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

During the last 5 years, 7 families suffering from familial polyposis coli have been investigated; we found 23 members affected and we operated 10 of them. One of them died of metastases and 9 members of these pedigrees died of carcinoma which appeared at the average age of 41,5 years. This confirms that this condition is the most serious precancerous illness and needs regular controls of all members of these families. At the occasion of this review, we describe the main features of this condition and briefly our surgical attitude.
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PMID:[Familial colonic polyposis (author's transl)]. 87 11

Results after 55 colectomies are reported in the period from 1962-1986. The surgical intervention was indicated by ulcerative colitis in 19, Crohn's disease in 18 and familial polyposis of the colon in 18 cases. 37 total colectomies, 12 subtotal colectomies with ileorectal anastomosis and 6 colectomies with a remaining terminal closed stump of the rectum were performed. During the period of observation postoperative lethality decreased from 37% to 6%. Death was most frequently caused by thromboemboli and peritonitis. In 44% of the patients ill with familial polyposis malignant degeneration could be observed. 3 died by generalized metastases. Metabolism of protein, lipid and electrolyte showed no essential disturbances after colectomy. Intestinal assimilation was nearly standard. More difficult is social reintegration.
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PMID:[Results and late sequelae of colectomy]. 166 79

Since 1977, 196 patients (177 with ulcerative colitis and 19 with familial polyposis) have undergone colectomy, mucosal proctectomy and endorectal ileal pull-through with or without an ileal reservoir (PTR) at UCLA Medical Center. Fourteen of the patients (7.1 per cent) had carcinoma of the colon or rectum at the time of operation; 12 had colitis and two, polyposis. Another 40 patients had mucosal dysplasia. Only five of the 14 patients with carcinoma were diagnosed before operation despite close surveillance by gastroenterologists. The mean duration of colitis before the diagnosis of carcinoma was made was 17 years; the mean age that the carcinoma was identified was 38 years. Eleven of the 12 patients with colitis had universal involvement. Two patients with colitis and carcinoma who underwent colectomy and PTR died a mean of 30.5 months postoperatively of metastatic disease. Twelve patients with carcinoma (ten with colitis and two with polyposis) are alive a mean of 29 months postcolectomy and PTR; two of these have received chemotherapy. The low mortality (0.4 per cent) and good clinical results after colectomy and the PTR procedure and the unexpectedly high incidence of carcinoma and mucosal dysplasia among patients referred for operation suggest that surgical treatment should be considered at an earlier stage than the current general practice, particularly in patients at high risk (mucosal dysplasia, pancolitis and duration of more than ten years).
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PMID:The endorectal ileal pullthrough procedure in patients with ulcerative colitis and familial polyposis with carcinoma. 254 48

To assess prognostic factors in patients who develop colorectal cancer before the age of 40 years, a 30-year experience from 1956 through 1985 was reviewed. There were 50 patients ranging in age from 7 to 39 years. Five cases were associated with either ulcerative colitis (2) or familial polyposis (3). The most common presenting symptoms were abdominal pain (66 percent), hematochezia (60 percent), change in bowel habit (41 percent) and weight loss (30 percent). On pathologic staging (N = 44), only 14 of 44 (31 percent) had a Dukes' stage A or B lesion, 20 (45 percent) had Dukes' stage C, and the remaining 10 (23 percent) had distant metastases at the time of surgery. Five-year survival rate was 28 percent with a disease-free survival rate of 18 percent. Median survival was only 28 months. Negative prognostic factors were Dukes' stage C/D (P less than .001), symptom duration of longer than 3 months (P = .01), noncaucasian ancestry (P = .01), and poorly differentiated histology (P = .06). In contrast to older patients with colorectal cancer, only 1 of 30 (3 percent) patients with stage C D disease was disease-free at 5 years. In view of the poor survival rate associated with both delay in diagnosis and the presence of advanced disease, it was concluded that young patients presenting with the symptoms listed above need early, aggressive evaluation for possible colorectal cancer.
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PMID:Colorectal cancer in patients younger than 40 years of age. 279 69

Of 518 patients undergoing the ileal pouch-anal anastomosis (IPAA), 17 (13 with chronic ulcerative colitis [CUC] and four with familial polyposis coli [FPC] ) also had a total of 22 cancers of the colorectum. Tumors were concentrated distally (rectum 6; sigmoid colon 5; proximal colon 11) and were diagnosed preoperatively in eight patients. Histologic grade and stage were as follows: grade I, 36 percent; II, 23 percent; III, 23 percent; IV, 18 percent; stage A, 5 percent; B1, 32 percent; B2, 18 percent; C1 and C2, 45 percent. Median hospital stay was 17 days with no operative mortality. Relaparotomy was required in 35 percent (sepsis in four patients; obstruction in two) and minor procedures were done in 12 percent (anastomotic dilatation in one; rectovaginal fistula in one). Mean frequency of defecation was 6.4/day, 1.0/night; incidence of minor seepage, 17 percent (day), 50 percent night); incidence of pouchitis, 8 percent; intermittent dyspareunia, 17 percent of six women. One patient died from hepatic metastases nine months after operation. IPAA should be considered in favorable cancers complicating CUC or FPC, although it may be contraindicated in advanced rectal cancer, and may be unsuitable in advanced proximal cancer.
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PMID:Ileal pouch-anal anastomosis for chronic ulcerative colitis and familial polyposis coli complicated by adenocarcinoma. 283 17

A survey is presented on the incidence of colorectal carcinomas in the GDR, exogenous causes possibly being responsible for the increase in incidence, common screening methods, macro-anatomy and micro-anatomy of colorectal carcinoma, staging, prognosis, and pathways of metastases. The correlation between intestinal polypi and colorectal carcinoma as well as the frequency of their degeneration are also referred to. Adenomatous polypi (polypous adenoma), villous polypi (villous adenoma), and certain rare intestinal polypi, such as familial polyposis coli, multiple polyposis of the entire gastro-intestinal tract, as well as the Gardner- and Turcot-syndromes, are some of those polypi which depending on their size tend to malignant degeneration. Histological information provided by the pathologist is discussed in its value and importance for surgical practice.
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PMID:[The colorectal carcinoma; pathological remarks (author's transl)]. 721 Sep 73

Sulindac is useful in regression of adenomatous polyps. In addition to orally administered sulindac, rectal preparations also appear to be efficacious [32]. However, further studies are necessary to determine whether regression of adenomas, the precursor of colorectal cancer, will cause decrease in colorectal cancer risk in both FAP and non FAP patients. Moreover, clinical studies are needed to test the application of this potential chemopreventative drug in several other patient populations. Several interesting observations have been made concerning the use of sulindac. Indomethacin, a related NSAID to sulindac, did not cause polyp regression. Also, upper gastrointestinal tract polyps in the stomach and duodenum appear not to be affected by sulindac therapy. These observations might be explained by the metabolism of sulindac in which the pharmacologically active sulfide metabolite is generated and distributed in the large intestine. Also, investigators noted that after discontinuation of sulindac adenomas recurred. Sulindac treatment was well tolerated at the usual clinical doses. Although some investigators have speculated on the effect of prostaglandin inhibition sulindac on cAMP-dependent mechanisms which control cellular proliferation [33], the cause of adenoma regression is unknown. There is evidence that colorectal endogenous prostaglandin levels decrease with sulindac. Evaluation of colorectal mucosal cellular proliferation in patients treated with sulindac has revealed a decrease in labelling index by bromodeoxyuridine labeling in one study [28] but no change in labelling index by [3H]thymidine incorporation in another investigation [34]. Also, ki 67 labelling index, another measure of cellular proliferation, was not affected in the colorectal mucosa of patients taking sulindac.(ABSTRACT TRUNCATED AT 250 WORDS)
Cancer Metastasis Rev 1994 Dec
PMID:Sulindac and polyp regression. 771 90

We report four unusual cases of hyalinizing trabecular thyroid tumors, three of which displayed capsular and/or blood vessel invasion and were classified as minimally invasive carcinomas. These three patients were all euthyroid women aged 18, 39, and 62 years. The youngest patient also had familial polyposis, while the oldest patient was being followed for Hashimoto's thyroiditis. All three lesions were solitary nodules, were "cold" by radioactive iodine thyroid scan, and ranged from 2.5 to 4.0 cm in diameter. The tumors were encapsulated and had growth patterns and cytologic features similar to those described for hyalinizing trabecular adenomas. In fact, the only difference between these minimally invasive hyalinizing trabecular carcinomas and the corresponding adenomas was the presence of capsular invasion in all three of the cases and vascular invasion in two. All three patients are free of recurrent or metastatic disease at 1 to 2 years' follow-up. The fourth patient, a 48-year-old woman, had a micropapillary carcinoma within a hyalinizing trabecular adenoma. She is also free of disease 5 years following excision of the involved lobe. These findings suggest that hyalinizing trabecular thyroid tumors have a malignant counterpart, similar to conventional follicular adenomas, and that papillary thyroid carcinomas may arise within hyalinizing trabecular thyroid tumors.
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PMID:Hyalinizing trabecular carcinoma of the thyroid gland. 811 20

Genetic and environmental aspects play an important role in the development of colorectal cancer. However, the common molecular alteration in both hereditary and sporadic colon cancer is localized in the APC gene. the APC gene maps in the long arm of chromosome 5 and was discovered in patients with familial adenomatous polyposis (FAP). The search for the APC gene led to the identification of restriction fragment length polymorphisms (RFLPs) in FAP patients. Using these RFLPs in relatives of FAP patients it is possible to make the presymptomatic and prenatal diagnosis. The FAP syndrome is an interesting model of carcinogenesis in vivo. Thus the different stages involved in the FAP syndrome which include hyperproliferative epithelium, adenoma, adenocarcinoma and metastases, have allowed the analysis of molecular alterations in oncogenes and tumor suppressor genes. The APC gene alteration if not inherited, occurs as the earliest molecular alteration in the development of colorectal cancer whereas structural alterations of the genes myc, ras, p53, MCC and DCC are considered to be late events. All these investigations have lead to 1) a better understanding of the ethiology of cancer and 2) early diagnosis of colorectal cancer in both the hereditary and sporadic forms of the disease.
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PMID:[Molecular genetics of colorectal cancer and carcinogenesis]. 813 31

The case history of a 24-year-old woman with Gardner's syndrome [familial adenomatous polyposis (FAP)] and papillary thyroid carcinoma is presented, representing the 37th report of this association. Although FAP is transmitted as an autosomal dominant trait with similar penetrance in both sexes, thyroid carcinoma has been found almost exclusively in women (94.3%). The majority have been papillary carcinomas (88.5%), which have become apparent during the third decade (average 23.6, range 16-40 years). Most (55.5%) thyroid carcinomas have been discovered 1-17 years after FAP was identified, although some have been found before (29.6%), or at the same time (14.8%) FAP was diagnosed. Multicentric papillary carcinomas have been reported in 64% (14 of 22) of FAP patients, a frequency at least twofold greater than usual. Although papillary carcinoma found before age 30 (as it was in most patients with FAP) typically has an excellent prognosis, one patient with FAP developed distant metastases from thyroid carcinoma and a 28-year-old woman's death was attributed to papillary carcinoma. The high frequency of multicentric papillary thyroid carcinoma in young patients with FAP and the potential for metastases and death due to thyroid carcinoma warrant aggressive diagnostic screening at regular intervals with neck palpation, ultrasonography, and if necessary, fine-needle aspiration biopsy. When thyroid carcinoma is found, total or near-total thyroidectomy should be considered because of the tumor's high likelihood of being multifocal.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Familial adenomatous polyposis (Gardner's syndrome) and thyroid carcinoma. A case report and review of the literature. 842 Jul 56


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