Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Tumor metastasis to the pancreas is a rare but recognized cause of acute pancreatitis. Autopsy series have reported a 24-40% of pancreatic involvement in small cell lung cancer. However, only a very few cases of tumor-induced acute pancreatitis have been described. Budd-Chiari syndrome complicating lung cancer is a rarely reported condition. We report a 68-year-old woman with extensive small cell lung cancer with the unusual initial presentation of both acute pancreatitis and acute Budd-Chiari syndrome. This patient suffered from progressive epigastralgia for 3 weeks. Severe epigastralgia with radiation to back and progressive jaundice developed 2 days prior to admission. After admission, the liver enlarged rapidly and the ascites increased markedly. Chest roentgenogram showed a mass lesion over the left lower lung field. Poorly differentiated carcinoma cells were found in ascites and bone marrow. The patient died on the ninth day of hospitalization before chemotherapy was initiated. Prompt diagnosis of extensive-stage small cell lung cancer may allow early chemotherapy treatment which favorably influences recovery when the pancreatitis is mild. Although prolonged survival might have been expected had this patient recovered from pancreatitis and received chemotherapy, diagnosis was delayed due to difficulty in immunohistochemical diagnosis of the tumor and the unusual clinical presentation. The use of stains employing antibodies against neurofilament and neuron-specific enolase cell antigens is important for early diagnosis of poorly differentiated metastatic tumor cells.
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PMID:Acute pancreatitis combined with acute Budd-Chiari syndrome as the initial manifestation of small cell lung cancer. 1603 34

Composite tumors of the stomach consisting of mixed glandular and endocrine components are rare. We report 3 cases of composite glandular and endocrine tumors with pancreatic acinar differentiation in the stomach with their clinicopathologic findings. The patients' presenting symptoms were variable and included abdominal pain, gastrointestinal hemorrhage, and weight loss. One patient with abdominal pain also had an elevated serum lipase level, clinically mimicking acute pancreatitis. The histology of these tumors was similar. They showed admixture of well-differentiated endocrine components with acinar and glandular components. The glandular component consisted of columnar epithelial cells resembling gastric foveolar or intestinal goblet cells, consistent with a well-differentiated adenocarcinoma. A panel of histochemical and immunohistochemical stains was performed, which included PAS, Alcian blue, Mib1, CEA, cytokeratin 7, cytokeratin 20, Muc2, Muc5AC, chromogranin, synaptophysin, trypsin, chymotrypsin, lipase, insulin, gastrin, serotonin, and pancreatic polypeptide. While the immunoreactivity for cytokeratin 7, cytokeratin 20, Muc2, Muc5AC, and CEA was largely restricted to the glandular component, the endocrine and pancreatic acinar markers showed marked variability and overlap. All cases showed immunoreactivity for at least one of the exocrine pancreatic enzymes, and all expressed endocrine differentiation. Some degree of amphicrine differentiation was suggested in all cases. Two cases showed metastases in perigastric lymph nodes, which histologically resembled the primary tumor. In summary, these tumors represent another distinct type of composite glandular and endocrine gastric neoplasm with pancreatic acinar differentiation.
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PMID:Composite glandular and endocrine tumors of the stomach with pancreatic acinar differentiation. 1622 21

Pancreatic metastases are found in up to 40% of patients with small cell lung cancer, but metastasis-induced acute pancreatitis is rare. Treatment of metastasis-induced acute pancreatitis is initially supportive, but failure of conservative management are common. There are few reports on aggressive treatment with chemotherapy which lead to rapid clinical improvement and prolongation of survival in patients with metastasis-induced acute pancreatitis. We experienced a case of metastasis-induced acute pancreatitis in a patient with small cell lung cancer. Despite conservative treatment with dietary restriction and intravenous fluid supply, serum amylase levels increased persistently with severe abdominal pain. After chemotherapy with irinotecan and carboplatin, abdominal pain and serum amylase levels resolved dramatically.
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PMID:[A case of metastasis-induced acute pancreatitis improved by chemotherapy]. 1630 56

Hepatocellular carcinoma (HCC) is the fifth most common cancer in the world, and its incidence has increasing in the latest years. Recent advances in both, diagnosis and treatment, have improved the prognosis. Transarterial chemoembolization (TACE) is a therapeutic option, valid for patients who are not candidates for curative treatments, which has demonstrate to improve survival. Complications of TACE are very frequent and often severe. Postembolization syndrome is extremely frequent. Liver abscess, acute pancreatitis, acute cholecistitis, biloma, intestinal ischemia, gastroduodenal ulcerations and liver failure, are less frequent complications. Recently, it has been described an increasing risk of distant metastasis after transarterial chemoembolization. Most frequent metastasis are in the lung, abdominal lymph nodes, bone, and suprarenal glands. Metastases in nervous system, especially in clivus, are rarely. We report the case of a patient with hepatocellular carcinoma treated with transarterial chemoembolization who was diagnosed with metastasis in clivus.
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PMID:[Clivus metastasis from hepatocarcinoma associated with transarterial hepatic chemoembolization]. 1693 55

Lung cancer metastases can occur in almost any organ. However, metastasis of small cell lung cancer to the pancreas is rare. Moreover, not all cases present with clinically diagnosed pancreatitis. We recently treated a patient with small cell lung carcinoma that invaded the pancreatic duct causing acute pancreatitis. Generally, the treatment for tumor-induced acute pancreatitis is initially supportive followed by aggressive chemotherapy or surgery. If the patient can tolerate the insertion of an endoscopic intrapancreatic stent, this is performed in addition to chemotherapy and surgery; this approach offers a safe and effective treatment modality for such patients.
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PMID:Pancreatitis from metastatic small cell lung cancer successful treatment with endoscopic intrapancreatic stenting. 1724 10

The coexistence of pancreatic carcinoma with severe form of acute pancreatitis (AP) is not only an extremely rare phenomenon described in literature but also a real problem in the aspect of differential diagnostics of neoplastic and inflammatory morphological changes in this organ. The study objective was the analysis of clinical material obtained from patients with inflammatory and neoplastic lesions, treated surgically in I Department of General and Endocrinological Surgery, Medical University of Bialystok in the years 1980-2005. Of these patients, 7 had pancreatic carcinoma at various stages of advancement diagnosed in the late postoperative period after severe form of AP. Patients' history, physical examination as well as biochemical tests and imaging diagnostic procedures (ultrasonography, CT) of the abdominal cavity explicitly showed severe form of acute pancreatitis. In every case, CA19-9 antigen values were substantially elevated (mean 780 +/-325 IU/ml, norm 0-37 IU/ml). Histopathological analyses of samples collected during laparotomy revealed the presence of necrotic-purulent tissues. In the late postoperative period, i.e. 3-24 months, all these patients were reoperated on for pancreatic carcinoma or its metastases. Only in one case, radical Whipple surgery was performed. All the remaining patients underwent palliative procedures or samples for histopathological examinations were only collected. In all the seven cases, metastatic carcinoma was diagnosed, including pancreatic carcinoma in 6 patients. These observations seem to indicate that severe AP may be insidiously accompanied by pancreatic carcinoma and that this coexistence should always be taken into consideration.
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PMID:[Carcinoma and acute pancreatitis--case reports]. 1829 50

NUPR1, or p8 or com1, was first identified from rat pancreas during acute pancreatitis and later as a gene whose expression was upregulated in metastatic breast cancer cells. NUPR1 is a molecule whose expression is upregulated in response to stress and is hence influenced by the host microenvironment. While NUPR1 has been implicated in several diseases, there is no singular biochemical pathway that can be attributed to its role in cancer. NUPR1 has been found to aid the establishment of metastasis and to play a key role in the progression of several malignancies including those of breast, thyroid, brain and pancreas. NUPR1 has been implicated in inducing chemoresistance in pancreatic and breast cancer cells, protecting them from apoptosis and making tumor cells genetically unstable. In prostate cancer, however, NUPR1 appears to have tumor suppressive activity. Understanding the mechanism of action of the multifaceted functions of NUPR1 may open up new dimensions towards creating novel therapies against cancer as well as other pathologies. This review draws on several published studies on NUPR1, mainly in cancer biology, and assesses NUPR1 from the perspective of its functional role in making cancer cells resistant to the action of conventional chemotherapeutic drugs.
Cancer Metastasis Rev 2009 Jun
PMID:Emerging role of nuclear protein 1 (NUPR1) in cancer biology. 1915 68

Lung cancer is one of the most frequent neoplasms. The symptoms are due to the cancer itself, its extension, and associated paraneoplastic syndromes. Although biliopancreatic metastases are common, biliopancreatic involvement as the initial symptom of lung cancer--whether as pancreatitis or obstructive jaundice--is rare. We describe our clinical experience, reporting two patients with acute pancreatitis and one patient with obstructive jaundice as the clinical presentation of advanced lung cancer. We also provide a brief review that highlights the absence of guidelines in this situation.
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PMID:[Acute pancreatitis and obstructive jaundice secondary to metastases from lung cancer]. 1980 Jan 49

In 61 patients pancreaticoduodenal resection (PDR) was performed: for pancreatic gland head cancer-in 29, periampullar zone cancer--in 20, chronic pseudotumoral pancreatitis--in 12. In 10 patients, suffering pancreatic gland and periampullar zone cancer, complicated by solitary hepatic metastases, PDR was added by cryodestruction of metastases. Cryoaffection on pancreatic gland stump during PDR performance have resulted in lowering of early postoperative complications frequency (pancreatic fistula, parapancreatic septic inflammation and an acute pancreatitis) and of chronic pancreatitis acute phase evolvement risk in the late postoperative period. Cryodestruction of hepatic metastases have promoted the patients survival median increase.
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PMID:[Comparative efficacy of pancreatoduodenal resection using intraoperative cryo-techniques]. 2045 43

In this report, we describe a 31-year-old man in whom acute pancreatitis was the initial feature of a subsequently diagnosed pancreatic adenocarcinoma with multiple metastases. He initially presented at our hospital with acute pancreatitis. Abdominal ultrasonography revealed a mildly dilated pancreatic duct and an enlarged pancreatic head. Although a follow-up abdominal ultrasonography revealed a progressively dilated pancreatic duct and a progressively enlarged pancreatic head, he refused further investigation and was lost to follow-up. Four months later, he returned to our hospital with relapsed acute pancreatitis. Obstructive jaundice was noted and drainage was performed. Because choledochoplasty with multiple balloon catheters was not fully effective, biliary tract bypass surgery was carried out. Intraoperative biopsy confirmed pancreatic adenocarcinoma with multiple metastases. The patient died of massive gastrointestinal bleeding a few weeks later. To our knowledge, this is the youngest case of pancreatic cancer with the uncommon initial presentation of acute pancreatitis reported in the literature. For a patient with acute pancreatitis, particularly recurrent episodes, but with no known risk factors for pancreatitis, a pancreatic neoplasm should be considered as a potential underlying cause, even in a young man.
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PMID:Relapsed acute pancreatitis as the initial presentation of pancreatic cancer in a young man: a case report. 2070 57


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