right iliac fossa lump, with special reference to right colonic cancer

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