Carcinoma of the colon: a clinical and pathological study of six cases

Abstract

In choosing a subject for clinical study many considerations had to be taken into account. In the first place it was felt that the choice should be a fairly common condition, so that more cases,might be seen than those actually reported. This serves two purposes. It permits cases being selected which illustrate different aspects of the disease rather than reporting on a rare condition of which only a very limited number of cases has been seen by the writer. Furthermore from a student's point of view it is more essential to study the common types of disease, which, if pursued fully, are just as interesting as rare conditions. On the other hand it was equally essential that a subject should be found on which it was possible to make personal investigations, in addition to recording and discussing the surgeon's management of the case. 1 In this respect it is obviously impossible for a student to take a very active part in the performance of the operations, but it is possible to make a full examination of any specimens removed. Taking into account these varying considerations it was felt that carcinoma of the colon would be a very suitable subject.From a total of fifteen cases studied by the writer during the period April 1938- April 1939 six cases have been selected. They have been chosen to illustrate as far as possible the varying manifestations of carcinoma of the colon. No cases of carcinom of the rectum have been included as it was felt that both clinically and pathologically this disease constituted a separate problem. A method of classifying rectal carcinomata has however been applied to growths in the colon in accordance with a suggestion made by Sir John Fraser (1938). As few attempts have been made to classify colon cancers: systematically, this part of the work proved most interesting. It is to this aspect that the majority of the references given at the end apply. The author has attempted to illustrate this part as fully as possible by photographing the essential features of all the specimens. In this way it is possible to contrast the tumours of the colon with the classified tumours of the rectum.ks the six cases are all concerned with the same disease, the records are first presented, and a commentary follows on all the cases together. In order however to facilitate reference a summary of the features and points of interest has been included at the end of each case.