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)

More than 70% of all carcinoids are localized in the gastrointestinal tract. Carcinoids of the upper, middle and lower intestines have to be distinguished ontogenetically. The classification according to Capella takes into account the size of the tumor (< 0.9 cm; 1-2 cm; > 2 cm), the grade of invasion of other structures, the grade of angioinvasion, the biologic behaviour, the grade of differentiation and the hormonal activity of the tumor. A carcinoid-syndrome is rarely found. Carcinoids of the small intestine occur multiple in 30-50% and in 20-30% a second malignant tumor is seen. In carcinoids of the colon this percentage is even higher (25-40%). The therapy of carcinoids depends on the size of the tumor and consecutively on the risk of metastasis. A local excision or non-oncologic radical operative procedure is justified in carcinoids smaller than 1 cm. In tumors 1-2 cm in size an individual decision has to be made. Larger tumors should be operated according to oncologic standards. Palliative resections, even of the liver, may be indicated to relieve the symptoms of a carcinoid-syndrome or, to prevent ileus or bleeding in the gastrointestinal tract. The prognosis of gastrointestinal carcinoids is heterogenous: The five-year-survival-rate of appendix-carcinoids is 85.9% over all stages. In rectal carcinoids this rate amounts to 72.2%, in carcinoids of the small intestines to 55.4% and in colon-carcinoids to 41.6%. Carcinoids of the stomach have a five-year-survival-rate of 64.3% in the absence of metastases. Within carcinoids of the stomach type III-tumors have the worst prognosis with a median survival time of 6.5 months.
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PMID:[Surgical therapy of carcinoid tumors of the gastrointestinal tract]. 1169 82

Neoplastic metastases in the small intestine are rare--only 2% of the metastases are localized in the small intestine. It is important to remember that colorectal metastases are the most frequent, though metachronous cancer of the small intestine is the rare cause of ileus or bleeding in patients who underwent resection of the colorectal cancer. The challenge is to select among those patients, the ones with metachronous tumor in the other parts of the small and large bowel. The diagnostics in these situations is often difficult and only the operative management is an optimal way of treatment. We present the case of the patient with metachronous cancer of the small intestine after the sigmoid resection and the diagnostic difficulties concerned.
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PMID:[Metachronous tumor of the small intestine--rare cause of ileus in a patient after resection of colon cancer]. 1218 11

Hepatocellular carcinoma rarely disseminates intraperitoneally. When it does, it usually is considered a terminal event. The successful treatment of complications of peritoneal metastases by surgical resection in a patient with hepatocellular carcinoma is reported. A 63-year-old man with hepatocellular carcinoma in the anterior segment underwent transarterial and portal embolization followed by extended radical hepatectomy. Five years and 8 months later, he presented with an ileus that was secondary to multiple peritoneal metastases that were resected to the extent possible. Eight months later, the patient presented with a second episode of ileus and underwent another operation that included bowel resection. However, pelvic tumors that were unresectable also were present. The patient survived for another 9 months before dying with peritoneal carcinomatosis. Although surgical treatment of peritoneal dissemination of hepatocellular carcinoma is not curative, surgery may improve survival and provide a good quality of life in selected cases.
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PMID:Successful surgical treatment of peritoneal dissemination of hepatocellular carcinoma. 1239 59

The majority of vaginal metastases from extra-genital tumors are from colorectal cancer. A case of metastases to the vagina from a huge rectal carcinoma is described. A 55-year-old woman was admitted to the hospital because of a barium ileus after upper GI. Further examination revealed that she had a huge rectal carcinoma. Hartmann's operation combined with resection of the right ureter, posterior wall of the uterus and left ovary was performed. Postoperative chemoradiotherapy was performed with 60 Gy of irradiation to the small pelvis with 500 mg/day continuous infusion of 5-FU. After 18 months, she had genital bleeding. Digital examination revealed a vaginal tumor and metastasis of the rectal carcinoma to the vagina was confirmed histologically. Abdominoperineal resection of the rectum and vagina combined with simple total hysterectomy and bilateral salpingo-oophorectomy was performed. Thirty-three months after operation, there is no sign of recurrence.
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PMID:[A case of metastatic vaginal tumor of rectal cancer]. 1248 86

Small intestinal metastasis from renal cell carcinoma (RCC) has only rarely been described. We report two patients who developed small bowel metastases from RCC showing different clinicopathological characteristics. Both patients underwent hemilateral nephrectomy for RCC and developed lung metastases metachronously or simultaneously. One patient developed occlusive ileus caused by multiple polypoid tumours composed of sarcomatoid tissue in the jejunum shortly after nephrectomy. The other patient presented melaena due to bleeding from a Borrmann 2-like tumour in the jejunum six years after nephrectomy. Clinically, his disease was slow-growing. Sarcomatoid histology and Borrmann 2-like tumour in this report are rare findings in metastatic tumour of RCC in the small bowel.
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PMID:Small intestinal metastasis from renal cell carcinoma exhibiting rare findings. 1280 Apr 66

Peritoneal metastases are a common sequela of gastrointestinal malignancy. The treatment of peritoneal metastases through use of aggressive surgical cytoreduction including peritonectomy, coupled with IPHC has now been reported in several large single institution series. The available literature suggests that in experienced hands and with appropriate patient selection, cytoreduction, and IPHC can be an effective therapy, particularly when all macroscopic tumor deposits are removed. Different techniques involving the administration of intraperitoneal chemotherapy have been reported including early postoperative, closed intraoperative, the open or coliseum technique, and the open technique using a PCE device. All techniques have been associated with low mortality and morbidity that is significant, but generally consistent with other major surgical procedures. Commonly reported complications of IPHC include prolonged ileus, fistula, abscess, and thrombosis. In theory, the coliseum and PCE techniques may have less associated morbidity due to improved heat distribution, however, this remains to be definitively proven in a controlled clinical trial. Such controlled studies are critical to defining the best techniques of IPHC administration and the appropriate role for this treatment regimen in patients with peritoneal metastases.
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PMID:Technology of intraperitoneal chemotherapy administration: a survey of techniques with a review of morbidity and mortality. 1456 36

A complex of clinical, functional, and morphological studies was made in 20 patients aged 39 to 78 years who had histologically verified gastrointestinal carcinoids in the pre- and postoperative periods, by employing laboratory tests and instrumental techniques. Removed tumors were morphologically studied. Sixteen patients were operated on. Among them, 10 and 6 patients underwent planned and emergency operations, respectively. On referral for emergency laparotomy, the preoperative diagnoses were acute ileus in 2 cases, acute pancreatitis in 1, and acute appendicitis in 3. The local paracrine effect of serotonin on the intestinal wall leads to spasm and fibrosis, which manifests itself as the clinical picture of obstruction of a hollow organ or acute appendicitis. Cordlike or concentrated deformity as a kink is a characteristic sign of small intestinal carcinoid. Formation of fibrosis occurs not only in the pathways of evacuation of excess serotonin from hepatic metastases into the right ventricle of the heart (Hedinger's syndrome), but by the paracrine pathway in the immediate vicinity of a carcinoid tumor, in whatever organ the tumor is located.
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PMID:[Manifestations of local fibrosis in the clinical picture of carcinoids of digestive organs]. 1466 72

The objective of the study was to compare the perioperative complication rates of our initial 60 laparoscopic radical prostatectomy (LRP) patients and our most recent 60 sequential open radical retropubic prostatectomy (RRP) patients. Sixty sequential LRP and 60 sequential RRP patients treated between March 2000 and March 2002 were retrospectively evaluated. Patients who received neo-adjuvant hormonal therapy or had metastatic disease and 3 LRP patients converted to open RRP were excluded. Estimated blood loss (EBL), transfusion rates, hemoglobin level, serum and drain fluid creatinine levels, hospital stay and complication rates were analyzed. There were 15 (25%) and 11 (18.3%) complications in the LRP and RRP cohorts, respectively. There were 3 (ulnar neuropathy, ureteral stricture, anastomotic leak with ureteral obstruction requiring reoperation), and 4 [2 bladder neck contractures (BNC) and 2 deep venous thromboses (DVT)] major complications, respectively. Minor complications included rectus hematoma, superficial wound infections, ileus and anastomotic urine leaks. A higher incidence of the latter (10 patients) was noted in the LRP cohort. One (1.7%) LRP and 31 (52%) RRP cohort patients received intraoperative or postoperative transfusions. The mean (median) EBL was 317 (250) and 1355 (1100) for the LRP and RRP cohorts, respectively. A transient, insignificant increase in serum creatinine from a median of 1.0 to 1.2 mg/dL was observed only in the LRP cohort. We concluded that our initial 60 LRP patients had a similar, but not improved, rate of perioperative complications when compared with 60 sequential open RRP patients of nearly identical age, preoperative PSA and prostate size. The types of complications differed between the LRP and RRP cohorts.
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PMID:Perioperative morbidity of laparoscopic radical prostatectomy compared with open radical retropubic prostatectomy. 1508 5

This report describes the autopsy case of a 71-year-old man presenting with clostridial infection and hemophagocytic syndrome (HS). The patient underwent pancreatoduodenectomy for a pancreatic tumor, and a histological examination revealed an invasive ductal adenocarcinoma. Multiple peritoneal metastases were noted when laparotomy was performed because of postoperative ileus 2 months after the initial operation. Then, acutely progressive anemia associated with fever developed in the patient before death. The autopsy revealed advanced cancer dissemination and HS. In addition, systemic spread of clostridium, confirmed by the polymerase chain reaction method, had resulted in generalized bleb formation. The clostridial infection appeared to be responsible for the HS. This case indicates that HS may occur as a result of clostridial infection.
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PMID:Hemophagocytic syndrome associated with clostridial infection in a pancreatic carcinoma patient. 1520 Feb 76

Small bowel solitary metastases are a very rare occurrence and are more frequently recognized only in the presence of a severe complication, such as intestinal hemorrhage or occlusion. We report the case of a 75 year-old man who was admitted with a recent history of mechanical ileus developed one year after the surgical removal of an endoscopically intubated carcinoma of the extrahepatic biliary tree (pT3 pN0 Mx). A solitary metastasis of the small bowel, 30 cm from the ileo-cecal valve, was excised during the emergency laparotomy and a side-to-side anastomosis was performed to reconstruct the intestinal continuity. Patient was, thereafter, discharged in the 9th postoperative day. Local recurrence and intrabdominal dissemination are often observed in patients treated for bilio-pancreatic carcinoma. Preoperative invasive (ERCP, FNA, PTBD, etc.) diagnostic procedures and surgical tumor manipulation are associated with a greater risk of metastasis implantation and intraabdominal dissemination. In accordance to the literature, the authors propose, in cases with resectable bilio-pancreatic neoplasms, the use of standard external low dose radiotherapy prior to any invasive diagnostic procedure and/or surgical removal.
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PMID:[Solitary small bowel metastasis after resection of bile duct carcinoma]. 1538 1


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