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

We reviewed 13 cases of biliary endoprosthetic insertion for malignant obstructive jaundice from August 1983 to May 1987, and recorded (1) location and etiology of the obstruction, (2) length of time the endoprosthesis remained functional, and (3) complications related to the endoprosthesis, its insertion, or its long-term function. Of the 13 patients, 3 had pancreatic carcinoma, 3 had cholangiocarcinoma, and 3 had metastatic disease to the porta hepatis. The underlying malignancy was not histologically proved in four patients despite evidence of neoplasm by percutaneous cholangiography and computerized tomography. These four patients were not considered good surgical risks and were referred for percutaneous therapy. The longest endoprosthetic patency was 3.5 years. Three patients experienced obstruction of the endoprosthesis at 3, 4, and 9 months after insertion, respectively. Two of the endoprostheses were subsequently removed endoscopically, while the third was extracted through a new percutaneous tract with use of a balloon angioplasty catheter. Complications related to endoprosthetic insertion included bilous hydro pneumothorax (1 patient), subcutaneous and subcapsular liver abscess (1 patient), postinsertion cholangitis (4 patients), and reflex ileus (1 patient).
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PMID:Endoprosthetic insertion for malignant obstructive jaundice: a retrospective review. 262 Nov 20

The results of surgical treatment of patients with cancer of the gallbladder (23), extrahepatic bile ducts (16), pancreas (28), major duodenal papilla (10), with tumour metastases in the liver (10), who developed, as a consequence of the tumour process progression, acute abdominal conditions--inflammatory syndrome, increasing jaundice, high ileus and hemorrhage are analysed. Emergency operative interventions were directed at solving the urgent situations and had, mainly, the palliative character. After the operation, 16 (21%) patients died.
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PMID:[Treatment of patients with malignant tumors of organs in the pancreaticobiliary zone complicated by the development of emergency situations]. 275 73

Between April 1986 and April 1989, each of 108 patients received an ileum neobladder, 94 patients for total bladder substitution after radical cysto-prostatectomy and 14 for augmentation of a fibrotic and contracted bladder following tuberculosis, interstitial cystitis or radiotherapy of the pelvis. The operative technique is standardized, relatively simple and safe, and it prevents upper urinary tract deterioration and reflux. Continence is preserved in more than 80% of all patients by the function of the external urethral sphincter and by the high capacity and the low internal pressure of the intestinal reservoir. Follow-up of more than 3 months postoperatively was possible in 96 patients, the evaluation including micturition behavior at home and a urodynamic investigation. Stress incontinence requiring correction by an artificial sphincter was found in 3 and nocturnal incontinence necessitating some external device in 6 patients. There was no perioperative mortality. Local tumor recurrence and/or metastases occurred in 14 patients; 7 patients died postoperatively, 5 owing to tumor progression, 1 of pneumonia and serve metabolic acidosis, and 1 owing to septicemia of unknown cause. Re-operation was necessary in 13 patients, in 6 because of mechanical ileus or intra-abdominal abscess, in 3 because of stenosis of the uretero-ileal anastomosis, in 1 because of tumor progression, in 1 because of vesico-vaginal fistula, in 1 patient because of incisional hernia, and in 1 because of wound dehiscence. Urethrotomy or dilatation of urethral strictures was necessary in 8 patients. All other early and late complications were rare and could be managed by conservative means.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[3 years' experience with the ileum neobladder--the first 108 patients]. 276 96

Thirty patients with recurrent epithelial ovarian carcinoma who underwent secondary tumor-reductive surgery at M. D. Anderson Cancer Center were studied retrospectively. All had been initially treated by primary reductive surgery and postoperative chemotherapy and had a period of clinical remission of at least 6 months thereafter. Ninety percent of patients had grade 2 or 3 tumors. In 17 (57%), residual tumor volume was reduced to less than 2 cm. There were no postoperative deaths, but 40% of patients suffered postoperative morbidity, mostly prolonged ileus. Median survival after second surgery was 16.3-18 months for patients with residual tumor volume less than 2 cm and 13.3 months for those with residual volume greater than 2 cm (nonsignificant). When the second surgery followed the first by less than 18 months, survival was a median of 13.5 months after the second operation as compared with 19 months when the interval was 18 months or longer (nonsignificant). Twenty-two patients received postsurgical chemotherapy; only 11% of those who were evaluable responded. Although secondary tumor-reductive surgery for recurrent ovarian cancer is technically feasible, in the absence of an efficacious second-line medical therapy, its value is limited.
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PMID:Secondary cytoreductive surgery for recurrent epithelial ovarian cancer. 276 25

Four years after mastectomy for a scirrhous carcinoma a 71-year-old woman developed diarrhoea. Crohn's disease was suspected. At endoscopy a stenosis of the sigmoid colon was found which could not be passed: the mucosa was normal looking. Gastrointestinal radiography revealed segmental subtotal stenoses of the colon with linitis plastica, typical for tumour-caused infiltration, as well as indentations in the small intestine by mesenteric metastases. The diagnosis was confirmed by computed tomography and, finally, operation. Chemotherapy failed to produce any regression of the colon stenoses, and the patient died from mechanical ileus. In case of a similar history and colon stenoses of uncertain aetiology the possibility of intestinal metastases should be considered in the differential diagnosis.
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PMID:[Segmental colonic stenosis in intestinal metastasis of breast carcinoma. A contribution to the differential diagnosis of colitis]. 283 27

We report a rare case of advanced renal cell carcinoma which showed complete resolution of multiple metastases following nephrectomy, partial metastatectomy and interferon therapy. A 55-year-old male patient underwent right nephrectomy for the renal cell carcinoma with metastases to the right lung and the left femur. In 45 days from the nephrectomy, metastasis to the right humerus was discovered. Immediately after this, the patient suffered occlusive ileus. Laparotomy revealed multiple intestinal tumors, and a temporary partial jejunotomy was performed for the detectable lesions proved to be metastases later. After this operation the pulmonary lesion revealed regression. Then, the patient was treated with daily intramuscular administration of human lymphoblastic interferon (3 X 10(6) units). In consequence, the pulmonary lesion showed complete resolution in two months and the humeral lesion in five months. The left femur which remained osteolytic was replaced by an artificial bone, and revealed no cancer cells histologically. No evidence of metastatic lesion has been found with following intestinal examinations. More than a year has passed since the detection of disease and complete response has persisted for three months under the interferon therapy.
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PMID:[A case of complete resolution of multiple metastases of advanced renal cell carcinoma following partial jejunotomy in intestinal metastases and interferon therapy]. 324 27

Eighteen patients with advanced refractory breast carcinoma were treated with vincristine (VCR), 0.5 mg I.V. bolus followed by continuous I.V. infusions of 0.25 mg/m2/day for 5 days every 3 weeks. The daily dose of VCR was infused in 1000 ml D5W to which was added hydrocortisone 50 mg and heparin 3000 U. Patients received from one to six courses (mean 2.3 courses). No objective responses were observed. Stable disease was noted in five patients who had skeletal metastases only. Disease progression occurred in the remaining 13 patients, 10 of whom had received prior VCR by bolus injection. The principal toxicity consisted of constipation without ileus and hyporeflexia-paresthesias. Vincristine, administered by continuous I.V. infusion according to this dose and schedule does not appear to be effective in the treatment of patients with advanced refractory breast cancer.
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PMID:Vincristine by continuous infusion in refractory breast cancer: a phase II study. 661 19

About 11 000 autopsies were done in Darmstadt from 1955 to 1977; 879 (8%) of the cases had had peritonitis. The incidence of acute peritonitis was highest (56,8%), followed by acute local peritonitis (26,6%), peritoneal abscess and covered perforation (11,4%) and strangulation ileus (3,8%). Peritonitis had been the cause of death in 56%; in 37% of the cases peritonitis was an essential finding, in 6,3% a minor finding. A comparison was made with statistics of peritonitis at postmortem in Berlin in 1908; total incidence of peritonitis was about the same, however peritonitis originating from appendicitis or female genital tract infection is much rarer - peritonitis originating from the biliary tract or from the intestinal tract is much more common nowadays. Morphological changes occurring during septic shock are described as well as the chronic sequels of peritonitis. Finally some special forms of peritonitis are discussed: Foreign body peritonitis, tuberculous peritonitis, peritoneal metastases, retroperitoneal fibrosis and peritonitis of the newborn.
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PMID:[Postmortem findings in peritonitis (author's transl)]. 702 78

The frequency of malign tumors in the small intestine was 1% of all malign tumors of the digestive tract. 4% of malign tumors found by autopsy in the digestive tract were located in the small intestine. 12 months passed between first symptoms and operative therapy. In 80% we found local or distant metastases. In only 5 of 11 cases a curative resection was attempted. A great number pf small intestine tumors were identified by autopsy for the first time. A curative resection depends on an early diagnosis. Ileus, massive bleeding, extreme weight loss and palpable mass are late physical findings. Obstipation, diarrhea, occult intestinal bleeding and abdominal pain indicate after subtle inquiry X-ray of the small intestine, gastroduodenoscopy and angiography. If there is no result an early laparotomy should be performed.
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PMID:[Primary small intestine malignancies]. 711 89

The dissection incontinuity is indicated for the treatment of malignant melanomas of the skin with high risk and favourable anatomic positions of the lesions. The performance of the incontinuity operation means to remove the primary site, intervening lymphatics and regional lymph nodes en bloc. Intransit- and micrometastases can be excised in addition to the tumor in stadium I of the disease. Melanomas with high risk are all nodular types as well as all other types of the levels IV and V. In level III the selection was made more appropriate to the addition of thickness measurements (greater than 1.5 mm). There were no operative mortalities in this series of 36 cases with high risk melanomas. The morbidity in the postoperative period with ileus, pulmonary embolism and hemorrhage in three patients could be controlled with appropriate measures. The large operation wounds measuring to 60 cm in length and 12 cm in width were closed by dermanaplasties and skin grafting. In two cases only necrosis of the wound edges impaired the healing somewhat; five patients developed edema. In 12 cases the dissection incontinuity was combined with an elective lymphadenectomy of the axillary and in 26 cases of the inguinal groups. Micrometastases in one node were found in three patients; four patients developed metastases. The after-care period with 19 month is still to short for final evaluations. Since the potential for nodal metastases can be reasonably predicted, the performance of dissection incontinuity with elective regional lymphadenectomy continues outweigh any hypothetical disadvantage.
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PMID:[Continuity dissection in malignant melanoma of the skin]. 722 68


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