Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 72-year-old man with an oncocytic carcinoma of the pancreas of 3 years' duration was treated by pancreatoduodenectomy; 5 and 16 months later, two pulmonary metastases and one subcutaneous metastasis of the thigh were removed. No sign of local recurrence or metastases was present at 20-month follow-up. It is suggested that oncocytic carcinomas of the pancreas have a favorable prognosis if treated surgically.
 ...
PMID:An oncocytic carcinoma of the pancreas with pulmonary and subcutaneous metastases. 809 54

This study reviews 6 patients who were referred with severe loin pain radiating to the groin and in whom a presumptive diagnosis of ureteric colic was made. Of these, 3 patients were found to have carcinoma of the pancreas and the remaining 3 had retroperitoneal lymph node metastases. Retroperitoneal malignancies rarely present with loin pain, but this diagnosis should be considered in patients with long-standing loin pain in whom an obvious diagnosis is not apparent.
 ...
PMID:Retroperitoneal malignancy masquerading as ureteric colic. 834 92

Endoscopic stent placement has become accepted palliative therapy for malignant biliary tract obstruction. Because stent occlusion remains a significant late complication, prophylactic replacement has been suggested, although the appropriate time interval remains unclear. Patients with malignant biliary strictures who received 10F or 11.5F stents were analyzed with respect to clinical response, occlusion rates at 3 and 6 months, and survival rates. Seventy stents were placed in 50 patients. Pancreatic carcinoma was the most common underlying malignancy. Overall, obstructive symptoms resolved in 94% of cases. Occlusion rates at 3 months (4.2%) and 6 months (10.8%) were not significantly different. Median overall survival averaged 22 weeks. Results were also stratified by underlying diagnosis, with the worst clinical response and survival being seen in the group of patients with metastatic cancer. Findings suggest that the time interval for stent replacement can be extended safely from 3 to 6 months, resulting in decreased patient discomfort and cost and obviating any replacement in that significant percentage of patients who expire before 6 months.
 ...
PMID:Optimal timing for stent replacement in malignant biliary tract obstruction. 838 45

To clarify the pattern of lymph node metastasis in carcinoma of the pancreas, lymph node involvement was examined in forty-two patients who underwent extensive nodal dissections, including the paraaortic lymph nodes. The correlation between the spread of the tumor and lymph node involvement was evaluated: The most common site of involved lymph nodes was the retropancreatic region. The prevalence of nodal metastases was 78.6%. Metastases to the paraaortic region were present in seven patients, among whom metastases in the paraaortic region were most common in the median region from the celiac artery to the inferior mesenteric artery and in the space between the aorta and the vena cava. The risk of lymph node metastases tended to increase with tumor size, except in the paraaortic region, where the correlation between the frequency of metastasis and tumor size was poor. The probability of lymph node metastases increased with the degree of lymphatic invasion (ly) and the growth pattern of the tumor (INF) and was high in patients with invasion into the retropancreatic tissue and in tumors with scirrhous histology. These results indicate that even in small cancers, lymph nodes of the paraaortic region frequently harbor metastases and should be dissected en block during radical resections of pancreatic cancer.
 ...
PMID:The pattern of lymph node involvement in carcinoma of the head of the pancreas. A histologic study of the surgical findings in patients undergoing extensive nodal dissections. 845 14

We present herein the case of a 64-year-old man diagnosed as having a mucoepidermoid carcinoma of the pancreas. The tumor originated in the tail of the pancreas and invaded the spleen, left adrenal gland, left kidney, and transverse colon. Liver and peritoneal metastases were also noted. Despite surgical treatment and adjuvant chemotherapy, the disease progressed rapidly and the patient died of cachexia 4 months after his initial diagnosis. Mucoepidermoid carcinoma of the pancreas is a rare entity, and is believed to be a form of adenosquamous carcinoma known as adenoacanthoma. However, in this patient, no differentiated squamous cell component could be detected. In fact, the tumor was composed of mucin-producing cells, epidermoid cells, and intermediate cells. Immunohistochemical staining for the carcinoembryonic antigen, CA19-9, and SPan-1 demonstrated a production of cancerous mucin in the epidermoid cells, suggesting that mucoepidermoid carcinoma may arise from the squamoid metaplasia of an adenocarcinoma.
 ...
PMID:Mucoepidermoid carcinoma of the pancreas: report of a case. 855 7

Many carcinomas of the pancreas are locally unresectable but have no gross evidence of metastases at diagnosis. Initial experience showed the disease to be relatively unresponsive to radiotherapy. However, results from Duke University and the Mayo Clinic led to the study of the disease by the Gastrointestinal Tumor Study Group (GITSG). The GITSG studies showed that radiotherapy and 5-fluorouracil chemotherapy in a relatively nonaggressive regimen prolonged the survival following apparent curative resection of carcinoma of the pancreas. In addition, for locally unresectable disease, GITSG showed that both chemotherapy and radiotherapy were necessary for the best results. However, even with optimal therapy the median survival in this group of patients is no more than 1 year. Many studies of specialized radiation techniques have also been evaluated. These included preoperative radiotherapy and chemotherapy, use of radiosensitizers, particle irradiation, interstitial irradiation, intraoperative irradiation, and hyperthermia. Results of these studies have not shown major improvement over the GITSG experience. In general, patients with pancreatic cancer who are irradiated appear to do better than those who are not. No other single modality has been more effective. It is therefore hoped that successful chemotherapeutic agents or other modalities can be developed and combined with the limited efficacy of radiotherapy.
 ...
PMID:Radiotherapy for carcinoma of the pancreas. 862 57

Pancreatic carcinoma is one of the most enigmatic and aggressive malignant disease facing oncologists. A precocious propensity to spread along peripancreatic neurons and lymphatic channels conspires with the limited activity of standard chemotherapeutic agents and the inability to deliver large doses of radiotherapy to the upper abdomen, leaving radical surgical resection as the primary treatment capable of influencing long-term survival. Theoretically, when the tumor is small and confined to the pancreas, adequate locoregional control is possible by radical resection of the tumor, lymph nodes, peripancreatic neurons, and surrounding soft tissue. Realistically, at the time of initial diagnosis, 50% of patients have distant metastases to the liver or peritoneal surface, and more than 80% of the remaining patients have locally advanced tumors. Fewer than 10% of all patients with a small pancreatic adenocarcinoma confined to the pancreas are candidates for cure by use of radical resection as the sole treatment modality. Given these sobering statistics on the late presentation of this tumor, it is not surprising that, even after radical resection, the overall median survival time is only 18 to 20 months and the overall 5-year survival is approximately 10%. These dismal results led to a call in the early 1970s for abandonment of radical therapy in this disease and for treatment of all patients with palliative care only. These statistics are discouraging, but over the last 10 years a therapeutic renaissance has erupted. This resurgence has been driven by surgeons performing pancreaticoduodenectomy with low perioperative mortality rates and excellent functional results. It has been fueled by the use of adjuvant and neoadjuvant chemoradiotherapy protocols. Improved radiographic imaging techniques such as endoscopic retrograde cholangiopancreatography, helical computed tomography scan, and endoscopic ultrasonography are beginning to show promise in facilitating an earlier diagnosis and in providing highly accurate tumor staging without operation. It is hoped that recent observations on the molecular genetics of pancreatic adenocarcinoma will lead to a better understanding of tumor biology, which in turn should result in a more rational application of new diagnostic and therapeutic strategies. Effective percutaneous, endoscopic, and laparoscopic techniques have been developed concomitant with the recent advances in radiographic and endoscopic imaging. These minimally invasive options can now provide meaningful, long-lasting palliation and improved quality of life for the large number of patients with unresectable or metastatic disease who have no other treatment options. The therapeutic nihilism so pervasive in previous decades has no place in the contemporary treatment of patients with pancreatic adenocarcinoma. True long-term survival seems possible for a growing proportion of patients, and minimally invasive, effective palliation is achievable in the vast majority of patients. It is only through aggressive recruitment of patients for treatment, application of novel diagnostic and therapeutic protocols, and further laboratory investigation into the biology of pancreatic cancer that the momentum of the last decade toward improved outcome and quality of life can be sustained.
 ...
PMID:Pancreatic adenocarcinoma. 890 2

A 58-year-old Japanese man was admitted complaining of abdominal pain. An abdominal computed tomography examination demonstrated a tumor in the head of the pancreas and multiple calcifications. A laparotomy was performed and the tumor was removed by Whipple's operation. Histologically, the neoplasm that invaded the duodenal wall and the papilla of Vater was composed of nests of malignant squamous cells with intercellular bridges and showed the formation of keratinized pearls with a small area of concurrently neoplastic glandular and squamous elements. On the basis of these features, the diagnosis of adenosquamous carcinoma of the pancreas was made. The patient died 18 months after the operation. The neoplastic behavior of this rare primary pancreatic carcinoma is similar to that of duct cell carcinoma as well as pure squamous cell carcinoma of the pancreas. As the pancreas can be the target of metastases of squamous carcinomas from other organs it is wise to be aware of this rare entity.
 ...
PMID:Adenosquamous carcinoma of the pancreas. 896 3

A 52-year-old-woman with non-insulin-dependent diabetes mellitus developed carcinoma of the pancreas and had a Whipple's resection performed. She required pancreatic exocrine supplements and insulin post-operatively. Five years later metastatic disease became apparent, and was accompanied by episodic spontaneous hypoglycaemia necessitating the cessation of insulin therapy. Hormonal analysis was performed, off insulin, at a time of hypoglycaemia (glucose 0.9 mmol l-1) and showed negligible insulin concentrations (< 2 mU l-1) but raised IGF-II together with low IGF-I concentrations (1.85 and 0.1 U ml-1, respectively). The association between diabetes and pancreatic carcinoma, and the pathogenesis of non-islet cell tumour induced hypoglycaemia (NICTH) are discussed.
 ...
PMID:Spontaneous hypoglycaemia in a noninsulin-dependent diabetes mellitus patient with disseminated pancreatic carcinoma. 911 88

A total 17,121 patients with pancreatic cancer have been collected by the Pancreatic Cancer Registration Committee of the Japan Pancreas Society. Significant differences in the postoperative prognosis were observed between patients with tumor limited to the pancreas and with tumor extending to surrounding tissues or adjacent organs. The lymph node metastases and distant metastases were definitive factors on the prognosis after resection. It might was possible for the subdivision of regional lymph nodes as Japanese classification to provide the Stage classification. Further development of the TNM system is necessary for assessing the outcome of most advanced cancers.
 ...
PMID:[Studies on TNM classification of carcinoma of the exocrine pancreas]. 946 43


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>