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)

Seventy-five patients with advanced abdominal carcinoid tumors (65 midgut, 10 others) have been examined retrospectively to evaluate the role of surgical treatment as a principle, irrespective of stage of disease. Eighteen of 52 patients (35%) exhibited the carcinoid syndrome. Two or more primaries were found in 39% of patients with midgut lesion, 81% of these patients had regional metastases, 5% of these patients had distant lymph node metastases, and 74% of the patients had liver secondaries. All patients underwent operation, an additional 34% of the patients had a further reoperation, 9% of the patients had a second reoperation, 3% of the patients had a third reoperation, and one patient (2%) had a fourth reoperation. Intraoperative debulking (liver excluded) was performed in 33% of the patients, and 48% of the patients had treatment (resection, hepatic artery ligation, embolization) directed at the liver. The postoperative mortality rate was 2% after the primary operation for midgut lesions. The median survival for midgut tumors was 92 months, compared to 40 months for other lesions (not significant). A significantly higher survival rate was revealed for those patients with midgut lesion who were undergoing intraabdominal debulking procedures (liver excluded); median survival was 139 months versus 69 months without debulking. For those patients with liver metastases, median survival after intervention was 216 months and 48 months without such treatment (p less than 0.001). It is concluded that resection of intraabdominal carcinoid tumor masses can be performed in a high proportion of patients. Despite the retrospective, uncontrolled nature of this study, the difference in survival probabilities in favor of aggressive surgical therapy is so marked that it is not unreasonable to conclude that surgery has played a role in prolonging life in these patients.
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PMID:Surgical treatment as a principle in patients with advanced abdominal carcinoid tumors. 172 75

Metastasis of one tumor to another is an intriguing and rare phenomenon. Lung and breast malignancies are common donor tumors, while renal cell carcinoma and meningioma serve as frequent recipients. We report a case of malignant carcinoid of the ileum with metastasis to adenocarcinoma of the ovary. Histologic examination of the ovary showed a clear dimorphic pattern consisting of uniform polygonal cells arranged in an insular pattern and highly pleomorphic epithelioid cells forming small glands or solid nests. Immunocytochemical studies firmly established the distinct identity of the two tumors.
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PMID:Malignant ileal carcinoid with metastasis to adenocarcinoma of the ovary. 174 3

A patient with asymptomatic histologically proven extensive hepatic metastases of carcinoid tumour had no progression of disease for over 4 years without specific treatment. Throughout a normal pregnancy the hepatic metastases remained stable by clinical, computerized tomography and biochemical criteria.
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PMID:Metastatic carcinoid tumour: stability throughout pregnancy. 175 80

A primary carcinoid tumour of the testicle without carcinoid syndrome was recorded from a patient aged 48 years. The tumour was made up of solid and acinar structures which exhibited strongly pronounced argyrophilia. Teratogenic structures were not established. Neuron-specific enolase (NSE) and chromogranin were immunohistologically recorded from tumour cells. The carcinoid had not spread metastases. Semi-castration was chosen as therapeutic approach. Orchidectomy was not followed by complications.
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PMID:[Primary carcinoid of the testis]. 176 90

One of the rare cases in which metastases of a carcinoid tumor infiltrate the aortic wall is reported. Cross-clamping the descending aorta and en-bloc resection of the tumor and the descending aorta were possible. The postoperative course was uneventful.
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PMID:Carcinoid tumor invading the thoracic aorta: en-bloc resection. 178 20

Our experience with [131I]metaiodobenzylguanidine (131I-MIBG) therapy in two patients with carcinoid tumor is described. These patients were selected because of multiple areas of uptake on 131I-MIBG scan, consistent with the extent of the disease. Both patients presented diarrhea and liver metastases. Para-aortical lymphonodes and skeletal metastases were present in the first and the second patient, respectively. Previous treatment involved r-alpha-interferon, surgery or radiotherapy. In both cases 131I-MIGB therapy was started in December 1990 and is still continuing. No haematologic or hepatic side-effects have been observed. Mild hypotension (90/60 mmHg) occurred in one patient during the first course of therapy and was resolved by corticoid treatment. A stabilization of disease and a progressive reduction of diarrhea have been observed in both patients. In the second patient an initial decrease in liver metastases was confirmed by ultrasonography 7 months after the beginning of therapy.
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PMID:[131I]metaiodobenzylguanidine therapy in carcinoid tumors. 182 55

In patients with midgut carcinoid tumors a curative, radical tumor removal should be attempted when possible. As these tumors are generally malignant, irrespective of size, the radical surgery implies that intestinal resection for excision of a primary tumor should be combined with an extended mesenteric resection. When the patients present with the carcinoid syndrome the disease is, with few exceptions, too advanced for curative surgery. However, surgery often has to be performed also in patients with the advanced carcinoids. Patients with more extensive disease may thus benefit from surgical debulking of large mesenteric or hepatic metastases. Moreover, when the patients present with abdominal symptoms it is important to exclude a threatening major abdominal complication, such as intestinal obstruction or ischemia. As these complications may cause malnutrition and deterioration, it is important to treat them properly, sometimes by repeated surgery.
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PMID:Abdominal surgery in patients with midgut carcinoid tumors. 185 12

Carcinoid tumors of the stomach are rare (0.4% of all malignancies of the stomach). Long-lasting hypergastrinemia, most often due to chronic atrophic gastritis, leads to hyperplasia of ECL-cells in the gastric fundic mucosa with consequent dysplasia or neoplasia. Between 1974 and 1988 four patients underwent surgical treatment after diagnosis of a gastric carcinoid tumor. One patient was treated by local excision, two by subtotal resection and one patient underwent complete gastrectomy. None of the patients had local or distant metastases or died in the follow-up period due to tumor progression. The different approaches to surgical therapy are discussed.
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PMID:[Carcinoid tumor of the stomach--aspects of surgical therapy]. 186 Mar 53

In this study the relationship between the initial clinical presentation and the extent of tumor progression was determined in a group of 31 patients with carcinoid tumors. The proportion of patients with symptomatic tumors was similar to those patients with carcinoid tumors that were incidentally found (55% versus 45%; SE = 0.089). Symptoms were caused by metastatic tumor in nine (30%) of the patients and by local effects of the primary tumor in eight (26%) of the patients. The patients with symptoms had a significantly increased frequency of metastatic disease, even when the symptoms were due to the primary tumor, compared to patients with no symptoms (76% versus 7%; p less than 0.001). Tumor size was related to the presence of symptoms and metastases. Symptoms were most common when the size of the primary tumor was greater than 1.0 cm (p less than 0.005), although the rate of metastases increased when primary tumors were 2.0 cm and larger (p less than 0.01). These results indicate that the presence of symptoms or a primary tumor 2.0 cm or larger are associated with an increased risk of metastatic disease in patients with carcinoid tumors. These patients should be treated with wide resection of the primary tumor and its lymphatic drainage.
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PMID:Carcinoid tumors: the relationship between clinical presentation and the extent of disease. 186 95

A 39-year-old woman with a primary carcinoid of the common bile duct is presented. The tumor showed argyrophilia; and, by immunohistochemical studies, chromogranin, serotonin, and somatostatin were demonstrated. The patient has no symptoms 42 months after surgical treatment. To the authors' knowledge, this is the first report of a carcinoid of the common bile duct as studied by immunohistochemistry. When six choledochal carcinoids were reviewed, the following characteristics were observed: in none of the cases were endocrine symptoms present; women were affected more frequently than men; the carcinoids occurred in younger patients than did adenocarcinomas; metastases were present in half of the patients; and, as a group, carcinoids seemed to have a better prognosis than adenocarcinomas in this location.
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PMID:Primary carcinoid of the common bile duct. Immunohistochemical characterization of a case and review of the literature. 187 30


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