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

CT has become an important tool in the diagnosis and management of diseases that affect the stomach and duodenum. By depicting the bowel lumen, wall, and extramural structures, CT can provide unique information that complements standard air contrast radiography and endoscopy. Proper scanning methods and knowledge of normal anatomy are necessary for optimal results. We utilize the gas contrast technique for organ-specific examination in patients with known or suspected gastroduodenal disease. Gastric adenocarcinoma is an important indication for CT evaluation. Unfortunately, early hopes that CT could accurately stage gastric cancer have not been realized. CT is not as accurate as laparotomy in staging early gastric cancer, primarily owing to its inability to detect small peritoneal implants, diagnose metastases in normal-sized lymph perigastric nodes, and predict pancreatic invasion. Nevertheless, CT retains an important role in depicting gross metastatic disease and guiding percutaneous biopsy, particularly in patients who are deemed poor surgical candidates or have undergone prior gastric resection. A variety of conditions other than primary gastric adenocarcinoma produce recognizable abnormalities on CT. Gastric lipoma, leiomyosarcoma, and varices have a distinctive appearance. Others, including gastritis and uncomplicated peptic ulcer, produce nonspecific gastric wall thickening. Endoscopic correlation and biopsy are required for specific diagnosis in these cases. The duodenum, by virtue of its location in the anterior pararenal compartment of the retroperitoneum, may be involved by numerous benign and malignant conditions. In blunt trauma, complicated pancreatitis, and peptic ulcer disease, as well as primary and metastatic malignancy, CT can provide data that may alter patient management.
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PMID:CT of the stomach and duodenum. 265 48

The modes for growth and spread of gastric cancer were investigated in a surgical series of 115 cases--88 of early disease, and 27 involving the muscular layer. In addition, 93 autopsy cases with advanced disease were examined in order to analyze metastatic spread. In cancers of differentiated type in the mucosal layer, changes in histologic features towards the undifferentiated type were observed in the deeper layers, but no histologic transformation was seen in cancers of undifferentiated type. At autopsy distant metastases were common in cases with primary tumor of differentiated type, whereas peritoneal dissemination predominated when the primary lesion was undifferentiated. From the clinical standpoint, follow-up and recommendations to the patient should focus mainly on risk of peritoneal dissemination when adenocarcinoma of the stomach is of undifferentiated type, whereas metastases to distant organs should be taken into consideration if the malignancy is histologically differentiated.
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PMID:Histologic features of gastric cancer in relation to patterns of spread. 292 3

A 77-year-old male was admitted to the hospital because of left hemiparesis secondary to multifocal cerebral metastases from adenocarcinoma of the stomach. He was treated with combination of radiotherapy and chemotherapy consisting of ACNU, Tegafur and PSK. He was in good condition, but abruptly developed severe dyspnea 40 days after administration of Tegafur and 28 days after that of ACNU. Chest X-ray at that time revealed diffuse opacity involving entire lung fields associated with marked hypoxia. The patient expired 9 days after this episode. The autopsy revealed acute interstitial pneumonitis associated with hyaline membrane formation consistent with adult respiratory distress syndrome involving entire lobes of both lungs without metastases. As to the etiology of the ARDS in this case, we concluded that the administration of Tegafur was the most likely as to the cause, although the possibility of betamethasone was not ruled out. The remaining factors were not likely as to the cause of the ARDS in this case.
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PMID:[A case of adult respiratory distress syndrome (ARDS) induced by radio-chemotherapy (RAFP therapy) of brain metastasis of stomach cancer]. 308 66

In a group of 322 patients with adenocarcinoma of the stomach, 158 underwent resection. The only 5 year survivors came from the resection group. Increasing age, lymph node metastases and increasing depth of invasion of the gastric wall were all adverse prognostic features. There was a high incidence (19%) of resected patients who had suture line involvement. In spite of this there were 5 year survivors among those patients with suture line involvement and also those with lymph node involvement. The judicious implementation of an aggressive resection policy will give patients with favourable tumours the chance of a 5 year cure without involving patients with widespread neoplasm in radical surgery. Patients who had undergone previous gastric surgery for any cause had an extremely bad prognosis. Improvement in 5 year survival rates in patients undergoing resection for gastric cancer could be attributed to the increase in the number of patients with early gastric cancer.
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PMID:Factors influencing prognosis in gastric cancer. 347 12

Metastatic tumors are the most common intraocular neoplasms. A rare case of adenocarcinoma of the stomach with simultaneous presentation of bilateral intraocular metastases is reported with a review of the literature. The prompt improvement in vision that occurred in this patient following radiation therapy underscores its important role in reducing the visual morbidity of patients with metastatic intraocular tumors.
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PMID:Simultaneous bilateral ocular metastases from a gastric carcinoma. 352 36

Overall bone metastasis (BM) was found upon autopsy in 271 (26.0%) of 1041 patients who died due to malignant epithelial neoplasm at our hospital over the last 20 years. The incidences of BM from primary organs were as follows; 71.4% for breast cancer, 70.0% for prostate, 49.6% for lung and 22.5% for stomach. The distribution of skeletal metastases was the lumber spine in 63.8% of cases, sternum in 38.0% and ribs in 26.2% as revealed by routine autopsy examination. The most common pathway of BM was the transpulmonary route, followed by the vertebral venous system which is known to be involved in metastasis to the spine. The frequency of BM via the vertebral venous system without pulmonary metastasis was 30% for carcinoma of the prostate, 10.4% for the uterus, 7.4% for the breast and 3.5% for the stomach in our examination series. Types of focal reaction to BM were classified as osteoplastic (OP), osteolytic (OL), intertrabecular and mixed types. The mixed type showed transitional and mixed features between OP and OL types. Therefore they were considered to be closely related. Relationships between primary organs and histologic appearances revealed a degree of specificity for BM. Squamous cell carcinoma in various organs and small cell carcinoma of the lung appeared to produce an OL but not OP reaction. OP was especially characteristic of prostatic cancer, poorly differentiated adenocarcinoma of the stomach and breast, in young patients. There appeared to be a relation between clinical course and the form of treatment for metastatic bone reaction.
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PMID:[Histopathology of metastatic bone tumors]. 359 9

A case of adenocarcinoma of the stomach was initially diagnosed by detection of epididymal metastases. The case is presented and the importance of histologic examination of peroperatively removed tissue is emphasized.
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PMID:Metastatic tumour of the epididymis. A case report. 370 72

The experience with the surgical treatment of adenocarcinoma of the stomach in a community hospital from 1970 to 1979 is presented. The single most important prognostic factor for survival is the extent of disease at the time of operation. Positive regional nodes or distant metastases are associated with a dismal survival regardless of treatment. Other variables such as histologic findings, tumor morphologic features or location did not affect survival in our series. Although fewer and somewhat less radical operations were performed by a large number of community surgeons, the results were comparable to those reported elsewhere. The results depended most strongly on the extent of disease at operation. Aside from a fortunate and unexplained decrease in the incidence of adenocarcinoma of the stomach in this country, the best hope for decreased mortality in the future lies with earlier detection at a surgically curable stage.
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PMID:Surgical treatment of adenocarcinoma of the stomach in a community hospital. 396 12

We encountered a relatively rare case of primary double cancer arising simultaneously from both the stomach and choledochus in a 72-year-old woman with obstructive jaundice. The patient was admitted to Saiseikai Shigaken Hospital, and was diagnosed as having both early gastric cancer at the lesser curvature of the antrum and cancer of the choledochus. She underwent curative pancreato-duodenectomy with extended gastrectomy. One of the resected tumors was histopathologically diagnosed as a well differentiated, tubular adenocarcinoma of the stomach with invasion reaching as deep as the submucosa. The other tumor was a moderately differentiated, tubular adenocarcinoma of the choledochus with lymph node metastases (hepatic, retroligamentic, paracholedochal, and posterior and superior pancreaticoduodenal lymph nodes). Our review of the literature suggests that the incidence of primary double malignancies is on the increase.
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PMID:[A case report of primary double cancer of the stomach and choledochus]. 670 Jan 18

Two cases of pancreatic polypeptide cell hyperplasia were obtained by operation. The first case exhibited adenocarcinoma of the stomach with metastases to the neck lymph nodes and pancreatic polypeptide hypersecretion. Pancreatic polypeptide cell hyperplasia was confirmed by the immunoperoxidase method and by the elevated level of pancreatic polypeptide in the pancreatic extracts and in the circulating blood. There was no watery diarrhea syndrome. The second case presented with persistent watery diarrhea of two and one-half year duration, and the resected pancreas contained extremely large atypical islets, exclusively composed of pancreatic polypeptide cells. It is speculated that in some cases pancreatic polypeptide oversecretion may be causative for pseudo-Verner-Morrison syndrome in the absence of ulcer of carcinoma in the upper gastrointestinal tract.
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PMID:Pancreatic polypeptide cell hyperplasia with and without watery diarrhea syndrome. 699 21


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