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

Carcinoma of the gallbladder is an uncommon, but not rare tumor that is associated with a 5% five-year survival rate after resection and this rate has not appreciably improved over the last decades in most series. Nevin et al.(20) however have reported that favorably staged gallbladder cancers (according to histologic grade and depth of invasion) have a relatively good prognosis. They quoted an overall five-year survival of 21% in 66 patients. Most of the surviving patients (11) were in the favorably staged category: Stage I (intramucosal cancer) and Stage II (invasion of mucosa and muscularis). The remaining few were in Stage III (invasion of all layers), Stage IV (cystic node metastases), or Stage V (extension of metastases to the liver or distant sites). Our data has been analyzed to determine whether microstaging of the primary cancer will select out a subgroup with a favorable prognosis, and whether there are survival benefits according to the type of surgical resection. A clinical and pathologic review was done of 100 patients treated at the University of Virginia Hospital from 1930 to 1978. There were 77 women and 23 men, with an average age of 65 years (range 21-89). Gallstones were described in 78% of the patients. Surgical procedures included cholecystectomy alone (23 patients), cholecystectomy with biliary drainage (17 patients), cholecystectomy and resection of the hepatic bed (8 patients), and exploration with biopsy or bypass (44 patients). Autopsy only was done in eight patients. There were only three long-term survivors (6 years, 11 years, and 24 years). Median survival was six months with cholecystectomy alone, five months with cholecystectomy and bypass, 14 months after partial liver resection, and 2.0 months after laparotomy/bypass/biopsy. The five-year survival rate was 5% after cholecystectomy alone or with bypass, and 13% (1/8) after cholecystectomy and partial liver resection (p = 0.07). Microstaging of the primary cancers showed no prognostically favorable subgroup. Of 46 patients with microstaged lesions, only 13% were in the very favorable Stage I and II groups (only one of six survived), 46% were Stage III (1/21 survived), and the remaining 41% were in the highly unfavorable Stage IV and V groups (1/19 survived). Most patients showed progression of disease either primarily or secondarily that was locoregional (liver and nodes). Although longterm survival may accompany cholecystectomy alone for a favorable early-staged cancer, this is still uncommon. There may be theoretical, although not proven, merit for resection of the hepatic bed and regional node dissection in the selected patient, possibly complimented by adjuvant therapy. Future advances in chemotherapy and radiation will be needed to augment the current poor cure rate of this disease.
 ...
PMID:Is carcinoma of the gallbladder a curable lesion? 707 60

This study demonstrates the presence of three antigens in glandular metaplasia occurring in patients with cholecystitis and cholelithiasis: specifically carcinoembryonic antigen (CEA), large intestinal mucin antigen (LIMA) and small intestinal mucin antigen (SIMA). These antigens could not be detected in normal gall bladder mucosa or in squamous metaplasia of the gall bladder. The occurrence of the three intestine-associated antigens in three carcinomas was irregular. In one mucinous carcinoma, only SIMA could be demonstrated. In one adenocarcinoma, SIMA was present in small areas of mucinous change, whilst CEA was present in the non-mucinous malignant tissue. In a mixed mucinous and non-mucinous adenocarcinoma with widespread dissemination, the three antigens were present both in the primary tumour and the metastases. These observations suggest that all forms of glandular metaplasia of the gall bladder are intestinal in nature and at least a proportion of gall bladder carcinomas are of an intestinal type. Finally they provide further immunological evidence that glandular metaplasia of the gall bladder should be considered a pre-malignant condition.
 ...
PMID:Inappropriate mucin production in gall bladder metaplasia and neoplasia--an immunohistological study. 723 50

In three successive papers the clinical, diagnostic and surgical possibilities of biliary tract carcinoma are discussed on the base of 119 patients, undergone operation at the Chair of Abdominal Surgery for the period 1952-1979: 52 (44%) with gallbladder carcinoma, 48 (40% with biliary ducts carcinoma and 19 (16%) with duodenal papilla carcinoma. The authors report that gallbladder carcinoma is most frequent - 4.4 per cent of all biliary operations. The ratio males: females is 1:3 and the highest number of the patients is over the age of 60. The diagnosis is usually made with 6 months later due to the atypical clinical picture, progressing under the mask of cholelithiasis, found in 70-100 per cent of the cases. That is the reason in 5 per cent of the cases that carcinoma involved the whole gallbladder, metastases and infiltration of the adjacent organs being frequent. Resectable proved to be only 9 patients, the mortality rate kept high. A complex diagnostics is recommended with present-day methods and early prophylactic cholecystectomy in case of calculosis.
 ...
PMID:[Biliary tract carcinomas. I. Gallbladder cancer]. 732 51

A diffuse neoplastic peptide-microcarcinoidosis, concentrated in the oral half of the stomach, with 3 small invasive mucosal carcinoids without metastases, was found in a 55 years old woman with a healed duodenal ulcer, cholelithiasis, and obsolete chronic cholecystitis and gastritis. The findings are to be considered within limits as malignant. The only sure hormonal consequence of the microcarcinoidosis was hyperthrophy of the muscularis propria et mucosae (perhaps a Motilin effect?), which was also seen in a previous case. In the clinical picture the symptoms of a chronic gastritis were obscured by gall-stone attacks. The case is of clinical interest as it shows that a diffuse microcarcinoidosis can occur together with one or serveral small gastric carcinoids which have been detected by biobsy and histology. For clarification new biopsies have to be performed.
 ...
PMID:[A further case of gastric microcarcinoidosis (author's transl)]. 746 77

Many complications following laparoscopic cholecystectomy have been reported. We report a case of delayed peritoneal and retroperitoneal abscesses caused by spilled gallstones from a laparoscopic cholecystectomy performed 1 year earlier. This diagnosis was suggested only at sonography because the aggressive behavior of the lesions containing nonopaque gallstones suggested, by computed-tomography scan, peritoneal metastatic disease.
 ...
PMID:Delayed peritoneal and retroperitoneal abscesses caused by spilled gallstones: a complication following laparoscopic cholecystectomy. 762 Apr 10

Overexpression of the c-erbB-2 proto-oncogene has been shown to correlate with relapse and poor prognosis in adenocarcinomas of the breast and stomach. In pancreatic cancer, c-erbB-2 overexpression has been demonstrated using immunohistochemistry, but the relationship between serum c-erbB-2 level and clinical data has not been fully evaluated. In this study, serum c-erbB-2 protein levels were measured in 100 patients with pancreatic adenocarcinomas and in 9 patients with mucin-producing tumors. Immunohistochemical studies for c-erbB-2 protein were performed in 36 patients and 4.0 U/ml in healthy controls (p < 0.001). The positive rate for serum c-erbB-2 was 34% (37/109) in patients with pancreatic cancer and 0% (0/66) in patients with gallstones and in healthy controls (p < 0.001). Immunohistochemical study disclosed that the positive staining rate was 28% (8/29) in common ductal adenocarcinoma specimens, 43% (3/7) in metastasis specimens, and 75% (3/4) in mucin-producing tumor specimens. Clinical evaluation revealed that 59% (22/37) of serum c-erbB-2-positive patients and 33% (24/72) of negative patients had liver or peritoneal metastases (p < 0.01). The mean survival time was 154 days in the c-erbB-2-positive group and 220 days in the negative group (p < 0.05). We suppose that c-erbB-2 is related to metastasis and progression of the disease in patients with advanced pancreatic cancer.
 ...
PMID:Elevated serum c-erbB-2 protein levels in patients with pancreatic cancer: correlation to metastasis and shorter survival. 763 57

MR imaging has a distinct role to play in two areas of hepatobiliary imaging that continue to challenge the radiologist--evaluation of the gallbladder and evaluation of the jaundiced patient. The distinction between primary gallbladder carcinoma and chronic cholecystitis remains a diagnostic dilemma for all cross-sectional imaging modalities. MR imaging may be useful in detection of local invasion or metastatic disease. Gallstones are commonly seen coincidentally on cross-sectional imaging studies; the imaging characteristics of gallstones must be well-understood for the interpretation of routine abdominal MR examinations. The evaluation of jaundice is a multimodality process, often requiring three or four separate imaging techniques to determine the cause of biliary obstruction. MR may supplant more invasive techniques for anatomic depiction prior to therapeutic intervention.
 ...
PMID:MR imaging of the biliary system. 776 42

Although clear cell carcinomas have been described in numerous anatomic sites, their occurrence in the gallbladder and extrahepatic bile ducts (EHBD) is practically unknown. We report 10 such cases. Seven arose in the gallbladder and three in the EHBD; all patients with gallbladder tumors were females with cholelithiasis whose ages ranged from 56 to 68 years. Patients with EHBD tumors were younger (38 and 40 years of age) and had extrahepatic biliary obstruction and abdominal pain. Two patients with gallbladder carcinomas had elevated serum carcinoembryonic antigen (CEA) levels, and another without hepatic involvement had markedly elevated circulating levels of alpha-fetoprotein (AFP). Histologically, nine tumors were adenocarcinomas and one was a squamous cell carcinoma. Seven adenocarcinomas consisted of cords, sheets, nests, papillae, and trabeculae of clear cells with well-defined cytoplasmic borders. Two were composed predominantly of glands and papillary structures. The cells contained PAS-positive diastase-labile granules and were cytokeratin- and EMA-positive and immunoreactive for erythropoiesis-associated antigen. One gallbladder tumor contained areas of hepatoid differentiation, a feature described in gallbladder neoplasms only once before. These areas were AFP-positive and immunoreactive for CEA. By electron microscopy, they showed hepatoid differentiation with formation of bile canaliculi. In two gallbladder tumors, neoplastic cells contained subnuclear vacuoles reminiscent of early secretory endometrium. Foci of conventional adenocarcinoma or mucinous carcinoma were recognized in all nine tumors. The squamous cell carcinoma showed only foci of squamous differentiation with keratinization. The clear cells of this neoplasm had a trabecular and solid growth pattern. These clear cell neoplasms of the gallbladder and EHBD must be differentiated from metastatic renal cell carcinoma, based upon the presence of areas of conventional adenocarcinoma or foci of squamous differentiation since results of special stains and immunohistochemistry are similar in both neoplasms. One of the patients with EHBD carcinoma is alive and symptom-free 6 years following right hepatic lobectomy. Five patients with gallbladder tumors had direct extension into the liver and died with metastases. Two are living with metastases.
 ...
PMID:Clear cell carcinomas of the gallbladder and extrahepatic bile ducts. 780 41

Although carcinoma of the gallbladder has a low overall prevalence, it is the most common malignant tumor of the biliary tract. Retrospectively, 59 cases of histologically proved gallbladder carcinoma were reviewed. The series consisted of 42 women and 17 men, ranging in age from 35 to 86 years. Clinical manifestations of gallbladder carcinoma include right upper quadrant pain, anorexia, weight loss, and jaundice. Radiologic findings included focal or diffuse thickening of the gallbladder wall (49%), a mass in the gallbladder fossa (37%), and an intraluminal mass (14%). Associated findings were cholelithiasis (64%), biliary duct dilatation (38%), invasion of the adjacent structures (67%), distant metastases other than those of the liver (3%), and porcelain gallbladder (4%). The histologic diagnoses were adenocarcinoma (90%) and squamous cell carcinoma (10%). Differential diagnoses include all conditions in which the gallbladder wall appears thickened. A general awareness of the radiologic features of gallbladder carcinoma enhances preoperative diagnoses.
 ...
PMID:Imaging of gallbladder carcinoma. 819 Sep 55

Oat cell carcinomas arising in the gallbladder are an extremely rare and aggressive form of gallbladder cancer. These neoplasms are morphologically identical to their pulmonary counterparts, contain neurosecretory granules on ultramicroscopic examination, and demonstrate immunohistochemical staining for cytokeratin, neuron-specific enolase, and other neuroendocrine markers. Oat cell carcinomas typically occur in elderly women with cholelithiasis, and pursue a fulminant course with extensive metastases, especially to the liver. The mean survival is less than 7 months. We present a well-documented case of oat cell carcinoma of the gallbladder and review the literature on this unusual entity.
 ...
PMID:Oat cell carcinoma of the gallbladder. A rare and highly lethal neoplasm. 821 21


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>