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)

Eight cases of feline pancreatic adenocarcinoma and two cases of pancreatic adenoma were reviewed. The adenomas were incidental findings. Most cats with adenocarcinomas had anorexia (75%) and vomiting (63%), while 38% had abdominal pain, a palpable abdominal mass, and/or jaundice. Diagnostic abnormalities included leukocytosis, hyperglycemia, increased alanine aminotransferase activity, poor serosal detail on abdominal radiography, and an abdominal mass effect on ultrasonography. The majority of cats with carcinomas had metastases (mostly to liver, lung, and small intestine), and all were euthanized or died within 7 days of diagnosis. Clinically, feline pancreatic carcinoma may be difficult to distinguish from feline pancreatitis.
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PMID:Exocrine pancreatic neoplasia in the cat: a case series. 1513 Nov 6

Metastasis is one of the major causes of mortality in cancer. It is well known that the activities of cell surface serine proteases are especially enhanced in malignant tumors. Proteolytic degradation of the extracellular matrix and basal membrane is a crucial event for tumor cell invasion and metastasis formation. FOY-305 (Foypan), a remedy for tumor pancreatitis, is a broad spectrum synthetic serine protease inhibitor which inhibits enzymatic activities including trypsin, thrombin, kallikrein and plasmin. Using Lewis lung carcinoma cell, we found that FOY-305 inhibited both spontaneous and experimental pulmonary metastasis. Furthermore, the combined treatment of FOY-305 and a traditional anti-cancer drug, 5-FU or bleomycin, resulted in marked enhancement of anti-pulmonary metastatic activity.
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PMID:Antimetastatic activity of a synthetic serine protease inhibitor, FOY-305 (Foypan). 1579 65

Tumor metastasis to the pancreas is a rare but recognized cause of acute pancreatitis. Autopsy series have reported a 24-40% of pancreatic involvement in small cell lung cancer. However, only a very few cases of tumor-induced acute pancreatitis have been described. Budd-Chiari syndrome complicating lung cancer is a rarely reported condition. We report a 68-year-old woman with extensive small cell lung cancer with the unusual initial presentation of both acute pancreatitis and acute Budd-Chiari syndrome. This patient suffered from progressive epigastralgia for 3 weeks. Severe epigastralgia with radiation to back and progressive jaundice developed 2 days prior to admission. After admission, the liver enlarged rapidly and the ascites increased markedly. Chest roentgenogram showed a mass lesion over the left lower lung field. Poorly differentiated carcinoma cells were found in ascites and bone marrow. The patient died on the ninth day of hospitalization before chemotherapy was initiated. Prompt diagnosis of extensive-stage small cell lung cancer may allow early chemotherapy treatment which favorably influences recovery when the pancreatitis is mild. Although prolonged survival might have been expected had this patient recovered from pancreatitis and received chemotherapy, diagnosis was delayed due to difficulty in immunohistochemical diagnosis of the tumor and the unusual clinical presentation. The use of stains employing antibodies against neurofilament and neuron-specific enolase cell antigens is important for early diagnosis of poorly differentiated metastatic tumor cells.
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PMID:Acute pancreatitis combined with acute Budd-Chiari syndrome as the initial manifestation of small cell lung cancer. 1603 34

Advanced disease, defined as vascular invasion or invasion into adjacent organs, in pancreatic ductal adenocarcinoma still remains a major diagnostic and therapeutic challenge. In most cases, only exploratory laparotomy will ultimately ensure surgical resectibility. A physician is ill-advised to make any decision regarding palliation relying on CT-scan, MRI, ultrasonography or angiography, since vascular invasion is difficult to diagnose because of peritumoral pancreatitis mimicking vascular invasion. Only in the case of complete vascular encasement of the mesenterico-portal axis or celiac trunk is a laparotomy unnecessary. If a T3 lesion is present, the patient will benefit greatly from R0 surgical resection, even if this includes en bloc resections of the transverse colon, or the portal vein, which can be reconstructed without vascular grafting in most cases. In the presence of distant metastases only palliative treatment is useful. If liver metastases are identified pre-operatively, palliation should include endoscopic common bile duct stenting in the presence of icterus, or endoscopic duodenal stenting in the case of percutaneous endoscopic gastrostomy. If metastases are found during exploratory laparotomy, surgical palliation should be considered (bilio-digestive anastomosis or gastro-enterostomy), since these procedures do not lead to a significantly longer hospital stay and are not associated with significant morbidity or mortality. Pain control can be ensured using morphine analogs, CT-guided sympathectomy or thoracoscopic sympathectomy. Currently, there is no answer as to which option offers the best pain control and quality of life. There is also an ongoing debate on the palliative Whipple's procedure, even in the event of single liver metastases, since this procedure is associated with limited mortality (well below 5% in high-volume centers) and ensures excellent pain control. This needs an individual assessment of risk and, furthermore, a detailed discussion with the patient. There are no studies in which resection has been performed as a standard procedure for palliation. This question should be answered in a multicenter randomized trial, otherwise the palliative Whipple's operation should still be considered experimental, since it is not likely to significantly prolong survival.
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PMID:Surgery for advanced and metastatic pancreatic cancer--current state and perspectives. 1673 38

Lesions in the spleen may be encountered in a variety of clinical settings ranging from asymptomatic patients to patients who are critically ill. Etiologies for multifocal splenic lesions include infectious and inflammatory processes, primary vascular and lymphoid neoplasms, metastatic disease, vascular processes, and systemic diseases. There is often overlap in the imaging appearance alone, so the clinical setting is very helpful in differential diagnosis. In the immunocompromised patient, multiple small splenic lesions usually represent disseminated fungal disease and microabscesses. The spleen is a relatively rare site for metastatic disease; patients with metastatic lesions in the spleen usually have disease in other sites as well. Breast, lung, ovary, melanoma, and colon cancer are common primary tumors that metastasize to the spleen. Vascular neoplasms of the spleen represent the majority of the nonhematologic/nonlymphoid neoplasms and commonly produce multifocal lesions. Splenic infarcts may be seen with localized processes such as portal hypertension or pancreatitis, or may arise from an embolic source. Radiologists should be aware of the spectrum of processes that may involve the spleen and the clinical context in which they occur.
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PMID:Multiple lesions of the spleen: differential diagnosis of cystic and solid lesions. 1704 54

A 35-year-old female received right hemicolectomy for a poorly differentiated adenocarcinoma of the ascending colon with lymph node metastasis (1/28) in February 1997. CEA was 1.68 ng/microl prior to colectomy. Adjuvant chemotherapy with weekly 5-FU and leucovorin intravenously was started following surgery and discontinued after 17 doses in May 1997. She received bilateral salpingo-ophorecctomy for metastatic cancer in August 1999. Intravenous chemotherapy was resumed with weekly 5-FU and leucovorin intravenously in August 1999. CEA was 93.8 ng/microl in November 1999. Intravenous chemotherapy was discontinued after 20 doses and oral chemotherapy with futraful and leucovorin was started in January 2000. CEA was found to be 240.3 ng/microl in December 1999 and then elevated to 1521.3 ng/microl in June 2001, which was 10 months after resection of metastatic ovarian cancer. No metastatic lesions could be detected, however, with image studies. The CEA decreased to 396.6 ng/microl three months later. Futraful was switched to uracil-tegafur (UFUR) in September 2001. The CEA for the patient ranged from 68.5 to 298.9 ng/microl for the following 5 years without aggressive chemotherapy. No evidence of recurrence could be demonstrated by imaging studies. The patient is not a smoker and denied exposure to a smoking environment. She was also not known to have persistent infections, inflammatory bowel disease, pancreatitis, cirrhosis of the liver, or any benign tumors. The current case suggested that: (i) elevation of CEA is not necessarily well correlated with presence of metastatic colon cancer; (ii) some patients may live with elevated CEA for years without evidence of recurrence or metastasis; (iii) aggressive chemotherapy may not be necessary in patients with only elevated CEA.
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PMID:Unusual elevation of CEA in a patient with history of colon cancer. 1706 Apr 6

Hemoperitoneum may occur in various emergent conditions. In the trauma setting, evidence of intraperitoneal blood depicted at computed tomography (CT) should lead the radiologist to conduct a careful search of images for the injured visceral organ (the liver or spleen). Specific CT signs, such as a sentinel clot or extravasation of intravascular contrast material, may indicate the source of bleeding and help direct management. In addition, the configuration of accumulated blood may help identify the injured organ; for example, triangular fluid collections are observed in the mesentery most often in the setting of bowel or mesenteric injury. Less commonly, hemoperitoneum may have a nontraumatic origin. Iatrogenic hemoperitoneum may occur as a complication of surgery or other interventional procedures in the abdominal cavity or as a result of anticoagulation therapy. Hemoperitoneum also may be seen in the setting of blood dyscrasias such as hemophilia and polycythemia vera. Tumor-associated hemorrhage, which most often occurs in hepatocellular carcinoma, hepatic adenoma, or vascular metastatic disease, also may produce hemoperitoneum. Other potential causes of nontraumatic hemoperitoneum are gynecologic conditions such as hemorrhage or rupture of an ovarian cyst and rupture of the gestational sac in ectopic pregnancy, and hepatic hematoma in syndromic hemolysis with elevated liver enzymes and low platelet count (HELLP syndrome). Vascular lesions (visceral artery aneurysms and pseudoaneurysms) that occur in systemic vascular diseases such as Ehlers-Danlos syndrome or in pancreatitis are another less common source of hemoperitoneum.
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PMID:Blood in the belly: CT findings of hemoperitoneum. 1723 2

Lung cancer metastases can occur in almost any organ. However, metastasis of small cell lung cancer to the pancreas is rare. Moreover, not all cases present with clinically diagnosed pancreatitis. We recently treated a patient with small cell lung carcinoma that invaded the pancreatic duct causing acute pancreatitis. Generally, the treatment for tumor-induced acute pancreatitis is initially supportive followed by aggressive chemotherapy or surgery. If the patient can tolerate the insertion of an endoscopic intrapancreatic stent, this is performed in addition to chemotherapy and surgery; this approach offers a safe and effective treatment modality for such patients.
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PMID:Pancreatitis from metastatic small cell lung cancer successful treatment with endoscopic intrapancreatic stenting. 1724 10

The ability to diagnose pancreatic carcinoma has been rapidly improving with the recent advances in diagnostic techniques such as contrast-enhanced Doppler ultrasound (US), helical computed tomography (CT), enhanced magnetic resonance imaging (MRI), and endoscopic US (EUS). Each technique has advantages and limitations, making the selection of the proper diagnostic technique, in terms of purpose and characteristics, especially important. Abdominal US is the modality often used first to identify a cause of abdominal pain or jaundice, while the accuracy of conventional US for diagnosing pancreatic tumors is only 50-70%. CT is the most widely used imaging examination for the detection and staging of pancreatic carcinoma. Pancreatic adenocarcinoma is generally depicted as a hypoattenuating area on contrast-enhanced CT. The reported sensitivity of helical CT in revealing pancreatic carcinoma is high, ranging between 89% and 97%. Multi-detector-row (MD) CT may offer an improvement in the early detection and accurate staging of pancreatic carcinoma. It should be taken into consideration that some pancreatic adenocarcinomas are depicted as isoattenuating and that pancreatitis accompanied by pancreatic adenocarcinoma might occasionally result in the overestimation of staging. T1-weighted spin-echo images with fat suppression and dynamic gradient-echo MR images enhanced with gadolinium have been reported to be superior to helical CT for detecting small lesions. However, chronic pancreatitis and pancreatic carcinoma are not distinguished on the basis of degree and time of enhancement on dynamic gadolinium-enhanced MRI. EUS is superior to spiral CT and MRI in the detection of small tumors, and can also localize lymph node metastases or vascular tumor infiltration with high sensitivity. EUS-guided fine-needle aspiration biopsy is a safe and highly accurate method for tissue diagnosis of patients with suspected pancreatic carcinoma. (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) has been suggested as a promising modality for noninvasive differentiation between benign and malignant lesions. Previous studies reported the sensitivity and specificity of FDG-PET for detecting malignant pancreatic tumors as being 71-100% and 64-90%, respectively. FDG-PET does not replace, but is complementary to morphologic imaging, and therefore, in doubtful cases, the method must be combined with other imaging modalities.
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PMID:Diagnosis of pancreatic cancer. 1833 85

We report two cases of autoimmune pancreatitis (AIP) in which fluorine-18 fluorodeoxyglucose (FDG) showed moderate accumulation in the pancreas, as well as in bilateral submandibular glands and in multifocal lymph nodes. FDG positron emission tomography (PET)/computed tomography (CT) is a useful diagnostic tool to assess the extrapancreatic lesions of AIP, which is a recently proposed new clinicopathological entity named immunoglobulin G4 (IgG4)-related systemic disease. Recognition of the FDG-PET/CT findings of IgG4-related sclerosing disease is crucial to avoid unnecessary surgery or other intervention because of similarities to malignant lymphoma or malignant tumor with multiple lymph node metastases.
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PMID:Extrapancreatic F-18 FDG accumulation in autoimmune pancreatitis. 1849 37


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