Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Among 22,816 inguinal hernia repairs done between 1950 and 1988, 15 patients (0.07%) had metastatic tumors found within their hernias. Inguinal herniation was the initial sign of cancer in six patients. A palpable inguinal mass (53%) and abdominal or groin pain (67%) were the most common presenting sign and symptom, respectively. Primary tumor sites included the gastrointestinal tract (40%), ovary (20%), prostate (13%), mesothelium (13%), and unknown sites (13%). The median patient survival was 20 months and depended on the primary tumor site. Grossly apparent inguinal hernia sac abnormalities should be examined microscopically to avoid missing the diagnosis of metastatic cancer, but routine histologic examination of all hernia sacs is not warranted.
 ...
PMID:A study of metastatic cancer found during inguinal hernia repair. 159 94

Eighty-four computed tomographic (CT) scans from patients referred for bowel obstruction between January 2, 1988, and December 31, 1989, were retrospectively evaluated. A pair of radiologists without knowledge of patient histories determined the presence or absence of bowel obstruction. Sixty-four patients ultimately proved to have intestinal obstruction, and 20 did not. Diagnosis was established by means of surgery (n = 39), barium studies (n = 17), and clinical course (n = 28). Causes of obstruction included adhesions (n = 37), metastases (n = 6), primary tumor (n = 7), Crohn disease (n = 4), hernia (n = 3), hematoma (n = 2), colonic diverticulitis (n = 2), and other (n = 3). In addition, 83 CT examinations in patients with no history or indication of intestinal obstruction were simultaneously reviewed. The overall sensitivity was 94%, specificity was 96%, and accuracy was 95%. The cause of obstruction was correctly predicted in 47 of 64 cases (73%). Intestinal obstruction was not diagnosed in any of the 83 control patients. CT is most useful in patients with a history of abdominal malignancy and in patients who have not been operated on and who have signs of infection, bowel infarction, or a palpable abdominal mass.
 ...
PMID:Bowel obstruction: evaluation with CT. 206 89

Surgical widening of the abdomen by a silastic pouch has been used very rarely in the management of critically ill infants with hepatomegaly due to neuroblastoma stage 4S. A female newborn baby was referred on the second day of life because of local compressive effects of a massive hepatomegaly, which lead to multiorgan failure. An artificial abdominal hernia was created on the third day of life using a silastic pouch. During the operation oxygenation and ventilation improved and urinary output returned. After chemotherapeutic reduction of hepatic metastases and primary tumor the pouch was successfully removed on day 57 without local complications. The child has survived for more than 1 year and is in complete remission. An artificial abdominal hernia should be considered more often in the critically ill neonate with stage 4S neuroblastoma and massive hepatomegaly.
 ...
PMID:Artificial abdominal hernia for the treatment of hepatomegaly in a neonate with stage 4S neuroblastoma. 1050 22

There were 468 patients (58% females and 42% males) operated for mechanical bowel obstruction over the period of 13 years, i.e. between 1987 and 1999 included into this study. In 82.3% of these patients the obstruction involved the small intestine; in this group 5.1% had multi-level obstruction related to massive carcinomatous dissemination. The remaining 17.7% of the patients had colonic obstruction. The most common cause of small bowel obstruction was intestinal strangulation (N = 352). Two thirds of those patients had strangulated hernias, and one-third--obstruction due to adhesions. In the former group, the majority of subjects suffered from femoral hernia incarceration, while inguinal hernia strangulation was somewhat less common. In 9 patients we observed rare small bowel obstruction caused by a gallstone. Of 83 patients with large intestine obstruction, in 80 (96.4%) obstruction was caused by a primary tumor. In the presented material we observed a higher rate of strangulated hernlas then the rate of obstruction due to adhesion, which is opposite to a typical pattern of developed countries. Most likely this difference results from a lower number of elective hernioplasty performed in Poland then in the USA and Western Europe.
 ...
PMID:[Causes of intestinal obstruction]. 1181 42

The presence of cancer in a hernia sac is uncommon. The tumor can involve the hernia sac, the herniated mass or be external to the hernia sac. We report two cases with this condition. A 68 years old male was operated of a right inguinal hernia. During surgery, several white nodules were noted in the internal side of hernia sac. The same lesions were present in the mesentery. Pathological study revealed an adenocarcinoma. The primary tumor was not located and the patient died one and a half years after the procedure. A 62 years old male was operated due to an irreducible inguinal mass, seven months after a subtotal gastrectomy for gastric cancer. During the resection of the mass, metastasis implants in the mesenteric adipose tissue were noted. A mini laparotomy was performed and an extensive peritoneal tumor dissemination was found. The patient died two months after surgery.
 ...
PMID:[Incidental finding of inguinal hernia sac cancer]. 1196 69

Ovarian serous borderline tumors (SBTs) are characteristically associated with an indolent course. Recurrences are often delayed and usually show morphologic features of SBT or low-grade serous carcinoma. Transformation to high-grade carcinoma has rarely been documented. We report 2 cases of ovarian SBTs that recurred early as high-grade carcinomas. The first was a 50-year-old woman treated surgically and with chemotherapy for a FIGO stage 1C SBT with microinvasion, who experienced a recurrence in an axillary lymph node at 27 months. The recurrent tumor consisted of well-differentiated papillary serous tumor that resembled the primary tumor and poorly differentiated serous carcinoma. The patient died of progressive disease 43 months after her initial presentation. The second case was a 61-year-old woman treated surgically and with chemotherapy for a stage 3C micropapillary SBT with noninvasive implants. Eighteen months later, an incisional hernia was found that contained high-grade sarcomatoid-type carcinoma with microscopic foci of better differentiated tumor that resembled the primary SBT. This patient is alive with disease 24 months after her initial presentation. Whereas the malignant potential of SBTs remains controversial, the cases described herein demonstrate that SBTs can behave unpredictably and may rarely transform into high-grade carcinoma.
 ...
PMID:Early recurrence of ovarian serous borderline tumor as high-grade carcinoma: a report of two cases. 1521 3

We present a case of a primary tumor of the peritoneum that manifested as a spigelian hernia in a 74-year-old woman. Multidetector computed tomography showed a large heterogeneous mass located subcutaneously on the right spigelian line connected to the abdominal cavity. We found no previous report describing a primary peritoneal tumor in a spigelian hernia.
 ...
PMID:Spigelian hernia with unusual content. 1580 24

Umbilical metastasis (Sister Mary Joseph's nodule) is often the first sign of intraabdominal and/or pelvic carcinoma. We describe the fourth case reported in the literature of Sister Mary Joseph's nodule originating from fallopian tube carcinoma. In a 54-year-old woman, Sister Mary Joseph's nodule was unexpectedly detected during umbilical hernia repair. Subsequent laparoscopy revealed a 2-cm friable tumor located at the fimbriated end of right fallopian tube and 1-cm peritoneal implant in the pouch of Douglas. Laparoscopic bilateral adnexectomy and resection of the peritoneal implant were performed. Because frozen section examination revealed fallopian tube carcinoma, the procedure was continued with laparotomy including total abdominal hysterectomy, omentectomy, and pelvic lymph node sampling. Final diagnosis was stage IIIB fallopian tube carcinoma. The patient received postoperative adjuvant chemotherapy with single-agent carboplatin and has remained alive and with no evidence of disease. It is concluded that in cases of Sister Mary Joseph's nodule, laparoscopy can be a useful tool in the search of the primary tumor in the abdomen and/or pelvis. Laparoscopy can provide crucial information with respect to the location, size, and feasibility of optimal surgical resection of the intraabdominal and/or pelvic tumors.
 ...
PMID:Sister Mary Joseph's nodule as the first presenting sign of primary fallopian tube adenocarcinoma. 1669 32

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.
 ...
PMID:Sister Mary Joseph's nodule as a presenting sign of internal malignancy. 1695 43

Pseudomyxoma peritonei (PMP) is a rare, progressive disease of unknown origin. The incidence is estimated at about 1-2/100,000,000 per year. The primary tumor site is usually discovered in the appendix or- in case of women--in ovaries, appearing as tumors of low malignancy. Making an accurate diagnosis causes difficulties--symptoms tend to be misleading, suggesting more frequent pathologies of the abdominal cavity. It is also not rare that the patient is for a long time asymptomatic. We present a case of a 68-year-old patient of the Surgical Oncology Department treated for pseudomyxoma peritonei, diagnosed incidentally at the time of clinical examination for the reasons of chronic hypertension. The symptoms reported by the patient did not suggest any neoplastic process of the peritoneal cavity. Systemic chemotherapy of two paths (a total number of 10 cycles) did not result and at the time of post-treatment control, due to no response to standard chemotherapy, it was decided to administer chemotherapy intraperitoneally in hyperthermia (HIPEC). During the operation, peritoneal cytoreduction prior to the scheduled HIPEC was performed; the right-sided inguinal hernia was repaired. Within the hernia sac the implanted myxoid cells were found, their presence inside was probably the main reason of clinical manifestation of the disease.
 ...
PMID:[Pseudomyxoma peritonei spread into the right inguinal hernia sac--a case report]. 2434 Aug 93


1 2 Next >>