Impact of family history of gastric cancer on colorectal neoplasias in young Japanese

AIM

The aim of this study was to elucidate risk factors for the development of colorectal neoplasia in the young population. In particular, we focused on the family history of gastric cancer.

METHOD

Young Japanese subjects aged 30-49 years old who underwent colonoscopy for the first time from August 2007 to August 2008 were included in this study. A total of 300 unselected consecutive patients (mean age 40.5 years) were eligible for analysis, and family history of colorectal cancer and gastric cancer, sex, age, body mass index, positivity of faecal occult blood test and the presence of symptoms were evaluated. Risk factors for developing colorectal adenoma and/or carcinoma were assessed.

RESULTS

Colorectal neoplasias were detected in 83 (27.7%) cases. Two were found to have invasive carcinoma. Univariate and multivariate analyses revealed that family history of gastric cancer (OR 2.09, 95% CI 1.12-3.92, P = 0.02) was an independent risk factor for the development of colorectal neoplasia, as well as male sex (OR 1.89, 95% CI 1.10-3.27, P = 0.02), older age (OR 2.05, 95% CI 1.18-3.55, P = 0.01) and positive faecal occult blood test (OR 1.99, 95% CI 1.14-3.48, P = 0.02).

CONCLUSION

In the young population under 50 years of age, a family history of gastric cancer is an independent risk factor for the development of colorectal neoplasia.

The occurrence of an abdominal wall abscess 11 years after appendectomy: report of a case

Most complications after appendectomy occur within 10 days; however, we report herein the unusual case of a patient in whom a wound abscess was detected more than 10 years after an appendectomy. A 26-year-old woman presented to our hospital with nausea and vomiting, pain, and a mass in the right lower abdominal wall. She had undergone an appendectomy 11 years previously. Physical examination revealed a tender mass, 5 cm in diameter, under the appendectomy scar. An abdominal ultrasonography demonstrated a low-echoic mass lesion measuring 9.0 x 5.0 x 2.0 cm. Incision of the connective tissue revealed about 3 ml of cream-colored and odorless fluid in the abscess cavity. Fistulography revealed an abscess cavity not communicating with the bowel lumen. Floss was discovered in the connective tissue and removed. Debridement of the abscess wall was performed and a piece of the wall was sent for histologic examination. Pathological examination revealed panniculitis of the subcutaneous tissue, and panniculitis with granulation and granuloma of the abscess wall. This case report demonstrates that a preoperative diagnosis should be based not on one finding, but on all findings collected, inclusively.

Syringomatous adenoma of the nipple: report of a case

We report herein a rare case of syringomatous adenoma (SA) of the nipple. Only 22 cases of SA of the nipple have been documented in the world literature, and to the best of our knowledge this is the first case to be reported in Japan. The patient was a 68-year-old woman who presented with a painful mass in the right subareolar region of over 15 years' duration. Clinical examination including needle biopsy indicated a high possibility of carcinoma; however, the final histopathological diagnosis after mastectomy proved to be SA. SA is a benign locally infiltrating neoplasm of the nipple which shares many clinicopathological features with adenoma of the nipple. Both lesions sometimes show deceptive clinicopathological findings, causing then to be easily confused with carcinomas. However, SA can be distinguished by its unique histological appearance resembling sweat duct, or syringomatous, tumors and locally infiltrating growth, which is probably responsible for its misleading clinical findings and higher rate of recurrence. Surgeons should be aware of the possibility of diagnosing this extremely rare tumor, and the appropriate treatment.