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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pedunculated Hepatocellular Carcinoma is an extremely rare neoplasm. There are less than 30 documented cases in the world literature. We present a case which was diagnosed preoperatively using abdominal CT scan and angiography. The fact that the pedunculated tumor had undergone torsion with some necrosis precipitated symptoms of abdominal pain. This is the first reported case of this rare tumor presenting with torsion.
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PMID:Torsion of pedunculated hepatocellular carcinoma. Report of a case in a young woman presenting with abdominal pain. 793 99

Primary hepatocellular carcinoma can be revealed by recurrent pulmonary embolism as observed in this case of a 63-year-old woman initially hospitalized for abdominal pain and shortness of breath. The clinical diagnosis was confirmed by laboratory findings, a ventilation perfusion scan and pulmonary angiography which demonstrated peripheral basal artery cut-off and slow filling with delayed washout. The patient was treated with heparin then with nicoumarol and responded well. One month after discharge the patient again complained of shortness of breath and was readmitted. Anticoagulation was adequate as evidenced by a prothrombin time of 1.39 INR and the physical examination and laboratory tests again suggested pulmonary emboli, confirmed by a ventilation perfusion scan. Computed tomography of the chest and abdomen revealed multiple hypodense masses filling half of the liver volume and needle biopsy led to the diagnosis of hepatocellular carcinoma. Hypercoagulability in malignancy is well-known although cases of migratory thrombophlebitis are extremely rare. Pulmonary embolism has not been described as a presenting feature of hepatocellular carcinoma. In this case, there was no evidence of hepatic dysfunction and the pulmonary embolism occurred despite adequate anticoagulation. Clinicians should include occult carcinoma among the possible causes of recurrent pulmonary embolism and when searching for malignancy can include hepatocellular carcinoma among the causes of hypercoagulation.
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PMID:Pulmonary embolism as the presenting feature of hepatocellular carcinoma. 802 23

Twenty patients with either unresectable primary hepatocellular carcinoma or hepatic metastases were entered into a chemoembolization program with cisplatin and lipiodol; 19 patients were evaluable for response. Doses of cisplatin ranged from 40 to 100 mg/m2. Toxicity was tolerable and reversible and included abdominal pain, transient elevation in serum creatinine, serum bilirubin, and serum transaminases. Less common side effects include fever, ascites or pleural effusion, and hiccups. Two of four patients with ocular melanoma had partial responses. Duration of response was 10 and 11 months. Among 8 patients with unresectable hepatoma, 2 patients had partial response for 10+ and 13 months, 2 had minor response for 2 months and 4+ months, 1 patient had stable disease for 5+ months, and 3 patients failed to respond. Of the six colon cancer patients treated, one had a partial response in the liver, but developed progressive nodal disease, and another patient had a partial response for 3 months. Chemoembolization of the liver with cisplatin and lipiodol is feasible and doses of cisplatin at least 100 mg/m2 are tolerable. Antitumor activity in metastatic ocular melanoma is encouraging but requires further study.
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PMID:A phase I study of chemoembolization with cisplatin and lipiodol for primary and metastatic liver cancer. 809 12

The prognosis of patients with multiple hepatocellular carcinoma (HCC) remains disappointing. In this study, we devised a new therapeutic modality for HCC consisting of transarterial immunoembolization (TIE) using OK-432 and fibrinogen and then analyzed the preliminary results. In the first series, we applied the treatment to 19 patients with advanced HCC who had proved to be insensitive to several previous conventional treatments. In all, 14 patients (74%) with unresected HCC have currently survived for between 2 and 16 months after TIE. The remaining 5 patients died at 17, 14, 8, 7, and 4 months after TIE. The serum levels of tumor markers decreased in all of the patients, and a marked reduction in tumor size was observed in six patients after TIE. A high fever occurred in all cases, and abdominal pain and loss of appetite were also observed after TIE. However, deterioration of liver function was negligible. After confirmation of the safety of this method, we started a second study series in which this TIE treatment was selected as the first choice. Six patients have been treated to date. All patients in this group underwent hepatic resection at 6-48 days following TIE. Histological examination of the resected specimens following TIE showed massive infiltration of mononuclear cells around tumor cell nests and lytic necrosis as well as coagulation necrosis of the main tumor and the intrahepatic metastases. In conclusion, our results indicate that TIE may be a safe and promising therapy for patients with HCC.
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PMID:New development of transarterial immunoembolization (TIE) for therapy of hepatocellular carcinoma with intrahepatic metastases. 813 85

A 50-year-old man was diagnosed with non-Hodgkin's lymphoma (NHL) in 1980; he was treated with chemotherapy and achieved complete remission. Six years later he reported upper abdominal pain. Ultrasound (US) showed a 3-cm mass in the right lobe of the liver. Needle aspiration showed hepatocellular carcinoma (HCC). The patient was treated with radical resection of the tumor. Three years later (June 1989), abdominal US showed two lesions in the right lobe of the liver. Needle aspiration and tissue core biopsy showed NHL in one lesion and HCC in the other. The lymphomatous lesion resolved after chemotherapy. The patient died 30 months later (January 1992) from a gastrointestinal hemorrhage; the NHL was in complete remission. This case of the simultaneous presence of HCC and hepatic lymphoma is, to our knowledge, the first diagnosed in vivo.
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PMID:Simultaneous relapse of liver cell carcinoma and non-Hodgkin's lymphoma in the liver. Report of a case with diagnosis by ultrasonically guided fine needle aspiration biopsy. 819 41

A 76-year-old man underwent an injection of 5 ml of ethanol for the treatment of a hepatocellular carcinoma 3 cm in diameter. Shortly after the procedure, he had an attack of abdominal pain. His condition soon deteriorated and he died 5 days later. Massive hepatic necroses distant from the injection site and a myocardial infarction were found at autopsy. To our knowledge, this is the first fatality associated with percutaneous ethanol injection therapy.
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PMID:Fatal liver necrosis following percutaneous ethanol injection for hepatocellular carcinoma. 822 36

In this report, we describe four cases of inflammatory pseudotumor of the liver and review the literature of this disease entity. The age of our patients ranged from 31 to 35 years (mean, 33 years). Two had fever, weight loss, and upper abdominal pain. The other had an incidental 1-cm nodule in the liver found during left hemihepatectomy for recurrent attacks of cholangitis. The preoperative clinical diagnoses in the former two cases were hepatocellular carcinoma. The patients had unremarkable recovery after resection. Grossly, the tumors showed a variegated appearance with areas of hemorrhage and necrosis and resembling hepatocellular carcinoma. Microscopically, the tumors were composed of a polyclonal population of reactive plasma cells and abundant plump spindle cells. The latter expressed vimentin but stained negatively for actin, desmin, and myosin. Ultrastructurally, these plump spindle cells showed features of fibroblastic differentiation. Forty-seven cases of inflammatory pseudotumor of the liver have been reported, 35 in males and 12 in females (male-to-female ratio of 2.9). The patients had a wide age range (10 months to 83 years; mean, 37 years). The most common symptoms were fever, upper abdominal pain and a space-occupying lesion in the liver. Surgical excision was curative. A few patients responded to antibiotic and steroid treatment. The recognition and distinction of this entity from hepatocellular carcinoma and other malignant tumors is particularly important in order to avoid unnecessary extensive surgery.
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PMID:Inflammatory pseudotumor of the liver. Report of four cases and review of the literature. 838 11

An 87-year old woman was admitted with a clinical picture of hypovolemic shock, preceded by a few weeks of abdominal pain. On admission, blood urea was high, the hemoglobin 5 g% and the CT scan revealed a large mass in the right hepatic lobe and free fluid in the abdominal cavity. A tentative diagnosis of ruptured hepatoma with spontaneous intraperitoneal bleeding was made. The diagnosis was confirmed by angiography and selective embolization of the hepatic artery stopped the bleeding. The patient left hospital a few days later.
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PMID:[Spontaneous rupture of a hepatocellular carcinoma successfully managed by embolization of the hepatic artery]. 838 82

This is a retrospective study to evaluate the ability of arterial chemo-embolization with Adriamycin, Lipiodol and Gelfoam to relieve symptoms, primarily abdominal pain, and to prolong survival in patients with hepatocellular carcinoma. Twenty patients were referred from 1986 to 1991 and in 18 the chemo-embolization procedure was successful. In the follow-up period to March 1992, 17 patients had died. Their survival times were not found to be significantly different from the reported rates of survival in patients given no therapy. In only one of 10 patients followed with computed tomography was a reduction in tumour size seen. Nine of 11 patients with pain reported significant relief from pain following treatment. Six patients had repeat embolizations that successfully relieved recurrent pain. In the authors' experience chemo-embolization was helpful in relieving pain, but did not prolong life.
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PMID:Symptom relief and survival after chemo-embolization with adriamycin, lipiodol and gelfoam for hepatocellular carcinoma. 839 Feb 37

Carcinosarcoma of the liver with mesenchymal differentiation are very rare in adult patients. A case is reported with an exhaustive pathologic examination and review of the literature. A 61-year old man presented with general fatigue and dull abdominal pain. Two liver masses were diagnosed and resected by a right hepatectomy. Specimen pathology revealed that the tumor and lymph node consisted of two cancerous components. One carcinomatous component corresponding to a hepatocellular carcinoma and a sarcomatous component characterized by a diffuse proliferation of spindle shaped cells with chondrosarcomatous and osteosarcomatous changes. Patient died 9 months later of a diffusion of the tumor. For the first time, to our knowledge, a mesenchymal differentiation is demonstrated in liver carcinosarcoma.
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PMID:Carcinosarcoma of the liver with mesenchymal differentiation: a case report. 868 74


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