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

We reviewed the records of 73 patients with primary melanoma of the choroid and ciliary body with metastasis treated at M. D. Anderson Hospital and Tumor Institute between 1973 and 1979. At time of diagnosis of primary melanoma 71 of 73 patients had tumor localized to the eye and were treated with enucleation of the affected eye. The interval from resection of primary tumor to detection of systemic metastases in the 71 patients ranged from one to 201 months (median 43.5 months). Weight loss and abdominal pain due to hepatomegaly were the most common symptoms, and hepatomegaly was the most common physical sign. The liver was the most common site of tumor recurrence, occurring in 44 of 71 patients. Among liver enzymes, serum lactic dehydrogenase was found to be the most sensitive indicator of liver metastasis and was elevated in 96% of patients with tumor in the liver. Liver involvement with tumor was associated with poor response to chemotherapy and significantly poorer survival than involvement of other extracranial sites. The survival duration from time of development of systemic metastasis ranged between one and 31 months (median seven months), with a one-year survival rate of 29%. The median survival of patients from diagnosis of ocular melanoma was 52 months, with a five-year survival rate of 43%.
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PMID:Prognosis in metastatic choroidal melanoma. 724 14

Twenty-six cases of carcinoid-related mesenteric angiopathy and intestinal infarction (three from our institution and 23 previously reported cases) were reviewed. Twenty patients presented with acute abdominal findings, including peritonitis (13 cases), intestinal obstruction (five cases), and bleeding per rectum (two cases). Fifteen patients (75%) experienced antecedent symptoms of abdominal pain and/or diarrhea, averaging 2.5 years in duration. Twelve patients (46%) exhibited symptoms of carcinoid syndrome. Mesenteric angiography in three cases demonstrated encasement and segmental branch narrowing or occlusion of major mesenteric vessels. Eleven patients underwent resection and primary bowel anastomosis with an early survival rate of 91%. Four additional patients who underwent lesser surgical procedures and five patients who did not undergo operation all died. Elastic vascular sclerosis (EVS) was identified in 19 of 22 cases with available histologic material (86%). These changes were observed in proximity to as well as distant to the primary tumor. In general, the severity of EVS did not correlate with the likelihood of gut ischemia. Although not the sole cause of intestinal gangrene in patients with midgut carcinoids, EVS may contribute significantly to the evolution of these ischemic changes.
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PMID:Mesenteric angiopathy, intestinal gangrene, and midgut carcinoids. 728 Oct 10

The records of 43 patients with histologically proved primary gastric sarcoma treated at M. D. Anderson Hospital and Tumor Institute between 1945 and 1975 were reviewed. Weight loss, abdominal pain, and hematemesis or melena were the most common symptoms, and palpable epigastric mass was the most common physical sign. Ninety-five percent of the gastric tumors were leiomyosarcomas. The median survival time and the five-year survival for the 29 patients who had curative gastrectomy were 33 months and 38%, respectively. Morphologic and histologic factors that adversely influenced the length of disease-free interval and survival following curative surgery included 1) primary tumor 8 cm or greater in diameter, 2) tumor extension to serosa of the stomach, and 3) low grade of differentiation of the primary tumor. Seventy-seven percent of recurrences in patients with curative tumor resection occurred within two years of resection of the primary. Of the 17 patients with advanced disease who received chemotherapy, two (15%) had objective tumor regression of greater a median survival time of eight months for patients who failed to respond. New approaches that may improve the results of treatment of gastric sarcoma are discussed.
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PMID:Sarcoma of the stomach: clinicopathologic study of 43 cases. 735 19

Peritoneal serous papillary carcinoma is a rare primary tumor of the peritoneum. We report here a case diagnosed by laparoscopy, and summarize the clinicopathological features previously reported in patients with this tumor. Laparoscopy was performed in a 66-year-old woman with high-protein ascites and a three-month history of lower abdominal pain. Macroscopically, the parietal and visceral peritoneum was studded with prominent white nodules up to 5 mm in diameter. Multiple biopsies revealed a tubulopapillary serous adenocarcinoma. After exclusion of metastatic peritoneal carcinomatosis (especially ovarian cancer) and malignant mesothelioma, the diagnosis of peritoneal serous papillary carcinoma was established. The patient was placed on chemotherapy (first-line: 5-fluorouracil, adriamycin, and mitomycin C; second-line: paclitaxel). She died 22 months after diagnosis. The present case is also remarkable for the coexistence of granulomatous peritonitis overshadowing the malignant nature of the process. This case report emphasizes the importance of laparoscopy with multiple biopsies in the workup of undetermined exudative ascites.
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PMID:Laparoscopic diagnosis of peritoneal serous papillary carcinoma. 755 42

We present a 61-year-old man who was hospitalized because of dyspnea, abdominal pain and liver dysfunction accompanied by ascites due to hepatic metastasis of a thymic carcinoid 20 years after the primary tumor was excised. His symptoms and liver function were well controlled by prednisolone, 30 to 60 mg daily, for the next 2 years, with a reduction in the size of the hepatic tumors and in the accumulation of ascites. He subsequently contracted pneumonia due to methicillin-resistant staphylococci, developed disseminated intravascular coagulation (DIC) and died. Thus, prednisolone should be considered for treating patients with metastasis of a thymic carcinoid.
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PMID:Efficacy of steroid therapy on liver metastasis of thymic carcinoid. 818 Apr 43

Three patients with a new, pathologically distinct solid tumor of childhood have been treated recently. The disease is characterized by male predominance, adolescent onset, an extensive abdominal primary tumor, and aggressive metastases to regional lymph nodes, liver, and lung. Two patients presented with vague abdominal pain and the third with testicular pain. All three noted fatigue and malaise of less than two months' duration with minimal associated weight loss. Computed tomography (CT) scans of the abdomen and chest were obtained for initial preoperative staging, and then all three underwent surgical exploration. Widespread disease was found in each case. In no instance was complete tumor extirpation possible because of extensive peritoneal spread and lymphatic and hepatic metastases. Histologically, all three tumors consisted of round blue cells with a dense desmoplastic reaction and focal rhabdoid features. Immunohistochemical markers for epithelial, neural, and muscle elements were positive. Aggressive multidrug chemotherapeutic regimens were used in each case, and all three patients are alive and well but with known residual disease. We conclude that in cases of the desmoplastic round cell tumor of childhood, CT scans underestimate the extent of disease, and exploratory laparotomy is necessary for diagnosis and appropriate staging. Surgery is usually palliative because of extensive spread. Awareness of this newly recognized aggressive solid tumor of childhood is essential to define its natural history and guide the development of effective multidisciplinary therapeutic regimens.
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PMID:The desmoplastic round cell tumor: a new solid tumor of childhood. 822 89

Medical records of 312 consecutive patients with enteroclysis were reviewed. Clinical indications, symptoms, roentgenologic results and clinical outcome were correlated. The most frequent indications were abdominal pain (22%), suspected inflammatory bowel disease (19%), evaluation of Crohn's disease (17%) and diarrhea (11%). Two-thirds of the studies (67.6%) gave normal results and 32.4%, abnormal. The most common abnormalities detected were pathology of the mucosa (40%), stenosis of the small bowel (34%) and fistulas (26%). A low incidence of pathology as found in cases of gastrointestinal bleeding of unknown origin (0%) and when a primary tumor was sought (13%). In 18% operation followed enteroclysis; results were found to be true-positive in 68% and false-negative in 28%. We conclude that in view of the implications (radiation dose and patient discomfort), the indications should be carefully considered before enteroclysis is performed.
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PMID:[State of the art of selective small bowel enema. Indications and results]. 833 28

During a seven year period 18 benign small intestinal tumors were histologically documented in patients referred to us for a small bowel study, using a barium infusion technique. These included seven leiomyomas, five adenomatous polyps, two Peutz-Jeghers hamartomas, one myoepithelial hamartoma, one lipoma, one Brunner's gland adenoma and one neurilemmoma. Ten of the patients were women and eight were men, with their ages ranging from 20 to 75 years (mean age 45 years). Presenting symptoms were gastrointestinal bleeding in 12, anemia in 9, abdominal pain in 4, partial intestinal obstruction in 3 and bloody diarrhea in one. The time elapsed from onset of symptoms to radiological diagnosis ranged between one month and seven years (mean time 16 months). Multiple lesions were encountered in four cases and solitary in fourteen. The site of involvement was the duodenum in 3 patients, the jejunum in 8 and the ileum in 7 of them. Main radiological appearances included solitary or multiple intraluminal filling defects, mass effect on neighbouring loops and dilation of intestinal loops proximally to the lesion. The primary tumor, in the form of a mass or other abnormality of the small intestine was identified in all study cases. Correlation with surgical or endoscopic findings showed that radiology depicted all single lesions, whereas multiple lesions were underestimated in one case. The individual morphological changes shown on examination of the resected specimens resembled the appearances on the barium study in all cases. However, enteroclysis missed four out of seven ulcers and a stalk in one of the five pedunculated lesions. A specific tumor-type diagnosis was reached preoperatively in eleven patients, it was suggestive in five and mistaken in two of them. Our experience indicates that enteroclysis is an effective means in evaluating patients with suspected benign small bowel tumors, preoperatively.
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PMID:Benign tumors of the small intestine: preoperative evaluation with a barium infusion technique. 846 75

Colorectal cancer has continued to increase in incidence over the past 25 years. It now ranks as the second most common noncutaneous malignancy for men and women together. The projected 1995 statistics predict 153,000 new cases in the United States, with 109,000 of colonic origin and 44,000 cancers of the rectum. The shift to more proximal colonic involvement and a decrease in size of the presenting lesion is again noted. Unfortunately, the warning signals (rectal bleeding, change in bowel habits and, later, abdominal pain, distention, and weight loss), often become evident only after the tumor has progressed significantly in the patient. Despite improvements in endoscopic detection, anesthesia, pre- and postoperative care and more extensive en-bloc resections, the cure rate for all patients with colorectal cancer remains unchanged at 53 per cent at five years. Although radical resectional surgery is relied on for locoregional control of the disease, there has been an increased use of cross-sectional radiologic studies for staging of the cancer. This newer management of colorectal cancer is the result of a better understanding of the natural history and biologic behavior of the cancer. The main strategy presently is to diagnose the disease sooner, stage the cancer more accurately, select tumors that will respond to adjuvant therapy, and detect recurrences more efficiently. It is in the area of staging of the primary tumor and accurate localization of recurrences that this new modality, immunoscintigraphy, is felt to have an impact.
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PMID:The role of immunoscintigraphy in the staging and management of colorectal cancer. 889 22

A case of a 38-years-old patient with carcinoid syndrome (paroxysmal skin flush, diarrhoea, abdominal pain) is documented although the search of the primary tumor was not able to localise it (possibly an intestinal one). Confirmatory diagnosis had a biochemical support in 262 mg/24 h urinary elimination of 5 HIAA (metabolic of serotonine). Particular aspects of the case are illustrated through intravitam documentation of the liver metastases (via portal vein) and the damage of the right heart (Hedinger syndrome) resulting from the involvement of the tricuspid valve apparatus (with clinical, phonomechanographic and echocardiographic abnormalities). The fatal evolution of the patient was due to uncontrolled aggravation of the portal high blood pressure syndrome (refractory ascites to diuretic treatment). It was impossible to us to obtain the morphopathological data. The specific elements of the carcinoid syndrome (including a convincing indirect illustration) with right cardiac involvement (known as Hedinger syndrome) are discussed, as well as the hypothetical place in pancreas of the primary carcinoid tumor.
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PMID:[The heart: bystander or participant in neoplasms? The Hedinger syndrome (carcinoid cardiopathy)]. 945 74


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