Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024623 (gastric cancer)
 36,219 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We describe the case of a 57-yr-old female with endobronchial metastasis from stomach carcinoma. Respiratory symptoms began 3 months before the diagnosis of the gastric cancer. Chest computed tomography revealed a reticular lymphangitic carcinomatosis pattern with hilar and mediastinal lymphadenopathy. Fibreoptic bronchoscopy showed a spread submucosal infiltration which narrowed the apical segment of the left lower lobar bronchus. The biopsy specimen at that level was histologically identical to the gastric primitive cancer. To the authors' knowledge, stomach carcinoma has rarely been reported to give rise to airway metastases.
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PMID:Endobronchial metastasis from stomach carcinoma. 1078 16

Acute tumor lysis syndrome (TLS) occurs frequently in hematologic malignancies such as high-grade lymphomas and acute leukemia, which are rapidly proliferating and chemosensitive tumors. It occurs rarely in solid tumors and has never been reported in gastric adenocarcinoma. Typical biochemical findings of acute tumor lysis syndrome are hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcemia in patients with a malignancy. Rapid changes of these electrolytes may cause cardiac arrhythmia, seizure, acute renal failure and sudden death. Therefore, as soon as it is detected, it should be taken care of immediately. Until now almost all cases of TLS associated with solid tumor have developed after cytoreductive therapy in chemosensitive tumors. We report here a case of spontaneous acute tumor lysis in a patient of advanced gastric cancer with hepatic metastases and multiple lymphadenopathy. The biochemical finding of TLS improved with the management and tumor burden also showed slight response to the one cycled combination chemotherapy but the patient died of progressive pneumonia.
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PMID:Spontaneous acute tumor lysis syndrome with advanced gastric cancer. 1128 89

Abdominal lymph node chains and route of lymph drainage of various organs (stomach, duodenum, liver, gallbladder, pancreas, small intestine, appendix, blind intestine, colon rectum) are analyzed according to their location. The role of conventional radiology and diagnostic imaging is evaluated in the study of abdominal lymphatic system with particular reference to lymphangiography and the new procedures of sonography, CT and MRI. Present methods used in inflammatory abdominal lymphadenopathy with special attention to tuberculous lymphadenitis, liver cirrhosis, neoplastic abdominal lymphadenopathy, colorectal and pancreatic cancer, are illustrated. Combined modality imaging is considered in gastric cancer based on the evolution of the classification of gastric lymph nodes. The role of sonography, endoscopic ultrasonography, spiral CT and MRI is assessed in gastric cancer N staging. A retrospective study is analyzed and perspectives for the application of a new CT protocol are proposed. PET potentialities in the study of abdominal lymph nodes are examined.
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PMID:Role of diagnostic imaging in abdominal lymphadenopathy. 1136 14

Treatment results of gastric cancer patients differ considerably between Japan and the West, even at the same stage of disease. This may be partly explained by the varying extent of local control and the "stage-migration" theory. There is an important conceptual difference concerning lymphadenopathy and lymphadenectomy: Japanese surgeons believe that lymph nodes are the governors of metastatic disease and thus that lymphadenectomy will result in cure, while in the West lymph nodes are seen merely as the indicators of systemic metastasis and thus lymphadenectomy serves only for staging. The UICC TNM system has recently abandoned the anatomical N-classification and adopted the numeric N-classification. Although this is a good prognostic indicator, it does not provide surgeons with any information for surgical decision-making. Japanese surgeons will continue to use the Japanese classification that has served as a guideline for standard D2 lymphadenectomy. To establish an international standard for gastric cancer treatment, both sides should make efforts to understand each other and discuss most practical and beneficial treatment modalities for patients in the respective medical environments.
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PMID:[Problems of international standardization of gastric cancer surgery]. 1168 Oct 2

TS-1, a novel oral formation of 5-fluorouracil that consists of 1M tegafur (5-FU), 0.4M CDHP and 1M Oxo, is reported to achieve a higher response rate of 49% in patients with advanced gastric cancer in a late phase II study. We report a case of recurrent gastric cancer that responded significantly to the short-term administration of TS-1. A 73-year-old man, who had undergone a curative distal gastrectomy with D2 lymphadenectomy 2 years earlier, had presented with obstructive jaundice resulting from cancerous lymphadenopathy. PTCD was performed for drainage, but cholestasis disappeared completely through the two courses of oral administration of TS-1. The serum level of transaminase and bilirubin remained within normal limits, even with PTCD unequipped, until the patient died of the original disease. The adverse effects observed with the drug were anemia (grade 1) and skin pigmentation (grade 2), both of which improved soon after discontinuing the medication. In conclusion, TS-1 may be well-tolerable and effective in some cases of terminal-stage and/or recurrent gastric cancer, especially those associated with obstructive jaundice arising from the cancerous lymphadenopathy, in that patient QOL can be maintained to a much greater extent.
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PMID:[Case report: a recurrent gastric cancer in the terminal stage, associated with obstructive jaundice which responded significantly to oral administration of TS-1]. 1168 Dec 55

A 68-year-old man was admitted to our hospital because of epigastric pain. An upper gastrointestinal contrast study and endoscopy revealed a II c type tumor in the posterior wall of the pyloric antrum. and computed tomography showed lymph node enlargement along the left gastric artery. Operation was performed after a presumptive diagnosis of gastric cancer with lymph node involvement. During the laparotomy, more extensive lymphadenopathy was found than was detected preoperatively, and tumor metastasis was suspected because of its firmness. Distal partial gastrectomy with D, and more extensive lymph node dissection were performed. Subsequently, the histology of permanent sections revealed not tumor metastasis but a sarcoid-like reaction in the lymph nodes. The patient recovered uneventfully: however, he was killed in an accident 38 months after the surgery. A postmortem examination was not performed, but there had been no clinical signs of either recurrence of gastric cancer or sarcoidosis.
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PMID:Multiple early gastric cancer associated with sarcoid-like reaction in the regional lymph nodes. 1168 83

OBJECTIVE: Currently available imaging modalities, including CT, ultrasound, and MRI are unsatisfactory in the detection of metastatic gastric cancer, especially lymph node metastases and peritoneal spread. The aim of this study is to evaluate FDG-PET in the diagnosis of primary as well as metastatic gastric cancer.METHOD: All patients (18M/5F; mean age 62, range 33-81) with gastric cancer referred for FDG-PET scan from 1/1/97 to 3/20/98 were studied. PET images of the neck, chest, and abdomen were acquired using a dedicated whole body scanner. A final diagnosis was reached in 21 patients by histology, surgical findings, or clinical follow-up.RESULTS: All but 1 primary tumor (12 out of 13) and both cases with local recurrence showed a high degree of FDG uptake, with mean SUV of 8.9 (range 4.8-17.6). The one false negative (FN) occurred in a poorly controlled diabetic with blood sugar of >400 at the time of study. Six cases with prior gastrectomy were true negative (TN) in the region of the stomach. This translates to a sensitivity of 93%, specificity of 100%, and accuracy of 95% for the primary site. In contrast, for intra-abdominal lymph node (LN) stations PET was true positive (TP) in 2, FN in 7, false positive (FP) in 1, and TN in 32, yielding a sensitivity of 22% and accuracy of 81%. PET detected only 2 out of 9 perigastric lymph node metastases. For the 8 patients in this series who had documented M1 disease, PET detected two with liver metastasis, one with colon metastasis, and one with submandibular LN. However, four cases of peritoneal spread were missed.CONCLUSION: FDG-PET is highly sensitive in detecting the primary lesion in gastric cancer and shows promise in the detection of liver and extra-abdominal metastasis. However, PET appears limited in the detection of perigastric lymphadenopathy as distinct from the primary tumor and in assessing peritoneal spread. Our preliminary assessment suggests that staging of gastric cancer with FDG-PET scanning is relatively effective at detecting distant metastatic disease and will complement standard staging methods such as laparoscopy, which are more effective at staging local nodal spread and peritoneal disease.
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PMID:Accuracy of FDG-PET in Gastric Cancer. Preliminary Experience. 1451 55

Previous reports indicate that enlarged hilar and mediastinal lymph nodes caused by sarcoid-like reactions may develop after curative resection of cancer, and their presence does not necessarily denote neoplastic recurrence. Reports further suggest that coexisting pulmonary infiltrates in this setting may be related to sarcoidosis. In this study, we describe two patients who had resected lung and gastric cancer and who later developed pulmonary interstitial infiltrate, concurrent with progressive mediastinal lymphadenopathy initially thought to be caused by intrathoracic dissemination of their cancer. These changes were shown by open lung biopsy to be a benign, granulomatous reaction interpreted as sarcoidosis. Thus, it is important to recognize this clinical pattern when pulmonary infiltrates develop after complete treatment of cancer in an otherwise relapse-free patient and to encourage lung or lymph node biopsy in these particular settings in order to confirm a sarcoid-like reaction, thereby avoiding unnecessary chemotherapy for presumed tumor recurrence.
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PMID:Pulmonary and mediastinal "sarcoidosis" following surgical resection of cancer. 1564 7

Here, a case of a patient with incidental finding of a carcinoid tumor of the ampulla of Vater, who was treated with endoscopic snare papillectomy, is reported. A 62-year-old male was admitted to our hospital due to a carcinoid tumor of the ampulla of Vater, which was found during follow-up endoscopy after an endoscopic mucosal resection of early gastric cancer. No lymphadenopathy or visceral metastasis was found on an abdominal CT scan, In-111 octerotide scan and EUS. The ampulla was then en bloc removed by endoscopic snare papillectomy. The resected specimen revealed a 0.7 x 0.5 x 0.1 cm sized carcinoid tumor. All margins of resection were negative for tumor. After six months of follow-up, there was no evidence of recurrence and metastasis, either endoscopically or radiologically. To our knowledge, this case is the first report of an ampullary carcinoid tumor treated by endoscopic snare papillectomy in Korea.
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PMID:A carcinoid tumor of the ampulla of Vater treated by endoscopic snare papillectomy. 1568 15

The rapid dissemination of multidetector-row computed tomographic (CT) technology will make faster and more accurate gastric imagining available. Two-dimensional multiplanar reconstruction and CT gastrography including virtual gastroscopy and transparency rendering using volume rendering are types of interactive two- and three-dimensional medical imaging tools. It provides multiplanar cross-sectional imaging, gastroscopic viewing, and upper gastrointestinal series imaging in the same data acquisition. Two-dimensional multiplanar reconstruction provides accurate staging of gastric cancer and extraluminal information such as lymphadenopathy and distant metastasis. Virtual gastroscopy detects subtle mucosal changes and differentiates them from submucosal lesions in the same way as gastroscopy. Transparency rendering provides global orientation of the focal findings in the stomach in the same way as upper gastrointestinal series findings and provides useful information for preoperative mapping. Thus, CT gastrography is a promising method for evaluating gastric lesion despite its limitations.
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PMID:CT gastrography. 1613 37


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