Abstract
While adenomas and adenocarcinoma account for the majority of colorectal neoplasms, several other less frequent types of malignancy can occur, which can often present as diagnostic and therapeutic challenges to the clinician. These tumors can be classified based on their tissue of origin and include epithelial, mesenchymal, neural, vascular, or lymphoid tumors.
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References
Kulke MH, Mayer RJ. Carcinoid tumours. N Engl J Med. 1999;340:858–68.
Ganim RB, Norton JA. Recent advances in carcinoid pathogenesis, diagnosis and management. Surg Oncol. 2000;9:173–9.
Eriksson B, Oberg K, Stridsberg M. Tumour markers in neuroendocrine tumours. Digestion. 2000;62:33–8.
Lucas KJ, Feldman JM. Flushing in the carcinoid syndrome and plasma kallikrein. Cancer. 1986;58:2290–3.
Reubi JC, Laissue J, Waser B. Expression of somatostatin receptors in normal, inflamed, and neoplastic human gastrointestinal tissues. Ann N Y Acad Sci. 1994;733:122–37.
Rea F, Binda R, Spreafico G. Bronchial carcinoids: a review of 60 patients. Ann Thorac Surg. 1989;47:412–4.
Schreurs AJ, Westermann CJ, van den Bosch JM. A twenty-five-year follow-up of ninety-three resected typical carcinoid tumours of the lung. J Thorac Cardiovasc Surg. 1992;104:1470–5.
Barclay TH, Schapira DV. Malignant tumours of the small intestine. Cancer. 1983;51:878–81.
Makridis C, Oberg K, Juhlin C. Surgical treatment of mid-gut carcinoid tumors. World J Surg. 1990;14:377–83.
Moertel CG, Dockerty MB, Judd ES. Carcinoid tumors of the vermiform appendix. Cancer. 1968;21:270–8.
Moertel CG, Weiland LH, Nagorney DM, Dockerty MB. Carcinoid tumor of the appendix: treatment and prognosis. N Engl J Med. 1987;317:1699–701.
Berardi RS. Carcinoid tumors of the colon (exclusive of the rectum): review of the literature. Dis Colon Rectum. 1972;15:383–91.
Jetmore AB, Ray JE, Gathright Jr JB. Rectal carcinoids: the most frequent carcinoid tumor. Dis Colon Rectum. 1992;35:717–25.
Naunheim KS, Zeitels J, Kaplan EL. Rectal carcinoid tumors – treatment and prognosis. Surgery. 1983;94:670–6.
Burke M, Shepherd N, Mann CV. Carcinoid tumours of the rectum and anus. Br J Surg. 1987;74:358–61.
Eriksson B, Oberg K. Summing up 15 years of somatostatin analog therapy in neuroendocrine tumors: future outlook. Ann Oncol. 1999;10:S31–8.
Kubota A, Yamada Y, Kagimoto S. Identification of somatostatin receptor subtypes and an implication for the efficacy of somatostatin analogue SMS 201-995 in the treatment of human endocrine tumors. J Clin Invest. 1994;93:1321–5.
Kvols LK, Moertel CG, O’Connell MJ. Treatment of the malignant carcinoid syndrome: evaluation of a long-acting somatostatin analogue. N Engl J Med. 1986;315:663–6.
Tomassetti P, Migliori M, Corinaldesi R, Gullo L. Treatment of gastroenteropancreatic neuroendocrine tumours with octreotide LAR. Aliment Pharmacol Ther. 2000;14:557–60.
O’Toole D, Ducreux M, Bommelaer G, Wemeau JL, Bouché O, Catus F, et al. Treatment of carcinoid syndrome: a prospective crossover evaluation of lanreotide versus octreotide in terms of efficacy, patient acceptability, and tolerance. Cancer. 2000;88:770–6.
Rubin J, Ajani J, Schirmer W, Venook AP, Bukowski R, Pommier R, et al. Octreotide acetate long-acting formulation versus open-label subcutaneous octreotide acetate in malignant carcinoid syndrome. J Clin Oncol. 1999;17:600–6.
Moertel CG, Hanley JA. Combination chemotherapy trials in metastatic carcinoid tumor and the malignant carcinoid syndrome. Cancer Clin Trials. 1979;2(4):327–34.
Engstrom PF, Lavin PT, Moertel CG, Folsch E, Douglass Jr HO. Streptozocin plus fluorouracil versus doxorubicin therapy for metastatic carcinoid tumor. J Clin Oncol. 1984;2(11):1255–9.
Bukowski RM, Johnson KG, Peterson RF, Stephens RL, Rivkin SE, Neilan B, et al. A phase II trial of combination chemotherapy in patients with metastatic carcinoid tumors. A Southwest Oncology Group Study. Cancer. 1987;60(12):2891–5.
Moertel CG, Kvols LK, O’Connell MJ, Rubin J. Treatment of neuroendocrine carcinomas with combined etoposide and cisplatin. Evidence of major therapeutic activity in the anaplastic variants of these neoplasms. Cancer. 1991;68(2):227–32.
Moertel CG, Johnson CM, McKusick MA, Martin Jr JK, Nagorney DM, Kvols LK, et al. The management of patients with advanced carcinoid tumors and islet cell carcinomas. Ann Intern Med. 1994;120(4):302–9.
Schupak KD, Wallner KE. The role of radiation therapy in the treatment of locally unresectable or metastatic carcinoid tumors. Int J Radiat Oncol Biol Phys. 1991;20(3):489–95.
Virgolini I, Britton K, Buscombe J, Moncayo R, Paganelli G, Riva P. In- and Y-DOTA-lanreotide: results and implications of the MAURITIUS trial. Semin Nucl Med. 2002;32(2):148–55.
Barakat MT, Meeran K, Bloom SR. Neuroendocrine tumours. Endocr Relat Cancer. 2004;11(1):1–18.
Rengtgen DS, Thompson W, Garbutt J, Seigler HF. Radiologic, endoscopic and surgical considerations of melanoma metastatic to the GI tract. Surgery. 1984;95:635–9.
Malik A, Hull TL, Floruta C. What is the best surgical treatment for anorectal melanoma? Int J Colorectal Dis. 2004;19(2):121–3.
Tessier DJ, McConnell EJ, Young-Fadok T, Wolff BG. Melanoma metastatic to the colon: case series and review of the literature with outcome analysis. Dis Colon Rectum. 2003;46(4):441–7.
Ollila DW, Essner R, Wanek LA, Morton DL. Surgical resection for melanoma metastatic to the gastrointestinal tract. Arch Surg. 1996;131:975–9.
Allen PJ, Cott DG. The surgical management of metastatic melanoma. Ann Surg Oncol. 2002;9(8):762–70.
Schuchter LM, Green R, Fraker D. Primary and metastatic diseases in malignant melanoma of the gastrointestinal tract. Curr Opin Oncol. 2000;12:181–5.
Kawashima A, Fishman EK, Kuhlman JE, Schuchter LM. CT of malignant melanoma: patterns of small bowel and mesenteric involvement. J Comput Assist Tomogr. 1991;15:570–1.
Damian DL, Fulham MJ, Thompson E, Thompson JF. Positron emission tomography in the detection and management of metastatic melanoma. Melanoma Res. 1996;6:325–9.
Buzaid AC, Sandler AB, Mani S, Curtis AM, Poo WJ, Bolognia JL, et al. Role of computed tomography in the staging of primary melanoma. J Clin Oncol. 1993;11:638–43.
Agrawal S, Yao TJ, Coit DG. Surgery for melanoma metastatic to the gastrointestinal tract. Ann Surg Oncol. 1999;6:636–44.
Khadra MH, Thompson JF, Milton GW, McCarthy WH. The justification for surgical treatment of metastatic melanoma of the gastrointestinal tract. Surg Gynecol Obstet. 1990;171:413–6.
Ricaniadis N, Konstandoulakis MM, Walsh D, Karakousis CP. Gastrointestinal metastases from malignant melanoma. Surg Oncol. 1995;4:105–10.
Clemmensen OJ, Fenger C. Melanoctyes in the anal canal epithelium. Histopathology. 1991;18:237–41.
Avital S, Romaguera RL, Sands L, Marchetti F, Hellinger MD. Primary malignant melanoma of the right colon. Am Surg. 2004;70:649–51.
Sarah P, MaNiff JF, Madison MD, Wen-Jen Poo H, Bayar S, Sallem RR. Colonic melanoma, primary or regressed primary. J Clinic Gastroenterol. 2000;30:440–4.
Gervasoni Jr JE, Wanebo HJ. Cancers of the anal canal and anal margin. Cancer Invest. 2003;21(3):452–64.
Blecker D, Abraham S, Furth EE, Kochman ML. Melanoma of the gastrointestinal tract. Am J Gastroenterol. 1999;94(12):3427–33.
Wanebo HJ, Woodruff JM, Farr GH, Quan SH. Anorectal melanomas. Cancer. 1981;47:1891–5.
Brady MS, Kavolius JP, Quan SH. Anorectal melanoma. A 64-year experience at Memorial Sloan-Kettering Cancer Center. Dis Colon Rectum. 1995;38(2):146–51.
Billingsley KG, Stern LE, Lowy AM, Kahlenberg MS, Thomas Jr CR. Uncommon anal neoplasms. Surg Oncol Clin N Am. 2004;13(2):375–88.
Yeh JJ, Shia J, Hwu WJ, Busam KJ, Paty PB, Guillem JG, et al. The role of abdominoperineal resection as surgical therapy for anorectal melanoma. Ann Surg. 2006;244(6):1012–7.
Belli F, Gallino GF, Lo Vullo S, Mariani L, Poiasina E, Leo E. Melanoma of the anorectal region. The experience of the National Cancer Institute of Milano. Eur J Surg Oncol. 2009;35(7):757–62.
Lens MB, Dawes M. Interferon alfa therapy for malignant melanoma: a systematic review of randomized controlled trials. J Clin Oncol. 2002;20(7):1818–25.
Verma S, Quirt I, McCready D, Bak K, Charette M, Iscoe N. Systematic review of systemic adjuvant therapy for patients at high risk for recurrent melanoma. Cancer. 2006;106(7):1431–42.
Kawano N, Tashiro M, Taguchi M, Kihara Y, Yoshikawa I, Syukuwa K, et al. Combined treatment with dacarbazine, nimustine, cisplatin, and tamoxifen plus interferon-beta in a patient with advanced anorectal malignant melanoma. Nippon Shokakibyo Gakkai Zasshi. 2008;105(11):1627–33.
Quintas-Cardama A, Lazar AJ, Woodman SE, Kim K, Ross M, Hwu P, et al. Complete response of stage IV anal mucosal melanoma expressing KIT Val560Asp to the multikinase inhibitor sorafenib. Nat Clin Pract Oncol. 2008;5(12):737–40.
Mazur MT, Clark HB. Gastric Stromal tumors: reappraisal of histogenesis. Am J Surg Pathol. 1983;7:507–19.
Hirota S, Isozaki K, Moriyama Y, Hashimoto K, Nishida T, Ishiguro S, et al. Gain of function mutations of c-kit in human gastrointestinal stromal tumors. Science. 1998;279:577–80.
Heinrich MC, Corless CL, Duensing A, McGreevey L, Chen CJ, Joseph N, et al. PDGFRA activating mutations in gastrointestinal stromal tumors. Science. 2003;299(5607):708–10.
Biasco G, Velo D, Angriman I, Astorino M, Baldan A, Baseggio M, et al. Gastrointestinal stromal tumors: report of an audit and review of the literature. Eur J Cancer Prev. 2009;18(2):106–16.
Steigen SE, Eide TJ. Gastrointestinal stromal tumors (GISTs): a review. APMIS. 2009;117:73–86.
Tryggvason G, Gisalason HG, Magnusson MK, Jonasson JG. Gastrointestinal stromal tumors in Iceland, 1990–2003: the Icelandic GIST study, a population based incidence and pathologic risk stratification study. Int J Cancer. 2005;117:289–93.
Miettinen M, Lasota J, Sobin LH. Gastrointestinal stromal tumors of the stomach in children and young adults: a clinicopathologic, immunohistochemical, and molecular genetic study of 44 cases with long term follow up and review of the literature. Am J Surg Pathol. 2005;29:1373–81.
Kingham TP, DeMatteo RP. Multidisciplinary treatment of gastrointestinal stromal tumors. Surg Clin N Am. 2009;89:217–33.
Diment J, Tamborini E, Casali P, Gronchi A, Carney JA, Colecchia M. Carney triad: case report and molecular analysis of gastric tumor. Hum Pathol. 2005;36:112–6.
Matyakhina L, Bei TA, McWhinney SR, Pasini B, Cameron S, Gunawan B, et al. Genetics of Carney triad: recurrent losses at chromosome 1 but lack of germline mutations in genes associated with paragangliomas and gastrointestinal stromal tumors. J Clin Endocrinol Metab. 2007;92:3728–32.
Miettinen M, Fetsch JF, Sobin LH, Lasota J. Gastrointestinal stromal tumors in patients with neurofibromatosis 1: a clinicopathologic and molecular genetic study of 45 cases. Am J Surg Pathol. 2006;30(1):90–6.
Takazawa Y, Sakurai S, Sakuma Y, Ikeda T, Yamaguchi J, Hashizume Y, et al. Gastrointestinal stromal tumors of neurofibromatosis type I (von Recklinghausen’s disease). Am J Surg Pathol. 2005;29(6):755–63.
Agaimy A, Wünsch PH, Hofstaedter F, Blaszyk H, Rümmele P, Gaumann A, et al. Minute gastric sclerosing stromal tumors (GIST tumorlets) are common in adults and frequently show c-KIT mutations. Am J Surg Pathol. 2007;31(1):113–20.
Nilsson B, Bümming P, Meis-Kindblom JM, Odén A, Dortok A, Gustavsson B, et al. Gastrointestinal stromal tumors: the incidence, prevalence, clinical course, and prognostication in the preimatinib mesylate era – a population-based study in western Sweden. Cancer. 2005;103(4):821–9.
Ueyama T, Guo KJ, Hashimoto H, Daimaru Y, Enjoji M. A clinicopathologic and immunohistochemical study of gastrointestinal stromal tumors. Cancer. 1992;69:947–55.
Sandrasegaran K, Rajesh A, Rushing DA, Rydberg J, Akisik FM, Henley JD. Gastrointestinal stromal tumors: CT and MRI findings. Eur Radiol. 2005;15(7):1407–14.
Miettinen M, Lasota J. Gastrointestinal stromal tumors: review on morphology, molecular pathology, prognosis, and differential diagnosis. Arch Pathol Lab Med. 2006;130(10):1466–78.
Goerres GW, Stupp R, Barghouth G, Hany TF, Pestalozzi B, Dizendorf E, et al. The value of PET, CT and in-line PET/CT in patients with gastrointestinal stromal tumours: long-term outcome of treatment with imatinib mesylate. Eur J Nucl Med Mol Imaging. 2005;32(2):153–62.
Rader AE, Avery A, Wait CL, McGreevey LS, Faigel D, Heinrich MC. Fine-needle aspiration biopsy diagnosis of gastrointestinal stromal tumors using morphology, immunocytochemistry, and mutational analysis of c-kit. Cancer. 2001;93:269–75.
Stelow EB, Stanley MW, Mallery S, Lai R, Linzie BM, Bardales RH. Endoscopic ultrasound guided fine needle aspiration findings of gastrointestinal leiomyomas and gastrointestinal stromal tumors. Am J Clin Pathol. 2003;119:703–8.
DeMatteo RP, Lewis JJ, Leung D, Mudan SS, Woodruff JM, Brennan MF. Two hundred gastrointestinal stromal tumors: recurrence patterns and prognostic factors for survival. Ann Surg. 2000;231:51–8.
Novitsky YW, Kercher KW, Sing RF, Heniford BT. Long-term outcomes of laparoscopic resection of gastric gastrointestinal stromal tumors. Ann Surg. 2006;243:738–45.
Eisenberg BL, Judson I. Surgery and imatinib in the management of GIST: emerging approaches to adjuvant and neoadjuvant therapy. Ann Surg Oncol. 2004;11:465–75.
Yeh C, Chen H, Tang R, Tasi W, Lin P, Wang J. Surgical outcome after surgical resection of rectal leiomyosarcoma. Dis Colon Rectum. 2000;43:1517–21.
van Oosterom AT, Judson I, Verweij J, Stroobants S, Donato di Paola E, Dimitrijevic S, et al. Safety and efficacy of imatinib (STI571) in metastatic gastrointestinal stromal tumours: a phase I study. Lancet. 2001;358(9291):1421–3.
Gold JS, DeMatteo RP. Combined surgical and molecular therapy: the gastrointestinal stromal tumor model. Ann Surg. 2006;244:176–84.
dos Santos Fernandes G, Blanke CD, Freitas D, Guedes R, Hoff PM. Perioperative treatment of gastrointestinal stromal tumors. Oncology. 2009;23(1):54–61.
Malhotra P, Singh M, Kochhar R, Nada R, Wig JD, Varma N, et al. Leukemia infiltration of bowel in chronic lymphocytic leukemia. Gastrointest Endosc. 2005;62(4):614–5.
Heiberg E, Wolverson M, Sandaram M, Sheilds JB. CT findings in leukemia. AJR Am J Roentgenol. 1984;143:1317–23.
Salek J, Sideridis K, White S. Chronic lymphocytic leukemia of the intestinal tract. Gastrointest Endosc. 2006;63(7):1072–3.
Hunter T, Bjelland JC. Gastrointestinal complications of leukemia and its treatment. AJR Am J Roentgenol. 1984;142:513–8.
Gavan DR, Hendry GM. Colonic complications of acute lymphoblastic leukemia. Br J Radiol. 1994;67:449–52.
Sloas MM, Flynn PM, Kaste SC, Patrick CC. Typhlitis in children with cancer: a 30 year experience. Clin Infect Dis. 1993;17:484–90.
Hayes Jr D, Leonardo JM. Neutropenic enterocolitis in a woman treated with 5-fluorouracil and leucovorin for colon carcinoma. NC Med J. 2002;63:132–4.
Avigan D, Richardson P, Elias A, Demetri G, Shapiro M, Schnipper L, et al. Neutropenic enterocolitis as a complication of high dose chemotherapy with stem cell rescue in patients with solid tumors: a case series with a review of the literature. Cancer. 1998;83(3):409–14.
Pestalozzi BC, Sotos GA, Choyke PL, Fisherman JS, Cowan KH, O’Shaughnessy JA. Typhlitis resulting from treatment with taxol and doxorubicin in patients with metastatic breast cancer. Cancer. 1993;71(5):1797–800.
Paulino AF, Kenney R, Forman EN, Medeiros LJ. Typhlitis in a patient with acute lymphoblastic leukemia prior to the administration of chemotherapy. Am J Pediatr Hematol Oncol. 1994;16:348–51.
Cunningham SC, Fakhry K, Bass BL, Napolitano LM. Neutropenic enterocolitis in adults: case series and review of the literature. Dig Dis Sci. 2005;50:215–20.
Kulaylat M, Doerr R, Ambrus J. A case presentation and review of neutropenic enterocolitis. J Med. 1997;28:1–19.
Hsu TF, Huang HH, Yen DH. ED presentation of neutropenic enterocolitis in adult patients with acute leukemia. Am J Emerg Med. 2004;22:276–9.
Ullery BW, Pieracci FM, Rodney JRM, Barie PS. Neutropenic enterocolitis. Surg Infect. 2009;10(3):307–14.
Davila ML. Neutropenic enterocolitis. Curr Opin Gastroenterol. 2006;22:44–7.
Gorshluter M, Ulrich M, Strehl J, Ziske C, Schepke M, Schmidt-Wolf IGH, et al. Neutropenic enterocolitis in adults: systematic analysis of evidence quality. Eur J Hematol. 2005;75:1–13.
Picardi M, Camera A, Pane F, Rotoli B. Improved management of neutropenic enterocolitis using early ultrasound scan and vigorous medical treatment. Clin Infect Dis. 2007;45:403–7.
Villar HV, Warneke JA, Peck MD, Durie B, Bjelland JC, Hunter TB. Role of surgical treatment in the management of complications of the gastrointestinal tract in patients with leukemia. Surg Gynecol Obstet. 1987;165(3):217–22.
Glenn J, Funkhouser WK, Schneider PS. Acute illnesses necessitating urgent abdominal surgery in neutropenic cancer patients: description of 14 cases and review of the literature. Surgery. 1989;105:778–9.
Quayle FJ, Lowney JK. Colorectal lymphoma. Clin Colon Rectal Surg. 2006;19:49–53.
Koch P, del Valle F, Berdel WE, Willich NA, Reers B, Hiddemann W, et al. Primary gastrointestinal non-Hodgkin’s lymphoma: I. Anatomic and histologic distribution, clinical features, and survival data of 371 patients registered in the German Multicenter Study GIT NHL 01/92. J Clin Oncol. 2001;19(18):3861–73.
Zighelboim J, Larson MV. Primary colonic lymphoma, clinical presentation, histopathologic features and outcome with combination chemotherapy. J Clin Gastroenterol. 1994;18:291–7.
Dionigi G, Annoni M, Rovera F, Boni L, Villa F, Castano P, et al. Primary colorectal lymphomas: review of the literature. Surg Oncol. 2007;16 Suppl 1:S169–71.
Dawson IM, Cornes JS, Morson BC. Primary malignant lymphoid tumours of the gastrointestinal tract. Br J Surg. 1961;49:80–9.
Musallam K, Hatoum H, Barada K, Taher A, Salem ME, Malek EM, et al. Primary colorectal lymphoma. Med Oncol. 2010;27(2):249–54.
Wong MTC, Eu KW. Primary colorectal lymphomas. Colorectal Dis. 2006;8:586–91.
Lewin KJ, Ranchod M, Dorfmann RF. Lymphomas of the gastrointestinal tract – a study of 119 cases presenting with gastrointestinal disease. Cancer. 1978;43:693–707.
Contreary K, Nance FC, Becker WF. Primary lymphoma of the gastrointestinal tract. Ann Surg. 1980;191:593–8.
Wychulis AR, Bears OH, Woolner LB. Malignant lymphoma of the colon – a study of 69 cases. Arch Surg. 1966;93:215–25.
Fan CW, Changchien CR, Wang JY, Chen JS, Hsu KC, Tang R, et al. Primary colorectal lymphoma. Dis Colon Rectum. 2000;43(9):1277–82.
Azab MB, Henry-Amar M, Rougier P, Bognel C, Theodore C, Carde P, et al. Prognostic factors in primary gastrointestinal non-Hodgkin’s lymphoma. A multivariate analysis, report of 106 cases, and review of the literature. Cancer. 1989;64(6):1208–17.
Jinnai D, Iwasa Z, Watanuki T. Malignant lymphoma of the large intestine – operative results in Japan. Surg Today. 1983;13:331–6.
Acknowledgments.
This chapter was authored by Richard Devine and Marc Brand in the previous edition of this textbook.
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Boushey, R.P., Moloo, H. (2011). Miscellaneous Neoplasms. In: Beck, D.E., Roberts, P.L., Saclarides, T.J., Senagore, A.J., Stamos, M.J., Wexner, S.D. (eds) The ASCRS Textbook of Colon and Rectal Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1584-9_49
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