Significance of selected morphological and histopathological parameters of colon tumors as prognostic factors of cancer spread.

BACKGROUND/AIMS: The identification of prognostic factors of metastatic development is one of the most important issues in colorectal cancer (CRC) research. The aim of this study was to determine the usefulness of colon tumor characteristics, including location, circumferential location, histological type, and histological grade, as predictors of metastases. MATERIALS AND METHODS: To identify potential predictors of CRC spread, we analyzed data of 191 patients who had undergone surgery for colon tumors. We searched for potential associations between the location in the right or left colon, circumferential location, histological type, and histological grade (G-parameter) of colon tumors and the incidence of lymph node and distal metastases. The analysis was based on Pearson's chi-square (χ2) test with a statistical significance of p<0.05. RESULTS: Lymph node metastases were found in 100 patients, including 44 patients with synchronous liver metastases. Lymph node involvement was detected in 43 (52.4%) patients with right-sided and in 57 (52.3%) patients with left-sided tumors (p=0.984). Liver metastases were detected in 19 (23.17%) patients with right-sided colon tumors and in 25 (22.9%) patients with left-sided tumors (p=0.969). Lymph node and liver metastases were found in 60 (47.6%) and 24 (19.0%) patients with annular tumors, respectively (p=NS), and these were found on the mesenteric side in 75.0% (n=30) and 20.0% (n=8) patients (p=0.004) and on the antimesenteric side in 47.6% (n=10) and 48.0% (n=12) patients (p=0.044), respectively. CONCLUSION: The circumferential location of primary colon tumors is a significant predictor of their metastatic potential. The mesenteric location of the tumor is predisposed to lymphatic spread, whereas the antimesenteric location predicts hematogenous spread.

Co-existence of insulinoma and diabetes: A case report.

Neuroendocrine tumors constitute a group of heterogeneous neoplasms, both those that are clinically asymptomatic and those which present with an array of symptoms. This variable clinical manifestation and unsatisfactory detection rate on diagnostic imaging make preoperative diagnosis particularly challenging. Insulinoma is a rare tumor originating from insulin-synthetizing pancreatic beta cells which clinically manifests hypoglycemia. The current study presents the case of a patient with a one month history of diabetes, and a tumor of the pancreatic head diagnosed at the Regional Hospital of Lomza (Lomza, Poland). The patient subsequently underwent surgery. The histological examination indicated insulinoma; islet cell tumor of the pancreas. The patient's postoperative period was uneventful and during two years of follow-up, the patient has remained in good health with completely controlled diabetes mellitus. The hereby-presented case of pancreatic insulinoma confirms this finding, as a correct diagnosis could only be established on the basis of pathomorphological examination. In addition, radical surgical resection is currently the only available treatment.