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)

The case of a female patient with an alpha-fetoprotein (AFP)-producing acinar cell carcinoma of the pancreas is reported, and 28 cases in the literature are reviewed. In our case, the serum AFP level declined drastically after removal of the tumor, but increased when widespread metastases appeared. AFP was detected in the cytoplasm of the cancer cells by immunohistochemical staining. Immunoelectron microscopic studies revealed AFP on the endoplasmic reticulum of the cancer cells. Of the 28 cases with AFP-producing pancreatic cancer, liver metastases were identified in 21 cases (76% overall). There was no correlation between the serum AFP level and liver metastases. Immunohistochemical studies revealed localization of AFP at the primary lesion in 6 out of eight cases tested. In cases of AFP-producing pancreatic cancer, serum AFP levels are useful for the diagnosis and as a marker for evaluating recurrent disease and therapeutic response, and for the management of gastrointestinal disease it should be remembered that some pancreatic cancers produce AFP.
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PMID:Alpha-fetoprotein-producing pancreatic cancer--a case report and review of 28 cases. 138 Apr 76

We have examined the microscopic appearance, immunohistochemical staining properties, and clinical behavior of 28 cases of acinar cell carcinoma of the pancreas. Two of the tumors occurred in children. The adult patients ranged in age from 40 to 81 years (mean, 62 years). Males greatly outnumbered females, and most of the patients were white. Presenting symptoms were nonspecific, and jaundice was infrequent. The frequently reported complications from increased serum lipase levels (i.e., arthralgias and subcutaneous fat necrosis) were present in only 16% of the patients. Grossly, the tumors were relatively circumscribed and fleshy, averaging 10.8 cm, with occasionally extensive hemorrhage and necrosis. Microscopically, the tumors were very cellular and characteristically lacked a desmoplastic stroma. Acinar, solid, trabecular, and glandular patterns of growth were identified; individual tumors were usually mixed. Nuclei were round to oval, with minimal pleomorphism and single prominent nucleoli. Mitotic activity was variable. In general the cytoplasm was moderately abundant, eosinophilic, and granular, but many of the solid tumors had cells with scanty cytoplasm. Characteristic periodic acid-Schiff-positive, diastase-resistant cytoplasmic granules were demonstrated in greater than 90% of the cases, and the butyrate esterase histochemical stain for lipase activity was positive in 73%. Immunohistochemically, there was positivity for trypsin in 100% of the cases, for lipase in 77%, for chymotrypsin in 38%, and for amylase in 31%. A minor endocrine component was recognized with antibodies against chromogranin or islet cell hormones in 42% of the tumors. Ultrastructurally, exocrine secretory features were present, with polarized cells showing microvillilined lumina, abundant rough endoplasmic reticulum, and 125-1,000-nm zymogen-like granules. In addition, many cases showed pleomorphic electron-dense granules measuring up to 3,500 nm and containing fibrillary internal structures. Follow-up information was available in 88% of the cases. Half of the patients had metastatic disease at presentation and an additional 23% subsequently developed metastases, which were usually restricted to the regional lymph nodes and liver. The mean survival for all cases was 18 months, with 1- and 3-year survivals of 57 and 26%, respectively. Patients presenting before age 60 years survived nearly twice as long as older patients did. Stage also influenced prognosis, whereas the histologic subtype of the tumors and the location within the pancreas correlated only weakly with survival.
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PMID:Acinar cell carcinoma of the pancreas. A clinicopathologic study of 28 cases. 138 74

Fine-needle aspiration (FNA) of the liver is a procedure considered virtually risk-free. We report here a patient with carcinoma of the pancreas, who suffered a fatal hemoperitoneum (HP) subsequent to FNA of the liver under the guidance of ultrasound. The patient had presented with migratory deep vein thrombosis (DVT), and recurrent cerebral embolism. The prothrombin time (PT) and partial thromboplastin time (PTT) had been normal, and FNA demonstrated adenocarcinoma cells. Autopsy findings demonstrated carcinoma in the tail of the pancreas with liver and adrenal metastases, massive HP, and findings of chronic disseminated intravascular clotting (DIC). Since chronic DIC with enhanced fibrinolysis might have participated in the fatal bleeding, we recommend that FNA should be contraindicated in patients suspected of having malignancy with migratory DVT and recurrent arterial embolism, despite normal PT and PTT tests, unless the appropriate laboratory tests succeed in excluding DIC.
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PMID:Fatal hemoperitoneum after fine-needle aspiration of a liver metastasis. 153 72

Malignant tumours both of the pancreatoduodenal zone and of other organs situated close to or remote from it occupy a certain place among various etiopathogenetic factors of acute pancreatitis. Complication of the neoplastic process of these organs by acute carcinogenic pancreatitis (ACP) has an effect on the clinical picture of the disease as well as on the therapeutic tactics and the outcomes of the treatment. According to the authors' data (30 patients), ACP occurs in primary carcinoma of the pancreas and in its secondary involvement (metastases and growth of tumours of other organs into the pancreatic tissue). The article discusses the causative factors and clinical forms of ACP, the specific features of their diagnosis and therapeutic tactics. Purposeful nonoperative and operative treatment of ACP makes it possible to reduce the mortality in malignant diseases and prolong the patients' survival.
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PMID:[Acute pancreatitis in primary and metastatic tumors of the pancreas]. 171 52

The frequency of pancreatic carcinoma appears to be increasing. Effective treatment is essential for most patients whose tumours are unresectable. Definitive treatment by stenting techniques are currently limited to those patients who are high surgical risks, elderly, present with metastatic disease or refuse the surgical option. Surgical bypass offers the best palliation and should reliably decompress the biliary obstruction caused by the tumour with the least surgical trauma. Roux-en-Y choledochojejunostomy (CDJ), with or without a gastroenterostomy, is usually the preferred method of bypass; however, for patients with a distended gallbladder this procedure is often made easier by its removal. Even then providing a proximal, tension-free anastomosis can be challenging. In 13 consecutive patients who still had a gallbladder and required a biliary bypass for carcinoma of the pancreas, the authors interposed the gallbladder between the proximal bile ducts and a Roux-en-Y loop. This procedure could be done more quickly than CDJ and performed well.
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PMID:Choledochocholecystojejunostomy: a quick, effective method of biliary decompression for carcinoma of the pancreas. 174 28

The tumour-associated antigen CA-50 was analysed in plasma from 90 patients with cytologically verified exocrine carcinoma of the pancreas, and related to the size of the primary carcinoma, the largest metastasis of the liver and the degree of tumour-transformed liver parenchyme at 143 examinations. The median concentration of CA-50 in the patients with metastases of the liver was significantly higher than in the group lacking metastases. Spearman rank correlation test at three different levels of CA-50 (all values, exceeding 100 U/ml and exceeding 200 U/ml), showed a correlation between CA-50 and diameter of the primary pancreatic carcinoma in patients with liver metastases, but not in the group lacking liver metastases. No correlations were seen between CA-50 levels and size of liver metastasis or degree of tumour-transformed liver parenchyme. Hence, high plasma concentrations of CA-50 in patients with diagnosed or suspected exocrine pancreatic carcinoma could strongly indicate metastatic processes.
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PMID:Plasma concentrations of CA-50 in relation to tumour burden in exocrine pancreatic cancer. 183 99

Sixty-nine unselected patients with locally advanced and metastatic carcinoma of the pancreas, who had not received previous chemotherapy or radiotherapy were randomised to receive either 5-fluorouracil, epirubicin and mitomycin C (FEM) or epirubicin. Survival was not significantly different in the two arms. Toxic reactions (WHO grade greater than 3) in the FEM and epirubicin arm respectively included nausea (2), (4), severe alopecia (1) (3) and leucopenia (1), (5), none of these were statistically significant. We therefore suggest that combination chemotherapy should not be used in preference to single agent chemotherapy as standard treatment for locally advanced or metastatic cancer of the pancreas.
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PMID:Randomised trial of epirubicin alone versus 5-fluorouracil, epirubicin and mitomycin C in locally advanced and metastatic carcinoma of the pancreas. 190 26

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

Resection of hepatic metastases from carcinomas of the colon and rectum appears to extend the survival time in appropriately selected patients. Selection criteria have been widely published. Similar data for patients with hepatic metastases from primary sites other than the colon and rectum are lacking. To determine which, if any, patients in the latter category benefit from resections, we reviewed ten such instances treated at our institution plus 141 instances of resection for noncolorectal hepatic metastases previously reported. The over-all five year survival rate after resection of noncolorectal hepatic metastases is 20 per cent. When Wilms' tumor is excluded, the five year survival rate is 15 per cent. Approximately four of ten patients with metastases to the liver from Wilms' tumor or carcinoid survived five years after resection. Similar benefit is rarely obtained after resection of hepatic metastases of the breast, kidney, adrenal gland and carcinomas of the stomach; malignant melanoma, and leiomyosarcoma. No extension of survival is apparent for resection of hepatic metastases of gynecologic malignancies or carcinoma of the pancreas. Specific guidelines for selection are discussed in view of the limited prognosis when tumors other than carcinomas of the colon and rectum metastasize to the liver. Careful patient selection and minimization of complications are required.
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PMID:Results of resection and proposed guidelines for patient selection in instances of non-colorectal hepatic metastases. 194 2

Fifty patients affected by histologically confirmed gastrointestinal tract cancer (GTC) were treated with oral tegafur (TG) 1,000 mg m-2 p.o. on days 1-14 repeated after a 14 day interval. Out of 42 evaluable patients seven patients had a partial response (PR. 17%) with a median duration of 20.5 weeks, three had a minimal response (7%) with a median duration of 23.7 weeks, nine showed a stabilisation which lasted a median of 31.3 weeks, and 23 progressed (55%). No response was obtained in patients affected by carcinoma of the pancreas and the hepatobiliary system. All PRs were achieved in patients with metastatic disease to the liver. No response was seen in patients with bone, lung or nodal metastasis. Three PRs were obtained in patients resistant to 5-fluorouracil. The difference in survival between patients who achieved PR and those who had a stabilisation was not statistically significant. On the other hand the survival of patients with PR was significantly longer than that of patients who progressed. Oral TG was well tolerated by most patients. WHO grade 1-2 gastrointestinal and neurological toxicities were seen respectively in 36% and 25% of cases. Five patients had grade 3 nausea/vomiting and one had grade 3 diarrhoea. Our data suggest that oral TG is effective in the treatment of stomach and colorectal cancers.
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PMID:Oral tegafur in the treatment of gastrointestinal tract cancers: a phase II study. 210 30


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