Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report an extremely high serum CA125 value of 1243 units/mL in a 21-year-old-patient with Crohn's disease who developed endometriosis. Such a high CA125 value has not been reported to date in endometriosis or other pathologies except ovarian carcinoma. The pelvic mass of unknown nature in the above patient was discovered by ultrasound during a sudden onset of severe abdominal pain which subsided within two days. The high CA125 value six days after the onset of pain and at the end of menses declined spontaneously to 100 units/mL in 15 to 30 days, and stabilized over the three months prior to colectomy and removal of the left ovarian endometrioma, after which it gradually declined to 7 to 11 units/mL as found a year earlier. Although primary cells from endometrioma produced 113 units/mL of CA125 in the culture medium, the cell line established from it gave a value of less than 7 units/mL even after treatment with interferons. The adherent cells were moderately positive for CA125, cytokeratin and non-specific esterase, were strongly positive for periodic acid Schiff's (PAS) and acid phosphatase, and had epithelioid morphology. In addition to the extremely high CA125 level in our endometriosis patient and the establishment of the cell line, the case illustrates the usefulness of CA125 estimation in helping to determine the nature of abdominal masses in female inflammatory bowel disease patients.
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PMID:An extremely elevated serum CA125 level in a Crohn's patient developing endometriosis and the establishment of a cell line (MD-E) from the endometrioma. 177 Mar 21

A retrospective review of 130 patients with peripheral-type cholangiocarcinomas (PTCC), hilar-type cholangiocarcinomas (HTCC), extrahepatic cholangiocarcinomas (EHCC), gallbladder cancers (GBCA), and periampullary cancers (PACA), seen at National Cheng Kung University Hospital and Tainan Municipal Hospital from June 1987 to July 1993 was performed. There were 47 (36%) HTCC, 32 (25%) PACA, 24 (19%) PTCC, 17 (13%) GBCA, and 10 (8%) EHCC patients. The distribution is completely different from that reported in western countries. These cancers mainly occur in elderly patients. HTCC and GBCA were predominantly noted in female patients. Biliary cancers in Taiwan were not related to liver fluke infestation, inflammatory bowel disease or hepatitis B virus infection. However, a close association with biliary lithiasis was found. The incidence of gallstones was 67, 39, 20, 29 and 19% for PTCC, HTCC, EHCC, GBCA and PACA, respectively. The most common presentation for PTCC and GBCA was abdominal pain, or jaundice for HTCC, EHCC and PACA. These symptoms correlate well with the location of the tumors. Among serum tumor markers, the elevation of CA19-9 was most frequent, occurring in 86% of the patients while CA125 and CEA occurred in 47% and 30% of the patients, respectively. During the course of disease, infection developed in 61% of the patients and was the main cause of death in 25%. Biliary tract infection and sepsis were the two leading manifestations and occurred in 49% and 32% of the patients, respectively. Overall survival was poor except in patients whose tumor could be completely resected.
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PMID:A clinical study of 130 patients with biliary tract cancers and periampullary tumors. 896 Jan 45

We have generated an immunoglobulin G1 (IgG1) murine monoclonal anti-idiotype antibody (Ab2) designated ACA125, which mimics a specific epitope on the tumor-associated antigen CA125. This antigen is expressed by most of malignant ovarian tumors. Patients with CA125-positive tumors are immunologically tolerant to CA125. We used ACA125 as a surrogate for the tumor-associated antigen CA125 for vaccine therapy of 16 patients with advanced epithelial ovarian cancer or recurrences. Each of the patients received a minimum of 3 injections up to 19 injections of the complete anti-idiotype MAb ACA125 at a dosage of 2 mg per injection. Nine of 16 patients developed anti-anti-idiotypic (Ab3) responses to the ACA125. All 9 patients generated specific anti-CA125 antibody demonstrated by reactivity with purified CA125. Nine of 16 patients developed a CA125-specific cellular immune response by their peripheral blood lymphocytes (PBL) and 3 of 16 showed an increase in gamma-interferon concentrations accompanied by Ab3 responses. Toxicity was limited to abdominal pain in one case, which led to the withdrawal of further immunizations. The median progression free survival in those patients, who showed a specific immune response to the tumor-associated antigen CA125, was 11.0 +/- 5.6 months without any other therapy, in contrast to 8.0 +/- 4.2 months in the anti-anti-idiotype negative group. This is the first report of the induction of a specific active immunity to the tumor-associated antigen CA125 in patients with advanced ovarian cancer treated with an anti-idiotype antibody that "mimics" CA125. Patients showed the development of a specific humoral and cellular immune response to an otherwise nonimmunogenic tumor antigen. The immune responses in patients treated with this anti-idiotype vaccine, the low rate of side effects, and the improved time to progression after the induction of a specific immune response against the tumor-associated antigen CA125 justify follow-up clinical trials in advanced ovarian cancer patients with minimal residual disease in an adjuvant approach.
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PMID:Immunological responses to the tumor-associated antigen CA125 in patients with advanced ovarian cancer induced by the murine monoclonal anti-idiotype vaccine ACA125. 908 26

Primary ovarian carcinoid tumors are rare. A 47-year-old woman presented to our emergency room with lower abdominal pain. Physical examination, pelvic ultrasonographic evaluation and abdominal computed tomography revealed a 10-cm mass in the right ovary containing cystic and solid components, as well as calcifications typical of a dermoid cyst. At laparotomy, a smooth-surfaced, firm and mobile right adnexal mass with solid and cystic portions was detected. Initially, right salpingo-oophorectomy was performed. Frozen-section examination identified the mass as a sex cord stromal tumor containing a mature cystic teratoma. Based on this finding, total abdominal hysterectomy, left salpingo-oophorectomy, omentectomy, appendectomy were performed, and the pelvic-paraaortic lymph nodes were also removed. All histological findings in the right ovary were similar to the features of cystic teratoma and trabecular carcinoid tumor. Examination of the resected lymphatic, omental, and appendiceal tissue indicated no tumoral invasion. The diagnosis was ovarian carcinoid Stage IA. Serum testing post-surgery revealed that the levels of cancer antigen (CA) 19-9 and CA125 were 18.5 u/ml and 10.5 u/ml, respectively. The patient was discharged on postoperative day 5. The report describes the clinicopathologic and immunohistochemical features of a primary ovarian carcinoid that contained a mature cystic teratoma.
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PMID:Primary carcinoid tumor of the ovary: a case report. 1465 8

An 18-year-old woman with abdominal pain was diagnosed as having splenic cysts by computed tomography scan. She had high serum levels of CA19-9 (2886.8 U/mL; normal value, <35 U/mL), CA125 (131.1 U/mL; normal value, <35 U/mL) and soluble IL-2 receptor (1490 U/mL; normal range, 220-530 U/mL). The resected spleen weighed 1050 g, was 14 x 28 cm, and had more than 10 macroscopic cysts up to 10.3 x 9.5 cm. There were numerous microscopic cysts in the spleen and several on the splenic capsule. The levels of CA19-9 and CA125 in the cyst fluid were 2165550 U/mL and 160400 U/mL, respectively. After the surgery, the serum levels of the tumor markers decreased gradually. The inside of the largest cyst was mainly covered by granulation tissue with a focal lining of epithelial cells, and the other macroscopic cysts had stratified squamous epithelium. The microscopic splenic cysts and cysts on the splenic capsule were lined by either attenuated single-layered or multilayered epithelial cells. The lining epithelial cells of these cysts were positive for epithelial membrane antigen and cytokeratins. CA19-9 and CA125 were detected in the lining cells of the splenic cysts. In the present case, it is suspected that the splenic cysts were derived from the capsular lining cells that showed migration from the capsule or formed microcysts on the splenic capsule, as in the case of ovarian inclusion cysts.
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PMID:Multiple epithelial cysts of the spleen and on the splenic capsule, and high serum levels of CA19-9, CA125 and soluble IL-2 receptor. 1508 40

The clinicopathological characteristics are presented of 19 extragenital cystic lesions of female patients located at the retroperitoneum (9 cases), the mesentery (6 cases) and the peritoneum (4 cases). Median age was 42.3 years and the main symptom was abdominal pain. The cysts measured 4-27 cm in diameter and were classified as: epithelial (7/19), mesothelial (5/19), vascular (2/19), parasitic (1/19) and developmental in origin (4/19). Of the cases 18/19 were benign lesions and one case was a borderline mucinous cystic tumor. Immunohistochemistry by a streptavidin-biotin method was performed to investigate CEA transcripts (MoAb, Novosan), CA125 (MoAb, CIS Diagnostics), vimentin (MoAb Ve6, Novocastra), secretory component (a polyclonal antibody, DAKO), Factor VIII (MoAb, DAKO), CD34 (MoAb, Scytec), calretinin (a polyclonal antibody, Zymed, San Francisco, CA). Cytokeratins were of low and high molecular weight (Immunon, AE1-MoAb). The results are helpful in the correct classification of various tumors. The treatment of choice is complete surgical resection of the tumors.
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PMID:Extragenital cystic lesions of peritoneum, mesentery and retroperitoneum of the female. Clinicopathological characteristics of 19 cases. 1599 37

Adenocarcinomas developing in endometriotic lesions have been reported, most commonly in the ovary. The rectovaginal septum is a rare location of this neoplastic transformation. We report a case of primary adenocarcinoma arising from endometriosis of the rectovaginal septum in a 25-year-old woman presenting with lower abdominal pain and dyspareunia. Diagnostic and treatment modalities were discussed. Immunohistochemical studies of different keratin subtypes and CA125 expression of the tumor cells are of interest for the diagnosis. Preoperative radiation therapy promotes clinical symptoms relief, tumor volume reduction, and better radical surgical approach.
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PMID:Primary adenocarcinoma arising from endometriosis of the rectovaginal septum: a case report. 1634 14

Peritoneal tuberculosis mimics advanced ovarian cancer because of the similarities in clinical signs and symptoms such as ascites, pelvic and abdominal pain and mass, and elevation of serum CA125 level. We have presented four cases of peritoneal tuberculosis that underwent exploratory laparotomy for suspected advanced ovarian cancer during a 3-year period. Definitive diagnosis of tuberculosis was performed at laparotomy in all the cases. The frozen-section analysis seems to be the gold standard in the differential diagnosis. In view of these data, clinical diagnosis of advanced ovarian cancer is not sufficient for administering neoadjuvant chemotherapy. Cytologic or pathologic findings must be consistent with ovarian cancer for candidates who are being considered for neoadjuvant chemotherapy.
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PMID:Peritoneal tuberculosis simulating advanced ovarian carcinoma: is clinical impression sufficient to administer neoadjuvant chemotherapy for advanced ovarian cancer? 1651 10

Hepatoid carcinoma is a rare ovarian tumor and is thought to be a histopathologic subtype different from hepatoid type yolk sac tumor based on its pathologic features. A 63-year-old woman who had postmenopausal bleeding and lower abdominal pain was found to have right ovarian mass on pelvic examination and computed tomography. She had high serum levels of alpha fetoprotein (AFP) and CA125. Histologically, the tumor resembled hepatocellular carcinoma by architectural and cytologic features. Immunohistochemically tumor cells were immunoreactive for AFP, alpha 1 antitrypsin, and carcinoembryonic antigens.
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PMID:Hepatoid carcinoma of the ovary: immunohistochemical finding of one case and literature review. 1680 43

CASE 1: A 64-year-old, otherwise healthy woman was referred to the surgery clinic for a presumed umbilical hernia. On physical examination, a cutaneous nodule was noted on the umbilical region and the patient was referred to the dermatology clinic. The patient was reexamined and an erythematous nodule was observed in the umbilicus measuring 2.5 cm in diameter. The patient denied pain, change in bowel habits, or weight loss. There were no other abdominal masses, no sign of ascites, and no regional lymphadenopathy. A skin biopsy from the nodule showed mucinous adenocarcinoma. Immunohistochemical staining was positive for carcinoembryonic antigen, and negative for cytokeratin (CK)7 and CK20. These results were consistent with a Sister Mary Joseph's nodule and led to the diagnosis of an occult colon carcinoma. The patient had no risk factors for colorectal carcinoma. The patient underwent surgery in another hospital, and died 3 months after the initial diagnosis of Sister Mary Joseph's nodule. CASE 2: A 73-year-old woman was referred to the dermatology clinic for evaluation of a painful, ulcerated, 3-cm lesion in the umbilicus (Figure 1). She was otherwise asymptomatic. A skin biopsy showed neoplastic glandular cells infiltrating among collagen bundles (Figure 2). Stainings for mucin and for CK7 were positive, while staining for CK20 was negative. An abdominopelvic CT scan demonstrated a 3.5-cm space-occupying lesion in the liver. Results of gastroscopy, colonoscopy, chest computed tomographic (CT) scan, and mammography were normal. Serum levels of the tumor-associated protein CA125 were elevated to 164 units, while those of CA 19-9 and carcinoembryonic antigen were within normal range. A gynecologic examination and a transvaginal ultrasound were normal. The patient had no personal or family history of any malignancy or any risk factors for developing a carcinoma. The patient was scheduled for a palliative resection of the umbilical nodule, combined with a laparoscopic inspection in search of the undetected primary tumor. She refused surgery and was lost to follow-up. She died 4 months after the initial diagnosis of umbilical metastasis. CASE 3: A 51-year-old man was aware of a silent mass in his umbilicus for 2 years without seeking medical advice. Following 2 weeks of increasing pain in this area, he was referred to the emergency room for a suspected incarcerated umbilical hernia. Surgery revealed a mass attached to the fascia and peritoneal fat. The mass was removed and diagnosed as a poorly differentiated adenocarcinoma, staining positively for carcinoembryonic antigen, and negatively for CK20, CK7, prostate-specific antigen, and prostatic acid phosphatase. Both gastroscopy and colonoscopy failed to detect the primary tumor. An abdominopelvic CT scan was normal, but a CT scan of the chest disclosed a nodule measuring 2.5 x 1.5 cm in the lower lobe of the right lung. On bronchoscopy, it was found to be an invasive adenocarcinoma, consistent with a primary tumor of the lung. The patient was a heavy smoker (45 pack-years). The patient received 4 cycles of combined chemotherapy with carboplatine and gemcitabine, with no improvement. A month later, the patient complained of abdominal pain. Following demonstration of intra-abdominal spread of disease by CT scan, a second line chemotherapy was instituted with paclitaxel. A month later the patient's condition deteriorated and he complained of cough, sweating, and pain along the right leg. A bone scan revealed bone metastases in the right femur and left tibia. Two weeks later he was admitted to the hospital with intestinal obstruction and underwent laparotomy. He had massive intra-abdominal spread of cancer and ascites. Only a palliative colostomy was performed. The patient died 3 weeks later, 9 months after the diagnosis of adenocarcinoma of the lung. The clinical data on the three patients are summarized in Table I.
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PMID:Sister Mary Joseph's nodule as a presenting sign of internal malignancy. 1695 43


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