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)

The simultaneous occurrence of carcinoma and carcinoid in the stomach is rare. Only 5 cases have been reported in the literature so far. Our patient developed double primary neoplasms adjoining the gastric antrum. One was an early ulcerated adenocarcinoma limited to the submucosa, the other a minute carcinoid also within the submucosa. A large amount of 5-HIAA, but a normal amount of histamine, was excreted in the urine. The carcinoid syndrome, however, was absent through clinical course. The patient died of liver metastasis 3.5 months after gastrectomy. Microscopic examination after autopsy disclosed that the metastases consisted of only carcinoid cells.
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PMID:[Adenocarcinoma adjoining to the gastric antrum and minute carcinoid--a case report]. 663 17

Small bowel carcinoid tumors usually metastasize to regional lymph nodes and the liver but metastases to the neck are extremely rare. Over a ten-year period 48 cases of small bowel carcinoid were diagnosed at our institution and of these, three cases (6%) were associated with neck metastases--one to the thyroid gland and two to cervical lymph nodes. The former patient and one of the latter patients had symptoms of the carcinoid syndrome. The other patient was asymptomatic and presented with a solitary neck mass. Urine levels of 5-hydroxyindolacetic acid (5-HIAA) were elevated in the two symptomatic patients but were undetectable in the asymptomatic patient. Extirpation of the involved cervical nodes and the primary small bowel lesion was performed in two patients. In addition, both patients have received chemotherapy with 5-fluorouracil. One patient remains asymptomatic four years after diagnosis but the other patient continues to have five to six bowel movements per day nine months after operation. Small bowel resection was performed in the patient with a metastasis to the thyroid. This patient died of sepsis after a second operation for an intraabdominal abscess. The histological patterns of the primary tumor and the metastatic lesions were similar and the cells of the metastases contained argentaffin-positive granules. We conclude that 1) an intraabdominal carcinoid tumor should be considered as the location of the primary tumor in patients who present with a neck mass containing metastatic carcinoid and 2) the prognosis for patients with extraabdominal metastases is similar to that for patients with intraabdominal disease only.
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PMID:Cervical metastases from small bowel carcinoid tumors. 663 95

We reviewed the clinical data and pathologic material from 30 patients with appendiceal carcinoids. Most of the tumors were discovered incidentally in appendectomy specimens. Approximately two thirds were tiny lesions identified only by microscopic examination. One tumor metastasized to a regional lymph node. Five histologic patterns were identified. Problems in differential diagnosis may arise in interpreting the variant patterns, but these patterns appear to have no bearing on prognosis. In reviewing the literature we found that appendiceal carcinoids infrequently metastasize widely and only rarely produce the carcinoid syndrome.
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PMID:Tumors of the appendix: II. The spectrum of carcinoid. 670 9

Carcinoid tumors of the ovary are uncommon, but 150 cases of primary ovarian carcinoids and 40 cases of carcinoid tumors metastatic to the ovary have been reported. Primary carcinoid tumors of the ovary are divided into insular, trabecular, strumal and mucinous types. The insular type is most common, followed by the strumal type. The majority of primary ovarian carcinoids occur in association with mature cystic teratoma, but a considerable number present in pure form. Only the insular type is associated with the carcinoid syndrome. The age incidence of patients with ovarian carcinoids shows a wide range but most patients are postmenopausal. Primary carcinoids of the ovary are invariably unilateral. They form a solid nodule within a cystic teratoma, or when pure a solid yellow-grey mass, and vary from microscopical to large tumors measuring in excess of 20 cm in the longest diameter. The metastatic carcinoids are nearly always bilateral and scattered tumor deposits are present throughout both ovaries. Primary ovarian carcinoids metastasize only occasionally, and should be treated as ovarian tumors of low malignant potential.
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PMID:Carcinoid tumors of the ovary. 671 97

An autopsy case of a 67-year-old Japanese male is presented. He had been suffering from carcinoid syndrome for 5 years and showed a typical picture of carcinoid heart disease. In Japan, carcinoid heart disease is rare and we can find only four reported cases (33% of reported carcinoid syndrome). The patient had high urinary secretion of 5-HIAA and high serum serotonin, and finally he died of heart failure and bronchopneumonia. The primary site of this carcinoid tumor was of the bronchus of the right B10c , and it had large hepatic metastases. Electronmicroscopically, the tumor cells had secretory granules measuring 1500-3500 A in diameter. Immunohistochemically, the tumor cells were markedly positive for human chorionic gonadotropin (hCG) and antidiuretic hormone (ADH) and positive for serotonin, in both the primary site and hepatic metastases. Characteristic fibrous plaques were detected in the right atrium, tricuspid valve, right ventricle, and left atrium. Electron-microscopically, the fibrous plaques consisted of smooth muscle cells and myofibroblasts surrounded by basement membrane-like material. The abundant matrix of the fibrous plaques contained acid mucopolysaccharide, microfibrils and collagen fibers. The same fibrous plaques were also found in hepatic veins. Furthermore, retroperitoneal fibrosis was present, which showed proliferation of myofibroblasts, fibroblasts and immature mesenchymal cells.
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PMID:Cardiovascular lesion of carcinoid syndrome. An autopsy case of bronchial carcinoid. 673 Sep 65

Eighty-two symptomatic patients with carcinoid tumors of the small intestine were examined and treated over a 20-year period. Common clinical features included weight loss, diarrhea, and symptoms of intermittent bowel obstruction; 25 patients (30%) exhibited the carcinoid syndrome. Multiple carcinoid tumors occurred in 23 patients (28%), and hepatic metastases were present in 30 (37%). All patients underwent operation. The overall mortality was 7%, and the cumulative five-year survival rate was 59%. Two factors influenced prognosis after operation: hepatic metastases and incomplete resection. Other variables, including the sex and age of the patient and the size of the primary tumor, were of no additional prognostic value. Wide resection of the tumor, including regional lymph nodes, is indicated, regardless of the size of the primary tumor.
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PMID:Surgical therapy for small-bowel carcinoid tumors. 683 Apr 29

A case of carcinoid of the stomach is described and a review of 100 patients with carcinoid of the stomach reported in Japan up to 1980 is made. Of the 100 cases, the male to female ratio was 2.54. Typical clinical manifestations of the carcinoid syndrome were quite rare. Metastases to the liver were observed in 76% of cases with tumours larger than 5 cm in diameter. The liver and lymph nodes were common sites of metastases. Carcinoids arising from the anterior wall of the stomach also showed a high incidence of metastasis. As a result of histochemical examinations, it was revealed that the nonreactive cell type was found in 31% of cases, while the argentaffin cell type was found in only 10%. Confirmation of the diagnosis of carcinoid is sometimes difficult. Occasionally, therefore, electron-microscopic demonstration of specific secretory granules becomes essential for the final diagnosis.
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PMID:Carcinoid of the stomach: a case report and review of 100 cases reported in Japan. 684 9

The many manifestations of carcinoids will continue to puzzle and intrigue surgeons. Because these are dynamic tumors which produce multiple hormones with many potential side effects, an aggressive surgical debulking of them is advocated. Even in the presence of metastatic disease, some long-term survival can be anticipated. The most debillitating aspect of this tumor to the patient is the carcinoid syndrome. The symptoms occur erratically and are often not well controlled by presently available medication. Although metastatic disease present at diagnosis is most commonly seen with jejunoileal carcinoids, colorectal carcinoids appear to be the most lethal tumors. However, they are rarely associated with the symptoms of carcinoid syndrome. Carcinoids may often be associated with other types of tumors, some of which are known to produce their own hormones. Survival of the patients seems to be related to their other tumor type rather than the primary carcinoid. The clinician should be aware of the strong association of carcinoids with peptic ulcer disease. The ulcer diathesis is probably related to ectopic histamine production and can usually be controlled by cimetidine and antacids, although surgical intervention may be required.
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PMID:Carcinoids and the carcinoid syndrome. 685 14

Thirty patients with carcinoid tumors of the ileum over a recent 10-year period have been analyzed. Seventeen patients were symptomatic and 13 others were found to have tumors incidentally at autopsy or celiotomy. Patients with symptoms almost invariably had metastatic disease, yet preoperative diagnosis was rarely achieved. Arteriography in five patients with intestinal angina demonstrated encasement, kinking, and irregularity of mesenteric branches due to nodal metastasis. In five patients, each with liver metastasis, the classic carcinoid syndrome developed. Multiple primary carcinoid tumors were found in 9 of 30 patients (30 percent); 14 had an associated second malignant neoplasm (47 percent), most frequently colorectal carcinoma. En block surgical excision was the only effective therapy. Despite a prolonged natural history, the 5-year actuarial survival rate from the date of diagnosis was only 31 percent.
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PMID:Carcinoid tumors of the ileum. 686 70

A 56-year-old man with a midgut carcinoid tumor had extensive metastatic involvement of lymphatic spaces and carcinoid heart disease. Unlike similar previously reported cases with carcinoid heart disease, hepatic metastases and history of the carcinoid syndrome were absent in this patient. Tumor involvement of cardiac lymphatic spaces may have been responsible for the development of carcinoid heart disease due to a local fibrogenic effect similar to the extensive fibrosis associated with tumor seen within the abdominal cavity at autopsy.
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PMID:Midgut carcinoid tumor with carcinoid heart disease. Its presence in the absence of hepatic metastases--a case report. 689 38


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