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

We report a case of perforated metastatic small intestine tumor from the lung. A 56-year-old male admitted for lung cancer with multiple distant metastases developed severe epigastralgia. As radiographic examination revealed free air below diaphragm, we have suspected perforation of upper digestive tract. Exploratory laparoscopy carried out the next day demonstrating perforation of proximal jejunum. Despite jejunal resection, the patient has died of respiratory failure. Pathological evaluation of resected intestine showed a metastatic jejunal tumor with perforation. Metastatic tumor in the digestive tract from lung is a rare condition, and it usually occurs as a part of systemic involvement. To achieve an early diagnosis and treatment, perforation of metastatic tumor should be taken into notice.
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PMID:[A case of perforated metastatic small intestine tumor from the lung]. 1821 3

Nested stromal epithelial tumor is a recently described primary neoplasm of the liver. This tumor is characterized by well-demarcated nests of spindle and epithelioid cells with occasional calcification and bone formation. An association between these tumors and Cushing syndrome has been described. Herein we report a case of a recurrent nested stromal epithelial tumor of the liver in a 17-year-old female with aggressive clinical behavior and an extrahepatic lymph node metastasis. Also, we provide the first detailed clinical, histologic, immunohistochemical, and cytogenetic comparison of the original and recurrent tumors. Initially, the patient presented with Cushingoid symptoms and epigastric pain, radiating to her back. A computed tomographic (CT) scan revealed a large lesion in the liver. After a partial hepatectomy, the Cushingoid features were resolved. A year later, a CT scan revealed multiple lesions within the liver, and positron emission tomographic/CT imaging showed a hypermetabolic lymph node. The patient underwent a cadaveric liver transplant. Histologically, both the original and recurrent tumors had similar characteristics, with different immunoreactivity, correlating with the absence of systemic hormonal symptoms. Electron microscopy of the original neoplasm revealed an abundance of rough cytoplasmic reticulum and mitochondria. No evidence of endocrine differentiation was found. Cytogenetics of the primary tumor was complex with an abnormal hypotriploid karyotype. Our data indicate that patients with nested stromal epithelial tumor of the liver must be carefully followed with imaging to detect hepatic recurrence and extrahepatic metastases.
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PMID:Recurrent nested stromal epithelial tumor of the liver with extrahepatic metastasis: case report and review of literature. 1833 37

Fibrosarcoma of the pancreas is a very rare tumour. Its localisation in any part of the pancreas causes various dominant symptoms. Tumour is often enormously enlarged, very vascular, often with central necrosis and penetration into the gastric wall causing ulcers and bleeding. Prognosis of the tumour is not always bad due to low malignancy. The authors describe a 53-year-old woman with fibrosarcoma of the pancreatic body. The first symptom was an epigastric pain when subcardial gastric ulcer was diagnosed and conservatively treated. One year later a huge palpable epigastric tumour was found with massive gastrointestinal bleeding as a dominant symptom. Gasher was dislocated from the less curvature side by the tumour. During the operation a great, solid and highly vascular tumour was removed, 2100 grams of weight and 15 cm in diameter Subtotal gastric resection with Billroth II anastomosis was done because of the infiltration of the posterior gastric wall and bleeding ulceration. Histopathology showed the first stage malignany of pancreatic fibrosarcoma. The patient is symptom free, without local recidivation and distant metastases over 3 years after the operation.
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PMID:[Fibrosarcoma of the pancreas]. 1870 69

Multiple endocrine neoplasia type 1 (MEN 1) is a syndrome characterized by tumors of the parathyroid glands, pancreatic islet cells, duodenum, and pituitary gland. We report a case of cervical metastases of glucagonoma with MEN 1. The patient was a 34-year-old woman admitted to our hospital with epigastric pain. Her medical history included two resections of prolactinoma and two upper GI hemorrhages secondary to duodenal ulcers. Computed tomography (CT) showed two hypervascular lesions in the tail of the pancreas and cervical ultrasound showed multiple hypoechogenic ovoid images in the neck. A cervical CT scan confirmed two 15-mm lymph nodes in the left cervical region and 111In-DOTATOC imaging showed focal abnormal somatostatin expression in the pancreatic tail and the cervical nodes. The patient had asymptomatic hypoglycemic episodes, with blood sugar levels as low as 30 mg/dl, which raised our suspicion of MEN 1 associated with pancreatic insulinoma. Thus, we performed a distal pancreatectomy with bilateral cervical dissection and parathyroid gland resection. Histopathological examination revealed 12 pancreatic tumors as well as metastases in four cervical lymph nodes. The resected parathyroid glands had normal structure, suggesting parathyroid hyperplasia. A follow-up CT scan, 18 months after surgery, showed new tumors in the head of the pancreas and in the duodenal wall. A pancreatoduodenectomy was performed and histopathological examination revealed nine nonfunctioning endocrine tumors in the pancreas, one tumor in the duodenal wall, and metastases in two peripancreatic lymph nodes. The patient recovered well and remains asymptomatic.
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PMID:Cervical metastases of glucagonoma in a patient with multiple endocrine neoplasia type 1: report of a case. 1903 43

Ewing's sarcoma (ES) is a neoplasm of undifferentiated small round cells, which occurs in the bones and deep soft tissues of children and adolescents. We present a rare case of a 44-year-old woman with gastric ES presenting with epigastric pain and weight loss. Ultrasound and computed tomography scans indicated a solid/cystic mass in the pancreatic tail. At laparotomy, the tumor was found attached to the posterior surface of the stomach, completely free from the pancreas, with no lymphadenopathy or local metastases. The polynodal, partly pseudocystic, dark-red soft tumor was excised. Histopathology revealed an anaplastic small-round-cell tumor with strong membranous CD99 immunoexpression. Additionally, there was patchy immunostaining for S-100 protein, vimentin, protein gene product (PGP) 9.5 and neuron-specific enolase, and weak focal CD117 cytoplasmic immunoreactivity. The patient had no adjuvant chemotherapy; her postoperative recovery was uneventful, and she remains symptom-free, and without any sign of recurrence at 20 mo. To the best of our knowledge, this is only the third ever case of gastric ES.
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PMID:Perigastric extraskeletal Ewing's sarcoma: a case report. 1913 77

This retrospective study analyzes, whether patients suffering from extensive hepatic metastatic disease treated with SIRT can become suitable candidates for RFA.Within 38 months 46 patients (26 female, 20 male; age 32-75 years) bearing an extensive hepatic metastatic disease were treated with SIRT. Patients suffered from metastases of breast cancer (16/46), colorectal cancer (CRC) (21/46), neuroendocrine (3/46), and other primary carcinomas (6/46). The indication for SIRT was otherwise untreatable metastases confined to the liver. Forty-three patients received single-session whole-liver radioembolization treatment using Yttrium90 resin microspheres with a mean activity of 2.13GBq. In 1 patient SIRT was confined to the left and in 2 patients to the right liver lobe. In 3 patients major complications (2/3 gastric ulceration and 1/3 oedematous pancreatitis) and in 24 patients minor complications occurred (acute abdominal/epigastric pain and/or nausea). Follow-up CT and/or MRI were obtained in 44 of 46 patients. In 5 of 44 patients tumor load decreased substantially (3/5 breast cancer, 1/5 CRC and 1/5 pancreatic cancer) making RFA feasible. The patients were referred for RFA after the first 3-month follow-up. RFA of the liver was successful in all cases in terms of complete ablation. In selected patients radioembolization is able to downstage liver metastases to an extent making a subsequent RFA suitable and therefore allows increasing the number of patients with a "complete response" after a minimally invasive therapy.
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PMID:Radiofrequency ablation after selective internal radiation therapy with Yttrium90 microspheres in metastatic liver disease-Is it feasible? 1926 63

A 65-year-old man was admitted for epigastralgia. On endoscopy, a type 3 cancer from the lower body of the stomach to the antrum was found, and abdominal CT scan demonstrated multiple liver metastases and peritoneal dissemination. A distal gastorectomy was performed. On, pathological examination, a diagnosis of adenosquamous carcinoma was confirmed, and lymph node metastases around the perigastric areas were found. The patient was given chemotherapy consisting of S-1 alone (120 mg/day, days 1-28 with two weeks rest). After two courses of chemotherapy, his liver metastases were found to have progressed, and paclitaxel was given at a weekly dose of 80 mg/m2 for 3 weeks, followed by a one-week rest. The carcinoembryonic antigen level decreased remarkably, and the liver metastases had decreased on CT. Thus, extensive chemotherapy for the liver metastases improved the patient's prognosis, while maintaining his quality of life.
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PMID:Weekly paclitaxel therapy is effective for gastric adenosquamous carcinoma: a case report. 1957 45

We report a series of ten cases of the clinical, endoscopic and pathological features of gastric metastases. Patients were six women and four men between 54 and 88 years old, with gastric metastases from breast carcinoma (4), lung carcinoma (4) and melanoma (2). Patients underwent an upper gastrointestinal endoscopy for epigastralgia (2), hematemesis (2), dysphagia (1) and anemia (5). On endoscopy, tumors appeared as nodules with a central ulceration (5), an ulceration (4) or simulating linitis plastica (1). Metastases were located in the cardia (2), fundus (5) and antrum (3). Primary tumors had been diagnosed between one day and 20 years before upper endoscopy. Eight patients had multivisceral metastases. The microscopic features of the gastric metastases resembled a primary gastric cancer in eight cases. Thanks to clinical data, the pathologist confirmed the diagnosis of gastric metastases on immunohistochemistry. Nine patients died in the eight-month follow-up period. Gastric metastases are rare, occur at a late stage of the neoplastic disease, and have a poor prognosis. Diagnosis of gastric metastases is difficult because they simulate primary gastric cancer on endoscopy and on microscopic examination. A correct diagnosis is based on good communication between gastroenterologists and pathologists.
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PMID:Gastric metastases. An endoscopic series of ten cases. 2062 37

A 72-year-old man complained of dyspnea and epigastric pain. He was admitted to our hospital with progressive dyspnea and abnormal chest radiograph findings. Chest CT scan on admission showed multiple nodular shadows with and without air-bronchograms, vessels or cavitation. Transbronchial and percutaneous lung biopsy specimens demonstrated poorly differentiated carcinoma. Pulmonary metastases were suspected, but their primary origin was unknown. Chest and abdominal CT scans on the 18th hospital day showed a giant tumor of the small intestine and rapid progression of the pulmonary tumor, forming cavitation. The patient's condition worsened, and he died on the 51st hospital day. At autopsy, a final diagnosis of T-cell lymphoma of the small intestine and pulmonary metastases was obtained. This is a rare case which was found primarily based on the characteristic radiologic features of pulmonary metastases.
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PMID:[A case of primary small intestinal malignant lymphoma found based on multiple pulmonary nodules with cavitation]. 2068 12

BACKGROUND: Metastasis to the pancreas originating from malignant tumours is a rare event and, in the literature, we have found only 11 reported cases of solitary pancreatic metastases originating from breast cancer. CASE REPORT: We report a case of a 51-year-old woman with primary breast cancer who developed obstructive jaundice and epigastric pain after 2 years without any symptoms. The pancreatic mass revealed by computed tomography (CT) scan and magnetic resonance imaging (MRI) was not recognised as a metastasis from breast cancer and the patient underwent cephalic pancreaticoduodenectomy. CONCLUSIONS: We discuss all aspects of the case management, stressing the importance of a careful evaluation of the clinical history and the primary cancer features and the usefulness of a multi-disciplinary approach. These aspects are of main importance for a correct diagnostic process and an appropriate therapeutic choice when a pancreatic lesion develops in a patient with prior neoplasm.
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PMID:Metastasis to the Pancreas from Breast Cancer: Difficulties in Diagnosis and Controversies in Treatment. 2104 32


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