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)

Angiographic findings in one giant cell carcinoma, one cystadenocarcinoma, one poorly vascularized mucinous cystadenocarcinoma, as well as in two avascular (gastrin- and glucagon-producing) islet-cell tumors of the pancreas are described. Two hypervascularized islet-cell tumors are presented for comparison and a case of tumorous chronic pancreatitis in a child is reported because ot its rarity. The aggressiveness of the giant cell carcinoma of the pancreas was demonstrated by its expansive growth. In the case of cystadenocarcinoma angiography revealed the tumor with hepatic metastases not diagnosed at explorative laparotomy. The relative hypovascularity in the case of mucinous cystadenocarcinoma was unusual. Both avascular islet-cell tumors simulated a pancreatic pseudocyst and the final diagnosis was made only by immunoassay. Chronic pancreatitis in a child presented with marked hypervascularization.
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PMID:Angiographic findings in some rare pancreatic tumors. 18 40

Of 623 cases of malignant pancreatic tumor seen at University of Chicago hospitals over the last 30 years, 23 cases of malignant islet cell tumor were found (8 additional cases were found in the literature). Calcification, found in 2 of these cases, was characteristically discrete and nodular (calcifications found in chronic pancreatitis are typically diffuse, multiple, and punctuate). At least 7 of the 10 cases of islet cell tumor with calcification were malignant. Slow growth of the tumor, with calcified metastases, strongly suggests the diagnosis of malignancy; this combination of findings has been established in 3 cases. In 73 cases of benign islet cell tumor, no calcifications were found.
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PMID:Pancreatic calcifications in malignant islet cell tumors. 18 51

The possibilities for nuclear medical investigation in the retroperitoneal space were extended by the introduction of the scintillation camera with an evaluation system. The diagnostic aid in diseases of the kidney (unilateral and bilateral nephropathies, shock kidney, stenosis of the renal arteries, aortic occlusion), suprarenals (Conn syndrome) and the skeleton of the entire body (diagnosis of metastases and non-malignant bone diseases) are reviewed. Scanning scintigraphy can be used in the identification of lymphnode metastases in negative (198 Au colloid) and positive (67 Ga) tumor contrast and in double radionuclide substraction techniques in pancreatic tumor and chronic pancreatitis. Clinical examples are demonstrated.
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PMID:[Possibilities for nuclear medical investigation in the retroperitoneal space: (author's transl)]. 40 33

Circulating CEA levels were determined in 102 patients wtih histologically proven pancreatic carcinoma and 26 patients with chronic pancreatitis. In the group with pancreatic carcinoma eleven patients had resectable tumors, the mean CEA in the nonjaundiced patients was 10 +/- 5 ng/ml while the mean value in jaundiced patients in this group was 27 +/- 40. Thirty-four patients with nonmetastatic locally unresectable disease had a mean serum CEA of 25 +/- 52 with a range of 1 to 250 ng/ml. Twenty-one percent had values of 5 ng/ml or less. The mean value in 57 patients with metastatic disease was 97 +/- 194 with a range of 0.05 to 1000 ng/ml and 19 percent had values of 5 ng/ml or less. Survival of patients with locally unresectable or metastatic carcinoma was significantly longer in those patients who had a normal CEA at the time of diagnosis. Circulating CEA in the metastatic group was much lower in patients with nonhepatic metastases as well as in those with well differentiated adenocarcinoma histology. Twenty-three patients with chronic pancreatitis and normal serum bilirubin had a mean CEA value of 5.3 +/- 4 ng/ml with 65% of values being 5 ng/ml or less but the CEA ranged from 4.6 to 27 in three who were jaundiced.
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PMID:Circulating carcinoembryonic antigen in pancreatic carcinoma. 70 16

Dilatation or occlusion of the gastrocolic trunk (GT) may be a clue to a portal venous or pancreatic pathologic condition. To evaluate the normal and abnormal appearances of the GT and its tributaries at computed tomography (CT), the CT scans, angiograms, and surgical-pathologic records of 21 patients with cancer of the pancreas and 15 patients with chronic pancreatitis were reviewed retrospectively. The CT examinations of 30 patients with metastatic disease of the liver and no known pancreatic disease were studied for comparison. A normal GT (2.6-4.7-mm diameter) was identifiable in 48% of the control group in CT scans obtained with 10-mm-thick sections and in 90% of CT scans obtained with 5-mm-thick sections. The GT was dilated in five patients with isolated splenic vein occlusion and in five patients with occlusion or stenosis of the portal-superior mesenteric vein confluence (P-SMVC) above the level of the GT entry into the superior mesenteric vein. The GT was obliterated in eight patients and was associated with P-SMVC occlusion. Findings at surgery confirmed tumor extension into the root of the transverse mesocolon in three patients with cancer of the pancreas. Abnormal findings at CT, however, do not enable differentiation between benign and malignant pancreatic diseases.
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PMID:The gastrocolic trunk and its tributaries: CT evaluation. 153 11

We reviewed the results of 187 consecutive ultrasound-guided fine-needle biopsies of the pancreas in 171 patients to assess the diagnostic accuracy of the method. The final diagnosis obtained at operation, autopsy or follow-up were: adenocarcinoma (n = 83), metastatic cancer (n = 11), cystadenocarcinoma (n = 2), lymphoma (n = 2), malignant gastrinoma (n = 1), pseudocyst (n = 25), cyst (n = 13), chronic pancreatitis (n = 9), normal pancreas (n = 10), abscess (n = 7), benign islet-cell tumour (n = 5), cystadenoma (n = 3). Sufficient cytologic material was obtained in 95.3% of biopsies and the overall accuracy in distinguishing benign from malignant disease was 85.4%. False negative results were obtained in 12 patients (13.1%). Inconclusive results (CIII) were found in aspirates from one cyst and two islet cell tumours. There were no false-positive results. The only complication was a post-biopsy haematoma around the head of pancreas, which resolved spontaneously. Ultrasound-guided pancreatic fine-needle biopsy is a safe method and allows of a high degree of diagnostic accuracy. It has a high specificity. Its sensitivity in the detection of malignancy improves if biopsies are repeated in doubtful cases. It further permits tumours to be graded and allows complications of pancreatitis to be diagnosed.
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PMID:Diagnostic accuracy of ultrasound-guided fine-needle pancreatic biopsy. 173 79

This study was performed in order to evaluate the role of various local and systemic alterations in influencing serum glycoproteic markers in patients with pancreatic cancer, and in healthy and diseased controls. Cancer antigen 19-9 (CA 19-9), carcinoembryonic antigen (CEA), and ferritin were determined in the sera of 23 control subjects, 30 patients with pancreatic cancer, 27 with chronic pancreatitis, and 27 with extra-pancreatic diseases mainly of gastrointestinal origin. A number of acute-phase proteins and indices of liver function and cholestasis were also assayed. The three antigens increased only in patients with pancreatic cancer. Higher CA 19-9 and CEA, but not ferritin, levels were found only in patients with hepatic metastases. Acute-phase proteins and synthetic functional indices were found to be higher and lower, respectively, in patients with pancreatic malignancy when compared with controls. Multiple regression analysis documented the dependence of circulating ferritin, but not of CA 19-9 and CEA, on the systemic indices. Canonical correlation showed a similar trend for CA 19-9 and CEA, which differed from that of ferritin. Ferritin was found to depend on the presence of systemic and hepatic alterations, especially of cholestasis. We can conclude that the variations of serum glycoprotein markers in patients with pancreatic cancer depend on various regional and systemic factors. CA 19-9 and CEA are related mainly to the extent of the neoplasia. The influence of a decreased liver function capacity associated or not to cholestasis and the interrelation with the acute-phase response may also be suggested. Ferritin, on the other hand, is related to a higher degree than CA 19-9 and CEA to hepatic dysfunction and also behaves similar to an acute-phase protein.
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PMID:Role of local and systemic factors in increasing serum glycoprotein markers of pancreatic cancer. 177 Mar 22

US and direct cholangiography have considerably simplified the diagnostic workup of mechanical icterus. These procedures allow diagnosis of choledocholithiasis in most cases. We analyze the possible additional role of CT in the diagnostic workup of malignant jaundice in a retrospective study. Between January 1986 and December 1989. ERCP was performed in 37 patients with malignant jaundice. 21 of the lesions were located in the pancreas, 7 in the papilla and 6 in the bile duct; in 2 cases the choledochus was compressed by metastases and in one chronic pancreatitis was present. In 34 of 37 patients (92%), ERCP alone permitted a definite diagnosis. 22 patients underwent CT as the primary diagnostic procedure. In only 9 of these (41%) was an unequivocal diagnosis possible, as opposed to ERCP (19 of 22 or 86%). No complications of ERCP were observed. We therefore conclude that the diagnosis of malignant jaundice can be based on history, physical examination, laboratory results, US and ERCP alone. In the vast majority of cases CT is unnecessary.
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PMID:[The value of computerized tomography and endoscopic retrograde cholangiopancreatography in the assessment of malignant jaundice]. 186 11

A 43-year-old alcohol-dependent man had sustained three acute episodes of chronic pancreatitis. At the third hospital admission enlarged axillary and supraclavicular lymph nodes, widening of the mediastinum and bone metastases were noted. Cytological examination of a needle biopsy of the supraclavicular lymph node revealed a poorly differentiated adenocarcinoma. Because of the marked enlargement of the pancreas and the history, a rapidly and unusually metastasizing carcinoma of the pancreas was diagnosed. In view of the rapid deterioration of the patient no chemotherapy was begun and he died 4 weeks after admission. Autopsy confirmed the chronic pancreatitis but no carcinoma of the pancreas. Instead there was a peritoneal mesothelioma with extensive lymphogenous and haematogenous metastases. The incidence of this tumour is ever increasing. It should be included in the differential diagnosis, because survival time can be increased if the correct diagnosis is made very early.
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PMID:[Malignant peritoneal mesothelioma with unusual and extensive metastasis]. 191 10

Serum CA 19-9 was determined in 83 control subjects, 99 patients with pancreatic cancer, 104 with chronic pancreatitis and 137 with extra-pancreatic diseases mainly of gastrointestinal origin in order to evaluate whether hepatic factors can influence circulating CA 19-9 in pancreatic cancer. Sensitivity, specificity and accuracy of this test in determining pancreatic malignancy were: 74%, 83% and 57%. We divided patients into two groups: group A (159 cases) and group B (181 cases) with and without anatomical liver damage (presence of primary or metastatic cancer, cirrhosis, hepatitis, steatofibrosis, cholangitis). Group A presented higher CA 19-9 values as compared to group B. Significant correlations were found in group B but not in group A between CA 19-9 and ALT, ALP and total bilirubin. Multiple regression analysis (CA 19-9 dependent and ALT, ALP and total bilirubin predictor variables) was significant only in group B. The standardized partial regression coefficients found to be significant were those of ALP and total bilirubin. We can conclude that CA 19-9 is an index of pancreatic cancer with satisfactory sensitivity and specificity. The presence of anatomical liver damage seems to increase the value of this index, probably releasing CA 19-9 into the bloodstream. Extra-hepatic cholestasis may also be an important factor in elevating CA 19-9 probably by reducing the hepatic catabolism of this glycoprotein.
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PMID:How does liver dysfunction influence serum CA 19-9 in pancreatic cancer? 213 20


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