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Advanced adenoma

V J Mallikarjuna, Vivek Mathew, Vageesh Ayyar, Ganapathy Bantwal, V Ganesh, Belinda George, G N Hemanth, P Vinotha
Background: Primary hyperparathyroidism (PHPT) is a common endocrine disease with a variable clinical presentation. PHPT is usually symptomatic at presentation in majority of the patients, especially in developing countries. As the accessibility to investigations, advanced imaging methods and surgical procedures are improving, the clinical profile of the patients with PHPT has undergone a palpable change compared to the earlier description. Hence we decided to look for a change in clinical, imaging and surgical outcomes of PHPT patients from South India...
May 2018: Indian Journal of Endocrinology and Metabolism
Adán-Merino Luisa, Aldeguer-Martínez Mercedes, Barrio-Antoranz Jose, Burdaspal-Moratilla Ana, Martín Chávarri Sonia
AIM: The risk of presenting synchronous or metachronous neoplasm, either adenoma or carcinoma, increases after an initial colonic lesion develops. It is known as tumor multicentricity and constitutes the rationale for surveillance programs. This study was designed to identify the clinical, pathologic, and molecular features related to previous or synchronous colorectal cancer (CRC) in patients with advanced adenomas (AA) or serrated polyps (SP). PATIENTS AND METHODS: We carried out a prospective analysis of 4143 colonoscopies performed at our medical department between 1 September 2014 and 30 September 2015...
August 6, 2018: European Journal of Gastroenterology & Hepatology
Maria Candida Barisson Villares Fragoso, Isadora Pontes Cavalcante, Amanda Meneses Ferreira, Beatriz Marinho de Paula Mariani, Claudimara Ferini Pacicco Lotfi
Recent advances in molecular genetics investigations of primary macronodular adrenal hyperplasia (PMAH) have been providing new insights for the research on this issue. The cAMP-dependent pathway is physiologically triggered by ACTH and its receptor, MC2-R, in adrenocortical cells. Different mechanisms of this cascade may be altered in some functioning adrenal cortical disorders. Activating somatic mutations of the GNAS gene (known as gsp oncogene) which encodes the stimulatory G protein alpha-subunit (Gsα) have been found in a small number of adrenocortical secreting adenomas and rarely in PMAH...
July 31, 2018: La Presse Médicale
Natalia Tolloczko-Iwaniuk, Dorota Dziemianczyk-Pakiela, Beata Klaudia Nowaszewska, Katarzyna Celinska-Janowicz, Wojciech Miltyk
BACKGROUND AND OBJECTIVES: It is generally accepted that inflammatory cells found in the tumor microenvironment are involved in the neoplastic process, promoting cell proliferation, survival, and migration. Therefore, administering anti-inflammatory medication in cancer therapy seems to be justified. A potential pathway associated with the aforementioned issue is cyclooxygenase-2 inhibition, particularly as the overexpression of this enzyme has been proven to occur in cancer tissues and is also associated with a poor prognosis in several types of human malignancies...
August 3, 2018: Current Drug Targets
Barbara Altieri, Giovanna Muscogiuri, Stavroula A Paschou, Andromachi Vryonidou, Silvia Della Casa, Alfredo Pontecorvi, Martin Fassnacht, Cristina L Ronchi, John Newell-Price
Adrenal incidentalomas constitute a common clinical problem with an overall prevalence of around 2-3%, but are more common with advancing age being present in 10% of those aged 70 years. The majority of these lesions are benign adrenocortical adenomas (80%), characterized in 10-40% of the cases by autonomous cortisol hypersecretion, and in 1-10% by aldosterone hypersecretion. Several observational studies have shown that autonomous cortisol and aldosterone hypersecretion are more prevalent than expected in patients with osteopenia and osteoporosis: these patients have accelerated bone loss and an increased incidence of vertebral fractures...
August 2, 2018: Endocrine
Jung Yoon Kim, Tae Jun Kim, Sun-Young Baek, Soohyun Ahn, Eun Ran Kim, Sung Noh Hong, Dong Kyung Chang, Young-Ho Kim
OBJECTIVES: Individuals with advanced adenomas or three or more adenomas have a higher risk of metachronous advanced neoplasia (AN) and are recommended to undergo surveillance colonoscopy at shorter intervals. However, it is questionable whether patients with multiple (three or more) non-advanced diminutive adenomas should be considered as high-risk. METHODS: We analyzed 5482 patients diagnosed with one or more adenomas during their first colonoscopy screening and who underwent a follow-up colonoscopy...
August 3, 2018: American Journal of Gastroenterology
Daniel Rodríguez-Alcalde, Sabela Carballal, Leticia Moreira, Luis Hernández, Lorena Rodríguez-Alonso, Francisco Rodríguez-Moranta, Victoria Gonzalo, Luis Bujanda, Xavier Bessa, Carmen Poves, Joaquín Cubiella, Inés Castro, Mariano González, Eloísa Moya, Susana Oquiñena, Joan Clofent, Enrique Quintero, Pilar Esteban, Virginia Piñol, Francisco Javier Fernández, Rodrigo Jover, Lucía Cid, Esteve Saperas, María López-Cerón, Miriam Cuatrecasas, Jorge López-Vicente, Liseth Rivero-Sánchez, Gerhard Jung, María Vila-Casadesús, Ariadna Sánchez, Antoni Castells, María Pellisé, Francesc Balaguer
BACKGROUND:  Serrated polyposis syndrome (SPS) has been associated with an increased risk of colorectal cancer (CRC). Accordingly, intensive surveillance with annual colonoscopy is advised. The aim of this multicenter study was to describe the risk of advanced lesions in SPS patients undergoing surveillance, and to identify risk factors that could guide the prevention strategy. METHODS:  From March 2013 to April 2015, 296 patients who fulfilled criteria I and/or III for SPS were retrospectively recruited at 18 centers...
August 1, 2018: Endoscopy
A Goverde, A Wagner, M J Bruno, R M W Hofstra, M Doukas, M M van der Weiden, H J Dubbink, W N M Dinjens, M C W Spaander
BACKGROUND & AIMS: It is important to identify individuals with Lynch syndrome because surveillance programs can reduce their morbidity and mortality from colorectal cancer (CRC). We assessed the diagnostic yield of immunohistochemistry to detect Lynch syndrome in patients with advanced and multiple adenomas within our national CRC screening program. METHODS: We performed a prospective study of all participants (n=1101; 55% male; median age, 66 years; interquartile range, 61-70 years) referred to the Erasmus MC in The Netherlands after a positive result from a fecal immunohistochemical test, from December 2013 to December 2016...
July 28, 2018: Gastroenterology
Masau Sekiguchi, Ataru Igarashi, Taku Sakamoto, Yutaka Saito, Minoru Esaki, Takahisa Matsuda
OBJECTIVE: Recommendations on post-polypectomy surveillance vary, and no consensus has been reached even regarding the necessity of risk stratification based on polyp characteristics for surveillance. We examined an optimal post-polypectomy surveillance program by performing a cost-effectiveness analysis. METHODS: We performed a Markov model analysis using parameters based on Japanese data and evaluated four post-polypectomy surveillance programs with respect to their effectiveness in terms of quality-adjusted life-years (QALYs), cost-effectiveness, and required number of colonoscopies...
July 30, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Meghan G Lubner, Christine O Menias, Rashad J Johnson, Ayman H Gaballah, Akram Shaaban, Khaled M Elsayes
Villous lesions are advanced adenomas that manifest most commonly in the colon; however, they can develop throughout the gastrointestinal tract. The duodenum is the most common small-bowel site of these lesions. Although in most cases these are isolated lesions that occur sporadically, patients with certain specific colorectal cancer syndromes, including familial adenomatous polyposis and hereditary nonpolyposis colorectal cancer, may develop multiple advanced adenomas. Villous lesions are important because although they are histologically benign, they may harbor dysplasia and have potential for malignancy...
July 30, 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Jeremy Meyer, Lorenzo A Orci, Christophe Combescure, Alexandre Balaphas, Philippe Morel, Nicolas C Buchs, Frédéric Ris
BACKGROUND & AIMS: We performed a systematic review and meta-analysis to assess the prevalence of colorectal cancer in patients with acute diverticulitis. METHODS: We searched MEDLINE from inception through November 2nd, 2017 for studies reporting the prevalence of colorectal cancer in patients with diverticulitis, identified based on the protocol CRD42017083272. This systematic review was conducted in accordance to the MOOSE guidelines. Pooled prevalence values were obtained by random effects models and robustness was tested by leave-one out sensitivity analyses...
July 26, 2018: Clinical Gastroenterology and Hepatology
Tomoko Saito, Atsushi Niida, Ryutaro Uchi, Hidenari Hirata, Hisateru Komatsu, Shotaro Sakimura, Shuto Hayashi, Sho Nambara, Yosuke Kuroda, Shuhei Ito, Hidetoshi Eguchi, Takaaki Masuda, Keishi Sugimachi, Taro Tobo, Haruto Nishida, Tsutomu Daa, Kenichi Chiba, Yuichi Shiraishi, Tetsuichi Yoshizato, Masaaki Kodama, Tadayoshi Okimoto, Kazuhiro Mizukami, Ryo Ogawa, Kazuhisa Okamoto, Mitsutaka Shuto, Kensuke Fukuda, Yusuke Matsui, Teppei Shimamura, Takanori Hasegawa, Yuichiro Doki, Satoshi Nagayama, Kazutaka Yamada, Mamoru Kato, Tatsuhiro Shibata, Masaki Mori, Hiroyuki Aburatani, Kazunari Murakami, Yutaka Suzuki, Seishi Ogawa, Satoru Miyano, Koshi Mimori
Advanced colorectal cancer harbors extensive intratumor heterogeneity shaped by neutral evolution; however, intratumor heterogeneity in colorectal precancerous lesions has been poorly studied. We perform multiregion whole-exome sequencing on ten early colorectal tumors, which contained adenoma and carcinoma in situ. By comparing with sequencing data from advanced colorectal tumors, we show that the early tumors accumulate a higher proportion of subclonal driver mutations than the advanced tumors, which is highlighted by subclonal mutations in KRAS and APC...
July 23, 2018: Nature Communications
Douglas Grunwald, Alex Landau, Zhenghui G Jiang, Joy J Liu, Robert Najarian, Sunil G Sheth
GOALS: We set out to determine whether variation from this 3-year follow-up interval was associated with the finding of subsequent high-risk adenoma (HRA). BACKGROUND: HRAs include the following: (1) an adenoma measuring ≥10 mm, (2) ≥3 adenomas found during a single procedure, and (3) an adenoma with high-grade dysplasia or villous architecture. The current Multi-Society Task Force guideline for timing of surveillance colonoscopy after removal of a HRA is 3 years...
July 20, 2018: Journal of Clinical Gastroenterology
Sakthivel Chinnakkulam Kandhasamy, Thangadurai Ramasamy Raju, Ashok Kumar Sahoo, Gopalakrishnan Gunasekaran
Cystic lymphangioma of the parotid gland is an uncommon congenital lymphatic malformation. Its occurrence in patients of advanced age is infrequent. Patients usually present with painless soft swelling, often having experienced a long duration of symptoms. Lymphangioma among the salivary glands frequently involves the parotid gland. When evaluating cystic lesions of the parotid gland, cystic lymphangioma should be included in the differential diagnosis in addition to Warthin's tumor, branchial cyst, cystic pleomorphic adenoma, and cystic mucoepidermoid tumor...
May 18, 2018: Curēus
Richard A Feelders, John Newell-Price, Rosario Pivonello, Lynnette K Nieman, Leo J Hofland, Andre Lacroix
Cushing's syndrome is associated with multisystem morbidity and, when suboptimally treated, increased mortality. Medical therapy is an option for patients if surgery is not successful and can be classified into pituitary-directed drugs, steroid synthesis inhibitors, and glucocorticoid receptor antagonists. In the last decade there have been new developments in each drug category. Targeting dopamine and somatostatin receptors on corticotroph adenomas with cabergoline or pasireotide, or both, controls cortisol production in up to 40% of patients...
July 19, 2018: Lancet Diabetes & Endocrinology
Mikito Mori, Keiji Koda, Atsushi Hirano, Kiyohiko Shuto, Chihiro Kosugi, Kazuo Narushima, Isamu Hosokawa, Takayuki Suzuki, Masato Yamazaki, Hiroaki Shimizu
BACKGROUND: The clinical findings of early anal gland carcinoma (AGC) have not been well delineated because AGC is a rare malignancy usually diagnosed at an advanced stage. Knowledge of the characteristic findings will be helpful for both diagnosis and determination of the treatment options for early AGC. CASE PRESENTATION: A 62-year-old man was referred to our hospital for treatment of a rectal submucosal tumor (SMT) detected during a medical checkup at another hospital...
July 21, 2018: World Journal of Surgical Oncology
Afsaneh Mojtabanezhad Shariatpanahi, Maryam Yassi, Mehdi Nouraie, Amirhossein Sahebkar, Fatemeh Varshoee Tabrizi, Mohammad Amin Kerachian
A large number of tumor-related methylated genes have been suggested to be of diagnostic and prognostic values for CRC when analyzed in patients' stool samples; however, reported sensitivities and specificities have been inconsistent and widely varied. This meta-analysis was conducted to assess the detection accuracy of stool DNA methylation assay in CRC, early stages of CRC (advanced adenoma, non-advanced adenomas) and hyperplastic polyps, separately. We searched MEDLINE, Web of Science, Scopus and Google Scholar databases until May 1, 2016...
2018: PloS One
Juliana Drummond, Federico Roncaroli, Ashley B Grossman, Márta Korbonits
Context: Silent pituitary adenomas are anterior pituitary tumors with hormone synthesis but without signs or symptoms of hormone hypersecretion. They have been increasingly recognized and represent challenging diagnostic issues. Evidence Acquisition: A comprehensive literature search was performed using MEDLINE and EMBASE databases between January 2000 and March 2018 with the following key words: (i) pituitary adenoma/tumor and non-functioning; or (ii) pituitary adenoma/tumor and silent...
July 17, 2018: Journal of Clinical Endocrinology and Metabolism
Tamara Maghathe, William K Miller, Luke Mugge, Tarek R Mansour, Jason Schroeder
INTRODUCTION: Pituitary adenomas (PAs) are primary central nervous system (CNS) tumors, accounting for as much as 25% of intracranial neoplasms. Although existing remedies show success in treating most PAs, treatment of invasive and non-functioning PAs, in addition to functioning PAs unresponsive to standard therapy, remains challenging. With the continually increasing understanding of biochemical pathways involved in tumorigenesis, immunotherapy stands as a promising alternative therapy for pituitary tumors that are resistant to standard therapy...
July 17, 2018: Journal of Neurosurgical Sciences
Teresa M Seccia, Brasilina Caroccia, Elise P Gomez-Sanchez, Celso E Gomez-Sanchez, Gian Paolo Rossi
The identification of several germline and somatic ion channel mutations in aldosterone-producing adenomas (APA) and detection of cell clusters that can be responsible for excess aldosterone production, as well as the isolation of autoantibodies activating the angiotensin II type 1 receptor, have rapidly advanced the understanding of the biology of primary aldosteronism (PA), in particular that of APA. Hence, the main purpose of this review is to discuss how discoveries of the last decade could impact on histopathology analysis and clinical practice...
July 10, 2018: Endocrine Reviews
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