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)

We review eight cases of early gastric cancer which occurred in five female and three male patients. In seven patients the main complaint was epigastric pain and in one melena. In seven of the eight cases, endoscopic diagnosis was established on the first examination and confirmed by biopsy. Types of early gastric cancer observed were: type I, one case; IIa, one case; IIc three cases: III, two cases and type III + IIc, one case. In five cases the neoplasia was located in the antrum, two in the pre-pyloric region, two along the greater curvature and one in the anterior wall. Three cases were located in the body of the stomach, two in the lower third of the lesser curvature and one in the upper third of the greater curvature. From the histopathologic standpoint four cases were differentiated adenocarcinomas, three undifferentiated adenocarcinomas and one case mucus carcinoma. In no case did we encounter regional lymph node metastases. Postoperative survival rates at the present time varies between one and five years.
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PMID:Evaluation of eight cases of early gastric cancer. 629 47

A series of 60 patients with early gastric cancer (EGC) operated on from 1.1.1971 to 31.5.1983 is reviewed; since three cases had two and another case even had three synchronous primitive neoplastic lesions, a total of 65 EGC are reported. A prevalence of the "ulcerated" types, a large variability of lesion size and a prevalence of location along the lesser curvature and the antrum was observed; 38 EGC (58.46%) were confined to the mucosa (m), 27 (41.54%) also involved the submucosa; histologically, 53 EGC (81.54%) were of the intestinal type, and 12 (18.46%) were of the diffuse type. Associated lesions, above all chronic atrophic gastritis, intestinal metaplasia and adenomatous gastric polyps were often found. Clinical symptoms were not very specific (epigastric pain, abdominal distension, vomit, dyspepsia, GI hemorrhage) whereas x-ray and endoscopic evaluation had a very high diagnostic accuracy. Our policy is to perform curative resection for gastric cancer, in the form of partial or total gastrectomy with the removal of first level (n1) and second level (n2) lymph node groups and occasionally additional resection of enlarged lymph nodes in the tertiary (n3) group when metastases are suspected. All our patients have been followed up in order to detect any recurrences or metastases.
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PMID:Early gastric cancer: evaluation of diagnostic, clinicopathologic and therapeutic aspects in 60 cases. 652 25

To investigate whether there has been a time trend change in the percentage of early gastric cancer to gastric cancer and the clinicopathologic features of early gastric cancer in Taiwan, we reviewed 208 patients diagnosed between 1964 and 1992. Patients were divided into group I from 1964-1980 (n = 106) and group II from 1981-1992 (n = 102). The percentage of early gastric cancer among total gastric resections in group II (14.7%) did not differ from group I (12.7%; p = 0.19). Epigastralgia (58.2%) was the most common complaint; 11.8% (12/102) of cancers in group II were incidentally detected by endoscopy. Endoscopy provided a better diagnostic aid than did radiology. Tumors were frequently located in the antrum (50.9%) with a mean diameter of 2.8 cm. Small cancers of less than 1 cm in diameter were more prevalent in group II (37.3%) than group I (10.4%; p < 0.001). Cancers of the elevated type (17.8%) were uncommon in contrast to depressed ones (82.2%; p < 0.001). The frequency of mucosal carcinoma (51.0%) was similar to submucosal carcinoma (49.0%). Mucosal carcinoma had less lymph node metastases (3.1%) than submucosal carcinoma (12.2%; p < 0.05) with an overall frequency of metastases of 7.5% (14/186). The five-year survival rate of group I (91.7%) was not statistically different from group II (94.6%). We concluded that, except for the symptomatology and the ability to diagnose, the clinicopathologic features of early gastric cancer were similar between these two time periods. Repeated investigation of suspicious lesions and endoscopic screening on asymptomatic subjects may increase the rate of detection and thus guarantee a favorable outcome.
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PMID:Secular changes in the clinical manifestation and pathologic pattern of early gastric cancer in Taiwan. 791 68

To investigate whether there are any differences between the clinicopathologic characteristics of early gastric cancer (EGC) patients in Eastern and Western countries, 208 Taiwanese patients with EGC were reviewed between 1964 and 1992. The incidence of cancer has increased slightly over the 29-year period. Men were diagnosed with EGC frequently than women, and their mean age was 56 years. Epigastralgia (58.2%) was the most common symptom, whereas 5.8% of cancers were incidentally detected by endoscopy. Physical signs and laboratory tests were of limited value in making the diagnosis. Endoscopy was a better diagnostic aid than radiology. Tumours were frequently located in the lower third (53.2%) and middle third (43.3%) of the stomach. Cancers of the elevated type (17.8%) were less frequent than the depressed type (82.2%). Type IIc (31.2%) was the most common macroscopic type. The frequency of mucosal carcinoma (51.0%) was similar to submucosal carcinoma (49.0%). Mucosal carcinoma had less lymph node metastases (3.1%) than submucosal carcinoma (12.2%; P < 0.05), with an overall frequency of metastases of 7.5% (14/186). The 5-year survival rate was 90.8%. The clinicopathologic characteristics of EGC in Taiwan were similar to those of Western countries and other Eastern countries. Improvement of diagnostic examinations and endoscopic surveillance of asymptomatic subjects may lead to early diagnosis and thus ensure a more favourable outcome.
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PMID:Clinicopathologic study of 208 patients with early gastric cancer in Taiwan: a comparison between Eastern and Western countries. 794 16

Fotemustine is a new chloroethylnitrosourea characterized by the grafting of a phosphonoalanine group onto a nitrosourea radical. Clinical studies using fotemustine have been conducted in malignant glioma, brain metastasis of non-small cell lung cancer, and disseminated malignant melanoma. In recurrent malignant glioma, fotemustine has been used as a single agent: assessed by computed tomography scan, after 8 weeks, the objective response rate was 26.3% among 38 evaluable patients. Median duration of response was 33 weeks. The main toxicity was hematological (thrombocytopenia and leucopenia). A trial with high-dose fotemustine and autologous bone marrow rescue in newly diagnosed glioma was conducted in 26 patients, and 6 showed a partial response. The median overall survival was approximately 11 months. Myelosuppression was noted in all patients except 1, and other toxicity reported was central nervous system toxicity and epigastric pain. Combined with radiotherapy in 55 patients, a 29% response rate was observed, and this combination was well tolerated and easily manageable on an outpatient basis. Finally, fotemustine has been used intraarterially, with 10 objective responses observed among 26 evaluable patients. In brain metastases of non-small cell lung cancer, fotemustine proved to be active with a response rate of 16.7%. Combined with cisplatinum, fotemustine is still under study, but preliminary results are promising. In cerebral metastases of disseminated malignant melanoma, fotemustine has been evaluated in a total of 140 patients in the various studies: median response rate is 24.3%, ranging from 8.3% to 60.0%. Fotemustine appears to be a good candidate in the treatment of primary brain tumors and metastases.
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PMID:Fotemustine in the treatment of brain primary tumors and metastases. 803 64

Neuroendocrine pancreatic tumors are neoplasms derived from APUD cells, characterized by hyperincretion of several peptides of hormonal activity. The incidence of these tumor is low. They are usually classified according to the predominant secreted peptide: gastrinoma, insulinoma, VIPoma, glucagonoma. Insulinoma is the most frequent endocrine pancreatic tumor, characterized by a peculiar clinical picture due to insulin action. This neoplasm is prevalently benign (90%), and may cause symptoms due to hypo-glycemia such as epilepsy, asthenia, deep coma, dizziness, hunger and epigastric pain. Surgery still constitutes the principal therapy for insulinoma treatment, but an accurate tumor identification is necessary. Selective arteriography of the pancreas and new diagnostic investigations as intraoperative US, selective sampling of pancreatic veins with insulin Quick-RIA, aid the diagnosis and more precise localization of the tumor. When surgical therapy is not practicable, for diffuse metastases, octreotide has an inhibitory effect upon hormone release, and may be combined with chemotherapy for controlling clinical symptoms. We review the clinical records of 2 patients from our Institute, who had hyper-insulinism due to benign insulinomas of the tail of the pancreas. Surgical treatment was performed with enucleation of the neoplasms.
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PMID:[Pancreatic insulinomas]. 817 52

We report a case of eruptive metastases to the skin of the face and neck from a hitherto unknown gastric carcinoma, occurring in a fifty-two-year-old man (a regular blood donor), about six months after he contracted human immunodeficiency virus-1 infection. The eruption, consisting of more than thirty pea-sized cutaneous nodules appeared within about twenty days. The patient complained of epigastric pain and weight loss. Histologic examination showed signet-ring cells of gastric carcinoma metastases. Gastroscopic examination showed a widely infiltrating tumor. No metastases were found elsewhere after a careful screening. Immunologic variables were only slightly altered. This case and a brief review suggest that gastric carcinomas, possibly as well as other coincidental tumors, may present atypically during human immunodeficiency virus-1 infection.
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PMID:Unusual eruption of cutaneous metastases from occult gastric carcinoma shortly after HIV-1 infection. 824 3

The records from seventy cases of early gastric cancer (EGC) diagnosed at the Hospital de la Santa Cruz y San Pablo in Barcelona during 1981-1990 were reviewed in order to analyze their clinical features and their influence on survival. There was a male predominance (47/23). The disease was seen mostly in patients who were 60-70 years old, although women were younger than men. The most frequent symptom was epigastric pain, more commonly referred in ulcerated forms of EGC. Protruded forms resulted in digestive haemorrhage. Barium meal examination of the upper digestive tract and gastroscopic examination (without histologic study) only revealed about half of the lesions. So it is very important to get some material for histological studies even in apparently benign lesions. EGC was mostly located at the antrum (68.1%). These antral tumours used to have lymph node metastases more frequently than the rest. Tumours were larger in women than in men. EGC with greater size showed deeper infiltration, more lymph node involvement and higher recurrence risk. Another malignancy--besides EGC--was seen in 8.2% of the patients. This event implied a 40% of mortality. Development of recurrence also meant a high mortality risk. Patients with big, multifocal tumours and with lymph node metastases were prone to recurrence of the disease. In this study, development of recurrence and detection of another malignancy have become the clinical features with more influence over survival.
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PMID:[Early gastric cancer at a third-level hospital in Barcelona in 1981-1990. Clinical considerations]. 839 79

Many patients diagnosed with breast cancer will develop metastases and these have diverse presentations. We have reviewed 100 consecutive patients who have died with metastatic breast cancer, to determine the frequency, sites and mode of presentation of recurrent disease. The commonest site of failure was loco-regional (n = 61), this usually presented with a mass, but a minority of patients also complained of pain. Bone metastases developed in 60 patients and produced bone pain, pathological fracture (n = 6) or cord compression (n = 5). Pulmonary metastases producing shortness of breath were diagnosed in 34 patients and were asymptomatic in a further 10. Intra-abdominal metastases were found at some time in 23 patients, most commonly in the liver (n = 20) and the majority complained of epigastric pain (n = 17). Brain metastases occurred in 23 patients and produced a wide range of symptoms including those of a space-occupying lesion (n = 10), cranial nerve palsy (n = 7), diabetes insipidus (n = 3), focal limb weakness (n = 2) and meningitis (n = 1). Three patients had choroid metastases producing reduced visual acuity. Recurrent breast carcinoma can present in a variety of ways, therefore any new symptom or sign should be considered to represent recurrence until proved otherwise.
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PMID:Patterns of clinical metastasis in breast cancer: an analysis of 100 patients. 863 4

Leiomyosarcoma is the second most common non epithelial malignant tumor of the stomach. It is almost always a single lesion. Multiple leiomyosarcomas of the stomach are extremely rare. To our knowledge only three cases have been reported so far. We present a 40 year old female with epigastric pain, nausea, diarrhea, weight loss and melena in whom we diagnosed multiple lesions of the stomach. At operation, we found a total of 11 submucosal or subserosal lesions ranging in size from 0.5 to 6 cm in diameter localized throughout the stomach. Histological examination showed leiomyosarcoma in every lesion. Almost all the lymph nodes along curvatures had metastases. Other lymph nodes, peritoneum, liver and other organs were disease free. A total gastrectomy and Roux-en-Y esophagojejunostomy was performed. She had an uneventful recovery and has remained symptom-free so far (nine months).
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PMID:Multiple leiomyosarcoma of the stomach. 916 45


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