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)

Tumour metastases to the pancreas are a rare but recognized cause of acute pancreatitis, there is a 24-40% incidence of pancreatic involvement from small cell lung cancer in autopsy series but only a very few cases of tumour-induced acute pancreatitis have been described. Chemotherapy has been advocated as the primary therapy in patients with known oat cell carcinoma who develop acute pancreatitis. We describe 2 patients with acute haemorrhagic pancreatitis in association with disseminated small cell carcinoma but without evidence of tumour invasion in the gland and with gall stones present in the gall bladder. Chemotherapy would have been inappropriate therapy for these patients.
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PMID:Acute pancreatitis in association with small cell lung carcinoma: potential pitfall in diagnosis and management. 299 75

A retrospective analysis of 25 primary adenocarcinomas of the pancreas, 16 metastatic pancreatic tumors, 8 cases of chronic pancreatitis, and 3 adult normal pancreas was performed to ascertain the reactivity of monoclonal antibody (MAb) B72.3 to malignant and nonneoplastic pancreatic lesions. Formalin-fixed, paraffin-embedded sections of pancreas were evaluated by immunohistochemical techniques (avidin-biotin-peroxidase complex [ABC] method). Twenty-one of 25 malignant primary tumors were reactive, and all 16 metastatic sites expressed the B72.3 antigen. In contrast, all cases of pancreatitis and normal pancreas were either weakly reactive or nonreactive. Ten malignant and two benign pancreatic fine-needle aspirates provided results similar to those seen with fixed tissues. Because MAb B72.3 has selective reactivity for primary and metastatic pancreatic cancer, it may be of value as a diagnostic adjunct in cytologic examination or for radioimmunodetection of regional and/or distant metastases of adenocarcinoma of the pancreas.
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PMID:A tumor-associated antigen in carcinoma of the pancreas defined by monoclonal antibody B72.3. 327 79

Pancreatic metastases were found in 14 of 250 patients (5.6%) with bronchial carcinoma. The most common histological type leading to pancreatic metastases was the small-cell anaplastic carcinoma (86%). Metastasis-induced pancreatitis is rare, having been noted in only one patient (metastases in the head of the pancreas). In two other patients acute pancreatitis was found by autopsy which, however, had been clinically silent. In the other eleven the pancreatic metastases were also clinically silent.
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PMID:[Acute metastasis-induced pancreatitis in bronchial carcinoma]. 362 72

A case is presented of a 56 year old man with a history of idiopathic pancreatitis and multiple admissions for Klebsiella sepsis from an intra-abdominal focus, who in February 1980, developed spontaneous jejunal perforations on two occasions due to multiple ulcers in the small intestine associated with multiple hepatic metastases from a gastrin-secreting islet-cell tumor (gastrinoma) of the pancreas. On searching the literature, no other record could be found of an association between pancreatitis and a gastrinoma, although in this patient the two disease processes appear to be inextricably related.
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PMID:A case of pancreatitis associated with gastrinoma. 386 97

Ultrasound has proven invaluable in detecting and evaluating pancreatic pseudocysts, and it is now a standard test to rule out complications of pancreatitis. In reviewing the authors' experience with 122 patients treated surgically for a pancreatic pseudocyst, five patients were identified in whom an ultrasound demonstrated a pseudocyst that was associated with an unexpected cancer at the time of operation. A sixth patient, with a pseudocyst documented by ultrasound, died prior to surgery and was found at autopsy to have metastatic common bile duct carcinoma. There was little difference in presenting symptoms, age, frequency of alcoholism, or physical findings compared with patients with pseudocysts secondary to pancreatitis. In two patients, pseudocysts were found in the tail of the pancreas at operation, in addition to carcinoma. In the other three patients, no pseudocyst was found; however, a subcapsular splenic hematoma was present in one. Five patients had metastatic disease, three from pancreatic adenocarcinoma, one from islet cell carcinoma, and one from a common bile duct carcinoma. One patient with a pancreatic adenocarcinoma confined to the head underwent a Whipple procedure and has no evidence of disease 6 months later. Malignancy may cause or coexist with pancreatic pseudocysts. Ultrasound is often not helpful in distinguishing pseudocysts associated with malignancy from those associated with pancreatitis. Biopsy should be performed to rule out malignancy when operating for pancreatic pseudocysts.
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PMID:Carcinoma masquerading as a pancreatic pseudocyst on ultrasound. 620 50

The authors carried out a study of some pathogenic mechanisms related to the development of acute renal failure in animals following pancreatitis-induced shock. The study was made in 110 white rats in which acute pancreatitis was induced experimentally, and the results were compared with those obtained in a control lot of 40 rats. The behaviour of some biochemical parameters was investigated (cathecholamines, acid phosphatases, catepsine, aminoacids and polypeptides), in tissue homogenates (liver, intestine and kidney), and in the serum. Histopathologic changes were also evaluated, which occurred in the intestine, the kidney, the liver and the pancreas. Histopathologic changes in the kidney, and acute renal failure which accompanied them in rats with acute pancreatitis are rather a result of protesic activation in the tissues of the organs involved (especially the intestine and the kidney), and are less the results of enzymatic extension or metastases following pancreatic necrosis.
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PMID:[Pathogenetic aspects of acute renal insufficiency in experimental acute pancreatitis]. 621 22

Twelve patients with biopsy-proven clinically localized ductal pancreatic cancers (less than 7 cm in greatest diameter) judged unsuitable for resection were treated by bypass surgery, an Iodine-125 implant (20-39 mCi), and postoperative irradiation (4000-4500 rads). The potential problems of significant bleeding, pancreatic fistula, or pancreatitis were not experienced. A local recurrence developed in one patient and two recurred in regional lymph nodes. The projected median survival of the group is 11 months with four of the 12 patients still surviving. For purposes of comparison all patients with pancreatic ductal carcinoma treated by radical resection during a similar time were evaluated. All ten have died with a median survival of six months. Twelve of 22 (55%) of the combined implanted and resected groups have developed distant metastasis. Further pursuit of intraoperative techniques of irradiation in combination with adjuvant multidrug chemotherapy seems indicated in an attempt to prolong patient survival which is now limited by hematogenous metastases.
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PMID:Iodine-125 implant and external beam irradiation in patients with localized pancreatic carcinoma: a comparative study to surgical resection. 624 74

Data was collected from results of injection and dissection of 100 autopsy specimens; the examination of 34 case-reports of cancer patients; the injection of lymphatics in 14 live dogs; and the reconstruction of the mesodorsal region of the pancreas from a 30 mm embryo using Born's technique. Anatomy of the pancreas and lymph vessels shows that the "primary mesodorsal region" of the pancreas is two-fold; a right part for the right side of pancreas: the retroportal process (RPP); a left part for the left side of pancreas, a formation not previously described: the left lateroportal process (LLPP). Whereas lymphatic drainage visible on the anterior surface of the pancreas is apparently as described, posterior drainage, which collects lymph from posterior and anterior vessels, is quite atypical. The right portion drains into the RPP and the left into the LLPP. Terminal collecting vessels of pancreatic lymphatics have only a short distance to travel before emptying into the thoracic duct. The study of lymph node metastases from pancreatic cancer appears to confirm these cadaver anatomic results but the series is too small for valid exploitation. The very rapid passage into the thoracic duct probably greatly diminishes the value of widely extended surgery, justification for the latter being exclusively to remove lymph nodes insofar as adjuvant therapy has currently failed to demonstrate absolute efficacy. Precise knowledge of the anatomy of the pancreatic lymphatics should allow development of experimental models to study lymph circulation changes during acute pancreatitis. Pancreatic edema, an enzyme-rich fluid, is an essentially "lymphatic" edema. The interstitial and lymphatic shunt pathways due to increased duct pressure were evident during the dog study. The lymphatic system acts as a "buffer system" or "safety valve" against progression to necrosis. Ligature of very proximal pancreatic lymphatic efferents (included in the bands) was followed by a fatal necrotic pancreatitis on both occasions when this was performed. Development and study of a lymphagogue drug for the treatment of acute pancreatitis is a justifiable project. A protocol is proposed which combines lymphagogue treatment with anti-enzymes, the former assists use of the enzymes by the lymphatic system. The anti-proteases prevent the onset of fatal shock caused by the outpouring of enzymes into the lymphatic system and the general circulation.
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PMID:[Clinical and surgical anatomy of the lymphatic circulation of pancreas]. 651 23

The diagnostic accuracies of measurement of carcinoembryonic antigen (CEA) and analysis of the cytologic characters of pure pancreatic juice were assessed in 16 control subjects, 20 patients with pancreatitis and 22 patients with pancreatic cancer. Pure pancreatic juice was collected from the pancreatic duct by endoscopic cannulation using a duodenofiberscope after intravenous administration of secretin. The pancreatic fluid was centrifuged and the supernatant was used for CEA assay, while the cell pellet was examined cytologically. Abnormally high CEA levels in the pure pancreatic juice were significantly more frequent in patients with pancreatic cancer; an increased CEA concentration in the pancreatic juice was found in 68.2% of the patients. The location of the cancer had no influence on the CEA level of the pancreatic juice, but the level tended to be high when the tumor had distant metastases. Positive cytologic findings were obtained in specimens of pure pancreatic juice of 68.2% of the patients with pancreatic cancer. Positive cytologic results were more frequent in patients with carcinoma of the head of the pancreas than in those with carcinoma of the body or tail, and those with localized tumors had the lowest yield of positive cytologic results. For sensitive tests, it was necessary to collect pure pancreatic juice containing no contrast medium. High CEA levels and positive cytological results were significantly more frequent in pancreatic juice obtained 10 to 20 minutes after secretin stimulation than in those collected immediately after stimulation. Correct diagnosis of malignancy was made by CEA assay alone or by cytological examination alone in 68.2% of the patients examined, while a combination of these methods raised the diagnostic rate to 86.4%.
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PMID:Significance of carcinoembryonic antigen levels and cytology of pure pancreatic juice in diagnosis of pancreatic cancer. 662 6

A case report is given of a patient with a metastasizing teratocarcinoma of the testis (ripe teratoma and embryonal carcinoma), which was misinterpreted in the beginning as acute pancreatitis. At post mortem, metastases of this tumour were found in the pancreas, which apparently had led to inflammatory lesions of this organ, which could not explain however all of the clinical symptoms seen before. The literature dealing with cases suffering from acute pancreatitis induced by tumours is reviewed. A list of possible associations between pancreatitis and tumours is given.
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PMID:[Differential diagnosis of pancreatitis: metastasis to the pancreas]. 713 32


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