ABSTRACT
INTRODUCTION: Bladder urothelial carcinoma rarely spreads to the gastrointestinal tract, and its presentation in the rectum varies. We report a case of a patient who presented with an annular constriction of the rectum. PRESENTATION OF CASE: A 60-year-old man was referred to our hospital with chief complaints of anal stricture and partial obstruction for about 1 month. Computed tomography and magnetic resonance imaging revealed diffuse wall thickening of the rectum, possible high cellularity in the lower portion of urinary bladder, and lesions in the visible pelvic bony structure. A colonoscopy showed a contiguous annular constriction from 5 to 15 cm above the anal verge. Carcinoembryonic antigen and carbohydrate antigen 19-9 levels were 39.75 ng/mL and 139.2 U/mL, respectively. A transurethral bladder biopsy revealed high-grade urothelial cell carcinoma, and anal biopsy showed a poorly differentiated carcinoma arranged in a small nested pattern within the subepithelial area of the anorectal tissue. A colostomy was performed, and the patient was transferred to another hospital for further treatment after series of survey with lung metastasis. DISCUSSION: Invasive bladder cancers rarely infiltrates into the rectum and is known with the difficulty diagnosis by colonoscopy. Furthermore, the secondary rectum tumor due to bladder cancer had poor record for survival in the literature review. CONCLUSION: This case of bladder urothelial carcinoma penetrating to the rectum was interesting because it mimicked proctitis with diffuse annular swelling observed in the colonoscopy.
ABSTRACT
INTRODUCTION: Anaesthesia mumps is an extremely rare postoperative complication that occurs following various surgical procedures after general anaesthesia. We aimed to contribute to the growing knowledge of potential clinical presentations, outcomes, and possible causes. PRESENTATION OF CASE: A 93-year-old man experienced acute swelling of a unilateral parotid gland 1 day after laparoscopic right hemicolectomy under general anaesthesia. The symptoms he presented with were acute, non-tender swelling in the left preauricular and submandibular triangle with well-marginated, circular swelling of the buccal mucosa. Amylase level was within the normal range. Computed tomography showed left preauricular soft tissue swelling and enlargement and an enhanced left parotid gland exhibiting inflammation. The swelling subsided after 3 days of conservative treatment. DISCUSSION: Anaesthesia mumps have been associated with a variety of surgeries, including colorectal surgery, and is a rare complication after the induction of general anaesthesia. Despite the few cases presenting with airway obstruction, the outcome for swelling of the parotid or submandibular gland is generally good. CONCLUSION: Early awareness of anaesthesia mumps and close evaluation lead to a fair prognosis for scar presentation.
