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

After cystoprostatectomy for cancer of the bladder 43 men were provided with a detubularized, low pressure ileal reservoir (Kock pouch) connected to the urethra. Reflux was prevented by an intussusception valve. There was no operative mortality and few early complications. At followup the mean postoperative observation time was 13 months, with a range of 5 to 20 months. Late complications included manifestations of local tumor recurrence or distant metastases in 9 patients within 6 months postoperatively, which made adequate functional evaluation impossible. In 18 patients reflux to the upper urinary tract due to eversion or sliding of the antireflux valve occurred at various postoperative intervals. In 16 of these patients incontinence developed as a consequence of the reflux. Surgical correction of the failing antireflux valve restored reflux prevention and continence. Within 3 to 6 months the capacity of the reservoirs had reached an ultimate volume of approximately 600 ml. Pressure waves exceeding 40 cm. water seldom occurred in the mature reservoirs and then only at high filling volumes. The mean urethral resting resistance to flow was 64 cm. water. The configuration and function of the upper urinary tract improved or stabilized postoperatively. Of 34 evaluable patients 30 were continent during the day with a voiding frequency of 3 to 5 times and dry at night with a frequency of 0 to 2.
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PMID:Replacement of the bladder by the urethral Kock pouch: functional results, urodynamics and radiological features. 270 96

A review of 60 patients with primary small bowel tumours seen at the University Hospital, Jamaica, during the 15 year period 1971-1985, revealed that adenocarcinoma was the commonest tumour (27%), followed by smooth muscle tumour (23%), and carcinoids (11%). There were 32 malignant and 28 benign tumours. The mean age at presentation was 56 years, with a range of 4 to 85 years. The most common clinical presentation was intestinal obstruction, followed by pain, weight loss, abdominal mass and intussusception. In the majority of patients the diagnosis was not made preoperatively, and 80% with adenocarcinoma had lymph node metastases. Increased awareness of the diagnosis in symptomatic patients may result in improved survival.
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PMID:Primary tumours of the small intestine in Jamaica. 320 47

This report describes unusual radiologic and pathologic findings in a patient with multiple small bowel metastases from squamous cell carcinoma of the lung. The diagnostic work-up revealed a large, pleural-based, right lung mass, a large left adrenal mass, two ulcerated small bowel masses, and a unique giant peduncular mass that caused intermittent intussusception. A pertinent review of the literature is presented.
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PMID:Intussusception secondary to squamous carcinoma of the lung. 329 35

A 55-year-old male patient who had melena and intussusception that proved to be due to malignant melanoma of the small intestine is described. History and close examination failed to show any evidence of a primary lesion. The diagnosis was made after a biopsy was performed on two lesions in the neck. This was followed by a palliative and incomplete resection of an involved ileal segment. The patient did not receive chemotherapy, radiotherapy, or immunotherapy. He is now alive 8 years after diagnosis without evidence of malignancy. This case represents spontaneous regression of malignant melanoma of the small intestine that is considered either a primary intestinal tumor or a metastatic tumor from an occult regressed primary. The latter assumption makes this case unique in that spontaneous regression occurred twice, once in the occult primary lesion and once in the intestinal metastases.
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PMID:Spontaneous regression of intestinal malignant melanoma from an occult primary site. 340 91

Malignant melanoma is the most common malignancy to metastasize to the gastrointestinal tract. In a retrospective computer-assisted data search of over 2500 patients with melanoma registered over the past 10 years, 110 patients have been identified to have premortem gastrointestinal metastatic disease (metastatic disease identified at least 6 months before death). The small intestine (35%), colon (14.5%), and stomach (7%) are the most common sites for metastases. Polypoid or ulcerating masses and intramucosal nodules are typical radiologic presentations for gastric and colonic lesions, while over 50% of the small bowel metastases are polypoid masses that many times act as leading points for intussusception. Endoscopic studies are helpful in the preoperative diagnosis of these lesions. In a subset of 38 patients with symptomatic small bowel metastatic disease, complete resections were performed in 26% of patients, with palliative bypasses being performed in 40%, despite the fact that over 50% of the patients had documented visceral metastasis in other body sites. The operative morbidity rate was 15% with no operative deaths. Ninety percent of patients gained relief of symptoms, and overall survival from the time of confirmed small bowel disease averaged 17.3 months, with a range of 6 months to 9 years. It would seem that patients with melanoma with gastrointestinal metastatic disease can benefit from aggressive radiologic and endoscopic procedures for diagnosis and staging. Only through surgical interventions for symptomatic gastrointestinal disease can the quality of life be improved and life expectancy be extended.
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PMID:Radiologic, endoscopic, and surgical considerations of melanoma metastatic to the gastrointestinal tract. 620 81

The four common types of small bowel malignancies have different clinical presentations, routes of metastatic spread, and prognoses, and may require selective treatment. A review of our experience over a 16-year period revealed 45 cases: 16 adenocarcinomas, 13 carcinoids, nine leiomyosarcomas, five lymphomas, and two fibrosarcomas. Adenocarcinomas tend to occur in the upper part of the small intestine, cause obstruction and occult blood loss, and metastasize to the regional nodes and liver. Carcinoids generally begin in the distal portion of the small bowel, may form rather large metastatic masses and cause obstruction from a metastatic mass or intussusception, and are often multiple. Leiomyosarcomas develop in any part of the bowel, may present a primary mass, gross hemorrhage, or perforation, and have blood-borne metastases. Lymphomas tend to occur in the distal part of the small bowel, with pain or mass formation, and spread via the lymphatics. Critical analysis of the clinical presentation and findings should allow preoperative recognition of the specific pathologic type.
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PMID:Malignant tumors of the small bowel. 648 73

A mass associated with the gastrointestinal tract was detected by sonography in 33 patients. Etiologies included primary or metastatic tumor; intussusception; inflammation secondary to bowel infarction, pancreatitis, or irradiation; and a dilated, fluid-filled gut related to retained gastric contents, obstruction, ileus, or an ileal bypass. Mesenteric or omental changes were identified with inflammation and frequently with metastatic disease. The diagnosis was confirmed by repeat sonography, abdominal radiography, barium examination of the small bowel, computed tomography, surgery, or autopsy. Ultrasound patterns are characteristic in tumor, intussusception, and inflammation; specific features allowing differentiation between tumor and inflammation are described. Colonic haustra, valvulae conniventes, or bowel contours and peristalsis on real-time sonography are helpful in identifying fluid-filled bowel loops.
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PMID:Ultrasound patterns of disorders affecting the gastrointestinal tract. 736 Sep 50

Albino noninbred weanling male and female rats were fed a basic grain diet (Group 1) or a basic diet supplemented with 33% bracken fern [BF (Group 2)] or 0.1% quercetin [purity, > 99% (Group 3)] for 58 weeks. The quantities of quercetin and kaempferol (a close structural analog) in BF as glycosides were determined to be 0.57 and 1.1 g, respectively, per kg of dried BF. Estimated mean total cumulative doses (mmol) per rat were: Group 1, quercetin, males and females < 0.03; kaempferol, males and females < 0.03; Group 2, quercetin, males 5.8, females 5.2; kaempferol, males 11.9, females 10.8; and Group 3, quercetin, males 27.8, females 25.3; kaempferol, males and females < 0.03. Growth of rats fed BF or quercetin was comparable but significantly (p < 0.01) slower after 24 weeks than that of Group 1. Mean survivals (weeks) of rats of all groups were: Group 1, 58 +/- 7 (S.D.); Group 2, 51 +/- 13; and Group 3, 56 +/- 8. They were not significantly different, although rats fed BF tended to die earlier secondary to intestinal tumor-induced intussusception and obstruction. The following incidences of intestinal or bladder neoplasms in male or female rats, respectively, were observed: Group 1, intestinal and bladder, males, 0 of 9, females, 0 of 10; Group 2, intestinal, males, 7 of 8, females, 10 of 11; bladder, males, 6 of 8, females 8 of 11; Group 3, intestinal, males, 6 of 7, females, 14 of 18; bladder, males, 2 of 7, females, 3 of 18. The histopathology of neoplasms of the 2 target organs was identical for rats of Groups 2 and 3. Multiple ileal intestinal neoplasms of rats fed quercetin included: adenoma, 4; fibroadenoma, 7; and adenocarcinoma, 9 (with mesenteric metastases, 3). The 5 bladder tumors were papillary or sessile transitional cell carcinomas.
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PMID:Quercetin, a rat intestinal and bladder carcinogen present in bracken fern (Pteridium aquilinum). 743 34

We report a 55-year-old man with angiosarcoma of the cecum who presented with generalized colicky abdominal pain with a mass in the periumbilical region. The lesion at surgery was a colo-colic intussusception extending to the midtransverse colon. A radical right hemicolectomy was done. Metastases to regional lymph nodes were noted in the specimen.
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PMID:Angiosarcoma of cecum: unusual presentation with intussusception. 786 Jan 21

Malignant melanoma metastases to the GIT are not uncommon, and often the diagnosis is delayed. Within the GIT, the small bowel is most frequently involved, followed by the stomach, large bowel, and esophagus. Patients with acute complications such as bleeding, perforation, intussusception, and obstruction require urgent surgical intervention. The diagnosis of metastatic melanoma is pathologically confirmed at surgical exploration in 80% of patients, by endoscopic procedures in 15%, and percutaneous biopsy in 5%. Small or large bowel resection for hemorrhage or obstruction provides symptomatic relief in 79-92% of patients with a postoperative mortality rate of 5%. Reported 1- and 5-year survival rates are 44% and 9-19%, respectively. Because of the acceptable morbidity in select symptomatic patients, surgical palliation should be undertaken when the quality of life may be improved. Malignant metastatic melanoma involving the GIT has a dismal prognosis. The symptoms are commonly nonspecific and not recognized antemortem. Gut metastases signify an advanced stage of disease. Chemotherapy and immunotherapy have been ineffective in prolonging survival for these patients. For patients with general good health and symptomatic metastases, their disease can be excised with limited morbidity and mortality while providing effective and lasting palliation. Because of this, surgical resection is warranted in many patients with symptomatic gastrointestinal metastases from melanoma.
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PMID:Metastatic melanoma of the gastrointestinal tract: a review of the literature. 813 14


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