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Query: UMLS:C0021843 (bowel obstruction)
 9,927 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although it is not uncommon to find multiple malignant neoplasms in the same organ, the incidence of synchronous malignant lymphoma and colonic adenocarcinoma has been very rare. This a case report involving a 52-year-old woman in whom malignant lymphoma actually arose within the same segment in which colonic adenocarcinoma was present. Under the diagnosis of advanced adenocarcinoma, she had been treated by right hemicolectomy. However, she developed intestinal obstruction about a month later. At the second surgery for this latter condition, cytologic examination of ascitic fluid revealed many malignant lymphoma cells. In spite of antilymphoma chemotherapy, the patient's condition became progressively worse during the subsequent five-month period, and she died of recurrent malignant lymphoma.
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PMID:[Coexisting malignant lymphoma and advanced adenocarcinoma of the colon--a case report]. 392 46

Recurrences of clinical Stage I endometrial carcinoma after initial treatment are rare. They are nonetheless a serious complication, uniformly associated with poor survival outcome. Between 1969-1980, 20 patients with clinical Stage I endometrial carcinoma were treated for recurrent tumor at the time of first relapse. Nonpapillary adenocarcinoma represented 70% of the primary tumors (pure adenocarcinoma, 50%; adenosquamous, 15%, clear cell, 5%) and papillary adenocarcinoma, 30%. The most common presenting symptom was vaginal bleeding, occurring in 95% of patients. The median time to recurrence after completion of primary treatment was 9.5 mo: Adenocarcinoma relapsed at a median time of 33 mo, adenosquamous, 6 mo and papillary adenocarcinoma, 4 mo. The vagina was the site of relapse in 65% of patients, the abdomen in 20%, the pelvis in 10% and the lung in 5%. Ninety-five percent of recurrences were treated with curative intent. Complications were seen in three patients, small bowel obstruction (2 pts) and vaginal vault necrosis (1 pt); however, these patients responded effectively to conservative treatment. Minimum follow-up of 4 years was available in 18 pts (90%). Actuarial 4 yr overall and NED survival was 50%, respectively, with a median survival of 39 mo to date. There have been no deaths from further recurrence of endometrial cancer beyond 39 mo. Significant prognostic factors for 4 year survival were 1) recurrence site--vagina, 82% (9/11 pts) vs extravagina, 0% (0/7 pts; median survival: 8 mo) [p = .0001]; and 2) histologic cell type--non-papillary carcinoma, 75% (9/12 pts) vs papillary adenocarcinoma, 0% (0/6 pts; median survival: 8 mo) [p = .002]. Our review suggests that: (1) Histology and site of relapse are important prognosticators of treatment outcome; (2) Long term survival may be achieved in vaginal recurrences with aggressive local treatment; and (3) There may be a role for multimodality ovarian type treatment in overall management of recurrent papillary adenocarcinoma, a cell type that appears to exhibit a tendency towards extrapelvic spread refractory to definitive loco-regional treatment.
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PMID:Recurrent stage I endometrial carcinoma: results of treatment and prognostic factors. 399 92

A woman suffering more than ten years with Crohn disease, makes one day a small intestinal obstruction. She undergoes a laparotomy in which a resection of 30 cm terminal ileum is done. Surprisingly the anatomo-pathologic diagnosis is adenocarcinoma between the Crohn's inflammatory lesions. Weedom and Greenstein have proven that Crohn disease and colon carcinoma are related in their follow-ups. But to find such a relationship between Crohn and carcinoma of the small intestine tumours is very small: +/- 0,3/100.000 in a year and so the cases in literature too. We have found 38 cases with enough information. This people with Crohn and carcinoma of the small intestine have an age of 43 years and more than 10 years Crohn symptoms before tumour was found. The tumours are localized in more than 70% in the ileum; 85% are adenocarcinoma. Such differences in localization, age and anatomopathology between Crohn's patients and a normal population let us presume that malign degeneration in Crohn disease is more than accidentally. A casual connection can't be given. For therapeutic use a resection is to prefer because many dysplasias are found in bypass segments.
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PMID:[Malignant degeneration of the intestine in Crohn's disease]. 665 16

Two cancer-prone families are reported. In the first one four first-degree relatives over three generations presented a colonic carcinoma, three of them at a proximal anatomic site. For grandmother and father these occurred at ages of 43 and 54 years, respectively, for the son and the daughter at ages of 26 and 22. The grandmother underwent a palliative ileotransversostomy, surgery typically associated with a bad prognosis, but she survived for forty years that initial neoplasm and had an hysterectomy with oophorectomy at age of 63 for endometrial malignancy; she deceased at age of 83 a few days after surgical treatment of tumoral small bowel obstruction: pathological evaluation disclosed a fourth cancer on first duodenum. The second kindred shows over three generations 11 cancer-affected individuals, three of them with double primary cancer: breast and sigmoid, breast and endometrium, colon and Hodgkin disease. This pedigree includes 8 colorectal neoplasms occurring at 47 years of mean age. These findings are consistent with the cancer-family syndrome and hereditary non-polyposis colon cancer described by Henry Lynch upon four criteria: high frequency of adenocarcinoma, excess of multiple primary malignancies, synchronous or metachronous, early age of onset of cancer and autosomal dominant inheritance. Moreover the hereditary colon cancer is usually localised to the proximal colon, not associated to polyposis coli and allows a prolonged survival. Up to day such families are only identified by pedigree data. The identification of a cancer-prone family calls for an active follow-up of relatives putatively at risk starting at the age of 15 to 20.
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PMID:[Familial cancer of the colon without polyposis and the familial cancer syndrome. Apropos of 2 cases over 3 generations]. 666 87

Three cases of metachronous adenocarcinoma of the large and small bowel are reported. The small-bowel lesions were not even suspected preoperatively and were diagnosed after extensive pathologic study. Though rare, metachronous primary carcinoma of the small bowels must be considered in a patient with intestinal obstruction or hemorrhage following colorectal cancer surgery. Pre-operative diagnosis, which demands a high index of suspicion and careful technical evaluation, is crucial in determining the overall surgical management of the patient.
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PMID:Metachronous primary carcinoma of small bowel following resected colorectal carcinoma: a report of three cases. 696 34

Various reviews documenting the rarity, diagnostic problems, and poor survival statistics prompted this retrospective clinicopathological study of 58 cases of primary small bowel tumors, periampullary and mesenteric tumors excluded, over a 14-year period between 1966 and 1979 inclusive. Of these cases 36 were male and 22 were female, ranging in age from 13 to 65 years. Initially, the symptoms were vague and ill defined. Prominent clinical features were: intermittent abdominal pain (6+%), loss of weight (62%), abdominal lump (53%), and chronic bleeding (7%). Routine barium meal examination and laboratory investigations were not helpful in preoperative diagnosis. Of these tumors 28 were benign and 30 malignant, with the commonest benign and malignant tumors being leiomyoma and lymphoma, respectively. The commonest site of involvement was the ileum both for benign and malignant lesions. None of the benign tumors was found in the duodenum. All patients with benign tumors, discovered either at laparotomy for intestinal obstruction or during surgical procedures for other diseases, had excision of the tumor through enterotomy or resection of small bowel with end-to-end anastomosis. Of 30 patients with malignant tumors, 12 underwent resection of the growth and end-to-end anastomosis. Of the remaining 18 unresectable cases, 7 had by-pass procedures and 11 had only biopsy. All patients of benign tumors are well without any gastrointestinal symptoms. All the malignant cases, except three cases of adenocarcinoma and two of lymphoma who underwent resection, died within 5 years. The 5-year survival of only 8.6% in malignant tumors indicates the necessity of an early exploratory laparotomy in doubtful cases with vague abdominal symptoms. A bold interventionist approach should improve the otherwise dismal outlook of malignant small bowel tumors.
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PMID:Primary tumors of the small bowel: a clinicopathological study of 58 cases. 708 85

This article reviews a case of small-bowel polyposis associated with a primary jejunal adenocarcinoma in a patient who had previously undergone a subtotal colectomy for familial colonic polyposis. The patient was seen for a spontaneously resolving, subacute small-bowel obstruction secondary to metastatic mesenteric and serosal nodules. The jejunal malignancy was metastatic to the lungs in the form of lymphangitic spread, the patient subsequently dying after an open-lung biopsy in an attempt to establish a diagnosis. This particular combination of clinical features, especially the pulmonary findings, appears not to have been previously reported.
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PMID:Polyposis and carcinoma of the small bowel and familial colonic polyposis. 727 88

Adenomas and hamartomas, two genetically transmitted histologic types of gastrointestinal polyposis, are associated in syndromes with extragastrointestinal manifestations. Adenomas that predispose to adenocarcinoma are basic to familial polyposis coli, the Gardner syndrome and the Turcot syndrome. Gastrointestinal polyps and extragastrointestinal lesions serve as a warning, providing time for diagnosis and treatment of adenomas to prevent their malignant transformation in patients and their relatives. Hamartomas with no malignancy potential, but having a tendency toward bleeding and bowel obstruction, are associated with the Peutz-Jeghers syndrome, juvenile polyposis, multiple hamartoma syndrome, basal-cell nevus syndrome and the Cronkhite-Canada syndrome. Most of these lesions and syndromes follow the inheritance pattern of a single autosomal dominant gene.
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PMID:Gastrointestinal Polyposis: Syndromes and Genetic Mechanisms. 740

Adenocarcinoma of the small intestine complicating coeliac disease is uncommon. Only 14 cases have been reported, and in only one of these was a jejunal biopsy carried out more than eight months before the diagnosis of malignancy. We describe four more patients with this association, all with long histories of coeliac disease, confirmed in three by jejunal biopsy over five years before the diagnosis of malignancy. Important presenting features of carcinoma were abdominal pain, anaemia, occult gastrointestinal bleeding, abdominal mass, and intestinal obstruction, and these were the main indications for operation. After resection of the tumour survival may be prolonged, as evidenced by one of our cases who remains well eight years after surgery.
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PMID:Adenocarcinoma of the upper small bowel complicating coeliac disease. 745 May 57

From January, 1985, to June, 1993, 125 patients with stages B2-C adenocarcinomas of the rectum were submitted to pre- and postoperative irradiation according to Thomas Jefferson University protocol guidelines. Five hundred cGy were administered as a single preoperative dose 24 hours before surgery using parallel opposed (AP-PA) treatment fields including the whole pelvis. Pathologic samples were classified following the Astler-Coller staging criteria. Forty-seven patients had no postoperative treatment because their disease stage was A, B1 or D, 11 for refused consent and 9 postoperative complications preventing any further therapy. Seventy-eight patients concluded the treatment schedule and are assessable for response. Radiotherapy total dose consisted of 4400-5000 cGy administered over 5-6 weeks: the patients were treated with megavoltage photons (15-MeV photons) and one dose fraction of 2 Gy was delivered daily, 5 days a week, with the "box" or the "three-field" technique. Median follow-up time was 50.2 months from the beginning of treatment for all the patients in our series (range: 18-120 months). Radiation therapy was well tolerated: 5 patients had severe diarrhea and 2 had small bowel obstruction which required surgery. Local recurrences were observed in 13 of 78 patients (16.7%). Overall actuarial survival at 5 years was 66.8%. Our results confirm the efficacy of this treatment, which is in agreement with international literature data. However, no difference was seen relative to the results obtained with postoperative irradiation alone. We conclude that sandwich radiotherapy can be an effective tool for the local control of rectal adenocarcinoma, with acceptable morbidity, even though it fails to prevent metastases.
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PMID:[The results of sandwich adjuvant radiotherapy in 2nd- and 3rd-stage rectal adenocarcinoma. The authors' personal experience]. 750 39


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