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Risk Factors: Colorectal carcinogenesis involves a complex interplay between genetic and environmental factors. The environmental factors are mostly dietary and include low intake of fiber and high intake of refined carbohydrates, fat, and animal protein (especially beef).

The genetic factors include hereditary cancer syndromes such as familial adenomatous polyposis (FAP), hereditary nonpolyposis colorectal cancer syndrome (HNPCC; Lynch syndrome) and related conditions. Other risk factors include inflammatory bowel disease and prior pelvic radiation.

This colectomy specimen is from a 40 y/o female who presented with abdominal pain, vomiting, and constipation. Imaging studies revealed a circumferential growth in the descending colon 45 cm proximal to the anal verge. The specimen shows a 5 cm fleshy, gelatinous tumor causing luminal stenosis. Microscopically, it was composed of mucus-secreting invasive adenocarcinoma. Lymphovascular invasion and metastases to pericolic lymph nodes were also found.

Case courtesy of: Dr. Sanjay D. Deshmukh, Professor of Pathology, Smt. Kashibai Navale Medical College, Pune, India.

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