TITLE

Colonic Histoplasmosis Presenting as Colon Cancer in the Nonimmunocompromised Patient: Report of a Case and Review of the Literature

AUTHOR(S)
Lee, Jason T.; Dixon, Matthew R.; Murrell, Zuri; Konyalian, Viken; Agbunag, Rodolfo; Rostami, Sassan; French, Samuel; Kumar, Ravin R.
PUB. DATE
November 2004
SOURCE
American Surgeon;Nov2004, Vol. 70 Issue 11, p959
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Histoplasmn capsulatum is an important pathogen that is the most commonly diagnosed endemic mycosis in the gastrointestinal tract of immunocompromised hosts. Failure to recognize and treat disseminated hisloplasmosis in AIDS patients invariably leads to death. Gastrointestinal manifestations frequently involve the terminal ileum and cecum, and depending on the layer of bowel wall involved present as bleeding, obstruction, perforation, or peritonitis. Because they can be variable in appearance, they may be mistaken for Crohn's disease or malignant tumors. Four distinct pathologic patterns of GI histoplasmosis have been described that all have differing clinical presentations. We report a case of a non-AIDS patient who presented with a nearobstructing colonic mass suspicious for advanced malignancy but was found to have histoplasmosis on final pathology. The patient underwent successful operative resection, systemic antifungal therapy, and extensive workup for immunosuppressive disorders, which were negative. The patient was from an area in Mexico known to be endemic for histoplasmosis. This is the first report of a colonic mass lesion occurring in a non-AIDS patient, and review of the worldwide literature regarding GI histoplasmosis reveals excellent long-term survival with aggressive therapy. We discuss the surgical and medical management of colonic histoplasmosis in this report.
ACCESSION #
15109188

 

Related Articles

  • CpG island methylator phenotype, microsatellite instability, BRAF mutation and clinical outcome in colon cancer. Ogino, Shuji; Nosho, Katsuhiko; Kirkner, Gregory J.; Kawasaki, Takako; Meyerhardt, Jeffrey A.; Loda, Massimo; Giovannucci, Edward L.; Fuchs, Charles S. // Gut;Jan2009, Vol. 58 Issue 1, p90 

    Background: The CpG island methylator phenotype (CIMP) characterised by widespread promoter methylation, is associated with microsatellite instability )MSI) and BRAF mutation in colorectal cancer. The independent effect of CIMP, MSI and BRAF mutation on prognosis remains uncertain. Methods:...

  • CDX2 mutations do not account for juvenile polyposis or Peutz–Jeghers syndrome and occur infrequently in sporadic colorectal cancers. Woodford-Richens, K L; Halford, S; Rowan, A; Bevan, S; Aaltonen, L A; Wasan, H; Bicknell, D; Bodmer, W F; Houlston, R S; Tomlinson, I P M // British Journal of Cancer;5/15/2001, Vol. 84 Issue 10, p1314 

    Peutz-Jeghers syndrome (PJS) and juvenile polyposis (JPS) are both characterized by the presence of hamartomatous polyps and increased risk of malignancy in the gastrointestinal tract. Mutations of the LKB1 and SMAD4 genes have been shown recently to cause a number of PJS and JPS cases...

  • Chemotherapy for colorectal cancer. Nicum, S.; Midgley, R.; Kerr, D.J. // Journal of the Royal Society of Medicine;Aug2000, Vol. 93 Issue 8, p416 

    The article discusses treatment options for colorectal cancer. Chemotherapeutic drugs available include 5-fluorouracil in combination with folinic acid and methotrexate, thymidylate synthase inhibitors, irinotecan and oxaliplatin. Adjuvant therapy is being given to patients who will undergo...

  • Invited Commentary. Gieseler, Frank // International Journal of Colorectal Disease;Mar2000, Vol. 15 Issue 2, p112 

    Presents a commentary about the dilemma of gastroenterological oncology. Emphasis on nonsteroidal anti-inflammatory drugs; Correlation between chronic inflammatory conditions of the bowel and the development of colon carcinoma; Indomethacin treatment of colon carcinoma cells.

  • The rationale behind complete mesocolic excision (CME) and a central vascular ligation for colon cancer in open and laparoscopic surgery. Søndenaa, K.; Quirke, P.; Hohenberger, W.; Sugihara, K.; Kobayashi, H.; Kessler, H.; Brown, G.; Tudyka, V.; D'Hoore, A.; Kennedy, R.; West, N.; Kim, S.; Heald, R.; Storli, K.; Nesbakken, A.; Moran, B. // International Journal of Colorectal Disease;Apr2014, Vol. 29 Issue 4, p419 

    Background: It has been evident for a while that the result after resection for colon cancer may not have been optimal. Several years ago, this was showed by some leading surgeons in the USA but a concept of improving results was not consistently pursued. Later, surgeons in Europe and Japan have...

  • Do young patients have different clinical presentation of colorectal cancer causing delay in diagnosis? Sousa, João; Souza, Caio; Fernandes, Maria; Castro Durães, Leonardo; Almeida, Romulo; Santos, Antônio; Silva, Eduardo; Oliveira, Paulo // International Journal of Colorectal Disease;Apr2014, Vol. 29 Issue 4, p519 

    Purpose: The incidence of colorectal cancer is increasing among young patients. In these patients, colorectal cancer is believed to have a poorer prognosis because it is more aggressive and diagnosed at later stages; however, the behavior of these tumors in young patients remains to be...

  • Observational cross-sectional study of compliance with the fast track protocol in elective surgery for colon cancer in Spain. Alcántara-Moral, Manuel; Serra-Aracil, X.; Gil-Egea, M.; Frasson, M.; Flor-Lorente, B.; Garcia-Granero, E. // International Journal of Colorectal Disease;Apr2014, Vol. 29 Issue 4, p477 

    Purpose: The purpose of this study was to establish the degree of compliance with the fast track (enhanced recovery) protocol in habitual clinical practice and to determine which measures are fundamental for achieving the results obtained by applying the entire protocol. Methods: Observational,...

  • Documented quality of care in certified colorectal cancer centers in Germany: German Cancer Society benchmarking report for 2013. Wesselmann, S.; Winter, A.; Ferencz, J.; Seufferlein, T.; Post, S. // International Journal of Colorectal Disease;Apr2014, Vol. 29 Issue 4, p511 

    Purpose: In order to improve the quality of treatment for cancer patients the German Cancer Society (Deutsche Krebsgesellschaft) implemented a certification system for oncological care institutions. The certified colorectal cancer centers present the structures, processes and results of their...

  • Outcome after Introduction of Complete Mesocolic Excision for Colon Cancer Is Similar for Open and Laparoscopic Surgical Treatments. Storli, Kristian E.; Søndenaa, Karl; Furnes, Bjørg; Eide, Geir Egil // Digestive Surgery;Mar2014, Vol. 30 Issue 4-6, p317 

    Background: Complete mesocolic excision (CME) and a high (apical) vascular tie may improve oncologic outcome after surgery for colon cancer. Our primary aim was to emulate a previous national result of 73.8% overall survival (OS) with both the open and laparoscopic techniques. Methods: A...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics