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)

Ultrasound is high frequency mechanical vibration. As far as is presently known, there are no harmful effects of ultrasound at the energy levels used in currently available commercial ultrasonic scanners. Ultrasonic studies are independent of organ function, are painless, and require nor special preparation. Ultrasonic scanning is useful in the diagnosis of pancreatic disease, especially in the detection of complications of pancreatitis such as pancreatic abscess or pseudocyst, and in diagnosing pancreatic carcinoma. Gallstones and dilation of the biliary tree can be detected ultrasonically even when the patient is jaundiced. Primary liver tumors and hepatic metastases can often be demonstrated. Intraabdominal abscesses are better investigated by ultrasound than by any other means currently available. Ultrasonic scanning also provides a sensitive means of detecting ascites. Ultrasonic control of needle placement has been suggested for pancreatic and liver biopsy, for aspiration of intraabdominal fluid collections, and for percutaneous transhepatic cholangiography. Ultrasonic B-mode scans provide undistorted images of cross sections through the abdomen which can be used in radiotherapy planning to localize tumor masses and to place kidney shields accurately. Organ volumes can be estimated from a set of ultrasonic B-mode scans without any assumptions being made as to the shape of the organ.
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PMID:The use of ultrasound in the diagnosis of gastroenterological disease. 76 96

A series of 76 patients treated for carcinoma of the extrahepatic bile ducts at three Swedish hospitals during the years 1952 to 1973 was studied. The mean age of the patients was 68 years. Gallstones were found in 22 patients, whereas 11 patients had undergone cholecystectomy earlier for gallstone disease. At operation widespread metastases were found less often in patients with cancer of the papilla of Vater than in patients with cancer of other locations. This is interpreted as indicating that patients with papillary carcinoma are treated in an earlier stagage of the disease. This interpretation is supported by the finding that these patients had a longer length of survival after bypass supported by the finding that these patients had a longer length of survival after bypass supported by the finding that these patients had a longer length of survival after bypass operations (11.5 months). In spite of treatment in an early stage, survival after radical surgery was disappointingly short (4.6 months). On the other hand, patients with cancer located above the papilla of Vater survived for 6.8 months after bypass operations as compared with 23.3 months after rescetion. The possibilities of radical surgery should be considered carefully, especially in patients in whom the malignancy is located above the papillary region.
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PMID:Malignant tumors of the extrahepatic bile ducts. 83 90

A retrospective study of 22 patients with cancer of the pancreas seen in a medical department was carried out. The mean age was 61.7 years, although the youngest was only 32 years. Weight loss, pain and jaundice were the most frequent presenting symptoms. Hepatomegaly and jaundice were the most common physical findings. The gall bladder was palpable in 27.3%. Serum alkaline phosphatase, bilirubin and ESR were raised in most cases. Ultrasound examination was done in 72.7% of cases and was diagnostic in 62.5% with 12.5% falsely negative. Five patients had CT scan of the abdomen, of which 4 were diagnostic. Percutaneous transhepatic cholangiogram was positive in all the 8 patients where it was carried out. The cancer was of the pancreatic head in 72.7%. Gallstones were present in 22.7%. Secondary tumour involvement of the liver was present in 40.9%. Laparotomy was performed in 11 patients of which only 2 had a curative procedure (Whipple's operation). The overall prognosis was very poor: 54.5% died during the same admission.
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PMID:Cancer of the pancreas--a clinical study of 22 patients. 667 37

Carcinoma of the gallbladder is an uncommon, but not rare tumor that is associated with a 5% five-year survival rate after resection and this rate has not appreciably improved over the last decades in most series. Nevin et al.(20) however have reported that favorably staged gallbladder cancers (according to histologic grade and depth of invasion) have a relatively good prognosis. They quoted an overall five-year survival of 21% in 66 patients. Most of the surviving patients (11) were in the favorably staged category: Stage I (intramucosal cancer) and Stage II (invasion of mucosa and muscularis). The remaining few were in Stage III (invasion of all layers), Stage IV (cystic node metastases), or Stage V (extension of metastases to the liver or distant sites). Our data has been analyzed to determine whether microstaging of the primary cancer will select out a subgroup with a favorable prognosis, and whether there are survival benefits according to the type of surgical resection. A clinical and pathologic review was done of 100 patients treated at the University of Virginia Hospital from 1930 to 1978. There were 77 women and 23 men, with an average age of 65 years (range 21-89). Gallstones were described in 78% of the patients. Surgical procedures included cholecystectomy alone (23 patients), cholecystectomy with biliary drainage (17 patients), cholecystectomy and resection of the hepatic bed (8 patients), and exploration with biopsy or bypass (44 patients). Autopsy only was done in eight patients. There were only three long-term survivors (6 years, 11 years, and 24 years). Median survival was six months with cholecystectomy alone, five months with cholecystectomy and bypass, 14 months after partial liver resection, and 2.0 months after laparotomy/bypass/biopsy. The five-year survival rate was 5% after cholecystectomy alone or with bypass, and 13% (1/8) after cholecystectomy and partial liver resection (p = 0.07). Microstaging of the primary cancers showed no prognostically favorable subgroup. Of 46 patients with microstaged lesions, only 13% were in the very favorable Stage I and II groups (only one of six survived), 46% were Stage III (1/21 survived), and the remaining 41% were in the highly unfavorable Stage IV and V groups (1/19 survived). Most patients showed progression of disease either primarily or secondarily that was locoregional (liver and nodes). Although longterm survival may accompany cholecystectomy alone for a favorable early-staged cancer, this is still uncommon. There may be theoretical, although not proven, merit for resection of the hepatic bed and regional node dissection in the selected patient, possibly complimented by adjuvant therapy. Future advances in chemotherapy and radiation will be needed to augment the current poor cure rate of this disease.
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PMID:Is carcinoma of the gallbladder a curable lesion? 707 60

MR imaging has a distinct role to play in two areas of hepatobiliary imaging that continue to challenge the radiologist--evaluation of the gallbladder and evaluation of the jaundiced patient. The distinction between primary gallbladder carcinoma and chronic cholecystitis remains a diagnostic dilemma for all cross-sectional imaging modalities. MR imaging may be useful in detection of local invasion or metastatic disease. Gallstones are commonly seen coincidentally on cross-sectional imaging studies; the imaging characteristics of gallstones must be well-understood for the interpretation of routine abdominal MR examinations. The evaluation of jaundice is a multimodality process, often requiring three or four separate imaging techniques to determine the cause of biliary obstruction. MR may supplant more invasive techniques for anatomic depiction prior to therapeutic intervention.
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PMID:MR imaging of the biliary system. 776 42

After we encountered one case of cystic duct carcinoma out of 110 cases of gallbladder carcinoma treated from 1976 to 1991, we reviewed the 14 treated Japanese cases, including our own, as well as the 18 Western cases hitherto reported in order to examine the clinical features of carcinoma of the cystic duct and to evaluate the various options for treatment. The patients' ages were similarly distributed between the Japanese and Western patients with a mean age of 62 years. Males were predominantly affected in the western countries with a ratio of male to female of 3.5:1; the ratio was similar in Japan. Gallstones were present in six of 18 Western cases and in two of 14 Japanese cases; both groups had a much lower rate of accompanying gallstones than did gallbladder carcinoma patients. Despite the depth of invasion, the prognosis of carcinoma of the cystic duct was relatively good, mainly owing to the absence of either lymph node metastases or distant metastasis. Although the lymph nodes and bile duct are not usually involved in carcinoma of the cystic duct, cholecystectomy, either with or without lymph node dissection, usually produced an unsatisfactory outcome, possibly due to bile duct invasion and perineural invasion. Thus, combined resection of the gallbladder and bile duct with lymph node dissection is the choice of treatment for carcinoma of the cystic duct.
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PMID:Primary carcinoma of the cystic duct. 833 Dec 64

A 57 year-old Japanese man with a carcinoid somatostatinoma of the papilla of Vater is presented. He was found to have cholecystolithiasis without any symptoms. Physical examination showed no abnormal findings. Routine laboratory data gave normal results, except for glucose intolerance and an elevated somatostatin concentration. A yellowish papillary tumor was found at the papilla of Vater, and histological examination suggested the diagnosis of carcinoid. He underwent a pancreatoduodenectomy in March 1992. The gallbladder contained a single pure cholesterol stone. Histological, immunohistochemical, and electron microscopic studies resulted in the diagnosis of a carcinoid somatostatinoma of the papilla of Vater, without regional lymph node metastases. Post-operative pancreatic juice output from the total pancreatic duct drainage increased to more than 1000 mL/day. Although an anastomotic leakage of the pancreatojejunostomy was noted, the pancreatic fistula closed 8 weeks later. His postoperative somatostatin value was normal. He has been well for 54 months following surgery, without any signs of recurrence.
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PMID:Carcinoid somatostatinoma of the papilla of Vater: a case report. 963 24

The casuistic describes a female patient, in whom a metastatic adenocarcinoma of the ovary was diagnosed 3 years after cholecystectomy due to cholecystolithiasis, which was compatible with metastases of a carcinoma of the gallbladder or the bile ducts. While clinical and imaging results suggested a primary ovarian carcinoma with inapparent primary tumor, the final diagnosis was obtained on the basis of histological findings. The case demonstrates that an ovarian metastasis can simulate a primary tumor according to clinical and imaging results. This fact can be of serious therapeutic consequences for the respective patient. Therefore, in the presence of a clinically inapparent primary tumor, the differential diagnosis of unclear ovarian masses should include metastatic adenocarcinoma in addition to primary ovarian carcinoma and other ovarian lesions.
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PMID:[Krukenberg syndrome in metastatic gallbladder adenocarcinoma with unknown primary tumor]. 1048 84

Laparoscopic cholecystectomy has rapidly become the preferred treatment for symptomatic cholecystolithiasis. However, the procedure is associated with a number of complications, one of which is the spillage of gallstones into the peritoneal cavity. Unretrieved gallstones may cause a wide variety of complications such as abscess, adhesion and small-bowel obstruction, or they may remain asymptomatic and harmless. In the latter case, spilled gallstones in the peritoneal spaces may cause diagnostic difficulty or mimic peritoneal metastasis. We present the computed tomography (CT) and magnetic resonance (MR) imaging features of intra-abdominal gallstone spillage in a case with head and neck neoplasm. Awareness of radiologic features of dropped intraperitoneal gallstones is necessary as they may be mistaken for peritoneal metastases.
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PMID:Intra-abdominal spilled gallstones simulating peritoneal metastasis: CT and MR imaging features (2008: 1b). 1835 58

Complex examination of 32 patients with gastric cancer in terms of more than 6 months after radical operations included endoscopic, radial and laboratory methods with the determination of indices of the carcinoembryonic antigen and carbohydrate antigens 19-1 and 72-4 every six months. It was established that normal concentration of all the three tumor markers within 12 months after surgery was a practically reliable sign of the absence of metastases and recurrence of gastric cancer. The increased level of one or two oncomarkers within 12 months after radical operation points to progression of gastric cancer with probability of 57.1% or the development of other surgical pathology (cholecystolithiasis, gastric stump polyps and others) in 28.6% of observations. In all cases of progressing gastric cancer in terms of more than 6 months after operation there was a more that 1.5 times elevation of any one or two tumor markers.
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PMID:[The role of tumor markers in diagnostics of gastric cancer metastases. Part II: postoperative monitoring]. 2002 Jun 21


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