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)

A patient with carcinoid syndrome on long-term antiserotonin therapy with parachlorophenylalanine, experienced a flushing attack with hypotension during the prophylactic administration of aprotonin prior to the induction of anaesthesia. When she was subsequently prepared with a long-acting somatostatin analogue, octreotide (Sandostatin, Sandoz SMS 201-995), plasma levels of tumour-released hormones were reduced and anaesthesia for resection of hepatic metastases was uneventful. The advantages of an anaesthetic approach based on inhibition of carcinoid tumour activity, rather than antagonism of released hormones, are discussed.
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PMID:Somatostatin, anaesthesia, and the carcinoid syndrome. Peri-operative administration of a somatostatin analogue to suppress carcinoid tumour activity. 288 27

A case of malignant bronchial carcinoid with multiple cutaneous metastases is reported. Despite the extremely aggressive behavior of the disease and the presence of multiple hepatic metastases, the patient did not exhibit the usual clinical features of the carcinoid syndrome. The relevance of the finding of elevated 24-hour urinary vanillylmandelic acid levels in patients with carcinoid tumors is discussed.
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PMID:Metastatic cutaneous carcinoid. 299 80

Carcinoid tumor arising in a Meckel's diverticulum is a rare lesion with only 52 cases described in the literature. Most of these tumors are found incidentally at autopsy or during an operation performed for an unrelated reason. The lesion can, however, in about one-third of cases, be the cause of symptoms necessitating surgical intervention; the diagnosis is nearly never apparent till the specimen has been removed. When the signs do not match the symptoms, consideration of uncommon conditions such as this may help in making a correct preoperative diagnosis. Resection of the intestinal segment containing the diverticulum along with its mesentery to the level of the superior mesenteric vessels usually results in cure; however, metastatic disease and even carcinoid syndrome may still occur. Second primary malignancies are often found in patients with carcinoid of Meckel's diverticulum.
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PMID:Carcinoid tumor in Meckel's diverticulum. 305 40

In the carcinoid syndrome, surgery is often curative when the disease is detected early and it may also provide palliation for some patients with metastatic disease. Often metastatic disease requires no treatment for months or years unless symptoms are serious or troublesome. Chemotherapy with either doxorubicin alone or streptozocin plus 5-FU achieves a response rate of about 23-33%. Hepatic artery occlusion followed by sequential chemotherapy has produced striking relief of symptoms, a higher percentage of regressions, and a longer duration of response. Somatostatin 201-995 is very effective in treating the syndrome and in preventing carcinoid crisis and has the advantage of producing virtually no significant side effects.
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PMID:The carcinoid syndrome: a treatable malignant disease. 307 20

Ivalon (polyvinyl alcohol) is a commonly used embolic agent, generally considered to be permanent. In a patient with the carcinoid syndrome, embolization of hepatic metastases with Ivalon failed to produce permanent occlusion, and recurrent tumor was supplied by many of the same small arteries identified on the original arteriogram. Occasionally, Ivalon may have only a temporary occlusive effect. A possible explanation for this phenomenon is proposed.
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PMID:Failure of Ivalon to provide permanent hepatic arterial occlusion. 310 22

Peripheral carcinoid tumours (PCT) of the lung are a distinct entity. These tumours arise from subsegmental or distal bronchioles, are usually well circumscribed and encapsulated, and contain varying amounts of spindle cells. Their histogenesis is from the Kultchitsky or neurosecretory type of cells. Of 52 patients with carcinoid tumours of the lung, 11 (21.1%) had PCT. The mean age was 60.2 years, 9 out of 11 patients were females, and about two-thirds of tumours were in the left lung (8 out of 13). No patient developed carcinoid syndrome, but three patients had nonspecific respiratory symptoms. Bronchoscopy was not helpful in diagnosing any of these cases. Four patients required a wedge resection of the lung; the other six underwent lobectomy. One patient had tumours detected incidentally at autopsy. Mean tumour size was 2.39 cm (range 1.0-5.0 cm); four tumours were 3.0 cm or larger in diameter. Three cases (27.3%) had regional lymph node metastases, but no systemic metastasis was discovered. Apart from the patient who was discovered to have carcinoid tumours at autopsy, all others are alive and disease-free from 1 to 6 years after surgery.
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PMID:Peripheral carcinoid tumours of the lung: a clinicopathological study. 318 54

A case of a 69 year old man in whom hypertrophic gastritis was associated with the carcinoid syndrome is reported. Concentrations of prostaglandin E2 were increased in plasma, gastric juice, gastric mucosa and urine. He had marked hypochlorhydria in response to pentagastrin stimulation (Peak acid output (PAO) pg:0.2 mmol/h). After successful hepatic arterial embolisation of the metastases (as indicated by an 85% decrease in 24 h urinary 5-HIAA) the concentrations of prostaglandin E2 decreased in the plasma, gastric juice and gastric mucosa. The gastric mucosal hypertrophy regressed and secretion of acid in response to pentagastrin returned (PAO pg:9.0 mmol/h). These findings suggest that the carcinoid tumour was producing a substance which stimulated increased local synthesis of prostaglandin E2 in the gastric mucosa, with concomitant gastric mucosal hypertrophy and inhibition of gastric acid secretion.
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PMID:Hypertrophic gastritis associated with increased gastric mucosal prostaglandin E2 concentrations in a patient with the carcinoid syndrome. 319 4

Operations were performed on 15 patients for carcinoid tumours in their small intestines. Prognosis of tumour localisation in the small intestine was confirmed to be worse, as compared to other tumour sites. Only four patients were initially free of metastases. Such unfavourable point of departure supported the need for radical surgery, with a view to alleviating the locally delimited symptoms of the primary tumour and the complaints caused by the carcinoid syndrome.
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PMID:[Carcinoid tumors of the small intestine]. 321 98

Clinical data about 104 patients with gastrointestinal carcinoids emphasized the heterogeneous nature of these tumours in different organs. The sites of the primary tumours were the stomach in 12 (11%), the duodenum in 3 (3%), the small bowel in 48 (45%), the appendix in 28 (26%), the colon in 6 (6%), and the rectum in 6 cases (6%). Gastric carcinoids were multiple in 4 (33%) and small-bowel carcinoids in 11 cases (23%). None of the gastric, duodenal, or rectal carcinoids had generated metastases, as contrasted to 34 (72%) small-bowel carcinoids. Twelve patients had symptoms of the carcinoid syndrome caused by hepatic metastases from ileal (11) or appendiceal (1) primary tumours. At least two patients with duodenal carcinoids had Zollinger-Ellison syndrome produced by the tumours. The cumulative 5-year survival rate was 91-100% for gastric, appendiceal, and rectal carcinoids, 77% for small-bowel carcinoids, and 33% for colonic carcinoids. Resectable mesenteric lymph node metastases did not affect the 5-year survival of patients with small-bowel carcinoids as compared with the tumours confined to the bowel wall. Poor prognosis was associated with hepatic metastases at the time of diagnosis. Small-bowel carcinoids remain a challenge in clinical work because of their distinct metastatic propensity and problematic diagnosis.
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PMID:Clinical presentation and prognosis of gastrointestinal carcinoid tumours. 322 92

Two cases of carcinoid tumour affecting the central nervous system through their metastases were treated surgically. The first case was carcinoid tumour of the lung with a single metastases in the right frontal lobe of the brain, while the second developed metastases of the sixth thoracic vertebra from a terminal ileum bowel primary causing spinal cord compression. Neither case developed carcinoid syndrome. The rarity of such metastases affecting the central nervous system is discussed together with a review of the literature.
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PMID:Metastatic carcinoid tumour of the CNS from two different primary sites. 326 93


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