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      Carcinomatosis peritoneal secundaria a adenocarcinoma de células en anillo de sello del colon: A propósito de un caso Translated title: Peritoneal carcinomatosis secondary to signet ring cell colon carcinoma: a case-report

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          Abstract

          La carcinomatosis peritoneal (CP) secundaria a adenocarcinoma de colon es una metástasis al peritoneo pocofrecuente e indicativa de mal pronóstico. Se reporta el caso de un varón de 26 años con diagnóstico de tuberculosis (TBC) enteroperitoneal y con tratamiento esquema sensible para TBC extrapulmonar. Tenía un tiempo deenfermedad de un mes caracterizado por dolor abdominal, náuseas,vómitos y constipación. Fue catalogado como “abdomen congelado” y se le realizó laparotomía exploratoria encontrándose nódulos blanquecinos en peritoneo como“granos de mijo”. Fue hospitalizado con diagnóstico sindrómico de obstrucción intestinal y con diagnóstico probables de TBC miliar peritoneal vs linfoma no Hodgkin enteroperitoneal. El estudio anátomo-patológico de la biopsia peritoneal y colónica fue carcinomatosis peritoneal secundaria a adenocarcinoma de células en anillo de sello de colon.

          Translated abstract

          Peritoneal carcinomatosis(PC) secondary to colonic adenocarcinoma is an infrequent condition usuallyassociated with poor prognosis We report the case of 26-year old male patient diagnosed of entero-peritoneal tuberculosis treated with a standard regimen for drug-sensitive tuberculosis.The patient had one month of illness characterized by abdominal pain, nausea,vomiting and constipation. A diagnosis of “frozen abdomen” was made and a laparotomy was performed finding white nodules mimicking “milliary seeds”. The patient was admitted with apresumed diagnosis of tuberculosis or non-Hodgkin lymphoma. The biopsy revealed PC secondary to signet ring cell colon carcinoma

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          Most cited references20

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          Predictors and survival of synchronous peritoneal carcinomatosis of colorectal origin: a population-based study.

          The aim of our study was to provide population-based data on incidence and prognosis of synchronous peritoneal carcinomatosis and to evaluate predictors for its development. Diagnosed in 1995-2008, 18,738 cases of primary colorectal cancer were included. Predictors of peritoneal carcinomatosis were analysed by multivariable logistic regression analysis. Median survival in months was calculated by site of metastasis. In the study period, 904 patients were diagnosed with synchronous peritoneal carcinomatosis (4.8% of total, constituting 24% of patients presenting with M1 disease). The risk of peritoneal carcinomatosis was increased in case of advanced T stage [T4 vs. T1,2: odds ratio (OR) 4.7, confidence limits 4.0-5.6), advanced N stage [N0 vs. N1,2: OR 0.2 (0.1-0.2)], poor differentiation grade [OR 2.1 (1.8-2.5)], younger age [<60 years vs. 70-79 years: OR 1.4 (1.1-1.7)], mucinous adenocarcinoma [OR 2.0 (1.6-2.4)] and right-sided localisation of primary tumour [left vs. right: OR 0.6 (0.5-0.7)]. Median survival of patients with peritoneum as single site of metastasis remained dismal [1995-2001: 7 (6-9) months; 2002-2008: 8 (6-11) months], contrasting the improvement among patients with liver metastases [1995-2001: 8 (7-9) months; 2002-2008: 12 (11-14) months]. To conclude, synchronous peritoneal metastases from colorectal cancer are more frequent among younger patients and among patients with advanced T stage, mucinous adenocarcinoma, right-sided tumours and tumours that are poorly differentiated. The prognosis of synchronous peritoneal carcinomatosis remains poor with a median survival of 8 months and even worse if concomitant metastases in other organs are present. Copyright © 2010 UICC.
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            Peritoneal carcinomatosis of colorectal origin: Incidence, prognosis and treatment options.

            Peritoneal carcinomatosis (PC) is one manifestation of metastatic colorectal cancer (CRC). Tumor growth on intestinal surfaces and associated fluid accumulation eventually result in bowel obstruction and incapacitating levels of ascites, which profoundly affect the quality of life for affected patients. PC appears resistant to traditional 5-fluorouracil-based chemotherapy, and surgery was formerly reserved for palliative purposes only. In the absence of effective treatment, the historical prognosis for these patients was extremely poor, with an invariably fatal outcome. These poor outcomes likely explain why PC secondary to CRC has received little attention from oncologic researchers. Thus, data are lacking regarding incidence, clinical disease course, and accurate treatment evaluation for patients with PC. Recently, population-based studies have revealed that PC occurs relatively frequently among patients with CRC. Risk factors for developing PC have been identified: right-sided tumor, advanced T-stage, advanced N-stage, poor differentiation grade, and younger age at diagnosis. During the past decade, both chemotherapeutical and surgical treatments have achieved promising results in these patients. A chance for long-term survival or even cure may now be offered to selected patients by combining radical surgical resection with intraperitoneal instillation of heated chemotherapy. This combined procedure has become known as hyperthermic intraperitoneal chemotherapy. This editorial outlines recent advancements in the medical and surgical treatment of PC and reviews the most recent information on incidence and prognosis of this disease. Given recent progress, treatment should now be considered in every patient presenting with PC.
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              The molecular biology of peritoneal carcinomatosis from gastrointestinal cancer.

              Peritoneal carcinomatosis is a frequent form of disease progression in gastrointestinal cancer, and all too often is a preterminal event with a median survival of only 6 months. Despite the introduction of aggressive surgical and chemotherapeutic approaches, any significant improvement in survival is unlikely until we better understand the molecular biology of peritoneal metastasis.
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                Author and article information

                Journal
                rmh
                Revista Medica Herediana
                Rev Med Hered
                Universidad Peruana Cayetano Heredia. Facultad de Medicina "Alberto Hurtado" (Lima, , Peru )
                1018-130X
                1729-214X
                July 2015
                : 26
                : 3
                : 190-194
                Affiliations
                [02] Lima orgnameUniversidad Privada San Juan Bautista orgdiv1Sociedad Científica de Estudiantes de Medicina Perú
                [03] Lima orgnameInstituto Nacional del Niño orgdiv1Departamento de Cirugía pediátrica Perú
                [04] Lima orgnameHospital Nacional Hipólito Unanue orgdiv1Unidad de Cuidados Intensivos Perú
                [01] Lima orgnameUniversidad Privada San Juan Bautista Perú
                Article
                S1018-130X2015000300009 S1018-130X(15)02600300009
                2b52b90d-4a8a-479d-9a0a-e1aff489d2d6

                http://creativecommons.org/licenses/by/4.0/

                History
                : 09 February 2015
                : 29 June 2015
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 13, Pages: 5
                Product

                SciELO Peru

                Self URI: Texto completo solamente en formato PDF (ES)
                Categories
                Reporte de caso

                Carcinoma,peritoneo,adenocarcinoma,Carcinomatosis,peritoneum

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