A Retrospective Cohort Study of Coexistence of Carcinoma and Tuberculosis of Colon: 12-Year Experience
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ORIGINAL ARTICLE
A Retrospective Cohort Study of Coexistence of Carcinoma and Tuberculosis of Colon: 12-Year Experience Poras Chaudhary 1 & Utsav Bhadana 1 & Romesh Lal 1 Received: 27 August 2020 / Accepted: 1 October 2020 # Indian Association of Surgical Oncology 2020
Abstract Coexistence of carcinoma colon and tuberculosis is rare. The aim of this study is to present our 12-year experience on colonic carcinoma with coexisting colonic TB. Histopathology and imaging records of 189 patients of colonic carcinoma patients who underwent treatment in surgical unit 6 in our institute between January 2006 and December 2017 were reviewed. In 7 patients, histopathology and/or imaging studies were suggestive of coexistence of colonic carcinoma and tuberculosis. Fifteen cases of colonic tuberculosis were also reviewed. Descriptive statistics were used to summarize the data. Colonoscopic biopsy was suggestive of only malignant lesion in 6 cases and coexistence of TB and carcinoma in 1 case. The duration of symptoms spanned between 2 and 7 weeks. Anorexia and weight loss were the predominant symptoms. Colonoscopic biopsy was suggestive of only malignant lesion in 6 cases and coexistence of TB and carcinoma in 1 case. The morbidity was low and there was no surgery associated mortality. Clinical awareness and advancement in diagnostic studies and improvement in management strategies may guide and lead to early diagnosis, optimum therapeutic guidelines and thus improved outcome. Keywords Colonic tuberculosis, carcinoma . Difficult pre-operative diagnosis . Surgical treatment . Antituberculous treatment
Introduction Tuberculosis (TB) is endemic in India. Gastrointestinal TB is the third most common form of extrapulmonary tuberculosis (EPTB) with ileocaecal junction being the most common site of involvement [1–3], followed by jejunum and colon [2]. Involvement of colon in tuberculosis is a rare occurrence even in the region where TB is endemic including India, comprising of 3–4% of intestinal TB cases [4]. Coexistence of carcinoma colon with tuberculous lesions in the small intestine has been reported, but coexistence of TB and carcinoma of colon is rare [5]. Carcinoma and TB may occur at the same site or at the different sites in the colon. The occurrence of two pathologies at the same site is even rarer. Studies have suggested that coexistence of these two pathologies might be a coincidence while some studies have shown a causal relationship between the entirely different pathologies with TB being a precursor lesion [6, 7]. Coexistence of TB with many other carcinomas * Poras Chaudhary [email protected] 1
General Surgery, Lady Hardinge Medical College and associated Dr Ram Manohar Lohia Hospital, New Delhi, India
has been reported in the literature [8]. In a study by Kaplan et al., TB was most commonly seen in patients with Hodgkin’s disease, lung cancer, lymphosarcoma and reticulum cell sarcoma [8]. The coexistence of tuberculosis and carcinoma colon not only influences the diagnosis and management plan but also aff
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