Benign and malignant intestinal tumors

Colon tumors are benign and malignant neoplasms. They grow from the tissue covering of the large intestine and are based in its various parts. The cells of the mucous layer in the intestines tend to renew themselves. But sometimes they can carry out regenerative changes unevenly, giving rise to tumors.

In terms of prevalence, after lung cancer and stomach cancer, malignant tumors localized in the large intestine are in third place in the world.

Fact. In general cancer statistics, cancer of the rectal segment of the colon occurs in 10% of cases of the total number of pathologies. According to WHO, this is about 500 thousand patients with colorectal cancer every year. Dangerous neoplasms occur mainly in the population aged 40 to 60 years. Most often, this disease affects residents of Canada. Residents of Africa and Asian countries are less susceptible to such diseases.

Risk factors

• The likelihood of detecting a tumor in yourself increases if the medical history of relatives already includes colon polyposis;
• Unbalanced diet: satiety with fatty foods, lack of vegetable and fruit components, legumes, whole grain bread, buckwheat and corn in daily dishes;
• Frequent constipation, especially those that were eliminated after the use of laxatives that irritate the mucous surface of the intestinal layer;
• Crohn's disease - inflammation of the colon mucosa with the appearance of numerous ulcers, diarrhea is much more pronounced than with ulcerative colitis, the presence of perianal lesions in the form of polyps and fistulas (inflammation in the recess of the anal mucosa, perirectal tissue or intersphincteric space);
• Hypodynamia - weakened motor tone;
• Age limit: over 50 years;
• Angiodysplasias are congenital malformations of blood vessels;
• Smoking;
• Nonspecific ulcerative colitis (UC) is a chronic diffuse inflammatory process of the mucous layer of the rectum and colon, which serves as an impetus for the formation of various ulcers of the mucous membrane.

Fact. The total length of the colon is approximately one and a half to two meters.

Classification of tumor formations

Initially, all tumor formations are divided into two large groups: malignant and benign. The latter are less common, characterized by slow growth, and do not metastasize. Malignant tumors actively increase in size and metastasize, which is why they are dangerous for humans. But benign formations also pose a certain danger. For example, over time they can become malignant. If the tumor is pedunculated, it can become twisted and damaged, causing bleeding.

Symptoms of the disease can be very different

As for classification, let's start with benign intestinal tumors. They are divided into several types depending on the tissue from which the cells are formed:

• epithelial;
• muscular;
• connecting;
• nervous;
• vascular.

Epithelial formations include adenomas. They can be villous, tubulovillous and tubular. Polypoid tumors may have a thin stalk or a fairly wide base. They often become malignant, which makes them dangerous for humans. Non-epithelial formations are represented by such types as leiomyomas, schwannomas, lipomas. Vascular formations include hemangiomas and lymphangiomas.

Consultation with an Israeli specialist Leiomyomas are nodular tumors located in the submucosal layer. Reaching large sizes, they can compress tissues and provoke bleeding. Schwannomas are formed by nerve tissue. Lipomas are formed from adipose tissue and have the appearance of a capsule. They can cause intestinal obstruction.

Vascular formations are often congenital. Their presence is associated with a high risk of bleeding. But the appearance of symptoms of an intestinal tumor may not be noted immediately, but after many years of life.

According to the direction of growth, intestinal tumors are divided into:

Based on the number of formations, single and multiple are distinguished.

If we talk about malignant tumors, they are also divided into categories according to the type of tissue from which they were formed. It is not difficult to understand what the diagnoses are called, because the name is based on the type of tissue whose cells have transformed into cancer.

There is also a classification according to developmental features - primary, which appeared from the tissues of the organ, as well as secondary, which are metastases of other formations.

Important! The most common type of cancer is adenocarcinoma. It becomes a consequence of the malignant degeneration of polyps, which consist of glandular tissue. This form occurs in 98% of cases of all cancers of the organ in question.

There is also a classic classification of cancer by stages:

• 1 – the size of the formation does not exceed 3 cm. It does not grow deeper than the submucosal layer. There are no metastases;
• 2 – has a larger size and can grow into the muscle layer of the organ. But there are no metastases;
• Stage 3 – gives metastases to regional lymph nodes;
• 4 – extends beyond the organ, giving multiple metastases.

Benign tumors of the colon

• An intestinal polyp is a harmful formation that is raised above the mucous membrane in the form of a branched or rounded process located on a so-called “leg” like a mushroom, or on a broad base. They sometimes seem to “hang” into the intestinal lumen. Signs of polyps may include gastrointestinal hemorrhage or even intestinal obstruction;
• Glandular and glandular-villous adenomas of the colon - develop from intestinal epithelial cells, they are detected in 60-80% of patients with benign neoplasms of the colon;
• Cystic granulating (juvenile) - the largest polyps, can grow up to 2 cm. One of the central symptoms of these colon polyps is the presence of blood in the stool;
• Nonepithelial: lymphoid polyps, cystic pneumatosis intestinalis, carcinoid tumors, lipomas, metastatic lesions;
• Fibrous polyps of the anal canal are harmful formations of connective tissue that arise as a result of an inflammatory process or vascular dysfunction;
• Hyperplastic - occupy locations in the distal (farthest from the center) parts of the colon; they can arise as a result of a violation of the integrity of the muscle layer (when a high concentration of lymphocytes is observed in the muscle layer). They are often a continuation of the pathological development of ulcerative colitis;
• Diffuse polyposis of the colon is a hereditary lesion of the large intestine by polyposis with widespread destruction of adjacent parts of the gastrointestinal tract.

According to the areas of distribution, the following types of diffuse polyposis are distinguished:

• Classic, aimed at “disabling” the rectum;
• Associated with vascular defects;
• Gardner's syndrome, which involves the lesion not only in the intestines, but also in the soft tissues surrounding it;
• Peutz-Jeghers syndrome - completely destroys the functional abilities of the gastrointestinal tract, “gives itself away” as pigment spots on the cheeks and around the mouth;
• Villous tumors are round or oval-shaped formations, the surface of which is covered with a kind of “lint” of blood vessels and connective tissue, sometimes formed into “nodules”;
• Leiomyoma is a derivative of smooth muscle;
• Lipoma is a derivative of adipose tissue, often present in the subcutaneous tissue, but can also occur in internal organs that are supplied with a fatty layer.

Types of benign intestinal tumors

Intestinal tumors are tumors that affect any part of the intestine. Most often, tumors form in the small, large, cecum and sigmoid colon. The risk group consists of people over 50 years of age, while young people are also susceptible to intestinal tumors.

The question of why tumors form in the intestines remains open, since the exact reasons have not been established. Predisposing sources named:

1. improper diet;
2. chronic diseases of the gastrointestinal tract;
3. bad habits.

The danger of any tumor formation lies in its long-term existence without obvious manifestations. And only with significant development of the tumor can the patient notice such typical signs of a tumor as:

1. pain;
2. dysfunction of the intestines;
3. flatulence;
4. nausea;
5. vomit.

Similar symptoms can be accompanied by both benign formations in the intestines and intestinal cancer. To find out the nature of the pathology, it is necessary to undergo instrumental diagnostics, as well as laboratory testing.

All types of intestinal tumors are treated surgically, and if intestinal cancer is treated abroad, the operation is combined with additional treatment procedures.

Benign tumors of the small intestine tend to degenerate into cancerous formations, so it is important to ensure early diagnosis of the disease and immediately undergo high-quality treatment. The prognosis for a benign tumor of the small intestine is always good, treatment is usually simple and gentle. If a malignant tumor develops, cancer treatment abroad will be more difficult, and the prognosis depends on the stage of the tumor.

The classification of benign intestinal tumors is as follows:

1. Polyps. Such formations are diagnosed most often and carry the greatest danger compared to other intestinal tumors. Polyps can develop into cancer, so they are regarded as a precancerous condition. Such formations are divided into villous, tubular, tubular-villous adenomas, as well as inflammatory, hyperplastic and hamartomatous polyps.
2. Tumors are villous. Benign tumors of the rectum in most cases are villous and are formed from glandular epithelium.
3. Polyposis is diffuse. A systemic pathology in which many polyps form in the large intestine. Sometimes the entire gastrointestinal tract is affected. There are familial and secondary diffuse polyposis. Treatment of intestinal tumors abroad is only possible with surgery. Moreover, if treatment is not carried out in a timely manner, the pathology will turn from benign to malignant. Due to its specific location, a benign tumor of the cecum does not manifest itself for a long time, so its early detection is only possible with regular preventive examinations.
4. Lymphomas. These are the most common intestinal tumors in children under 10 years of age. This formation can also affect adults over 50 years of age.
5. Leiomyoma. This is a rare nonepithelial tumor of the small intestine and rectum that arises from smooth muscle tissue.
6. Lymphangioma. A rare congenital intestinal formation with a predominant localization in the duodenum, which consists of lymphatic vessels.
7. Lymphoma of the stomach. A very rare type of tumor, the structure of which includes lymphatic tissue.
8. Hemangioma. A rare benign tumor of the colon that causes bleeding because it consists of blood vessels.
9. Lipoma of the colon. The tumor is formed from adipose tissue.

Almost all types of intestinal tumors are divided into multiple, solitary and diffuse.

Colon cancer

The following types of colon oncology are distinguished:

• Adenocarcinoma - originates in glandular cells that produce mucus to lubricate the inner surface of the intestine;
• Carcinoid tumor - arises from hormone-producing cells of the intestine;
• Lymphoma is a cancer directly related to disorders of the immune system;
• Squamous cell carcinoma develops from mucous membranes and epithelial tissue. Quickly grows into adjacent tissues and organs;
• Angiosarcoma - formed from fragments of the wall of blood vessels (hemangiosarcoma) or lymphatic vessels (lymphangiosarcoma).

Classification

Benign tumors of the large intestine are represented by lipomas, leiomyomas, lymphangiomas, neuromas, fibromas, hemangiomas, adenomatous polyps and villous tumors. In addition, familial colon polyposis and carcinoid tumors fall into this category. The most common benign neoplasms are adenomatous polyps, which develop from epithelial tissue. The most common benign tumor of non-epithelial origin is lipoma. In terms of prevalence, it is only slightly inferior to polyps. Lipoma differs from other neoplasms in its soft consistency.

A relatively rare tumor of the large intestine in clinical proctology is fibroma, which develops from connective tissue and occurs mainly in elderly people. Leiomyoma, which originates from smooth muscle fibers, is also a rare neoplasm. Neuroma is small in size and grows inside the mucous and serous membranes. Hemangioma develops from the tissue of the vessels of the large intestine and is located closer to the border of the rectum. This benign tumor most often manifests itself as intestinal bleeding.

Symptoms of colon tumors

Benign tumors can be asymptomatic; doctors often discover them during a general diagnostic examination.

Also signs of benign tumors of the large intestine are diarrhea, pain in the abdomen, and blood in the stool. Villous tumors can provoke changes in the protein composition of the blood and lead to anemia. Large benign formations also cause intestinal obstruction, the invasion of one section of the intestine into another.

A tumor of the distal sigmoid colon manifests itself as scarlet blood in the stool without mucous admixture. Pathology in the descending colon is indicated by dark blood with a mucous extract. With malignant formations in the proximal intestine, bleeding, often hidden, is expressed only in anemia. Also, symptoms of colon cancer can include tenesmus - a false urge to have a bowel movement, which is caused by spasms of the anal sphincters. In the later stages of tumor formation, constipation and intestinal obstruction appear. There may be a feeling of incomplete bowel movement. Patients with colon cancer also experience symptoms such as decreased appetite, weakness, and sudden weight loss. As the disease progresses, the liver enlarges and abdominal hydrops (fluid accumulation in the abdominal cavity) appears.

Malignant tumors

A malignant tumor of the colon poses a threat to the patient's life. The thing is that the formations consist of cellular structures that are partially or completely undifferentiated. Gradually, the organ begins to mutate and become covered with tumors. Moreover, the malignancy of the disease is that it can metastasize and affect other organs.

People aged 40 to 70 years are at risk.

Types of malignancies

Colon tumors have several types, including:

• adenocarcinoma. Carcinoma is considered the most common type. The disease occurs in 80 percent of all cases. The neoplasm contains glandular tissue. The prognosis of cancer depends on the severity and extent of involvement;
• mucous adenocarcinoma. This type of disease is quite difficult to cure;
• squamous cell carcinoma. Affects the rectum. The neoplasm consists of flat cellular structures of the epithelium. The degree of malignancy is very high;
• signet ring cell cancer. Localized inside the intestinal walls. Education has no clear boundaries. It is considered dangerous because it grows quickly and metastasizes to other organs. It is also diagnosed in young people;
• basal cell type cancer. Occurs in rare cases. Affects the anal area.

Once a patient is diagnosed with cancer, the likelihood of surviving more than five years is very low. It all depends on the stage of the disease.

Stages of cancer development

Colon cancer develops gradually. In medicine, there are four main stages of cancer.

1. First stage. The tumor-like formation is small in size and located only in one area of ​​the intestinal canal. Affects the mucous and submucous membrane of the organ.
2. Second stage. The neoplasm increases significantly in size. It is still quite possible to cure colon tumors with chemotherapy. Metastases are not observed.
3. Third stage. The cancer spreads to the entire organ and gradually metastasizes. It is much more difficult to cure pathology. The survival rate is 30-40 percent.
4. Fourth stage. Colon cancer is becoming serious. Affects neighboring organs and lymph nodes. Treatment involves removal of tumors, chemotherapy and radiation techniques. The survival rate in such cases is very low.

It is worth noting that any type of malignant tumor develops according to this scenario.

Causes of the pathological phenomenon

Colon cancer can occur for a variety of reasons such as:

• hereditary predisposition;
• abuse of fatty and fried foods. In this case, there is no fiber;
• sedentary lifestyle;
• the presence of ulcerative diseases;
• constant inflammatory processes and infectious diseases;
• presence of bad habits such as smoking and drinking alcohol.

Most often, the pathology occurs in people over 40 years of age. But recently, colon cancer has begun to be detected at a young age.

Symptoms of malignant tumors

Malignant formations in the early stages rarely make themselves felt.
Therefore, cancer is detected already at the second and third stages. The main features include:

• bowel dysfunction in the form of constipation and diarrhea;
• development of anemia;
• painful sensations in the abdomen;
• discomfort when emptying the intestinal canal;
• the appearance of blood clots and mucus.

When the disease worsens, intoxication of the body begins. It is accompanied by:

• severe weakness, fatigue, drowsiness;
• pain in the head;
• sleep disturbance;
• nausea and vomiting;
• dizziness;
• increased sweating;
• increase in temperature indicators;
• dry mouth;
• paleness of the skin;
• loss of appetite and sudden weight loss.

Symptoms can be varied and depend on the stage of the disease.

Diagnosis and treatment of malignant tumors

To prevent the disease from developing, you need to undergo a preventive examination every year. You should also seek help from a doctor if unpleasant signs appear. The doctor will listen to the patient’s complaints, examine and palpate the abdomen.

If a pathology is suspected, he will prescribe an examination in the form of:

• biochemical and general blood tests;
• analysis for tumor markers, which are determined by urine and blood;
• stool analysis;
• performing a biopsy;
• genetic tests to identify mutations;
• esophagogastroduodenoscopy;
• colonoscopy;
• ultrasound diagnostics of the abdominal cavity;
• irrigoscopy;
• sigmoidoscopy;
• computed tomography;
• chest x-ray.

If the diagnosis is confirmed, then treatment is prescribed. All measures directly depend on the stage of the disease. Basically, surgery is performed to remove the tumor.

If the patient loses the function of independent emptying of the intestinal canal, the surgeon forms a colostomy. This method is used in the later stages of the disease.

After this, chemotherapy and radiation are prescribed. These methods help destroy cancer cells and prevent them from multiplying.

The patient is also advised to adhere to some recommendations.

1. Watch your diet. Food should be healthy, rich in vitamins and fiber.
2. Monitor your drinking regime. This will reduce the manifestation of intoxication in the body.
3. Maintain a rest and sleep schedule.
4. Lead an active lifestyle, despite the pathology.

Symptoms and treatment of tumors should be determined as soon as possible. If the body is affected by formations and metastases continue to grow, then there is no point in the surgical procedure. Treatment of the disease will be ineffective.

To somehow prolong life, radiotherapy is performed daily. But it’s difficult to say how long people will live. In such cases, the prognosis is completely unfavorable.

Diagnosis of precancerous diseases

A number of methods are used to detect precancerous diseases and even to diagnose colon cancer:

• Sigmoidoscopy - examination of the rectum and final sections of the colon. Using this method, polyps and tumors can be detected in the rectum and distal sigmoid colon;
• Irrigoscopy (link to x-ray page);
• Videocolonoscopy;
• Radiography;
• Ultrasound examination of the abdominal organs;
• CT (computed tomography);
• Complete blood test to determine the level of red blood cells and white blood cells;
• Endoscopy.

Treatment of colon tumors

In the treatment of colon tumors, including cancer, surgery provides the most reliable results. Let's list their varieties.

• Resection of the large intestine - truncation, partial removal of a section of intestine;
• Hemicolectomy is the resection of one half of the colon followed by the application of an interintestinal anastomosis (artificial connection). This type of operation is prescribed mainly for significant damage to parts of the colon (Crohn's disease, colon cancer, large benign formations, etc.);
• Colproctectomy - complete removal of the colon + creation of an intestinal fistula on the anterior abdominal wall (a hole in the intestinal wall connecting it to the surface of the body);
• A total colectomy is the complete removal of the large intestine while preserving the rectum. There are clear indications for this operation: multiple common polyposis, nonspecific ulcerative colitis, diverticulosis (the muscular layer of the intestinal wall weakens and so-called “pockets” of diverticula form in it, where feces can accumulate), chronic protracted coprostasis (stagnation of feces);
• Abdominoanal resection is the elimination of part of the rectum followed by a colostomy (the surgeon brings the end of the sigmoid or colon to the abdominal wall). The anal canal is sutured;
• Ileorectal anastomosis is the restoration of the continuity of the intestinal tract after radical colectomy (absolute removal of the colon) by forming an intestinal anastomosis between the ileum and rectum;
• Transanal excision is appropriate when the tumor is about 10 cm from the edge of the anus and if the tumor is mobile and can be “cut off” by moving it into the anal canal.

During the postoperative period, patients recovering their health stay in the hospital for about a day or two.

Examination and treatment tactics

Only a doctor knows how to determine the presence of a tumor and its type. Treatment is prescribed only after the following studies:

• FEGDS;
• colonoscopy;
• irrigoscopy;
• general clinical tests;
• stool tests for occult blood;
• biopsies;
• sigmoidoscopy;
• digital examination of the rectum;
• palpation;
• biochemical blood test;
• studies for tumor markers.

If necessary, genetic tests are organized. An ultrasound is required. It can be used to assess the condition of other organs and detect metastases. Sometimes an intestinal tumor develops secondarily, in which case it is necessary to identify the primary focus. Treatment is determined by the type of tumor.

To exclude malignant tumors, you need to conduct a cytological examination, for this a tissue fragment is taken. The timeliness of disease detection is a determining factor on which the health prognosis depends. Treatment of tumors is predominantly surgical. If colorectal cancer is detected, bowel resection is performed. The tumor is removed along with some healthy tissue.

When the lower parts are affected, treatment often involves abdominal-anal extirpation.
If the tumor affects other organs or the small intestine, then extended surgery is performed. If complications develop, a colostomy may be required. The five-year survival rate for stage 1 cancer is 80%, and for stage 4 cancer it is about 10%. For multiple metastases, treatment is palliative. Treatment of benign tumors is also radical. Polypoid neoplasms can be removed endoscopically, and electrocoagulation is often used. Most often, resection with anastomosis is performed. There is a certain risk with the development of intestinal obstruction. In this case, emergency treatment is organized. For colon tumors, transrectal access is used. Thus, intestinal tumors often go undetected. The only cure is surgery. It is often supplemented with chemotherapy and radiation for patients. In advanced stages of cancer, the prognosis is poor.

Question answer

How much does the food we eat affect the formation of tumors?

Yes, the risk of developing tumors increases if you have food in your daily diet that is low in fiber, but rich in animal proteins and fats. In this situation, a person may experience frequent constipation, and an imbalance of intestinal flora is likely. The content of bile acids and carcinogenic phenols increases in the intestines. And this harms the mucous membrane. Smoked foods and preservatives also cause harm. They also contain predominant carcinogens. Fact. A person is able to eat food even when placed upside down, since special peristalsis muscles “turn on” in time. This explains why astronauts eat in a weightless state.

Can anal sphincter insufficiency predict the appearance of a colon tumor?

Mostly no. Colon incontinence is associated primarily with obstetric trauma and muscle dysfunction as a result of nervous disorders. This is also a reaction to various inflammatory diseases, to prolapse of hemorrhoids or the rectum itself.

Is it possible to perform sphincter-sparing surgery for familial adenomatosis (a hereditary disease that is accompanied by the formation of many polyps on the mucous membrane) of the colon?

If the polyps have not progressed to the stage of cancer, then the probability remains approximately 85%. If the polyps have become malignant, then this kind of sparing surgery is permissible only in 30% of cases of the total number of cases. But removal of polyps in the affected parts of the intestine is mandatory, since cancer appears from them one way or another.

Prognosis and prevention

With proper and timely removal of benign tumors of the large intestine, this group of diseases has a favorable prognosis. However, if the polyp develops into a malignant tumor, the disease can be fatal. After removal of a benign neoplasm, repeat sigmoidoscopy, irrigoscopy or colonoscopy are performed to timely detect relapses.

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