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

Clinical findings and surgical treatment of a 68 years old man with carcinoid tumor of Meckel's diverticulum are reported. Carcinoids in Meckel's diverticula are rare tumors, commonly discovered incidentally during surgical procedures for different indications. Symptoms are frequently expression of a metastatic disease. Specific diagnostic and therapeutic tools are discussed.
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PMID:[Carcinoid of Meckel's diverticulum: presentation of a clinical case]. 1112 39

Meckel's diverticulum is an uncommon gastrointestinal congenital anomaly that occurs in 1-3% of the population. It is sometimes associated with complications related to the presence of ectopic tissue (obstruction, ulceration, hemmorhage, inflammation, perforation, fistula and tumors). Neoplastic degeneration of Meckel's diverticulum mucosa is rare, developing in only 1-5% of all diverticula, usually asymptomatic and occasionally discovered. Disease is metastatic, usually to the liver, in 25% of cases. We report a case of asymptomatic unsuspected carcinoid of Meckel's diverticulum with ileal, hepatic and mesenteric metastasis discovered during a gastrectomy performed for gastric adenocarcinoma. The patient underwent ileal and Meckel diverticulum resection, excision of mesenterial metastasis and liver bisegmentectomy. Furthermore, total gastrectomy with esophago-jejunal anastomosis was performed. After an 18-month follow-up period, the patient is alive and disease free. Owing to possible neoplastic degeneration, Meckel's diverticulum should be resected when occasionally discovered. In the presence of a carcinoid tumor, even if associated with metastatic disease, extended resection is recommended.
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PMID:A case of carcinoid of Meckel's diverticulum associated with gastric adenocarcinoma. 1169 8

This case reports the concomitant findings of carcinoid tumor within a Meckel's diverticulum presenting as an acute abdomen in an adult male. Most Meckel's diverticula remain asymptomatic throughout life, and symptomatic diverticula are virtually nonexistent in older adults. Meckel's diverticulitis is clinically indistinguishable from acute appendicitis, and abnormal or symptomatic diverticula are generally resected. Surgical treatment of Meckel's diverticula is recommended for children during exploration. However, resection is controversial in asymptomatic adults. Carcinoid tumors are the most common primary tumor of the small bowel. The duration of symptoms before diagnosis varies from 2 to 20 years, and half of all patients have incurable abdominal disease at first-look surgery. Metastatic events occur most commonly in the liver with a generally poor prognosis. Surgical resection is the treatment of choice. Both Meckel's diverticula and carcinoid tumor are rare clinical entities, and carcinoid tumors occurring within a Meckel's diverticulum are even more uncommon. Thus, the natural history is difficult to predict and treatment recommendations vary. Solitary, localized, asymptomatic nodules less than 1 cm are generally managed with diverticulectomy or segmental resection. Larger or multiple lesions require wide excision of bowel and mesentery, and hepatic resection may be required for metastatic disease.
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PMID:Meckel's diverticulitis secondary to carcinoid tumor: an unusual presentation of the acute abdomen in an adult. 1497 61

Carcinoid tumors are distinct neuroendocrine neoplasms with characteristic histological, clinical, and biological properties. Though commonly associated with the gastrointestinal tract and bronchopulmonary system, a substantial number of these tumors originate in less common anatomical sites and can range from indolent, unrecognized entities to highly active, metastatic secretory tumors. Their presentation within unfamiliar locations often results in clinical confusion, and they persist as unrecognized lesions, subjecting patients to delayed, inappropriate, or ineffective treatment. The authors reviewed 13,715 carcinoid tumors identified by three consecutive registries of the National Cancer Institute (NCI) from 1950 to 1999, focusing on the anatomic sites accounting for less than one percent of all carcinoids. In addition, data from the world's literature published on carcinoid tumors within these particular anatomic locations were then analyzed with respect to incidence, clinical presentation, symptoms, diagnostic evaluation, microscopic and immunohistochemical findings, treatment strategies, and prognosis. The primary organs in which carcinoids are most commonly mistaken for some of the more conspicuous endemic tumors include the esophagus, pancreas, liver, biliary tract, gallbladder, and Meckel's diverticulum, as well as within the pelvic and otolaryngeal organs and the breast. In general, the highest proportion of "rare" carcinoids was identified in the gastrointestinal (GI) tract, with the ovary as the single most affected extra-GI site. Tumors with the worst prognosis were those that involved the pancreas (37.5%: 5-year survival) and those in the cervix (12-33%: 3-year survival). While gastrointestinal carcinoids have become a more recognized entity and thus more amenable to identification, similar lesions are often not considered in other sites and have often either been overlooked or misdiagnosed. Widespread reports of their occurrence in rare locations warrants attention. The diminution of the likelihood of inadvertently neglecting these often benign, indolent neoplasms that are well known to metastasize if unaddressed would represent an important advance. Familiarity with such unusual sites of origin will facilitate appropriate recognition and characterization of such tumors, allowing for timely intervention.
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PMID:An analysis of rare carcinoid tumors: clarifying these clinical conundrums. 1559 42

A 56-year-old female presented with abdominal pain, weight loss and fatigue. Computed tomography revealed an abdominopelvic mass and ascites. At surgery she had carcinomatosis and bilateral ovarian metastases arising from a cancer in a Meckel's diverticulum. Histology identified the primary to be a signet-ring cell adenocarcinoma within the Meckel's with ovarian metastases. This is the first report of a Krukenberg tumor from a Meckel's diverticulum. A discussion of malignancies within a Meckel's diverticulum is provided.
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PMID:Krukenberg tumor: metastasis of Meckel's diverticular adenocarcinoma to ovaries. 1944 95

We describe a seven years follow-up of a high risk gastrointestinal stromal tumor in a Meckel's diverticulum in a 68-year-old man with abdominal pain and vomiting. The patient was operated in emergency for peritonitis due to perforation of small intestine and treated with imatinib mesylate. The metastatic progression of the disease demonstrated the value of prognostic indicators (mitotic rate >10/50 high power field, necrosis and 8 cm in maximum diameter) for assessing risk of aggressive behaviour. Computed tomography was a valuable procedure for detection of local recurrence, the distant metastases and for surveillance after surgery in the follow-up. The review of the literature shows that this case has the longest follow up and consents the comparisons of the same neoplasm in other sites most frequent and better described than Meckel's diverticulum.
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PMID:Clinical Outcome of High Risk Gastrointestinal Stromal Tumor in a Meckel's Diverticulum. 2367 19

Adenocarcinoma ex-goblet cell carcinoid is a very rare and histologically unique appendiceal malignancy with dual glandular and neuroendocrine differentiation. There is a high incidence of this tumor among middle-aged women with metastasis to the gynecologic tract with the mode of metastasis following peritoneal spread rather than hematogenous distribution. Adenocarcinoma ex-goblet cell carcinoid can spread to any peritoneal site including ovaries or omentum. We report a 37-year-old healthy woman who initially presented with right lower quadrant abdominal pain and pseudomyxoma peritonei. Histopathology of the appendectomy specimen revealed an adenocarcinoma ex-goblet cell carcinoid, signet ring cell type. Follow-up right hemicolectomy, omentectomy, bilateral salpingo-oophorectomy, and regional peritoneal resections revealed metastatic involvement by adenocarcinoma ex-goblet cell carcinoid, signet ring cell type. In this report, we describe a case of appendiceal adenocarcinoma ex goblet cell carcinoid with metastases to Meckel's diverticulum and areas of pelvic endometriosis, which have not been previously reported.
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PMID:Adenocarcinoma Ex-Goblet Cell Carcinoid of the Appendix With Metastatic Peritoneal Spread to Meckel's Diverticulum and Endometriosis. 2844 7

A case of 25- years-old female with NET deriving from Meckel's diverticulum is described. The patient had one year history of dermatological skin problems. Ultrasound examination of abdomen performed because of arterial hypertension, revealed multiple hepatic lesions, which was confirmed in contrast enhanced CT. The typical contrast enhanced metastatic lesions in CT and elevated levels of chromogranin A suggested NET of unknown origin. SRS with 99mTc-HYNICTOC was perform for primary tumor localization, and revealed liver and paraaortic lymph nodes metastases, but no sign of primary tumor location. As a next step for primary tumor localization 68Ga-DOTATATE PET/CT was done, which revealed focus of increased uptake in small intestine considered to be the primary tumor site. The imaging and clinical history of patient was discussed on ENETS Tumor Board. Due to location of primary tumor in the small intestine with no anatomical changes in CT, laparotomy guided with gamma probe after 68Ga-DOTATATE injection was performed. During surgery procedure, the primary tumor was hardly palpable in the tip of Meckel's diverticulum, confirmed by gamma probe. After surgery, tandem peptide receptor radionuclide therapy (PRRT) was started. Patient received 4 doses of 90Y/177Lu-DOTATATE with total activity of 360 mCi (13.32 GBq). The three months follow up 68Ga-DOTATATE PET/CT had shown stable disease of patient. The presented case showed importance role of multidisciplinary team cooperation in patient management. Use of RGS is essential in cases like presented, when the tumor cannot be localized only by surgical palpation.
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PMID:TeleNEN as a telemedicine model for neuroendocrine neoplasm management in case of Meckel's diverticulum NET. 2995 21


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