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

Four cases of hepatic angiosarcoma are reported with a review of 99 other cases in the English literature. Angiosarcoma of the liver is associated with chronic exposure to thorotrast, vinyl chloride, arsenicals, radium and possibly copper and with chronic idiopathic hemochromatosis. Although 40% of patients have hepatic fibrosis or cirrhosis at autopsy, the nature of the association between chronic liver disease and hepatic angiosarcoma is unknown. The clinical presentation of hepatic angiosarcoma is nonspecific with abdominal pain, weakness and weight loss common complaints and with hepatomegaly, ascites and jaundice common findings. Liver function tests are usually abnormal but there is no one liver function test or set of tests specific for the tumor. The occurrence of thrombocytopenia and disseminated intravascular coagulation is characteristic of hepatic angiosarcoma and may be related to local consumption of clotting factors and formed blood elements in the tumor. Catastrophic intraabdominal bleeding is also characteristic and occurs in one-fourth of all cases. This complication is likely related to the high incidence of clotting abnormalities and the vascular nature of the neoplasm. Selective hepatic arteriogram and open liver biopsy are the foundations of diagnostic evaluation. Percutaneous liver biopsy should be avoided. Failure to appreciate the possibility of hepatic angiosarcoma in the proper clinical setting, leading to blind percutaneous biopsy, may result in failure to make the diagnosis at the cost of significant morbidity and mortality. Survival of patients with hepatic angiosarcoma is brief; only 3% live longer than 2 years. Treatment of the tumor to date is empirical. There are probably a few patients who might benefit from radical surgery with curative intent. For all others chemotherapy is indicated. Adriamycin is active against hepatic angiosarcoma, but optimal dose and mode of administration require further investigation. Further study is also required to delineate the cause of hepatic angiosarcoma in the 60% of cases without definite epidemiologic association.
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PMID:The clinical features of hepatic angiosarcoma: a report of four cases and a review of the English literature. 36 8

Adriamycin-Lipiodol suspension was administered to 44 patients with metastatic liver tumor using the transcatheter arterial infusion method. The result revealed 23% in the over all effect (partial response or more) of the therapy which was evaluated by comparing the CT images of the tumor, 47% in the 25% or more of the decrease of the tumor, and 65%, very effective in the decrease of the smaller tumor (less than 50 cm2). Except for a case of hepatic subcapsular hematoma after the infusion of Adriamycin-Lipiodol suspension, minor complications were experienced such as abdominal pain, slight fever, and so on. No serious exacerbation in liver function test and white blood cell count was noted.
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PMID:[Transcatheter arterial infusion of adriamycin-lipiodol suspension to patients with metastatic liver tumor]. 131 13

We examined the quality of life in the arterial infusion chemotherapy of hepatocellular carcinoma patients using a questionnaire. The questionnaire used a category scale method of five grades. The questions about the quality of life covered ten areas for investigation (appetite, discomfort pain, nausea, daily activities, sleep, fatigue, time with family and friends, thinking about illness and confidence in the treatment). We added up scale points after one week and those after two weeks after the treatment. Patients after one-shot infusion showed aggravated scale points of anorexia and discomfort. Patients after transcatheter arterial embolization showed scale points of abdominal pain, general fatigue and discouragement about illness. Scale points in matters of thinking about illness and confidence in the treatment informed us about confidence in the course of treatment and comprehension of illness by cancer patients. How do we measure the quality of our care? This is difficult, but we thought the rate of being at home in survival might furnish us with much information in respect to the treatment and the quality of our care. In 36 patients with hepatocellular carcinoma treated with transcatheter arterial infusion and embolization, the arithmetic mean survival time after treatment was 412.1 days and time at home was 305.6 days. The rate of being at home doing survival time was 74.2% after the arterial infusion chemotherapy in 39 patients. The rate of being at home in 9 cases with one-shot infusion of Adriamycin was 43.5% (111 days); that in 9 cases with infusion of Mitomycin C microcapsules was 86.6% (716 days); that in 17 cases with transcatheter arterial embolization using spongel was 72.0% (234 days),; and that in 4 cases with infusion using implantable reservoir was 84.6% (220 days). In non-resected patients with chemotherapy, the rate of being at home was 20.3% for 61 cases of gastric cancer patients, 30.7% for 11 cases of colon cancer, 9.6% for 14 cases of gallbladder cancer and 39.8% for 112 cases of lung cancer. The arterial infusion and embolization of hepatocellular carcinoma has made it possible to lengthen the time that patients may stay home and thereby assure good quality of life.
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PMID:[Evaluation of quality of life in arterial infusion chemotherapy of hepatocellular carcinoma]. 216 36

Transcatheter arterial embolization (TAE) has now been widely accepted in the treatment of hepatocellular carcinoma (HCC). Forty-five patients with tissue proven HCC received TAE and were followed up for more than 6 months; 28 of them were followed for more than one year and 13 for 2 years. The embolic materials used were Lipiodol 0.1-0.2 ml/cm2 (tumor area of its maximal diameter), which was prepared by pumping with contrast agent at a ratio of 1:2 and mixed with anticancer drugs (Mitomycin C: 8-10 mg or Adriamycin 40-50 mg), gelform particles 1-2 mm in size were subsequently embolized. The postembolization syndrome: abdominal pain, fever, nausea and vomiting usually subsided within 1-3 weeks. The overall cumulative half-year, 1-year and 2-year survival rates were 77.8%, 57.1% and 46.2%, respectively. Cases with regular follow-up and those with massive type without satellites, esp. when tumor size less than 5 cm, had better survival rates. In contrast, portal vein thrombosis and big tumors (especially with satellites) indicated poor prognosis. In addition, actively treated coexisting peptic ulcer and/or esophageal varices in HCC patients also improved TAE results.
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PMID:The outcome of hepatocellular carcinoma treated with transcatheter arterial chemoembolization. 217 16

Sixteen evaluable patients with advanced gastric cancer who had no prior therapy were treated intravenously with cisplatin (DDP) 20 mg/m2/day on days 1-5 and with Adriamycin 40 mg/m2 and 5-fluorouracil 600 mg/m2 on day 1 (DAF) every 3 weeks. There were five objective partial responses, giving a response rate of 31%. Five patients had minor responses, and 5 others achieved disease stabilization. The median duration of response for responders was 10 months, and the median time to tumor progression in nonresponders was 6 months. The overall median survival was 12 months (responders 14 months, nonresponders 9 months; NS). Most patients had a subjective improvement, including disappearance of abdominal pain (7/9) and gastrointestinal bleeding (5/7). The drug toxicity was moderate to severe. The primary nonhematologic toxicities were nausea and vomiting (in all patients), severe weakness (44%), and parasthesias (31%). Eight patients (50%) experienced significant bone marrow suppression. The DAF combination appears to have some activity in patients with advanced gastric cancer. However, further efforts in new drug development and other combinations are needed to improve the results of chemotherapy in stomach cancer.
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PMID:Treatment of advanced gastric cancer with DDP (cisplatin), adriamycin, and 5-fluorouracil (DAF). 361 11

The present paper discusses the efficacy of cancer chemotherapy in 46 patients with advanced hepatocellular carcinoma. In most of patients, Adriamycin (20-40 mg) or Mitomycin C (20 mg) was given by one shot injection via the hepatic artery and followed by serial administration of anticancer agents such as 5-fluorouracil (300-750 mg/day), Adriamycin and Toyomycin. Results were as follows: 1) The complete response was not seen. 2) The partial response (more than 50% decrease of the tumor size) was observed in 6 of 46 patients (13%) for 34 to 457 days. 3) Absence of tumor thrombi in the portal vein which was observed by hepatic angiography, CT and ultrasonography, was closely correlated in the partial response and the prolongation of survival time. 4) There were no significant differences with the therapeutic response or survival time among 3 groups (E2: tumor occupation rate (TOR) 20-40%, E3: TOR 40-60%, E4: TOR above 60%). 5) Obstinate abdominal pain and abnormal liver function remarkably were improved during the chemotherapy in 11 of 18 cases (61%), and 6 of 46 cases (13 %), respectively. 6) Major causes of death were hepatic failure (45.7%), gastrointestinal bleeding (30.4%) and intra-abdominal rupture of the tumor (14.7%). 7) As side effect, some extent of hematopoietic suppression was observed in 25% of the patients treated.
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PMID:[Evaluation of chemotherapy in hepatocellular carcinoma with liver cirrhosis]. 631 13

A 66-year-old man was admitted because of right lower abdominal pain and was operated on for acute appendicitis on March 12, 1983. It was found that his appendix was not inflamed, but a bleeding tumor was encountered in the posterior segment of the liver. Bleeding was controlled by suturing the liver above the tumor. Postoperative celiac angiography revealed many daughter tumors scattered in, but restricted to, the right lobe of the liver. The patient was treated by transcatheter arterial embolization combined with transcatheter arterial infusion of lipiodol and Adriamycin on April 25. Subsequently, a curative operation (right hemihepatectomy) was performed on May 24. The patient is still alive without recurrence 6 months after the resection. In case of ruptured hepatocellular carcinoma, it appears to be better to perform a two-stage operation with careful estimation of functional reserve of the liver, and to conduct transcatheter arterial embolization between operations to prevent the growth of the tumor during that period.
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PMID:[A case of hepatocellular carcinoma (acute abdominal type) misdiagnosed as acute appendicitis and satisfactorily treated by a two-stage operation]. 633 25

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

Since the first description of pancreatoblastoma as a malignant pancreatic tumor of childhood in 1957, approximately 200 cases have been reported. We describe an 18-year-old boy who presented with pain and jaundice and was found to have an abdominal mass. The patient initially presented with abdominal pain. During laparotomy, a 10 x 8 x 8-cm3 tumor was discovered in the pancreatic body and tail, and with 3 cystic masses, 15, 10, and 8 cm in diameter, respectively, involving the right lobe of the liver. Pathologic examination of the resected tumor revealed findings characteristic of pancreatoblastoma. The tumor formed acinar and glandular structures and solid areas and contained many "squamoid corpuscles," a defining feature of pancreatoblastoma. In spite of adjuvant chemotherapy with Adriamycin and gemcitabine, the patient returned 11 months later with several large hepatic masses, invading the pancreatic head and enlarged tracheobronchial lymph nodes. Radiotherapy, transcatheter arterial embolization therapy, and chemotherapy were performed. Unfortunately, the patient died 26 months later from disseminated tumor progression. A review of the literature reveals that pancreatoblastoma in childhood must be considered malignant but usually has a favorable prognosis in contrast to pancreatic neoplasms in adult patients. Biologic study will investigate the molecular biology of this rare tumor. The biology may help define prognosis and therapy for this kind of tumor.
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PMID:Clinical and biologic analysis of pancreatoblastoma. 1563 5

BACKGROUND Hepatic metastasis is well known in breast cancer. Approximately 12-20% of breast cancer patients will develop liver metastasis, which usually presents as discrete mass lesions. Rarely, metastatic spread can be so diffuse that it is unidentifiable on imaging but can progress to fulminant hepatic failure. Our case report suggests that clinicians need to have a high index of suspicion when patients present with rapidly decompensating liver failure in the absence of discrete radiologic hepatic lesions, and that weekly Adriamycin should be considered as a first-line therapeutic option. CASE REPORT A 28-year-old African American woman with a history of locally advanced estrogen receptor-positive, progesterone receptor-negative, and HER2-negative breast cancer presented with right upper quadrant abdominal pain and bilateral lower extremity swelling. She had been treated 3 years prior with neoadjuvant Adriamycin/cyclophosphamide - Taxol, bilateral mastectomies, radiation therapy, and tamoxifen. Diagnostic imaging revealed massive hepatomegaly and extensive areas of liver ischemia/necrosis without discrete masses or arterial/venous thrombosis. Biopsy of the liver revealed metastatic carcinoma diffusely infiltrating the hepatic sinusoids. Extensive work up for other etiologies of liver disease was negative. The patient's liver function quickly decompensated over several days. She was treated with weekly single-agent low-dose Adriamycin, and this resulted in successful reversal of her liver function tests back to baseline. CONCLUSIONS In addition to having a high index of suspicion for diffuse intrasinusoidal hepatic metastasis, physicians should consider weekly low-dose Adriamycin as a first-line therapeutic option for patients with progressive liver failure and biopsy-confirmed metastatic carcinoma diffusely infiltrating the hepatic sinusoids.
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PMID:Diffuse Intrasinusoidal Hepatic Metastasis from Breast Cancer Presenting as Liver Failure: Effective and Rapid Treatment with Weekly Low-Dose Adriamycin. 3287 89


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