Tumour perforation in colorectal cancer
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Tumour perforation in colorectal cancer is the conjunction of an intestinal perforation and a colorectal tumour.
The Royal College of Pathologists Australia (RCPA) defines it as: perforation at the site of the tumour.[1]
Definitions
- The Royal College of Pathologists Australia (RCPA) defines tumour perforation as: perforation at the site of the tumour.[2]
- The College of American Pathologists protocol (version 4.3.1.0) cites Anwar et al.[3] and notes that: perforation proximal to the tumour is a poor prognosticator.
- Possible implication: perforation at the tumour and proximal to the tumour may not be that different.
- Banaszkiewicz et al. states that: the perforation site does not need to be at the anatomical site of the tumour.[4]
General
- Poor prognosticator.[3]
- Does not affect the (overall) stage; however, it been suggested that perforated colorectal carcinoma be considered stage IV.[5]
Gross
- Defect should be inked at the time of gross.
- Ideally, a photograph should be taken.
Microsopic
Features:[citation needed]
- Inflammation on the external aspect (serosa).
DDx:
- Iatrogenic perforation - site of perforation has cautery.
- Artifact of extraction ("tissue abuse").
- Artifact of extraction is likely if all the following apply: (i) no inflammatory reaction is present, (ii) no cautery, and (iii) no perforation described in the operative report.
See also
References
- ↑ URL: https://www.rcpa.edu.au/Library/Practising-Pathology/Macroscopic-Cut-Up/Specimen/Gastrointestinal/Colorectal/Colorectal-tumour. Accessed on: June 21, 2018.
- ↑ URL: https://www.rcpa.edu.au/Library/Practising-Pathology/Macroscopic-Cut-Up/Specimen/Gastrointestinal/Colorectal/Colorectal-tumour. Accessed on: June 21, 2018.
- ↑ 3.0 3.1 Anwar, MA.; D'Souza, F.; Coulter, R.; Memon, B.; Khan, IM.; Memon, MA. (Aug 2006). "Outcome of acutely perforated colorectal cancers: experience of a single district general hospital.". Surg Oncol 15 (2): 91-6. doi:10.1016/j.suronc.2006.09.001. PMID 17049848.
- ↑ Banaszkiewicz, Z.; Woda, Ł.; Tojek, K.; Jarmocik, P.; Jawień, A. (2014). "Colorectal cancer with intestinal perforation - a retrospective analysis of treatment outcomes.". Contemp Oncol (Pozn) 18 (6): 414-8. doi:10.5114/wo.2014.46362. PMID 25784840.
- ↑ Ogawa, M.; Watanabe, M.; Eto, K.; Omachi, T.; Kosuge, M.; Hanyu, K.; Noaki, L.; Fujita, T. et al. (May 2009). "Clinicopathological features of perforated colorectal cancer.". Anticancer Res 29 (5): 1681-4. PMID 19443386.