Colorectal cancer in young patients: Presentation, clinicopathological characteristics and outcome

Previous studies have emphasized the increasing incidence of colorectal cancer [CCR] among young adults and suggest that they may have more aggressive disease and worse five-year survivals than their older counterparts. Describe the profile of sporadic colorectal cancer in young patients focusing on its prevalence, clinicopathological characteristics, prognostic and survival factors. Three hundred and twenty-five CCR patients were divided in two groups: Gl < 45 years and G2 > 45 years. 13.2% of patients were less than 45 years old. A family history of a first-degree relative with colorectal cancer was more frequent in young patients: 44.1% vs 18.2% [p - 0.025]. A significant delay in seeking medical care was noted in Gl patients: 29.7 weeks vs 18.6 weeks [p = 0.01]. A trend to have more aggressive stages III and IV at presentation was observed among young patients: 55.8% vs 48.6% [p = 0.8]. Mucin-producing tumors were more frequently observed in Gl group: 41.9% vs 12% [p = 0.000]. Mean survival was 76.9 months in Gl group and 91.7 months in G2 group [p = NS]. Five-year survival was 52% in Gl group and 58% in G2 group [p - 0.6]. Stage for stage comparison was not significant in determining survival. The only independent factors were delay in consultation, right location of the tumor, peritoneal carcinomatosis, and the need for chemotherapy. This study confirms that colorectal cancer in young patients is frequent. Despite more frequent occurrence of mucin-producing tumors, age is not by itself a worse outcome predictor

case of PAN with positive Hbs Ag cured by immunosuppressive and antiviral therapies: a case report

Polyarteritis nodosa [PAN] first described by Kussmaul and Maier in 1866, is a multisystem necrotizing vasculitis of small and middle-sized muscular arteries. The presence of hepatitis B antigenemia [Hbs Ag] in approximately 30% of patients with PAN as well as immune complexes of Hbs Ag-Immunoglobulins and complement in the blood vessel walls strongly suggest the role of immunologic phenomena. The extremely poor prognosis of classic PAN has been modified by corticosteroid treatment with boluses of cyclophosphamide, and plasmapheresis. We report a case of PAN with renal, cardiac, central and peripheral nervous system involvement associated with active hepatitis B that got a total remission with corticosteroids, lamivudine and boluses of cyclophosphamide without plasmapheresis