma if not detected early, so
endoscopic surveillance, establishment of polyposis
and surgical resection of FAP colon as early as
possible can decrease the incidence and mortality
from colorectal carcinomas.

 

Video Endoscopic Sequence 30 of 36.

Macroscopic Specimen of Familial adenomatous polyposis (FAP).

 

Macroscopic Specimen of Familial adenomatous polyposis (FAP).

Video Endoscopic Sequence 31 of 36.

Macroscopic Specimen of Familial adenomatous polyposis (FAP).

 

Synchronous Colon Cancers, Familial Adenomatous Polyposis

Video Endoscopic Sequence 32 of 36.

Synchronous Colon Cancers, Familial Adenomatous Polyposis

Macroscopic Specimen of Familial adenomatous polyposis (FAP).

 

Macroscopic Specimen of Familial adenomatous polyposis (FAP).

Video Endoscopic Sequence 33 of 36.

Macroscopic Specimen of Familial adenomatous polyposis (FAP).

 

Macroscopic Specimen of Familial adenomatous polyposis (FAP).

Video Endoscopic Sequence 34 of 36.

Macroscopic Specimen of Familial adenomatous polyposis (FAP).

 

 

 

 

Macroscopic Specimen of Familial adenomatous polyposis (FAP).

Video Endoscopic Sequence 35 of 36.

Macroscopic Specimen of Familial adenomatous polyposis (FAP).


Macroscopic Specimen of Familial adenomatous polyposis (FAP).

Video Endoscopic Sequence 36 of 36.

Synchronous Colon Cancers, Familial Adenomatous Polyposis

Macroscopic Specimen of Familial adenomatous polyposis (FAP).

 

Adenocarcinoma of the Cecum

Video Endoscopic Sequence 1 of 3.

Adenocarcinoma of the Cecum

This 42 year-old male presented with severe abdominal pain in the right iliac fossa and weight lost of 20 lbs.

Carcinoma of the cecum and ascending colon is commonly
believed to produce symptoms of anemia, diarrhea, and
alternating diarrhea and constipation obstruction and pain.
Symptoms of obstruction and pain are supposedly not
common symptoms of malignancy in this region of
the colon.

 

Adenocarcinoma of the Colon

Video Endoscopic Sequence 2 of 3.

Video Endoscopy of Adenocarcinoma of the Colon

Cecal carcinoma has been associated with a poorer prognosis than other colon carcinomas because of the presumed longstanding obscure symptoms.

Epidemiology

• Colorectal carcinoma is a disease of the older population except for people with hereditary non-polyposis and polyposis syndromes or chronic inflammatory bowel disease. • The male/female ratio for rectal carcinoma is 2/1 while the male/female ratio of right sided lesions is 1/1 • The remarkably higher incidence in more affluent countries and the change in incidence in migrants to the area of migration suggests a strong environmental affect which most studies relate to high dietary fat, low fiber and high refined carbohydrates.

 

Colorectal carcinoma

Video Endoscopic Sequence 3 of 3.

Colorectal carcinoma develops over a long period of time with an estimated doubling time of almost two years • Presenting symptoms are related to chronic blood loss with the signs and symptoms of iron deficiency anemia, increasing luminal obstruction with change in bowel habits, diameter of stool, variable constipation, diarrhea, and vague abdominal discomfort or pain. A palpable mass lesion is a late finding • Right sided tumors are most associated with blood loss and rarely with obstruction while left sided lesions present with signs of obstruction. • Treatment is surgical and prognosis is related to stage at presentation. • About 25% of patients will present with metastatic disease, primarily lymph nodes and liver. The overall survival is 50%.

 

 

 

 

Adenocarcinoma of the Cecum

Video Endoscopic Sequence 1 of 4.

Adenocarcinoma of the Cecum

This 69 year-old female was referred to our endoscopic
unit for evaluation of anemic syndrome, fecal occult blood
test for 3 times was negative. 

 

Colorectal cancer

Video Endoscopic Sequence 2 of 4.

Endoscopic Image of Cancer of the Colon

Colorectal cancer (CRC) is the second leading cause of
cancer-related death in the Western world and the
incidence in El Salvador is also rising.

 

Colon and rectal cancer incidence was negligible before

Video Endoscopic Sequence 3 of 4.

Colon and rectal cancer incidence was negligible before
1900.

The incidence of colorectal cancer has been rising
dramatically following economic development and
industrialization. Currently, colorectal cancer is the third
leading cause of cancer deaths in both males and females
in the United States

 

Rectum Adenocarcinoma

Video Endoscopic Sequence 4 of 4.

Approximately 20% of colon cancers develop in the cecum,
another 20% in the rectum, and an additional 10% in the
rectosigmoid junction. Approximately 25% of colon cancers
develop in the sigmoid colon.

 

Rectum Adenocarcinoma

Video Endoscopic Sequence 1 of 4.

Rectum Adenocarcinoma

This 72 year-old female, presented with rectal bleeding
since one year previously with weigh loss of 20 libs.

 

 

 

 

 

colorectal carcinoma

Video Endoscopic Sequence 2 of 4.

The significant portions of colorectal carcinomas are
adenocarcinomas. The adenoma-carcinoma sequence is
well described in the medical literature. Colonic adenomas
precede adenocarcinomas. Approximately 10% of
adenomas will eventually develop into adenocarcinomas.
This process may take up to 10 years.

 

Bleeding is the most common symptom of rectal cancer,

Video Endoscopic Sequence 3 of 4.

Bleeding is the most common symptom of rectal cancer,
occurring in 60% of patients. Bleeding often is attributed
to other causes (eg, hemorrhoids), especially if the patient
has a history of other rectal problems. Profuse bleeding
and anemia are rare. Bleeding may be accompanied by the
passage of mucus, which warrants further investigation.

 

Colon Cancer

Video Endoscopic Sequence 4 of 4.

Change in bowel habits is present in 43% of patients;
change is not evident in some cases because the capacity
of a rectal reservoir can mask the presence of small
lesions. When change does occur it is often in the form of
diarrhea, particularly if the tumor has a large villous
component. These patients may have hypokalemia, as
shown in laboratory studies. Some patients experience a
change in the caliber of the stool. Large tumors can cause
obstructive symptoms. Tumors located low in the rectum
can cause a feeling of incomplete evacuation and tenesmus.

 

Colon Cancer

Photography Sequence 1 of 6.

Ascending Colon Intussusception due to a Adenocarcinoma

Ulcerated Adenocarcinoma of the ascending colon that was
removed laparoscopicaly found intraoperatory causing
colonic intussusception.

The vast majority of intussusceptions occur in children
under the age of 2 years. Intussusception in adults is
usually caused by a tumor; when the intussusception is
colonic, the underlying tumor is most often malignant. The
most common cause is a polypoid cecal carcinoma,
although other lesions such as a lipoma, lymphomatous
mass, or even a cecal endometrioma may be responsible.

Click on the images to enlarge in a new windows.

 

Colon Cancer

Photography Sequence 2 of 6.

The appearance of this tumor is that of a enormous polyp that degenerated in a neoplasia.

Adult intussusceptions are rare entities that are almost always associated with a demonstrable lead point.

General Gross Description

• The gross appearance is dependent on the stage of the tumor.
• Early invasive carcinoma may maintain the appearance of the original adenoma either polypoid or sessile.
• More commonly, the tumor has obliterated evidence of the underlying adenoma and when first seen is a firm, white, flat, well demarcated mucosal lesion with raised rolled margins, often with central ulceration.
• Over time, the lesion spreads circumferentially through circular lymphatics to produce a constricting napkin-ring lesion in the mucosa.
• As mucosal spread occurs, tumor also invades the full thickness of the muscular wall, and only at this stage is tumor seen grossly involving the perirectal fat, or mesentery.
• Cecal lesions often have a different appearance because of the large volume of space in which they can grow before producing symptoms. Cecal carcinomas often cover large areas of the cecum with fungating sessile or bulky lesions which can be extensively necrotic.
• Because of their long growth time before discovery cecal lesions often are seen as large deeply invasive tumors with attachment to the adjacent peritoneal wall.

 

Colon cancer

Photography Sequence 3 of 6.

A close up of the Ascending Colonic Adenocarcinoma

The symptoms of adult intussusception of the colon vary
considerably. The signs and symptoms are often associated
with the chronic process of obstruction, and not with acute
abdomen. As a result, it is difficult to diagnose adult
intussusception of the colon, and most cases are diagnosed
when patients undergo laparotomy. When ultrasonography
shows the typical concentric hyperechoic double ring
coupled with thickening of the intestinal walls, a diagnosis
of colonic intussusception should be considered.
CT permits an even more detailed view of suspected
intussusception, and thus plays an important role in
determining the most appropriate therapeutic strategy.

 

Colon cancer

Photography Sequence 4 of 6.

Adenocarcinoma of the Ascending Colon

Radical surgical resection is the definitive treatment for
tumor-induced intussusception. Reduction of an
intussusception with suspected malignancy should be
avoided, since it can cause bowel perforation and tumor
cell dissemination. While resection has been assumed to
be the most appropriate treatment for intussusception of
the colon in adults, it is sometimes possible to reduce
intussusceptions by simple manipulation or by
compression. With total inversion, partial resection may
be necessary; however, when carcinoma is considered
peroperatively, an extended resection with lymph node
dissection should be performed.

 

Colon Cancer

Photography Sequence 5 of 6.

In emergency cases, the surgeon has to evaluate the need
for a resection with immediate or delayed anastomosis,
versus a colostomy with deferred resective treatment.
The choice of the type of operation may depend on the
clinical status of the patient, the condition of the bowel
(e.g., whether it is ischemic or not), the site of
intussusception and of the tumor, the diagnostic certainty
of malignancy, and the experience of the surgeon.

 

Cancer of colon

Photography Sequence 6 of 6.

Laparoscopic treatment of ascending colon intussusception
by large malignant tumor.

The combination of clinical findings and diagnostic
techniques can elucidate the diagnosis of adult colonic
intussusception, and the most decisive diagnostic modality
appears to be computerized tomography. Surgical resection
is the definitive treatment for intussuscepting tumors.
However, the choice and timing of the operation depend
on the clinical condition of the patient and the status of the
intussuscepted bowel.

 

Adenocarcinoma of the Cecum

Video Endoscopic Sequence 1 of 3.

Adenocarcinoma of the Cecum

A 85 year-old male, Retired Colonel, with weigh loss of 20 libs has this large mass in the cecum.

 

Adenocarcinoma of the Cecum

Video Endoscopic Sequence 2 of 3.

More images and video clips of a Adenocarcinoma of the Cecum

 

Adenocarcinoma of the Cecum

Video Endoscopic Sequence 3 of 3.

More images and video clips of Adenocarcinoma of the Cecum

 

Adenocarcinoma of the Cecum

Video Endoscopic Sequence 1 of 3.

Image and Video Clip of a descending Colon Cancer

This 76 year-old male, had 20 pounds weight loss and also had defecation disorders.

 

 


 

Endoscopic Image of Colon Cancer.

Video Endoscopic Sequence 2 of 3.

Endoscopic Image of Colon Cancer.

 

Endoscopic Image of Colon Cancer

Secuencia Video Endoscópica 3 de 3.

Video clip of colonic adenocarcinoma

Colonoscopy of Adenocarcinoma of the ascending colon

Video Endoscopic Sequence 1 of 8.

Colonoscopy of Adenocarcinoma of the ascending colon

This is a 38 year-old male, who presented eighteen months ago, lower gastrointestinal bleeding, after that underwent an upper endoscopy and colonoscopy, apparently did not find any pathology, he came to our facilities by a second opinion, finding patient with marked pallor his hemoglobin was 8 mg / dl.

A full colonoscopy was performed. A colon cancer was found a the ascending colon

This history that someone recently had a colonoscopy and not find anything. Is seen occasionally as some inexperienced not reach the right colon.

Criticizing: a year and a half ago with lower gastrointestinal bleeding and the first colonoscopy did not find nothing more probale is that not reached the cecum that cancer was already there.

 

 

 

 

 

Colonoscopy of Adenocarcinoma of the ascending colon

Video Endoscopic Sequence 2 of 8.

The distal part of the tumor was observed, we could not advanced the colonoscope though the tumor due to a stenosis.

 

Colonoscopy of Adenocarcinoma of the ascending colon

Video Endoscopic Sequence 3 of 8.

Image and video clip of cancer of the ascending colon

 

Colectomy Specimen shows the cecum, the Iliocecal Valve is displayed.

Video Endoscopic Sequence 4 of 8.

Cancer of the ascending colon

Colectomy Specimen shows the cecum, the Iliocecal Valve is displayed.

To enlarge image press on it.

 

Cancer of the ascending colon

Video Endoscopic Sequence 5 of 8.

Cancer of the ascending colon

Gross appearance of a colectomy specimen containing colorectal carcinoma, This case shows an ulcerated necrotic area in the center of the tumor mass.

 

Cancer of the ascending colon

Video Endoscopic Sequence 6 of 8.

Cancer of the ascending colon

Imaging studies revealed a circumferential growth in the ascending colon

Cancer of the ascending colon

Video Endoscopic Sequence 7 of 8.

With this clamp the distance between the iliocecal valve and the tumor is displayed.

To enlarge image press on it.

Cancer of the ascending colon

Video Endoscopic Sequence 8 of 8.

The image shows a Adenocarcinoa of the Ascending Colon

To enlarge image press on it.


Se observa la distancia entre la válvula ileocecal y la neoplasia del ciego.

Secuencia Video Endoscópica 8 de 8..

Se observa la distancia entre la válvula ileocecal y la neoplasia del colon ascendente.

Para agrandar la imagen presionar sobre ella.

 

Rectal cancer

Video Endoscopic Sequence 1 of 4.

Rectal Adenocarcinoma that infiltrates dentate line

65 years old female patient who nine months earlier, had a full checkup including a colonoscopy, apparently had been diagnosed in another country a no significant polyp.

 

 

 

 

 Rectal cancer

Video Endoscopic Sequence 2 of 4.

Video clip of Rectal Adenocarcinoma that infiltrates dentate line

.

 

Rectal cancer

Video Endoscopic Sequence 3 of 4.

Image and Video clip of Rectal Adenocarcinoma that infiltrates dentate line.

Colorectal cancer

Video Endoscopic Sequence 4 of 4.

Rectal Adenocarcinoma that infiltrates dentate line

.

 

 

 

 

 

 

 

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