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The Old Endoscopy Quiz (and Answer) of the Month January 2008

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Question:
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This gentleman in his upper middle age was found to have multiple metastatic lesions in his liver. His only symptom was a quite severe fatigue which had bothered him for a few weeks. A colonoscopy was made and this ins the finding in the caecum, just behind the ileocaecal valve in the regions where the appendix aperture usually is located. The tumour markers CEA and Ca 19-9 were very closely to normal. What is this finding?
Correct answer:
This lesion was supposed to be a malignant carcinoid tumour, but it was not. Chromogranin A was normal and so was 5-HIAA-urinary collection. Histologically this tumour was a malignant sarcoma, and it was not possible to differentiate between the different types of sarcomas from the small biopsy samples. But, it could have been a carcinoid, as very many of You have suggested, and these answers are considered correct. It is of course not possible to make a microscopic diagnosis on a macroscopic finding.
Correct answers and comments were emailed by
Cheryl Lynch, Erie, USA/PA
Dr.Virendra Parikh, Fort Wayne, USA,, Indiana
AYYAKANNU KUMAR, Brentwood, UNITED KINGDOM
VANDERLEI LIMA, SÃO SEBASTIÃO DO PARAISO - MG, BRASIL
BURHAN TAM, Esenyurt- İSTANBUL, TÜRKİYE
Hakan YAPICI, ISTANBUL / ESENYURT, TÜRKİYE
FernandoPeres, Rio de Janeiro, Brazil
Albert & Trinh Chang, Redlands, CA
DR. MAHDI ALJAROUDI, KHOBAR, Kingdom of Saudi Arabia
ERDEM ULUCAY, İSTANBUL, TURKEY
Lavrentios Papalavrentios, Thessaloniki, Greece
PARABOLI DA SILVA , Marcio Luiz M.D, SAO JOSE DO RIO PRETO, BRAZIL
Karakoidas Christos, Athens, Greece
engin yildirim, TEKİRDAĞ YAŞAM HASTANESİ
UMUT TİRYAKİ, TEKİRDAĞ, TÜRKİYE
Adrian Wró¿ek, 28-100 Busko-Zdroj, Poland
Jukka Karvonen, Turku, Finland
Mary Alizadeh, Jacksonville, Florida, USA
luisguillermoguerrero, Bogota, Colombia
Fabrizio Cereatti Gianfranco Fanello, Rome, Italy
Danilo Trifogli, Rome, Italy
Cevale Karslioglu Sgouros, Istanbul, Türkiye
 Rio de Janeiro, Brasil
Gustavo Pignaton, Rio de Janeiro, Brasil
Yankov, Sofia, Bulgaria
osman demirkol, Istanbul, Türkiye
Deena Brooks, New Lowell, Ontario, Canada
sheeja dhanesh, Manchester, England
Goran Ribic, Pula, Croatia
rashedhassen, fakous, Egypt
Mehmet Gök, Kayseri, Turkey
Noa Ciuraru, Kfar- Saba, Israel
Dr.Jaber Badran, Dayr Azzour, Syria
ESIN KABUL, ISTANBUL, TURKEY
CHITRA, CHENNAI, INDIA/TAMILNADU
Reza Alami, Gotenbourg, Sweden
MAJID HOSSEINIAN, TEHRAN, IRAN
venkata pokkunuri, Losangeles, USA/California
Dr.Arber Veliu, Prishtina, Kosovo
jawad, hamilton,ontrario,Canada
Jose Dondis, Panama, Panama
ABİT DEMİRCİ, Esenyurt-İSTANBUL, TÜRKİYE
German Lloret Salom, Alzira, Spain
Lazuchiewicz-Kot Malgorzta, Lodz, Poland
mario galluzzi, lecco, Italy
Jennifer Brenner, Houston, USA
Comments:
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I use this opportunity to Wish you and your staff the very Happy New Year and all the best always
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