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)

Between 1982 and 1986, liver segmentectomies were performed in 19 patients with liver tumors, including ten hepatocellular carcinomas, six liver metastases, one cholangiocarcinoma, and two benign tumors. During surgery, patients received a mean (+/- 1 SD) of 1050 +/- 150 mL of packed red blood cells and 860 +/- 80 mL of fresh-frozen plasma. There were no operative deaths. The only complication was a prolonged leakage of ascites through the abdominal drain in one patient with cirrhosis. Seven patients with hepatocellular carcinoma were still alive at this writing, with a follow-up ranging from two months to four years. The four patients with metastases from colorectal carcinomas were alive after follow-up times ranging from six to 24 months. These results suggest that liver segmentectomy is a safe procedure and should be considered as the operation of choice for resection of limited liver tumors.
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PMID:Segmentectomies in the management of liver tumors. 283 51

A rare case of combined hepatocellular and cholangiocarcinoma arising in a 56-year-old female is reported. The autopsy disclosed the presence of two different kinds of tumors in the right lobe of the liver, which showed advanced cirrhosis; a massive rubbery, ill-defined and whitish-yellow cholangiocarcinoma and a nodular soft, encapsulated and dark green hepatocellular carcinoma. They were adjacent to each other, but showed no intermingling. Only the massive cholangiocarcinoma had invaded the portal vein and showed several intrahepatic metastatic foci and hepatic, pancreaticoduodenal and perigastric lymph node metastases. Immunohistochemically, carbohydrate antigen 19-9 was strongly positive only for the cholangiocarcinoma component, explaining the high titer of this antigen in the serum on admission. On the basis of these findings, the possible morphogenesis of the tumor observed in the cirrhotic liver is discussed.
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PMID:Combined hepatocellular and cholangiocarcinoma arising in a cirrhotic liver. Report of an autopsy case. 283 62

Serum thyroxine was significantly higher in 59 patients with hepatocellular carcinoma than in normal subjects, patients with uncomplicated cirrhosis (48), or other primary tumours with or without hepatic metastases (50). Elevated thyroxine levels appeared attributable to high levels of thyroxine binding globulin which showed a positive linear correlation with serum thyroxine in all groups studied. Despite this hyperthyroxinaemia all patients appeared clinically euthyroid and, consistent with this, T3 was elevated in only one patient and the free thyroxine index was normal in all. Amongst a group of 25 cirrhotic patients who were followed-up for between 12 and 72 months, there was a striking dissociation between the TBG values of those destined to develop HCC and those who did not. In the former group TBG rose steadily with time whereas in the latter group levels remained stable, or, more often, fell. The rises in TBG occurred prior to any clinical signs of tumour development and may be one of the earliest serological changes to occur during carcinogenesis in the cirrhotic liver.
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PMID:Hyperthyroxinaemia in hepatocellular carcinoma: relation to thyroid binding globulin in the clinical and preclinical stages of the disease. 283 1

Serum decarboxy-prothrombin (DCP) was raised in 70.7% of histologically confirmed cases of hepatocellular carcinoma and, with alpha foetoprotein, constitutes a complementary biochemical marker for this disease. It is usually normal in other hepatic diseases but pathological values of DCP have been observed in a few cases of cirrhosis and in some pancreatic carcinomas with hepatic metastases. The differential diagnosis may be established by administering 20 mg of Vitamin K1 by slow intravenous injection: if the DCP remains pathological 15 days after Vitamin K1 the diagnosis of hepatocellular carcinoma is very probable. On the other hand, if the DCP is normal a Vitamin K deficiency may be diagnosed.
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PMID:[Assay of decarboxy-prothrombin: its value in the diagnosis of hepatocellular carcinoma]. 283 88

Although ultrasonography and computerized tomography have been useful in the diagnosis of hepatocellular carcinoma, the extent of metastases and the presence of cirrhosis are not identified by these techniques before surgery. We studied 27 cases of presumptive hepatocellular carcinoma by means of laparoscopy and fine needle aspiration. Fine needle aspirates provided positive diagnoses of hepatocellular carcinoma in all patients. Laparoscopy complements imaging studies and allows selection of patients amenable to hepatic resection.
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PMID:Laparoscopically directed fine needle aspiration for the diagnosis of hepatocellular carcinoma: a safe and accurate technique. 283 91

This retrospective study was undertaken to assess the place and efficacy of ultrasonography, and ultrasound-guided biopsy in the diagnosis of hepatocellular carcinoma in a series of 34 patients. The sonographic signs were not specific, as tumor patterns were very different from one case to another; there were no pathognomonic signs of hepatocellular carcinoma in comparison with hepatic metastases. Tissue characterization of the liver abnormalities was obtained by percutaneous ultrasound-guided biopsies. In our experience, ultrasonography has a double role: demonstration of hepatic nodules, particularly in high risk patients (cirrhosis); histologic identification of the nodules by ultrasound-guided biopsy.
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PMID:[Role of ultrasonography and ultrasound-guided puncture in the diagnosis of hepatocellular carcinoma]. 284 12

Sixteen patients with peripheral cholangiocarcinoma of the liver were examined with computed tomography (CT). None of the 16 patients presented with jaundice or had documented cirrhosis. On scans obtained both before and after the injection of contrast material, the tumors were depicted as low-attenuation masses in all cases, with wide variations in homogeneity. The tumor margin was irregular in 12 cases, and there was minimal contrast enhancement of the tumor in 14 cases. In 11 (69%) patients, CT demonstrated masses of markedly low attenuation, which corresponded to areas of diffuse microcystic change seen at histologic examination of resected specimens. In ten (63%) patients, the results of stool or intradermal tests for Clonorchis sinensis were positive. In all ten cases of clonorchiasis, mild, diffuse dilatation of the intrahepatic bile ducts was seen in addition to the low-attenuation masses, but there was no dilatation of the extrahepatic biliary tree. In five of the ten patients with clonorchiasis, stippled or aggregated, powderlike areas of high attenuation were seen on precontrast CT scans; at pathologic examination, those areas were found to be mucin. Extrahepatic metastases were demonstrated in ten (63%) patients. Peripheral cholangiocarcinoma should be the primary diagnostic consideration when these characteristic CT findings are detected in a noncirrhotic patient.
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PMID:Peripheral cholangiocarcinoma and clonorchiasis: CT findings. 284 40

Eleven cases of hepatocellular carcinoma (HCC) in childhood were investigated by immunohistochemistry for association with hepatitis B virus (HBV) infection. Seven of 11 cases (64%) demonstrated positivity for hepatitis B surface antigen (HBsAG), whereas all 11 were negative for hepatitis B core antigen (HBcAG). Cirrhosis was absent in all cases, and other causes for HCC in childhood were not found. All children with HBV-associated HCC died within 6 months of diagnosis. The median survival time of these children was 2 months. Only one child with HCC of trabecular subtype without HBV association is still living after 18 months. However, this child has metastases and a local recurrence. Three other children with HCC of fibrolamellar subtype are free of disease after 2, 5, and 6 years, respectively. The high number of cases of HBV-associated HCC shows the important role of HBV infection as an etiologic factor for the development of childhood HCC in middle Europe.
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PMID:The association of hepatocellular carcinoma in childhood with hepatitis B virus infection. 284 44

Between 1977 and 1986, 172 patients with primary hepatic cancer were treated at the Department of Surgery I, University of Vienna Medical School. In 76 cases (80%) males, 20% females), cirrhosis of the liver was also present. Ninety patients underwent curative surgery (hepatic resection in 64, and liver transplantation in 26 cases). There were no early tumor stages. Forty-five large tumors were confined to one lobe, 42 involved both lobes, 3 even invaded adjacent structures, the majority (74%) being hepatocellular carcinomas. Forty-four of the 64 liver resections were performed in patients with otherwise normal livers (mortality 18%), while 20 patients had associated liver cirrhosis. In view of the extremely high mortality rates after extended liver resection, only limited local resections have been performed in cirrhotic malignancies since 1982 (mortality 25%). Perioperative mortality (25% overall) was due mainly to hepatic failure and sepsis; non-fatal complications occurred in 12 patients (26%). Seventeen of the 26 liver transplants were cirrhotic hepatomas. Nine deaths (34%) were caused by technical problems (graft failure, clotting disorder after massive transfusion) and systemic infections. The outcome for the patient after the immediate postoperative period was determined by tumor regrowth (residual liver tissue, graft, distant metastases) in both groups (median life expectancy 18.4 months after radical liver resection and 18.6 months after liver transplantation). Surgery is the only alternative for these patients (50% survival of untreated hepatoma: 2.6 months), improving both their quality of life and survival. We believe that in carefully selected candidates with non-resectable tumors liver replacement may be a useful alternative.
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PMID:Primary hepatic cancer--the role of limited resection and total hepatectomy with orthotopic liver replacement. 285 Sep 84

Serum concentrations of lipids and apolipoprotein A-I, A-II and B were determined in patients with hepatic metastases of colorectal cancer, with primary liver cancer and with cirrhosis. In all three liver diseases, the HDL fraction and apolipoproteins A-I and A-II showed significantly low values, while apolipoprotein B was only increased in hepatic metastases. The decrease of apolipoprotein A-II levels was more prominent in cirrhosis, thereby enhancing the A-I/A-II ratio. This ratio is decreased in metastasis and normal in hepatomas. In patients with hepatic metastases a correlation was observed between alkaline phosphatase and apolipoprotein A-II (p less than 0.05), and between gamma-glutamyltransferase and the A-I/A-II ratio (p less than 0.05). The present work suggests that determination of apolipoproteins and lipids of the HDL fraction offers a new approach to the study of liver diseases.
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PMID:Serum apolipoproteins A-I, A-II and B in hepatic metastases. Comparison with other liver diseases: hepatomas and cirrhosis. 287 62


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