A male of 46 yrs is having this tumor since 6 months.O/E lumen of lower GIT is free, no any infiltration is noted. Anal orifice and anal sphincters are free from any growth.Pt. doesn't give any previous h/o treatment anywhere and even he didn't come back for further examination HPE etc. Only for academic point of view, Please discuss as this is important to me
DEAR DWIVEDI
I agree with mary and i also think condyloma acinatom and HIV also should be rule out
Thank you very much for your participation. Actually in developing countries like India it is very unfortunate that few patients in spite of good health care services are not attending the health care units. They prefer to go to quacks, may be illiteracy might be behind this. Only I can feel sorry for this. Even this patient was not ready to be admitted for further investigations like HPE etc. He never came back to me. I am only interested to share that this tumor seems Malignant apparently but the absence of infiltration in nearby structures seems unusual. Please take a note that my question is modified by editors though it was not required. Thanks
There's a saying about this case: Strange patients may have had very strange soars.
How do u know it is a colon tumor....first describe presentation ...history....
What investigation done......
How u reached diagnosis of colon tumor......
Then think of colonoscopy n biopsy....
And note that intiltration or invasin is not necessary for being a case of malignancy.....
Pl take a biopsy. If it is squamous cell ca It is treatable by Chemo/ RT.. It is possibly a perianal sq. cell CA.
ak pujahari
plese also inform us about physical exam especially inquvinal nodes
Dr Jain Dr Pujhari, Please read my comments too. Unfortunately it is editors who add " colon tumor" not by me I used the word "growth". Thanks
The question cannot be answered without histology. Anal cancer would be a possible option and the patient could be dead by now.
Your patient is very young to have a colon tumor. My 1st thought is something benign. There are some unanswered questions such as which part of the colon is the tumor at? How big is it? Studies done? Patient's presenting complaint? Wt loss? Is he able to eat? Problems with his bowel movements? Any biopsy done? Are you sure something external to the colon isn't pushing on the colon causing the appearance of a tumor?
Generally nowadays there is a stool test can diagnose early colonic neoplasm, I can't remember the generic name.
If the growth is originating from the perianal area it could possibly turn out to be one of the perineal rumors , mostly Busch Lowenstein tumor , condylomata accuminata, SCC. A biopsy only can tell the final diagnosis, though due to the size and the morphology of the growth I suggest it is a Busch Lownestein tumor
From the beginning all colleagues mention that a biopsy is mandatory. With the picture and short description we can guess but only histologic examination will very probably identify it. Dr.Sameh Emile mention Buschcke Lowenstein and of course this is a possible diagnosis. As another colleague, Dr. Carlos Miguel Lumi, say: “a biopsy is mandatory, after we can discuss”.I fully agree as most and probably all of discussers..
The most probable clinical diagnosis is Condiloma Accuminata due to HPV infection. However the final diagnosis can be achieved only after full surgical resection of the lesions since in that tumoral mass carcinoma transformation might appear (and it is highly probable) ...
It is anal cancer. Pl get the biopsy done. Get a proximal colostomy and after the biopsy report, treat appropriately.
I think that is mandatory to do a biopsy. Could be a Bushke -Lowenstein , anal cancer. We can discuss but without a biopsy we can´t do a treatement.
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