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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Primary adenocarcinoma of the jejunum which accounts for only approximately 3% of all gastrointestinal tract malignancies, is distinctly unusual. Ovarian metastasis from a jejunal cancer is extremely rare. It has significant therapeutic and prognostic implications to differentiate primary ovarian carcinoma from metastatic disease to the ovary. A 49-year-old Japanese woman presented with intermittent nausea, vomiting, and palpable abdominal mass. Pelvic examination and imaging studies revealed a huge ovarian tumor, suspicious for malignancy. Upper GI series and barium enema were unremarkable. Exploratory laparotomy was done for presumed primary ovarian malignancy. Mucinous adenocarcinoma of the right ovary, measuring 25 x 18 x 12 cm, without other intraabdominal dissemination was found. Exploration of the upper abdomen revealed an annular constriction of the jejunum 30 cm distal to the ligament of Treitz. Partial jejunectomy with end-to-end anastomosis was done. Metastatic ovarian cancer from the primary jejunal adenocarcinoma was confirmed microscopically. Although small bowel malignancy is uncommon, small bowel follow-through examination or enteroclysis may be indicated in patients with positive stool for occult blood who have no abnormality in the upper gastrointestinal series and barium enema. In addition to the imaging studies, thorough exploration of the entire abdominal cavity is necessary at ceiliotomy in patients with ovarian malignancy to distinguish primary ovarian cancer from metastatic disease to the ovary.
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PMID:Primary jejunal adenocarcinoma masquerading as a primary ovarian malignancy. 778 80

This report describes mucus retention developing in heterotopic pancreas of the gastric antrum. This unusual complication of heterotopic pancreas was seen in a 54-year-old black man who presented with postprandial nausea, vomiting, and weight loss. Gastroscopy revealed a 2-cm pyloric polyp, which was seen to intermittently obstruct the pylorus. Exploratory laparotomy confirmed an intramural mass in the antrum with serosal thickening and nodules. Frozen-section examination of the serosal nodule revealed a pool of mucus containing epithelial clusters and chronic inflammatory cells with no verifiable pancreatic tissue. These findings suggested the possibility of a mucinous carcinoma involving the serosa. Following gastrectomy, however, heterotopic pancreatic tissue was identified in the outer muscular propria extending to the mucosa of the antrum with no evidence of carcinoma. This heterotopic pancreatic tissue showed ductal obstruction and mucus retention. As a result, some ducts were ruptured and transformed into small nodules of mucus lakes with clusters of residual ductal epithelium. We therefore concluded that the mucous extravasation nodules on the antral serosa represented a benign lesion resulting from mucus retention in the heterotopic pancreas. In contrast to mucinous carcinoma, these benign mucous extravasation nodules were closely associated with the heterotopic pancreas, and showed significant inflammation and fibrosis but no overt epithelial anaplasia. The significance of the mucous extravasation nodule in the heterotopic pancreas is its potential confusion with mucinous carcinoma.
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PMID:Mucus retention in heterotopic pancreas of the gastric antrum. A lesion mimicking mucinous carcinoma. 750 68

This article reviews the preliminary but encouraging clinical data obtained from patients with platinum-refractory clear cell or mucinous carcinoma of the ovary who were treated with a chemotherapy regimen including irinotecan hydrochloride (CPT-11). Twenty-five patients with platinum-refractory macroscopic disease of which histologic type was either clear cell or mucinous carcinoma were treated. CPT-11 was administered at a dose of 120 mg/m2 intravenously (i.v.) over 4 hours on days 1 and 15, and mitomycin-C (MMC) was given IV as a bolus at a dose of 7 mg/m2 on days 1 and 15. At least 2 cycles of this regimen, 4 weeks apart, were given to the 25 patients. After a median of 4 cycles (range 2 to 8), we observed objective responses in 13 patients (52%), with 5 complete responses (CRs; 20%) and 8 (32%) partial responses (PRs) (95% confidence interval, 32.4% to 71.6%, 4.3% to 35.7%, 13.7% to 50.3%, respectively). The median overall survival time for all 25 patients was 15.3 months (range 3.5 to 38.0). Median overall survival time of the responders was 33.7 months versus 6.1 months of the non-responders (Log-rank, P = 0.0003). The median progression-free survival times for patients obtaining CR, PR, and CR+PR were 31.8 months (range 12.9 to 34.4), 10.5 months (range 5.6 to 18.2), and 12.9 months (range 5.6 to 34.4), respectively. Toxic effects were acceptable and included manageable haematologic reactions, diarrhoea, nausea/vomiting, and alopecia.
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PMID:A phase II study of combined CPT-11 and mitomycin-C in platinum refractory clear cell and mucinous ovarian carcinoma. 991 34

Intraductal papillary-mucinous carcinoma of the pancreas has been reported with increasing frequency. We report a case with intraductal papillary-mucinous carcinoma of the pancreas and discuss surgical treatment and current imaging modalities. A case with intraductal papillary-mucinous carcinoma was analyzed by radiological findings and clinical course. A 47-year-old man developed abdominal pain and nausea. Computed tomography showed a diffusely dilated main pancreatic duct. Duodenoscopy showed a patulous orifice of the pancreas with massive mucus secretion, but the pancreatic juice was not positive for malignant cells. Endoscopic retrograde cholangiopancreatography revealed a markedly dilated pancreatic duct extending from the body to the tail of the pancreas. Distal pancreatectomy was performed with splenectomy and lymph nodes dissection. Histopathological diagnosis was intraductal papillary-mucinous carcinoma. Endoscopic retrograde cholangiopancreatography is useful for diagnosing intraductal papillary mucin-producing tumors. To avoid unnecessary total pancreatectomy and preserve pancreatic function, intraoperative frozen section examination is widely available for the surgical treatment of intraductal papillary mucin-producing tumors.
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PMID:A case of intraductal papillary-mucinous carcinoma of the pancreas with the onset of acute pancreatitis. 1206 2

Appendiceal carcinoma is a very rare clinical entity, constituting 1% of all colorectal malignancies and 1% of all appendectomy specimens. Appendiceal malignancies often present atypically, thus creating diagnostic challenges. We present a patient with mucinous carcinoma of the appendix who presented with hematuria and abdominal pain. Similar case reports are extremely rare in the literature, while typical presentations of appendiceal carcinoma include abdominal pain, abdominal mass, early satiety, nausea, and iron-deficiency anemia. Initially, the diagnostic investigation in our patient was focused on urinary tract disorders, but ultimately resulted in finding a mucinous appendiceal carcinoma. The carcinoma had invaded the urinary bladder and was disseminated in the peritoneal cavity. Aggressive cytoreductive surgery is the most common therapeutic approach for disseminated tumors, often followed by intraperitoneal chemotherapy. However, treatment should be individualized based on patient-specific parameters, such as the presence of comorbidities, performance status, as well as the presence of metastatic disease. Our patient had optimal cytoreduction with subsequent systemic therapy with 5-fluorouracil, leucovorin, oxaliplatin, and bevacizumab, a monoclonal antibody directed against vascular endothelial growth factor. She completed her treatment regimen without complications and is currently being restaged. An integrative approach is required in the diagnostic investigation and management of appendiceal malignancies.
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PMID:Appendiceal carcinoma: a diagnostic and therapeutic challenge. 1902 Mar 71

Mucinous adenocarcinoma of the small bowel is very rare, and only few cases have been described in the literature. Association of this tumor with celiac disease has never been published. The authors report a unique case of jejunal mucinous adenocarcinoma in which a concomitant celiac disease has been histologically recognized. The difficult diagnosis, the role of laparoscopic surgery and the relationship between small bowel tumors and celiac disease are discussed. A 49-year-old man presented with recurrent melena, nausea, vomiting and anemia. A stenosis of the jejunum was documented by means of CT scan and video capsule enteroscopy. A laparoscopy was scheduled. A tumor, found in the first jejunal loop, was removed by laparoscopic surgery. Histopathology revealed a rare mucinous adenocarcinoma associated with epithelial changes secondary to celiac disease. Although small bowel tumors are rare entity, in patients with celiac disease complaining of symptoms related to altered intestinal transit or occult bleeding, an appropriate work-up should be planned for diagnosis. Mucinous type intestinal adenocarcinoma, even if never published before, could be observed. Laparoscopic surgery is often essential for the diagnosis and treatment.
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PMID:Laparoscopic treatment of mucinous adenocarcinoma of jejunum associated with celiac disease. Case report. 2266 31