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Liu Y, Chen Z, Dou L, Yang Z, Wang G. Solitary Rectal Ulcer Syndrome Is Not Always Ulcerated: A Case Report. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58081136. [PMID: 36013603 PMCID: PMC9412513 DOI: 10.3390/medicina58081136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/29/2022] [Accepted: 08/16/2022] [Indexed: 11/16/2022]
Abstract
Solitary rectal ulcer syndrome (SRUS) is a benign and chronic disorder well known in young adults that is characterized by a series of symptoms such as rectal bleeding, copious mucus discharge, prolonged excessive straining, perineal and abdominal pain, a feeling of incomplete defecation, constipation and, rarely, rectal prolapse. The etiology of this syndrome remains obscure, and the diagnosis is easily confused with that of other diseases, contributing to difficulties in treatment. We present a case of a 37-year-old male with a nonulcerated rectal lesion grossly resembling a superficial depressed rectal cancer misdiagnosed in another hospital and describe its appearance on endoscopy and in the analysis of its pathological manifestations. The aim of this case report is to report an easily misdiagnosed case of SRUS, which needs to be distinguished from superficial rectal cancer, which should be educational for endoscopists.
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Affiliation(s)
- Yi Liu
- Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; (Y.L.); (Z.C.); (L.D.)
| | - Zhihao Chen
- Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; (Y.L.); (Z.C.); (L.D.)
| | - Lizhou Dou
- Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; (Y.L.); (Z.C.); (L.D.)
| | - Zhaoyang Yang
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China;
| | - Guiqi Wang
- Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; (Y.L.); (Z.C.); (L.D.)
- Correspondence:
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Kawczyk-Krupka A, Bartusik-Aebisher D, Latos W, Cieślar G, Sieroń K, Kwiatek S, Oleś P, Kwiatek B, Aebisher D, Krupka M, Wiench R, Skaba D, Olek M, Kasperski J, Czuba Z, Sieroń A. Clinical Trials and Basic Research in Photodynamic Diagnostics and Therapies from the Center for Laser Diagnostics and Therapy in Poland. Photochem Photobiol 2020; 96:539-549. [PMID: 32112419 DOI: 10.1111/php.13243] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 01/09/2020] [Indexed: 12/29/2022]
Abstract
The purpose of this review is to present an overview of the development of photodiagnostic and photodynamic therapy (PDD and PDT) techniques in Poland. The paper discusses the principles of PDD, including fluorescent techniques in determining precancerous conditions and cancers of the skin, digestive tract, bladder and respiratory tract. Methods of PDT of cancer will be discussed and the current state of knowledge as well as future trends in the development of photodynamic techniques will be presented, including the possibility of using photodynamic antimicrobial therapy. Research pioneers in photodynamic medicine such as Thomas Dougherty are an inspiration for the development of methods of PDD and PDT in our Clinic. The Center for Laser Diagnostics and Therapy in Bytom, Poland, promotes the propagation of PDD and PDT through the training of clinicians and raising awareness among students in training and the general public. Physicians at the Center are engaged in photomedical research aimed at clinical implementation and exploration of new avenues in photomedicine while optimizing existing modalities. The Center promotes dissemination of clinical results from a wide range of topics in PDD and PDT and serving as representative authorities of photodynamic medicine in Poland and Europe.
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Affiliation(s)
- Aleksandra Kawczyk-Krupka
- Department of Internal Medicine, Angiology, and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Bytom, Poland
| | | | - Wojciech Latos
- Department of Internal Medicine, Angiology, and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Bytom, Poland
| | - Grzegorz Cieślar
- Department of Internal Medicine, Angiology, and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Bytom, Poland
| | - Karolina Sieroń
- Department of Internal Medicine, Angiology, and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Bytom, Poland.,Department of Physical Medicine, Chair of Physiotherapy, Medical University of Silesia, Katowice, Poland
| | - Sebastian Kwiatek
- Department of Internal Medicine, Angiology, and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Bytom, Poland
| | - Piotr Oleś
- Department of Internal Medicine, Angiology, and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Bytom, Poland
| | - Beata Kwiatek
- Department of Internal Medicine, Angiology, and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Bytom, Poland
| | - David Aebisher
- Faculty of Medicine, University of Rzeszów, Rzeszów, Poland
| | - Magdalena Krupka
- Department of Internal Medicine, Angiology, and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Bytom, Poland
| | - Rafał Wiench
- Department of Periodontal Diseases and Oral Mucosa Diseases, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Dariusz Skaba
- Department of Periodontal Diseases and Oral Mucosa Diseases, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Marcin Olek
- Department of Prosthetic Dentistry, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Jacek Kasperski
- Department of Prosthetic Dentistry, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Zenon Czuba
- Department of Microbiology and Immunology, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Aleksander Sieroń
- Department of Internal Medicine, Angiology, and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Bytom, Poland.,Department of Physiotherapy, Jan Dlugosz University in Częstochowa, Częstochowa, Poland
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Sadeghi A, Biglari M, Forootan M, Adibi P. Solitary Rectal Ulcer Syndrome: A Narrative Review. Middle East J Dig Dis 2019; 11:129-134. [PMID: 31687110 PMCID: PMC6819965 DOI: 10.15171/mejdd.2019.138] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 06/16/2019] [Indexed: 12/12/2022] Open
Abstract
Solitary rectal ulcer syndrome is a multifactorial pathology, which entails a variety of clinical, histologic and endoscopic aspects that needs step-wise logical approach for management especially in relapsing refractory cases. Apart from the diagnostic dilemma that may be faced due to similarities of presentation with inflammatory bowel diseases or colorectal neoplastic lesions, the syndrome also overlaps with dyssynergic defecation syndrome, health anxiety disorder, obsessive compulsive disorder, and latent mucosal rectal prolapse, a systematic composite treatment modality including psychological, pharmacological, physiological and possibly surgical interventions are sometimes essential. Selecting appropriate treatment in this condition not only affects clinical outcome but also patients’ experience and further stigma of SRUS life-long. In this review, we will discuss the detailed pathophysiology, diagnostic and therapeutic approaches in dealing with solitary rectal ulcer syndrome.
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Affiliation(s)
- Anahita Sadeghi
- Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Biglari
- Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojgan Forootan
- Department of Gastroenterology, Gastrointestinal and Liver Diseases Research Center (RCGLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Peyman Adibi
- Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Strzelczyk N, Kwiatek S, Latos W, Sieroń A, Stanek A. Does the Numerical Colour Value (NCV) correlate with preneoplastic and neoplastic colorectal lesions? Photodiagnosis Photodyn Ther 2018; 23:353-361. [PMID: 30055281 DOI: 10.1016/j.pdpdt.2018.07.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 07/18/2018] [Accepted: 07/20/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND White light endoscopy (WLE) is the gold standard for detection of colorectal cancer. Autofluorescence endoscopy (AFE) is among the novel methods expected to increase the sensitivity and specificity of endoscopic diagnosis. The main objective of the study was to determine the diagnostic efficacy of AFE for the detection of preneoplastic and neoplastic colorectal lesions and to identify high-grade neoplasia using Numerical Colour Value (NCV). METHODS This retrospective study included 188 patients with colorectal mucosal lesions diagnosed on WLE and assessed using AFE; they were included in the study if a complete patient record was available (description of visualized colorectal lesions, NCV and histopathology report). The NCV was compared with the histological result. RESULTS Histology revealed 38 hyperplastic colon polyps, 77 low-grade dysplastic lesions, 17 high-grade dysplastic lesions, 24 adenocarcinomas and 32 inflammatory lesions. The mean NCVs of high-grade dysplasia (HGD) and adenocarcinoma were 2.24 ± 0.22 and 2.73 ± 0.16, respectively, significantly higher than the NCV of hyperplastic colon polyps (0.95 ± 0.06), low-grade dysplasia (LGD) (1.27 ± 0.05) and inflammatory lesions (1.26 ± 0.17). The NCV cut-off value for HGD and adenocarcinoma was set at 1.7. The sensitivity, specificity, PPV (positive predictive value) and NPV (negative predictive value) were 95.2%, 87.9%, 97.5%, 84.8%, respectively. CONCLUSION Our study showed that AFE could provide useful diagnostic information regarding preneoplastic and neoplastic colorectal lesions. Additionally, the NCV significantly correlated with the histopathology results.
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Affiliation(s)
- Natalia Strzelczyk
- Specialist Hospital No 2, Department of Internal Diseases, Angiology and Physical Medicine, Center for Laser Diagnosis and Therapy, Batorego Street 15, 41-902 Bytom, Poland
| | - Sebastian Kwiatek
- Specialist Hospital No 2, Department of Internal Diseases, Angiology and Physical Medicine, Center for Laser Diagnosis and Therapy, Batorego Street 15, 41-902 Bytom, Poland
| | - Wojciech Latos
- Specialist Hospital No 2, Department of Internal Diseases, Angiology and Physical Medicine, Center for Laser Diagnosis and Therapy, Batorego Street 15, 41-902 Bytom, Poland
| | - Aleksander Sieroń
- School of Medicine with the Division of Dentistry in Zabrze, Department of Internal Medicine, Angiology and Physical Medicine, Center for Laser Diagnosis and Therapy, Medical University of Silesia, Batorego Street 15, 41-902 Bytom, Poland
| | - Agata Stanek
- School of Medicine with the Division of Dentistry in Zabrze, Department of Internal Medicine, Angiology and Physical Medicine, Center for Laser Diagnosis and Therapy, Medical University of Silesia, Batorego Street 15, 41-902 Bytom, Poland.
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Latos W, Sieroń A, Cieślar G, Kawczyk-Krupka A. The benefits of targeted endoscopic biopsy performed using the autofluorescence based diagnostic technique in 67 cases of diagnostically difficult gastrointestinal tumors. Photodiagnosis Photodyn Ther 2018; 23:63-67. [PMID: 29807149 DOI: 10.1016/j.pdpdt.2018.05.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 03/11/2018] [Accepted: 05/23/2018] [Indexed: 02/06/2023]
Abstract
INTRODUCTION The search for new diagnostic and therapeutic procedures is an essential task in contemporary oncology. The purpose of our study was the evaluation of the practical usefulness of autofluorescence endoscopy (AFE) using the Onco-LIFE system, compared with the use of white light endoscopy (WLE), and the estimation of the correlation between the histopathological evaluation with the degree of lesions' Numerical Color Value (NCV index) and the method's sensitivity and specificity valuation. MATERIAL 67 patients were analyzed at the Center for Laser Diagnostics and Therapy. All patients previously had a gastrointestinal tract tumor, which appeared malignant, but without histopathological confirmation. We measured NCV, estimated the correlation of the clinical diagnosis based on histopathological evaluation with the degree of NCV index from gastrointestinal lesions, and calculated the sensitivity and specificity of this method. RESULTS In the group of 67 patients, we found 44 cases of primary or secondary cancers and 7 cases of non-epithelial malignancies. In this group (51 patients) we identified 13 colorectal cancers and 38 upper gastrointestinal cancers. Based on the NCV index at NCV > 1.0, we revealed, that the sensitivity for malignant neoplastic lesions was 100% and the specificity was 73%, while for NCV > 1.5, the sensitivity for malignant neoplastic lesions was 86% and the specificity 100%. CONCLUSION AFE using the Onco-LIFE system is a helpful tool to perform targeted biopsies at the outset. A significant correlation was found between lesions' NCV index and the grade of dysplasia or tumor malignancy. AFE sensitivity and specificity is higher than WLE. Further studies are needed, especially performed by expert endoscopists.
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Affiliation(s)
- Wojciech Latos
- Department of Internal Diseases, Angiology and Physical Medicine, Center for Laser Diagnostics and Therapy, Specialist Hospital N(o)2, Batorego Street 15, 41-902 Bytom, Poland(1); School of Medicine with the Division of Dentistry in Zabrze, Center for Laser Diagnostics and Therapy, Department of Internal Diseases, Angiology and Physical Medicine, Medical University of Silesia, Batorego Street 15, 41-902 Bytom, Poland(2).
| | - Aleksander Sieroń
- School of Medicine with the Division of Dentistry in Zabrze, Center for Laser Diagnostics and Therapy, Department of Internal Diseases, Angiology and Physical Medicine, Medical University of Silesia, Batorego Street 15, 41-902 Bytom, Poland(2).
| | - Grzegorz Cieślar
- School of Medicine with the Division of Dentistry in Zabrze, Center for Laser Diagnostics and Therapy, Department of Internal Diseases, Angiology and Physical Medicine, Medical University of Silesia, Batorego Street 15, 41-902 Bytom, Poland(2).
| | - Aleksandra Kawczyk-Krupka
- School of Medicine with the Division of Dentistry in Zabrze, Center for Laser Diagnostics and Therapy, Department of Internal Diseases, Angiology and Physical Medicine, Medical University of Silesia, Batorego Street 15, 41-902 Bytom, Poland(2).
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Abstract
BACKGROUND Solitary rectal ulcer (SRUS) may mislead the inflammatory bowel disease (IBD) or rectal polyps, which may reduce the actual prevalence of it. Various treatments for SRUS have been described that can be referred to therapeutic strategies such as biofeedback, enema of corticosteroid, topical therapy, and rectal mucosectomy. Nevertheless, biofeedback should be considered as the first stage of treatment, while surgical procedures have been offered for those who do not respond to conservative management and biofeedback or those who have total rectal prolapse and rectal full-thickness. METHODS A systematic and comprehensive search will be performed using MEDLINE, PubMed, Scopus, EMBASE, AMED, the Cochrane Library, and Google Scholar. RESULTS The results of this systematic review will be published in a peer-reviewed journal. CONCLUSION To our knowledge, our study discusses the factors involved in the pathogenesis, clinical symptoms, diagnosis, treatment, and management of patients. This review can provide recommended strategies in a comprehensive and targeted vision for patients suffering from this syndrome.
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Affiliation(s)
- Mojgan Forootan
- Department of Gastroenterology, Gastrointestinal and Liver Diseases Research Center (RCGLD), Shahid Beheshti University of Medical Sciences
| | - Mohammad Darvishi
- Infectious Diseases and Tropical Medicine Research Center (IDTMRC), Department of Aerospace and Subaquatic Medicine, AJA University of Medical Sciences, Tehran, Iran
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Sieron A, Gibinski P, Pustelny T, Kwiatek S, Opilski Z, Kawczyk-Krupka A, Woznica T, Maciak E, Kubica W, Urbanczyk M, Latos W. Optical biopsy using spectral camera in BCC and oral leukoplakia. Photodiagnosis Photodyn Ther 2008; 5:271-5. [DOI: 10.1016/j.pdpdt.2008.10.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2008] [Revised: 09/19/2008] [Accepted: 10/02/2008] [Indexed: 10/21/2022]
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