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

Isolated, small bowel metastases from lung carcinoma are extremely rare; only 34 cases have been previously reported. Rarer still is the presentation of lung carcinoma with a lesion metastatic to the small bowel. These 34 cases and 3 recent ones from Easton Hospital (Easton, PA) were analyzed to clarify the clinical and pathologic features of the disease. The majority of patients had a history of abdominal pain (86%), melena (23%), or nausea and vomiting (26%). Few had weight loss (16%). Twenty-one patients (57%) came to the hospital with perforation and peritonitis, including 9 in whom lung carcinoma was undiagnosed before laparotomy. Thirteen patients (34%) underwent laparotomy because of small bowel obstruction, 2 (6%) for bleeding and 1 (3%) for a mass found during work-up. Squamous cell (49%) and large cell (22%) were the most common cell types, and the jejunum was the most common site of the metastases (79%). Survival time was dismal (mean 51 days) and was unaffected by therapy to the primary site of the cancer or its metastases. The authors conclude that small bowel metastases from lung carcinoma are not uncommon and may be seen more frequently as patients live longer after their diagnosis of cancer. Small bowel metastases must be considered in any patient with both lung carcinoma and abdominal pain, and should be expected in patients with both lung carcinoma and an acute abdomen.
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PMID:Small bowel metastases from primary lung carcinoma: a rarity waiting to be found? 148 99

Carcinoid tumor of the appendix is the most common neoplasm of the gastrointestinal tract in childhood and adolescence. Sufficient long-term follow-up data after surgical treatment are not currently available for patients diagnosed during the first two decades of life. From 1936 to 1988, 23 patients were observed at this institution with histologically confirmed carcinoid tumors involving the vermiform appendix. In contrast to the adult experience, in which the tumor is most commonly encountered as the result of an incidental appendectomy, 18 of these patients presented with signs and symptoms of an acute abdomen directing the surgeon to the appendix. In the other five cases, surgery was performed for other reasons. Median age at presentation was 13.0 years (range, 6 to 20 years). Fourteen patients were female, nine were male. Simple appendectomy was the initial procedure for all patients. Tumor size ranged from "microscopic" to 2.5 cm in largest dimension. Three patients subsequently underwent right hemicolectomy, and one patient had removal of a residual appendiceal stump, but no residual or metastatic tumor tissue was found in any of the resected specimens. Nineteen patients underwent simple appendectomy alone. Eighteen available specimens were reviewed at the time of this study for confirmation of histology and degree of invasion. The tumor invaded to the serosa in nine of 23 (39%). The mesoappendix or periappendiceal fat was involved in seven of 23 (30%). Vessel invasion was not noted in any specimen. Our median follow-up time was very long, being 26 years (range, 9 months to 51 years). No patient has had evidence of recurrent or metastatic disease.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Carcinoid tumor of the appendix in the first two decades of life. 226 61

Peritoneoscopy is a simple and effective means of diagnosing or excluding intra-abdominal disease. It is currently underutilized and merits increased recognition particularly by general surgeons. The first 77 peritoneoscopic examinations performed by a general surgeon in a large hospital associated with a cancer agency are reviewed. An exact diagnosis was made in 78% of 58 patients in whom the primary diagnosis was in doubt and in 93% of that group management was influenced. Surgical exploration of the abdomen was avoided in 29 patients. The major indications for using the method were: to search for metastases, to evaluate the acute abdomen and to stage lymphoma. Local anesthesia and nitrous oxide insufflation were used almost exclusively. Biopsy was performed in 36 patients and there was one death directly attributable to liver biopsy. In two patients peritoneoscopy was unsuccessful.
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PMID:Peritoneoscopy in general surgery. 645 2

An experience of surgical non-thoracic emergencies in patients admitted for chronic lung disease is herein presented. Fifty-four patients out of 10457 admitted in the four Departments of Pneumology of the Binaghi Hospital (Cagliari) between 1-1-1985 and 31-3-1993, were referred to our Department of General Surgery due to non-thoracic surgical emergencies. There was a considerable delay in the referral (only 25% of patients within 12 hours from the onset of symptoms): indeed predominant respiratory symptoms, hypoxia and hypercapnia made these patients no responsive to symptoms of surgical emergency. Surgical emergencies in causal correlation with respiratory disease (intestinal occlusion due to abdominal metastases of lung carcinoma, complicated peptic ulcer) had the worst prognosis (mortality: 52.9%). Those in chance connection, such as acute limb ischemia and preexisting abdominal disease, had a less adverse outcome. Mortality, however, was 37.5%: this datum outlines the role of chronic lung disease in defining operative risk. The authors call attention to three groups of observed patients: 1) three patients were operated on for intestinal occlusion due to unrecognized abdominal neoplasia, that showed itself in the course of hospitalization in the Department of Pneumology for lung metastases; 2) in 3 cases symptoms and signs of acute abdomen were observed without abdominal disease. The cause of acute pseudoabdomen was diaphragmatic pleural or basal pulmonary inflammation; 3) the eight patients with pulmonary embolism were all admitted in the Department of Pneumology with a wrong diagnosis of bronchopneumonia.
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PMID:[Extrathoracic surgical emergencies in hospitalized patients with bronchopulmonary diseases. Analysis of the operative risk]. 780 66

Endometrial stromal sarcoma (ESS) is a rare uterine malignancy with a variety of morphologic characteristics and clinical courses. We describe a case of high-grade malignant ESS in an adolescent girl, arising in a rudimentary uterine horn and presenting symptoms of an acute abdomen. The patient underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy and omentectomy due to a stage IVA high-grade ESS. An adjuvant chemotherapy and radiotherapy treatment was recommended, but 10 days after her discharge the condition of the patient deteriorated, with diffused metastases into the lungs and the abdomen, and finally she succumbed to the disease 1 month after her first admission to the hospital.
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PMID:High-grade endometrial stromal sarcoma in a 16-year-old girl. 802 Aug 47

A retrospective review was completed on 43 patients with metastatic lesions to the gastrointestinal tract between 1980 and 1993. The most commonly involved organs were stomach and small intestine. The main features were abdominal pain (70%), acute abdomen (42%), alimentary bleeding (21%), massive in 11.6%). Operations were performed on 42 patients (palliative resection in 40 patients, enteric bypass in 2). The results support surgical intervention for patients with complaints of gastrointestinal metastases, especially in emergency patients.
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PMID:[Value of surgical treatment in patients with gastrointestinal metastatic tumors]. 873 76

Leiomyosarcomas of the small bowel are quite rare. These tumors are mostly located in the jejunum distal of the duodeno-jejunal flexure. The non-metastasizing leiomyosarcomas have a good prognosis, according to the literature. The adequate surgical treatment is the resection of the small bowel. Chemotherapy is discussed if there is evidence of metastatic disease. For the diagnosis of leiomyosarcomas tumor markers have no significance. We report the case of a 79 years old patient with a leiomyosarcoma of the jejunum who was admitted as an emergency with an acute abdomen and underlying chronic anaemia. This case demonstrates the often unspecific symptoms and characteristics of leiomyosarcomas.
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PMID:[Leiomyosarcoma of the small intestine]. 906 24

We report elevated serum carcinoembryonic antigen (CEA) in a case of malignant carcinoid tumor of the appendix with liver and lung metastasis. A 55-year-old Thai man was found to have multiple nodules in the liver by ultrasonography. Serum CEA was 7,387.9 ng/mL (normal 0-4.1 ng/mL) leading to a clinical impression of colonic carcinoma with liver metastasis. During the investigation, he developed acute abdomen caused by ruptured acute appendicitis. Malignant carcinoid tumor of the appendix, 1 cm in diameter and located proximal to the ruptured acute appendicitis, was identified. The tumor cells showed trabecular or insular growth pattern, some nuclear pleomorphism but typically fine nuclear chromatin, frequent mitoses and focal necrosis. They were immunoreactive for antibody to chromogranin, neuron-specific enolase, CEA, and cytokeratin. Tumor metastases were discovered in the liver, right lung, mediastinal and right supraclavicular lymph nodes. Electron microscopic study demonstrated pleomorphic neurosecretory granules of the midgut type of carcinoid tumor.
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PMID:Malignant carcinoid tumor of the appendix with liver and lung metastasis: report of a case with a high level of serum carcinoembryonic antigen. 1071 Aug 76

A laparotomy was performed on a 44-year-old male patient with an acute abdomen who had findings suggestive of acute appendicitis and a periappendicular abscess. A histopathological examination revealed a carcinoid tumor infiltrating the intestinal serosa. The distal ileum and cecum were infiltrated with more than 40 multifocal tumors, with the largest measuring 1 cm in size. The distal ileum and cecum were resected. We failed to find any distant metastases either peroperatively or during postoperative scintigraphic tests. In addition, the patient had no symptoms of carcinoid syndrome either before or after surgery. No recurrence was experienced. We thus conclude that primary multifocal carcinoid tumors may act as a solitary carcinoid tumor, and the largest tumor tends to indicate the overall clinical outcome.
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PMID:Multifocal carcinoid tumor resembling a solitary tumor: report of a case. 1131 32

A multicentre phase II trial was undertaken to evaluate the activity and toxicity of docetaxel plus cisplatin as first-line chemotherapy in patients with urothelial cancer. Thirty-eight patients with locally advanced or metastatic transitional-cell carcinoma of the bladder, renal pelvis or ureter received the combination of docetaxel 75 mg m(-2) and cisplatin 75 mg m(-2) on day 1 and repeated every 21 days, to a maximum of six cycles. The median delivered dose-intensity was 98% (range 79-102%) of the planned dose for both drugs. There were seven complete responses and 15 partial responses, for and overall response rate of 58% (95% CI, 41-74%). Responses were even seen in three patients with hepatic metastases. The median time to progression was 6.9 months, and the median overall survival was 10.4 months. Two patients who achieved CR status remain free of disease at 4 and 3 years respectively. Grade 3-4 granulocytopenia occurred in 27 patients, resulting in five episodes of febrile neutropenia. There was one toxic death in a patient with grade 4 granulocytopenia who developed acute abdomen. Grade 3-4 thrombocytopenia was rare (one patient). Other grade 3-4 toxicities observed were anaemia (three patients), vomiting (five patients), diarrhoea (four patients), peripheral neuropathy (two patients) and non-neutropenic infections (seven patients). Docetaxel plus cisplatin is an effective and well-tolerated regimen for the treatment of advanced urothelial cancer, and warrants further investigation.
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PMID:Phase II multicentre study of docetaxel plus cisplatin in patients with advanced urothelial cancer. 1187 92


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