Multiple carcinomata and simple adenomata of the rectum
GC.10198
Multiple carcinomata and simple adenomata of the rectum.
Removed by operation from a male aged 67, who gave a history of irregularity of bowel action during the previous two months. Sigmoidoscopy revealed carcinoma in the anterior wall of the rectal ampulla. Perineo-abdominal excision of the rectum was carried out. At operation a second carcinoma of the pelvic colon was discovered and appeared to be giving rise to partial obstruction. There was some difficulty in separating the tumour from the urethra in front, and subsequently a urinary fistula (abnormal passage between a hollow organ and the body surface)developed.
The rectum and lower part of the pelvic colon measuring 30 cm in length have been laid open from the front. In so doing an ulcerative carcinoma lying in the anterior wall of the ampulla has been divided. The tumour transversely measures 3½ cm and longitudinally 2 cm. The edges are raised, irregular and friable. The tumour is adherent to the subjacent structures and has extended through the muscular coat.
17 cm from the anus there is a second ulcerative carcinoma of smaller appearance lying in the anterior wall and measuring 3 cm transversely and 2 cm longitudinally. 4 cm above the below the upper carcinoma there are two adenomata with well defined pedicles measuring nearly 2 cm in length.
