right iliac fossa lump, with special reference to right colonic cancer
TRANSCRIPT
RIGHT ILLIAC FOSSA LUMP
Sandipan Bhattacharya10.03.2017
Malda Medical College
RIGHT ILLIAC FOSSA(STRUCTURES)
• APPENDIX WITH MESOAPPENDIX• CAECUM• TERMINAL ILEUM• RETROPERITONEAL TISSUE• ILIAC NODES• ILIAC ARTERIES
RIGHT ILIAC FOSSA MASS
ABDOMINAL WALL INTRAPERITONEAL RETROPERITONEAL MISCELLANEOUSHaematoma Appendicular abscess Iliopsoas abscess Loose bodiesAbscess Carcinoma of colon Undescended testis Ovarian mass/ tubo-
ovarian massIncisional Hernia (post appendectomy)
Appendicular mass Retroperitoneal lymph nodes
Uterine mass
Tumours a. benign (lipoma, fibroma, neurofibroma, fibromatosis) b. malignant (desmoids tumour, soft tissue sarcoma)
Ileocecal tuberculosis AneurysmAmebomaPsoas abscessDiverticulitisCrohn’s disease
MASS CHARACTERISTICS
APPENDICULAR MASS ILEO -CAECAL TB CARCINOMA CAECUM
TENDERSOFT TO FIRMILL DEFINED BORDERSIRREGULAR AND FIXED
NON TENDERFIRM TO HARDHIGHLY PLACEDDOUGHY ABDOMEN
NON TENDERHARD FIXEDASCITISHEPATOMEGALY
COLON CARCINOMA
• INCIDENCE-Most common malignancy of GI tract
-Third most common cancer in the world
-95% colorectal carcinomas are adenocarcinoma
COLON CARCINOMA
• RISK FACTORS1.AGEING- incidence increases after 50 years
2. HEREDITARY- 80% sporadic, 20% with known family history.
3.DIETARY FACTORS AND ENVIRONMENTAL FACTORS: -i)Diet rich in animal fat- directly toxic to colonic mucosa inducing early malignant changes.ii) low dietary fibresiii)alcoholiv)obesity and sedentary lifestyle
COLON CARCINOMA
4. INFLAMMATORY BOWEL DISEASE- Chronic inflammation leading to malignant changes.
5. OTHERS: -i) Cigarette smoking - >35 years ageii) Ureterosigmoidostomy iii) Pelvic irradiation
PATHOGENESIS:-
PATHOGENESISMUTATION IN MICROSATELITE SEQUENCE IN
CODING AND PROMOTOR REGIONS OF GENES REGULATING CELL GROWTH
BAX TGF-B
INHIBITS COLONIC EPITHELIAL CELL PROLIFERATION
SURVIVAL OF GENETICALLY
ABNORMAL CLONES