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)

Renal carcinoma metastases to the gastrointestinal tract are seldom reported in medical literature. The study presented a case of a 76-year old female patient who underwent nephrectomy, due to T2N0M0 clear cell renal carcinoma and was additionally diagnosed with two metachronous metastases to the gall-bladder and pancreas. Abdominal ultrasound performed 32 months after nephrectomy demonstrated the presence of cholelithiasis and gall-bladder polyp. Laparoscopic cholecystectomy was performed. Clear cell renal carcinoma metastasis restricted to the gall-bladder mucosa was diagnosed on the basis of the histopathological examination. After surgery the patient remained under follow-up. In December, 2009 (47 months after nephrectomy) abdominal computer tomography (CT) revealed the presence of a tumor located in the tail of the pancreas. Distal pancreatic resection and splenectomy was performed. The histopathological examination confirmed the presence of clear cell renal carcinoma metastasis. The patient is in good general condition, under follow-up at the Oncological Outpatient Clinic.
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PMID:Renal carcinoma metachronous metastases to the gall-bladder and pancreas--case report. 2284 44

Cholangiocarcinoma is the second most common primary malignant tumor of the liver. Perihilar cholangiocarcinoma or Klatskin tumor represents more than 50% of all biliary tract cholangiocarcinomas. A wide range of risk factors have been identified among patients with Perihilar cholangiocarcinoma including advanced age, male gender, primary sclerosing cholangitis, choledochal cysts, cholelithiasis, cholecystitis, parasitic infection (Opisthorchis viverrini and Clonorchis sinensis), inflammatory bowel disease, alcoholic cirrhosis, nonalcoholic cirrhosis, chronic pancreatitis and metabolic syndrome. Various classifications have been used to describe the pathologic and radiologic appearance of cholangiocarcinoma. The three systems most commonly used to evaluate Perihilar cholangiocarcinoma are the Bismuth-Corlette (BC) system, the Memorial Sloan-Kettering Cancer Center and the TNM classification. The BC classification provides preoperative assessment of local spread. The Memorial Sloan-Kettering cancer center proposes a staging system according to three factors related to local tumor extent: the location and extent of bile duct involvement, the presence or absence of portal venous invasion, and the presence or absence of hepatic lobar atrophy. The TNM classification, besides the usual descriptors, tumor, node and metastases, provides additional information concerning the possibility for the residual tumor (R) and the histological grade (G). Recently, in 2011, a new consensus classification for the Perihilar cholangiocarcinoma had been published. The consensus was organised by the European Hepato-Pancreato-Biliary Association which identified the need for a new staging system for this type of tumors. The classification includes information concerning biliary or vascular (portal or arterial) involvement, lymph node status or metastases, but also other essential aspects related to the surgical risk, such as remnant hepatic volume or the possibility of underlying disease.
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PMID:Risk factors and classifications of hilar cholangiocarcinoma. 2391 7

Gallbladder cancer is found in about 1-2% of patients after laparoscopic cholecystectomy and it is difficult to diagnose preoperatively. Laparoscopic cholecystectomy may disseminate gallbladder cancer to peritoneum and even port sites. Here, we present a case of a 59-year-old female patient operated for gallstone disease and her histopathology was suggestive of well-diffentiated gallbladder carcinoma (T1N0M0). Patient presented to us with port site and distant peritoneal metastases after 3 months.
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PMID:Port site and peritoneal metastases after laparoscopic cholecystectomy for incidentally found gallbladder carcinoma. 2451 39

Carotid body paragangliomas are neuroendocrine cell tumors. Most invade locally to surrounding tissues with metastases being less commonly encountered than with other tumors: a minority of tumors metastasizes to distal sites. Spread is more unusual after surgical removal of the primary tumor. Hepatic spread is very rare but has been documented. We report a case of a clinically silent metastatic paraganglioma identified during an evaluation for choledocholithiasis. We describe a 70-year-old female presenting with symptoms of abdominal pain who was found to have cholelithiasis and choledocholithiasis. MRI imaging performed during evaluation revealed enhancing liver and lung lesions suspicious for metastasis. FNA of a hepatic lesion showed paraganglioma. She had a remote history of bilateral carotid body tumors, of which the left tumor was resected in 2005. This is a rare case of metastatic carotid body paraganglioma. Primary tumor source was a resected tumor or a smaller sized nodule that was managed with serial imaging. The subject's lack of symptoms and her disease extent with confirmed hepatic and presumed pulmonary spread is unique.
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PMID:Metastatic carotid body paraganglioma detected during evaluation for biliary stone disease. 2461 Jul 53

Hepatic cavernous hemangioma accounts for 73% of all benign liver tumors with a frequency of 0.4-7.3% at autopsy and is the second most common tumor seen in the liver after metastases. Patients affected by hemangioma usually have their tumor diagnosed by ultrasound abdominal examination for a not well defined pain, but pain persist after treatment of the hemangioma. The causes of pain can be various gastrointestinal pathologies including cholelithiasis and peptic ulcer disease.The malignant trasformation is practically inexistent. Different imaging modalities are used to diagnosis liver hemangioma including ultrasonography, computed tomography (CT), magnetic resonance (MR) imaging, and less frequently scintigraphy, positronemission tomography combined with CT (PET/CT) and angiography. Imaging-guided biopsy of hemangioma is usually not resorted to except in extremely atypical cases. The right indications for surgery remain rupture, intratumoral bleeding, Kasabach-Merritt syndrome and organ or vessels compression (gastric outlet obstruction, Budd-Chiari syndrome, etc.) represents the valid indication for surgery and at the same time they are all complications of the tumor itself. The size of the tumor do not represent a valid indication for treatment. Liver hemangiomas, when indication exist, have to be treated firstly by surgery (hepatic resection or enucleation, open, laproscopic or robotic), but in the recent years other therapies like liver transplantation, radiofrequency ablation, radiotherapy, trans-arterial embolization, and chemotherapy have been applied.
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PMID:What is changing in indications and treatment of hepatic hemangiomas. A review. 2492 3

Metastases to the spleen are rare and are generally part of a multi-visceral metastatic disease. The most common sources of splenic metastases include breast, lung and colorectal malignancies as well as melanoma and ovarian carcinoma. Solitary splenic metastasis is very uncommon. We present a case of a 44-year-old man who presented at our department for gallstones symptoms. He had a past medical history of neck cutaneous melanoma (T3bN0M0--Stage IIb). He had not attended follow-up schedule for personal reasons. However, abdominal ultrasound revealed the presence of a solitary solid lesion in the spleen. Preoperative workup was completed with CT scan that confirmed the presence of a large splenic lesion with subcapsular fluid collection, also compatible with a post-traumatic lesion.Preoperative findings could not exclude malignancy and patient was therefore submitted to surgery. At laparoscopy, a condition of peritoneal melanosis was present. Splenectomy was carried out. Histological report confirmed the peritoneal melanosis and the diagnosis of metastatic spleen lesion from melanoma. Patient was observed, but died of metastatic disease 14 months after surgery. Splenic metastases are uncommon. Isolated metastases from melanoma are rare and could be found several months after primary diagnosis of melanoma. Surgery remains the most effective treatment, especially for metachronous disease, offering the best chance of long-term survival. Prognosis remains poor, as metachronous disease is indicative of aggressive widespread of the disease.
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PMID:An uncommon presentation of metastatic melanoma: a case report. 2570 Mar 6

A 61-year-old woman was referred to our hospital for surgery for gallstones. She was diagnosed as having gallbladder cancer after a detailed radiologic examination. At the first laparotomy, gallbladder cancer with bulky invasion to the liver and multiple liver metastases were observed. Gemcitabine plus cisplatin (GC) administration was chosen. After 7 administration of GC, we changed GC to gemcitabine alone due to blood toxicity. After 7 months of chemotherapy, although CT findings showed regression of the liver invasion and the liver metastases, the serum CA19-9 level gradually increased. Because there were no obvious distant metastases on detailed radiologic examination, we performed surgery for the primary lesion after obtaining informed consent. Pathological examination demonstrated fibrosis without viable cancer cells in the metastatic liver tumor. Gemcitabine was administered as post-operative adjuvant chemotherapy. Twelve months after surgery, there was no sign of recurrence.
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PMID:[Resection of Initially Unresectable Gallbladder Cancer with Multiple Liver Metastases after Chemotherapy with Gemcitabine plus Cisplatin]. 2680 76

Pneumobilia, or air within the biliary tree, is a poor prognostic indicator in a patient without prior biliary sphincterotomy. Differential diagnosis includes infection with gas-forming organisms, choledochoenteric fistula in the setting of gallstones or penetrating ulcer disease, malignant invasion from a primary liver or biliary tract tumor, or metastatic disease. Treatment depends on etiology and patient factors, but often requires surgical intervention. We report a patient with gastrointestinal bleeding in whom pneumobilia was incidentally noted on abdominal plain film. Computed tomography and endoscopy revealed the biliary-enteric fistula to be caused by metastatic colon adenocarcinoma invading the biliary tree.
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PMID:Pneumobilia Resulting From Choledochoduodenal Fistula Secondary to Metastatic Colon Adenocarcinoma. 2695 63

Gangliocytic paraganglioma (GP) is a rare neuroendocrine tumor almost exclusively found in the ampulla. It is considered nonfunctioning in the literature. We herein report the first case of functioning GP arising in the ampulla. Our patient had a constellation of ampullary neuroendocrine tumor, flushing, diarrhea, weight loss, diabetes mellitus, and cholelithiasis, consistent with effects of serotonin and somatostatin that were overexpressed by the ampullary neuroendocrine tumor. The serum serotonin level was elevated. Immunostaining confirmed somatostatin expression by the epithelioid cells and ganglion-like cells of GP. After surgical resection of the tumor, the patient became euglycemic. However, computed tomography (CT) scan 3 months post-surgery showed regional lymphadenopathy suspicious for residual/recurrent/metastatic disease. In the interim, his flushing and hyperglycemia recurred and worsened. Increased awareness about the functioning potential of GP is important so that the underlying pathophysiologic link is not overlooked and patients are appropriately managed. Moreover, we describe the cytologic features that help make the preoperative diagnosis, and these have not been previously described.
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PMID:Functioning gangliocytic paraganglioma of the ampulla: clinicopathological correlations and cytologic features. 2703 8

A 52-year-old woman with follicular thyroid carcinoma presented for ablative radioiodide and whole body I-131 imaging following subtotal thyroidectomy. An abnormal focus of increased activity was present in the region of the gallbladder fossa, persistent on delayed imaging. Subsequent CT revealed no hepatic metastases. Contemporaneously, the patient described right upper quadrant abdominal pain. Abdominal ultrasound demonstrated cholelithiasis. Cholecystectomy revealed extensive cholelithiasis and evidence of chronic cholecystitis; no hepatic metastases were identified. This case demonstrates the potential pitfall of gallbladder activity on I-131 whole body imaging secondary to cholecystitis mimicking hepatic metastases.
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PMID:Gallbladder Visualization on I-131 Post-Ablative Whole Body Imaging Mimicking Hepatic Metastases. 2730 24


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