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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Documented rarity, diagnostic difficulty and poor results stimulated this study of 79 malignant and 37 benign small bowel tumors in order to emphasize these lesions, determine their symptomatology and improve diagnosis and results, particularly in the malignant group. Chief symptoms were recurrent abdominal pain and tenderness, signs of obstruction and gastrointestinal bleeding. Fourteen cases were asymptomatic. The mean symptom-diagnosis interval was 6.6 months. Roentgenographic contrast studies were helpful in diagnosing 33 of 43 patients, with false negatives in 10. Laboratory studies were usually not helpful. Metastases were present at the time of surgery in approximately 58%. In the malignant group curative procedures were performed in 36 and palliative in 43, with an operative mortality of 10%. Five and 10 year survival rates were respectively 21/51 (41.2%) and 8/38 (21.2%) for malignancies. Individual 5 and 10 year survival rates were respectively as follows: carcinoid 11/15, 4/8; undifferentiated carcinoma 3/5, 1/3; lymphoma 3/11, 1/9; leiomyosarcoma 2/7, 1/6 and adenocarcinoma 2/13, 1/12. In the benign group results were excellent, except for one death from pulmonary embolism. The study suggests that if results with malignant small bowel tumors are to be improved, prompt diagnostic study and early consideration of laparotomy in patients with suggestive symptoms is mandatory.
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PMID:The small bowel tumor problem: an assessment based on a 20 year experience with 116 cases. 45 45

Carcinoid of the appendix occurred in 92 of 400,000 surgical pathology specimens covering 70 years, and followed previously reported incidences by age, sex, symptoms, size, localization and histology. Invasion of the mesoappendix occurred in 13 cases, and in two of these, a reoperative ileocolectomy demonstrated regional node metastases. No distant metastases or fatalities appeared. Tumor size correlated with mesoappendiceal invasion. Carcinoid invasion of the mesoappendix may provide a valuable marker for more distant tumor spread, and justify an aggressive surgical approach in selected patients.
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PMID:Carcinoid tumors of the appendix. Mesoappendiceal extension and nodal metastases. 46 79

A 63-year-old man developed a carcinoid tumor of the cardia with unusual metastases of the brain and a rapid lethal course. Clinical aspects of these tumors, their attachment to apudomas and their new morphologic respectively functional--morphologic aspects are discussed.
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PMID:[Gastric carcinoid with brain metastases--a casuistical report (author's transl)]. 49 66

Bronchial adenomas are a histologically and clinically diverse group of respiratory tract neoplasms arising from mucous glands and ducts of the tracheobronchial tree. They represent 1% of pulmonary malignancies. The traditional concept of a single, histologically benign form is challenged and the malignant potential of these tumors is stressed. Three main cell types with their characteristic histopathologic and clinical features are discussed: carcinoid, adenoid cystic carcinoma, and mucoepidermoid carcinoma. A case of bronchial carcinoid with hepatic metastases is reported, emphasizing the malignant potential of this controversial group of tumors. The appropriate diagnostic evaluation is outlined and aggressive surgical management is stressed. Chemotherapy and radiation therapy which are reserved mainly for palliation do not add to overall five year survival rates.
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PMID:Bronchial adenoma: a malignant misnomer. 51 20

A 28-year review of the records at Hines V.A. Medical Center revealed 17 primary epithelial tumors of the appendix. Five of these tumors were benign and 12 malignant. It is suggested that the term mucocele be abandoned, because it represents the end result rather than a definite pathologic entity. The majority of benign tumors and carcinoid tumors of the appendix are discovered incidentally to other procedures. The majority of adenocarcinomas cause symptoms and signs of appendicitis. Simple appendectomy is sufficient treatment of all benign tumors of the appendix, and for all carcinoids that show no gross local metastases and are less than 2 cm in diameter. Simple appendectomy followed by right hemicolectomy or initial right hemicolectomy is the treatment of choice for all carcinoids of the appendix that show gross local metastases and are 2 cm or more in diameter and for all adenocarcinomas of the appendix, whether mucinous or colonic, in the absence of distant metastasis. A new classification for primary epithelial tumors of the appendix is suggested.
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PMID:Primary epithelial tumors of the appendix and a reappraisal of the appendiceal "mucocele". 52 32

The ultrastructure, differential diagnosis, and biologic behavior of the peripheral pulmonary spindled carcinoid tumor are reviewed. Electron microscopy is useful in distinguishing the spindled carcinoid from a variety of neoplasms with similar histologic features. The spindled morphology is a rare expression of the carcinoid tumor that is almost exclusively confined to the lung periphery. It appears that the spindled carcinoid without atypical features is fully capable of regional lymph node metastases in approximately 20 per cent of the cases.
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PMID:Peripheral spindled carcinoid tumor: a review of its ultrastructure, differential diagnosis, and biologic behavior. 52 62

Using two angiographically well documented cases the angiomorphological features of intestinal carcinoid tumors are described. One case is a carcinoid of the terminal ileum with hepatic metastases, the other case a cecal carcinoid without distant metastases. The primary tumor of the second case is strikingly hypervascular--most primary carcinoid tumors heretofore described in literature were hypovascular. In both cases is the mesentery afflicted in the typical manner indicating spread to local lymph nodes. By reviewing the literature the pathophysiologic mechanisms causing the anatomic changes are explained.
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PMID:[About the angiographic diagnosis of intestinal carcinoids (author's transl)]. 64 95

The gastric carcinoid tumour is a rare variety of carcinoid characterized by atypical production of 5-hydroxytrytophane rather than serotonin. In our case it is likely that other polypeptides are the source of symptoms, though these are as yet unidentified. Since surgery was not feasible in the management of the hepatic metastases, we have used a non-operative technique of embolization to destroy the carcinoid secondaries and ameliorate symptoms. The patient tolerated this procedure well and improved dramatically, with remarkable diminution of liver size and the disappearance of all carcinoid symptoms. Destruction of hepatic secondaries without recourse to surgery has obvious advantages in severely ill patients. Careful attention should, however, be paid to the large quantities of pharmacologically active compounds released from the liver by the procedure.
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PMID:Diagnosis and management of gastric carcinoid tumour with hepatic metastases. 66 50

The angiographic features in 5 cases of carcinoid tumors of the small intestine are discussed. Findings included irregularity and narrowing of the distal mesenteric and intestinal arcade arterial branches, minimal parenchymal stain, and obstructed venous return. A stellate arterial configuration was not noted. In 2 cases in which epinephrine was employed, tumor staining of the primary lesions and their hepatic metastases was markedly enhanced. Possible mechanisms of action for the pharmacoangiographic effect of epinephrine are discussed.
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PMID:Angiographic evaluation of carcinoid tumors of the small intestine: the value of epinephrine. 80 75

Sixty-five patients seen at the Massachusetts General Hospital between 1951 and 1974 with carcinoid tumors of the gastrointestinal tract are reviewed. Sixty-two patients were operated upon, and only one carcinoid was discovered for the first time at autopsy. Although corrected actual five and ten year survival rates of more than 60% were attained, only one of 15 patients was alive five years after the discovery of liver metastases. Patients less than 60 years of age, with tumors of less than 0.5 centimeter in diameter and with no history of weight loss, survived best. Most rectal and appendiceal carcinoids were small, and there were no deaths in patients who had undergone local resection. Only 33% of the patients with small intestinal carcinoids survived for five years; none survived for more than one year after diagnosis of the carcinoid syndrome was made. All colonic carcinoids had metastasized by the time the operation was performed. Carcinoids of less than 0.5 centimeter in diameter located anywhere in the gastrointestinal tract can be managed by simple local resection. Tumors 1 centimeter in diameter warrant consideration of a more extensive operation. A radical excision usually is required for tumors of more than 2 centimeters in diameter, even in the presence of metastatic disease.
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PMID:Management of carcinoid tumors of the gastrointestinal tract. 87 42


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