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)

Introduction: Little is known about adult intussusception, but current evidence suggests that malignancy, polyps, and diverticula are usual etiologies. We present a case of adult ileoceccal intussusception secondary to carcinoid tumor. Case Presentation: A 53-year-old African American male presented with hematochezia and non-radiating constant left upper quadrant pain accompanied by nausea and vomiting. CT of the pelvis demonstrated a pathognomic 'target' sign, consistent with ileoceccal intussusception and early small bowel obstruction. Two years prior to this current presentation, the patient had experienced an episode of hematochezia for which he underwent colonoscopy and polypectomy, with subsequent pathology results negative for colon cancer. He denies diarrhea, constipation, weight loss, decreased appetite or skin flushing. Due to persistent symptoms of bowel obstruction, he underwent exploratory laparotomy. During the surgery a white-colored, chalky mass indicative of penetrating tumor was noted 13 cm proximal to the ileocecal valve. An extended right hemi-colectomy followed the discovery of the mass. Pathology showed a well-differentiated neuroendocrine tumor consistent with carcinoid tumor. Evaluation for metastatic disease using 5-HIAA and chromogranin A was unremarkable, and the resection of the right colon carcinoid tumor was felt to be curative. Conclusion: It is uncommon for adults to present with intussusception; in such cases, malignancy should be ruled out as an underlying cause. Carcinoid should be listed among the other secondary causes, which include inflammatory bowel disease, diverticulitis, polyps, scar tissue, adhesions, and lipomas. Abbreviation: CT (Computer tomography), 5-HIAA (5-hydroxyindole acetic acid), NCCN (National Comprehensive Cancer Network).
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PMID:Carcinoid tumor causing ileoceccal intussusception in an adult patient. 3125 72

Small bowel adenocarcinoma is rare with an incidence of 2.6 in 100 000 patients. Diagnosis is often fortuitous and usually presents late. We present the case of a 36-year-old male who attended the emergency department with worsening abdominal discomfort. A computed tomography scan showed high-grade jejunal obstruction secondary to a jejunal mass suspicious for carcinoma with disseminated peritoneal carcinomatosis and hepatic metastases. Following a conservative approach, his obstruction settled. He commenced on a total of 12 cycles of FOLFOX (folinic acid, fluorouracil and oxaliplatin) and bevacizumab. After re-presenting with intermittent intussusception, a decision for surgical resection was made. On laparoscopy, there was no evidence of hepatic metastases or peritoneal carcinomatosis. A jejunal resection was carried out with an uneventful postoperative period. The patient remains disease free. Despite presenting with an advanced stage, a multimodal approach to these rare tumors may yield surprising and optimistic outcomes.
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PMID:Stage IV jejunal adenocarcinoma: a multimodal therapeutic success story. 3146 84

Intussusception, as a rare cause of small bowel obstruction, can be secondary to benign or malignant pathology. Malignant lesions causing intussusception can be primary or metastatic lesions. Metastasis can occur many years later. We present a case of metastatic melanoma in a 69-year-old man as the underlying etiology of his intussusception. The patient had laparoscopic Roux-en-Y gastric bypass four years prior to his presentation and did recall excision of a skin melanoma at age 64. Laparoscopic or open surgical resection is the best therapeutic option in cases such as this.
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PMID:Small Bowel Intussusception Caused by Metastatic Melanoma: A Case Report. 3157 36

A 34-year-old man with recent-onset constipation presented with colonic obstruction due to a palpable rectal tumour. Colostomy relieved the obstruction and biopsy revealed carcinoma. During workup, full-thickness rectal prolapse occurred with the tumour at the apex of an intussusception. Imaging revealed a low rectal tumour and no metastases. An abdominal oncological rather than perineal resection of the rectum was planned. At laparotomy, the tumour was reduced and was seen to originate at the rectosigmoid junction. Surgery was successful and follow-up has been clear. Histology revealed an adenocarcinoma with microsatellite instability. Rectal prolapse due to tumour intussusception is very rare. In this young man, it was due to straining at stool because of constipation and tenesmus rather than pelvic floor abnormality. An associated colorectal tumour should be considered in patients with rectal prolapse. In such cases, surgical and adjuvant management may need to be modified.
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PMID:Rectosigmoid carcinoma presenting as full-thickness rectal prolapse. 3189 18

A 71-year-old man underwent right hemi-hepatectomyfor a hepatocellular carcinoma(HCC)measuring 18 cm in diameter. The pathological diagnosis was poorlydifferentiated HCC. Ten months after the surgery, computed tomographyrevealed a nodule 12mm in diameter in the right lung as well as 2 nodules measuring 19 and 11mm in diameter in the retroperitoneum at the cranial aspect of the left kidney. Four months later, the nodule in the right lung had enlarged to 44 mm, while the 2 nodules in the retroperitoneum had enlarged to 68mm and 34 mm. These nodules were resected and histopathologicallydiagnosed as metastasis from HCC. Twenty-one months after liver resection, computed tomographyrevealed nodules 16 and 25mm in diameter in the retroperitoneum around the urinarybladder and jejunum, respectively. One month later, intussusception resulted from the jejunal tumor. Laparoscopic surgerywas performed for both tumors, which were diagnosed as metastases from HCC. Twenty-five months after liver resection, metastasis from the HCC appeared in the left adrenal grand, at the site of the jejunal anastomosis, and in the fattytissue around the right scapula. Twenty-nine months after liver resection, the patient died of respiratoryfailure from multiple metastases in the left lung.
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PMID:[A Resected Case of Retroperitoneal Metastasis and Small Bowel Metastasis from HCC]. 3215 10


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