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)

During a period of 4 years, 20 patients with obstructing carcinoma of the left colon were treated by subtotal colectomy with primary ileocolonic anastomosis. Thirteen patients (65%) were 65 years of age or older. All patients presented to the emergency room with large bowel obstruction. Twelve patients (age > 65) suffered other systemic diseases (chronic obstructive pulmonary disease, ischemic heart disease, morbid obesity), placing them in a high risk category. The mortality rate was 5% (1/20), 7.6% if only high risk patients are considered. The one-stage procedure in the treatment of obstructing carcinoma of the left colon offers the patient a number of advantages over stage intervention elimination of colostomy, namely removal of occult lesions in the resected colon, shorter hospitalization and low morbidity and mortality. We found this procedure to be a valid option also in the elderly (> 65) high risk patient. Metastatic disease in our view is not a contraindication, since the elimination of colostomy will improve the quality of life of these patients.
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PMID:Subtotal colectomy with primary ileocolonic anastomosis for obstructing carcinoma of the left colon: valid option for elderly high risk patients. 827 Apr 7

Herein, we report a case of cutaneous angiosarcoma in a 35-year-old, morbidly obese woman. The tumor arose in the most dependent portion of the lower abdominal panniculus and showed typical changes of chronic lymphedema. The patient underwent a radical resection of her lower abdominal wall panniculus, which showed a multicentric, high-grade angiosarcoma with bilateral superficial inguinal lymph node metastases. Histologically, conventional vasoformative areas were admixed with poorly differentiated sheets of spindle and epithelioid cells. Factor VIII was focally positive (membranous), whereas CD31 showed robust, diffuse positivity (membranous and cytoplasmic). The initial margins of resection were negative, and no follow-up radiation or chemotherapy was given. Following a recurrence at the previous excision site, the patient died 7 months after the surgery. Postmortem examination revealed a widely metastatic tumor that involved multiple organ systems. We believe this is the second report of cutaneous angiosarcoma occurring in a chronically lymphedematous abdominal panniculus due to morbid obesity.
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PMID:Cutaneous angiosarcoma complicating morbid obesity. 1126 Jun 30

Morbid obesity is a recognized risk factor for gastrointestinal cancer. Little is known about pancreatic cancer developing after gastric bypass surgery or about surgery for this type of tumor following bariatric surgery. This report describes a case of pancreatic head cancer identified 3 months after laparoscopic sleeve gastrectomy for morbid obesity. During routine follow-up, mild abdominal pain and elevated pancreatic enzymes prompted computed tomography, which revealed mild edematous pancreatitis. Hyperbilirubinemia developed, and magnetic resonance imaging showed a pancreatic head tumor. CA19-9 was elevated. After a pylorus-preserving pancreatic head resection, the postoperative course was uneventful. The patient received adjuvant chemotherapy. Unfortunately, at the time of writing (9 months postoperatively), a local recurrence and hepatic metastases were diagnosed. Patients treated with bariatric surgery who develop new symptoms or report constant mild symptoms should be evaluated using endoscopy and radiomorphological imaging. Interdisciplinary obesity treatment can then offer significant benefits for the patient, particularly in the case of pancreatic cancer, which is still difficult to diagnose. In addition, there is a need for epidemiological studies of patients who undergo bariatric surgery and subsequently develop cancer.
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PMID:Morbid obesity and subsequent pancreatic cancer: pylorus-preserving pancreatoduodenectomy after laparoscopic sleeve gastrectomy. 1881 48

A 43-year-old man presented with severe back pain. He had a history of morbid obesity, for which an esophagogastric silicone band was placed 2 years before presentation. Magnetic resonance imaging of the vertebral column showed multiple osseous metastases. On the computerized tomography scan of the abdomen, a tumor of the lower esophagus just proximal to the esophagogastric band was seen, of which histological examination revealed an esophageal adenocarcinoma. Esophageal adenocarcinoma after bariatric surgery has been described previously in only a few cases. Although there is no evidence for a causal relationship with bariatric surgery, one should bear in mind that the incidence of esophageal adenocarcinoma is increased in patients with morbid obesity because of the higher incidence of gastroesophageal reflux disease. Also, the symptoms of adenocarcinoma might be masked after bariatric surgery.
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PMID:Adenocarcinoma of the lower esophagus after placement of a gastric band. 1884 27

A 47-year-old male with a body mass index (BMI) 37.12 kg/m(2) was diagnosed with an ill-demarcated tumor within IVB segment of left lobe of the liver. Sixteen months earlier, he underwent laparoscopic gastric banding for morbid obesity (BMI 51 kg/m(2)). One year after bariatric procedure, he was diagnosed with rectal adenocarcinoma. Following abdominoperineal resection of rectum with total mesorectal excision and 2 months course of adjuvant FOLFOX chemotherapy, he was scheduled for liver resection. Left hemihepatectomy was performed with no major complications; wound discharge was successfully treated in outpatient clinic. Twelve months following surgery, he remains disease free with no evidence of local recurrence, metachronic primary tumor, or distant metastases. This is first to our knowledge report providing data on the outcome of left hemihepatectomy performed in postbariatric patient. The role of bariatric surgery and utilization of the time necessary for neoadjuvant chemotherapy to reduce the excessive body mass and the degree of liver steatosis is discussed.
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PMID:Two-staged surgery for metastatic liver tumor in morbidly obese individual-left hemihepatectomy following placement of laparoscopic adjustable gastric band. 2018 38

Acetabuloplasty is a valuable palliative adjunct for the treatment of patients with painful metastatic disease to the pelvis in selected cases. We report the case of a 45-year-old woman with morbid obesity and with breast carcinoma who was technically difficult to treat under fluoroscopic guidance due to very poor visualization secondary to her body habitus. It was possible to perform radiofrequency ablation and acetabuloplasty with the use of cone-beam computed tomography for guidance.
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PMID:Cone-beam computed tomography as an adjunct to performance of percutaneous cementoplasty of the acetabulum. 2242 8

Morbid obesity is a huge problem of the twenty-first century, mostly treated by bariatric surgery. The authors report the case of a patient with port site metastases from an unknown rectal adenocarcinoma when bariatric surgery took place. Implants in the site of the subcutaneous access port to the band are problematic, particularly in patients with occult intra-abdominal malignancy. This case underlines the importance of preventive measures to avoid cell implant in port sites in benign such as malignant diseases.
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PMID:Port--site metastases following bariatric surgery. 2268 78

The Stewart-Treves syndrome is a rare and deadly entity, which is defined as angiosarcoma arising in the setting of chronic lymphedema. It typically presents in women who develop lymphedema in the upper extremity secondary to axillary lymph node dissection for breast cancer surgery. It is extremely uncommon in the lower extremities as a result of idiopathic chronic lymphedema. Here, we present the case of a 63-year-old female patient with idiopathic chronic lymphedema of the lower extremities having morbid obesity (BMI 82.6) and multiple comorbidities. She developed multiple confluent, hemorrhagic and necrotic elevated purple-black papules in the lower extremities, for which the initial diagnosis was cellulitis. Because there was no improvement with antibiotics, a lower extremity ultrasound and biopsy was performed which showed multiple masses in the left inner upper calf with solid and cystic components. The pathology results of the punch biopsies were consistent with angiosarcoma. Immunohistochemical studies revealed positivity for CD31, FLI-1, and a high Ki-67 proliferation rate. Because of the patient's weight and medical comorbidities, no further extensive diagnostic tests were performed to detect metastatic disease, and because of contraindications, no further medical treatment was provided. The patient subsequently died 1 month after diagnosis.
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PMID:Stewart-Treves Syndrome: A Case Report and Review of the Literature. 2709 6

Although obesity has now been widely accepted to be an important risk factor for cancer survival, the associations between BMI and cancer mortality have not been consistently linear. Although morbid obesity has clearly been associated with worse survival, some studies have suggested a U-shaped association with no adverse association with overweight or lower levels of obesity. This 'obesity paradox' may be due to the fact that BMI likely incompletely captures key measures of body composition, including distribution of skeletal muscle and adipose tissue. Fat and lean body mass can be measured using clinically acquired computed tomography scans. Many of the earlier studies focused on patients with metastatic cancer. However, skeletal muscle loss in the metastatic setting may reflect end-stage disease processes. Therefore, this article focuses on the clinical implication of low skeletal muscle mass in early-stage non-metastatic breast and colorectal cancer where measures of body composition have been shown to be strong predictors of disease-free survival and overall survival and also chemotherapy toxicity and operative risk.
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PMID:Clinical implications of low skeletal muscle mass in early-stage breast and colorectal cancer. 2986 Sep 52

Pelvic lymph node dissection (pLND) is considered the most reliable method for the detection of lymph node metastases in prostate cancer. Current clinical guidelines recommend performing pLND in intermediate- and high-risk patients that are defined using different clinical nomograms and different cut-off values. Although the detection of lymph node metastatic disease can identify patients who could benefit from adjuvant therapies and potentially improve prostate cancer-related survival outcomes, so far there has been no level 1 evidence to support this survival benefit. Available retrospective data that suggest oncological benefits are subject to various forms of bias. Furthermore, pLND is not feasible or may be risky in some patient-related conditions, such as morbid obesity and previous history of intraabdominal surgery including organ transplants. In this review, we discuss the current controversies surrounding pLND during robotic-assisted prostatectomy in prostate cancer, specifically the pitfalls in interpretation of restricted evidence suggesting its oncological benefits, and examine the potential influence of patient- and surgeon-related factors that may determine the decision to perform pLND.
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PMID:The ongoing dilemma in pelvic lymph node dissection during radical prostatectomy: who should decide and in which patients? 3189 69


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