Tumours


Benign tumors of the intestine
Below you can find an overview of benign tumors of the intestine. Click on the links for more information.

Polyp

A polyp is a hyper proliferation of the mucosa of the intestine. Normally polyps are benign, but in ten percent of the cases malignant transformation into colon cancer can occur. Most polyps are incidental findings during a colonoscopy, but they can also be the cause of blood or mucus in the stool. If the blood is not visible, it is still possible for the patient to develop anemia due to gradually developing iron deficiency. If a polyp is found during colonoscopy, the whole polyp or a biopsy will be send for pathologic investigation. When malignant cells are found further treatment, via colonoscopy or surgery, is needed.

Hereditary disease can cause polyps as well, a well-known inherited condition that causes polyps is Familial Adenomatous Polyposis (FAP). These patients have a genetic alteration which causes hundreds to thousands of polyps. While these polyps start out benign, malignant transformation occurs when left untreated. These patients can choose prophylactic surgery. Family members of these patients need to be screened for this disease.



Malignant tumors of the intestine
Below you can find an overview of malignant tumors of the intestine. Click on the links for more information.

Adenocarcinoma

The most common malignant tumor of the colon and rectum is the adenocarcinoma. These tumors originated from the mucous membrane of the intestine. When it is located in the large intestine it’s called a colon carcinoma, when it is situated in the rectum it’s a rectum carcinoma.

Annually about 8600 people are diagnosed with colon cancer. This disease is about as common in men as in women, and may occur at any age, but most patients are over 50 years of age. The majority of colon carcinomas are not hereditary and rarely there is an identifiable cause. In a small percentage of patients with colon or rectum carcinoma there is a genetic predisposition. There are two main syndromes which cause this, namely:
Familial Adenomatous Polyposis Coli (FAP) and Hereditary Non-Polyposis Colorectal Cancer (HNPCC, also called Lynch syndrome)

Approximately 1% of patients with colorectal cancer is diagnosed with FAP. This means that these patients suffer from a genetic disorder causing numerous polyps in the colon. Polyps are seen as precursors of malignant tumors. In all patients with FAP colorectal cancer will arise. Patients who have been diagnosed with FAP are advised to have the colon surgically removed as a preventive matter. Family members of these patients are advised to be screened regularly.

Approximately 5% of patients with colorectal cancer are diagnosed with HNPCC. HNPCC patients have an increased risk of developing malignant tumors in the colon and rectum, but also in other organs, as the uterus, ovaries and stomach. A carcinoma of the intestine is often not preceded by polyps, in contrast to FAP-syndrome. Nevertheless also these patients and families should be screened regularly.

The majority of tumors, 50-60%, in the colon arises in the latter part of the large intestine, the sigmoid or in the rectum. A clear cause for the development of cancer in the colon or rectum is usually not known. It is known that when relatives suffer from colorectal cancer there is an increased risk. When colorectal cancer was diagnosed prior risks for developing colorectal cancer are increased. Just as chronic inflammation, like colitis ulcerosa or Crohn’s disease increase the risk for colorectal cancer.

Patients suffering from cancer have nonspecific complaints. Common complaints are a change in bowel habits (e.g. alternating constipation and diarrhea), blood and/or mucous in the stool, less pressure. And patients can present with symptoms of anemia (such as tired- or dizziness) caused by undetected blood loss in the stool.

When the tumor of a patient is rather large, this may lead to clogging of the intestine. This is called an ileus and leads to constipation and abdominal discomfort among other things. In colorectal cancer tumors cells may become detached from the original tumor. These tumor cells can spread through the body via the blood and the lymphatic system. Elsewhere in the body, in colorectal tumors this is mainly in liver and lungs, these cells can grow out into tumors. These are called metastases.

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