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)

Clinicopathologic features and surgical treatment of 15 patients with primary anorectal malignant melanoma were studied retrospectively. There was a female preponderance (2:1). The median age was 66 years. Common initial symptoms were rectal bleeding (87%) and/or anal pain (33%); 25% of the melanomas were amelanotic. The maximum tumor size ranged between 0.8 and 8.4 cm (median 3.0 cm). Of the tumors evaluated histologically (n = 12), tumor thickness ranged from 0.9 to 11.3 mm (median 6.1 mm). All melanomas invaded at least into the subepithelial tissue (n = 8) and/or the submucosa of the distal rectum (n = 4), with extension into the internal anal sphincter (n = 5) and lamina propria (n = 3). Endoluminal ultrasound accurately demonstrated depth of invasion in 3 of 3 patients. Three (20%) patients with distant metastases at initial presentation had a mean survival of 8 mo; one of these primary melanomas measured 0.8 cm. Of 12 patients undergoing "curative" treatments--4 by abdominoperineal resection (APR) and 8 by local excision (LE), the incidence of loco-regional recurrence was similar (2/4 and 5/8). All these 7 patients with loco-regional recurrence developed distant metastases within 3 months. The mean survival was similar between APR and LE in the total group (25 mo vs 20 mo), in the decreased (27 mo vs 24 mo) and in those treated with a curative intent (29 mo vs 22 mo). There was no long-term survivor but four patients remained tumor-free up to 19 mo after APR (n = 1) or LE (n = 3).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Anorectal malignant melanoma has a poor prognosis. 840 92

Anal gland adenocarcinoma is rare, with information concerning this lesion communicated mostly as case reports. Cases seen by authors, combined with a survey of the membership of The American Society of Colon and Rectal Surgeons, allowed 52 cases with sufficient data for analysis. It became clear from the survey that most colorectal surgeons have not treated this malignancy. Predominant symptoms are anal pain (58 percent), rectal bleeding (40 percent), and the presence of perianal mass (37 percent). Fifty-four percent of patients present with a fistula, the incidence of fistula being significantly higher in males. Metastases, which may be inguinal, pelvic, or hepatic, are present at diagnosis in 13.5 percent of patients. Three-fourths of patients are eventually treated by abdomino-perineal resection (APR). Twelve percent of the patients in this series had an APR after a failed local excision. The conclusions from this study are: 1) if local excision is attempted, it must be complete, and the patient must be followed closely for many years, and 2) APR is needed in most patients for local control, with the role of subsequent radiation therapy and/or chemotherapy not yet defined.
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PMID:Adenocarcinoma of the anal glands. Results of a survey. 845 66

OBJECTIVE: Untreated malignant large bowel obstruction is rapidly fatal. Short-term palliation of symptoms can be achieved by formation of a stoma in those patients for whom resection surgery is inappropriate. In the final months of life, a stoma represents a significant burden for both patients and carers. Palliative endoluminal stenting may therefore be an attractive alternative option for this poor prognosis group. In this paper, we examine our experience of palliative endoluminal colonic stenting. PATIENTS: Twenty patients, 11 males and 9 females of median age 81 years were referred for stenting. All had left sided colonic cancers. Ten patients had confirmed metastases on presentation, four had fixed rectal cancers and the remainder had severe comorbidity limiting surgical options. Stents were placed endoscopically using a radiologically controlled 'stent over wire' technique. RESULTS: Stenting successfully relieved the obstruction in 18 of the 20 patients attempted. In one patient the stricture could not be negotiated and the procedure was abandoned. Eleven patients have died of their disease, their median duration of palliation was 50 days (3-152 days). The rest of the patients continue in follow-up and have had 80 days median palliation (14-257 days). One stent-related complication has been observed in a patient who suffered anal pain due to fracture and migration of part of a stent into the low rectum. This complication occurred after 250 days and the distal stent fragment was removed with further symptom relief. CONCLUSION: Carefully selected patients benefit from colonic endoluminal stenting with relief of obstructive symptoms. They may be spared the potential problems associated with palliative stoma formation.
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PMID:Palliative stenting of malignant large bowel obstruction. 1278 May 93

A 47-year-old man was admitted to our hospital for anal pain and diagnosed with submucosal tumor by digital examination. Transsacral resection was performed because the patient refused a stoma. Leiomyoma with highly malignant potential was histologically diagnosed. Surveillance was performed by computed tomography, magnetic resonance imaging and digital examination, but a correct diagnosis was difficult. Due to local tumor increases in the resected region, trans-anal resection was performed 2 years later at the time of local recurrence diagnosis. Over the last 10 years, a total of 8 local resections have been performed since the first surgery. No distant metastases have been confirmed to the patient without a stoma. It appears that a local resection of leimyosarcoma of the rectum with a close surveillance was effective.
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PMID:[A case of long-term survival with recurrence leiomyosarcoma of the rectum treated by repeated local resections]. 1555 52

Small-cell carcinoma of the prostate (SCCP) is a rare entity. Many treatment modalities have been done, but thus far no uniform treatment has been clearly established. We carried out combination chemotherapy with gemcitabine, docetaxel, and carboplatin (GDC) regimen (for two patients with refractory SCCP. Case 1 involved a 53-year-old man diagnosed with SCCP after receiving hormone therapy for prostate cancer (stage D1). Six cycles of GDC chemotherapy was applied. Initially the primary site reduced according with a decline of neuro-specific enolase and with relief of the symptoms; however, bone disease occurred and he died of cancer 13 months after diagnosis of SCCP. Case 2 involved a 69-year-old man complaining of severe anal pain. He underwent a biopsy and a huge prostate tumor showing SCCP was showed. He had pelvic node metastases but no distant lesions, and received four cycles of GDC chemotherapy. He was discharged after receiving subsequent radiotherapy and remained stable for a while; however, he died of possible drug-induced hepatitis. This is the first report of chemotherapy with GDC against patients with SCCP. This regimen raised the possibility that it would intensify the outcome, which had been poorly achieved.
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PMID:Experience of the treatment with gemcitabine, docetaxel, and carboplatin (GDC) chemotherapy for patients with small-cell carcinoma of the prostate. 1698 66

An 80-year-old female visited our hospital with a chief complaint of anal pain and bleeding. The patient was diagnosed by colonoscopy to have rectal cancer which invaded the perineal region. A pelvic CT also revealed metastases to the lymph node located in the femoral artery. Miles operation was performed and a curative resection was successfully achieved. The pathological findings were poorly differentiated adenocarcinoma with pMP and pN2. Adjuvant chemotherapy was refused by the patient. Paraaortic lymph node metastasis was diagnosed by abdominal CT 6 months after the surgery. The patient was treated with S-1 combined with CPT-11. The S-1 (80 mg/m2) was orally administered for 2 weeks followed by a 2-week interval and CPT-11 (100 mg/m2) was also simultaneously administered biweekly. One cycle of chemotherapy was 28 days. The patient experienced grade 2 leukocytopenia, neutropenia, diarrhea and grade 1 alopecia. Abdominal CT revealed a partial response after 2 cycles. After 10 cycles, the patient continued to demonstrate a partial response. The S-1 combined with CPT-11 regimen for elderly patients was thus found to be very feasible and convenient, and we obtained a good compliance. As a result, this regimen was thus found to be promising for unresectable or recurrent colorectal cancer in elder patients. In the future, the efficacy and safety of this regimen should be verified in phase II clinical trial for elderly patients.
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PMID:[An elderly patient with recurrent rectal cancer successfully responded to S-1 combined with CPT-11]. 1821 96

We report a case of successfully treated lower rectal cancer with both inguinal lymph nodes by chemoradiotherapy. A 59-year-old man presented with anal pain. A colonoscopy revealed primary rectal cancer. The histological diagnosis was well to moderately differentiated adenocarcinoma. A computed tomography showed metastases to pararectal, both inguinal lymph nodes and right external iliac. After a ileostomy construction was done, he was treated with intensity modulated radiotherapy (a total 50.4 Gy) and chemotherapy with FOLFOX. The primary tumor had completely disappeared, and metastases to lymph nodes showed a remarkable shrinkage after the chemoradiotherapy. Nine months after radiation therapy, however, multiple lung and liver metastases were observed by a computed tomography, which were treated by systemic chemotherapy with FOLFOX and bevacizumab. The primary tumor and metastases to lymph nodes are still controlled well for 2 years after the initial chemoradiotherapy.
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PMID:[A case of successfully treated lower rectal cancer with both inguinal lymph nodes by chemoradiotherapy]. 2122 55

We report a case of anal cancer in a 58-year-old woman who complained of narrow, bloody stools and anal pain. Physical examination revealed anal stenosis associated with a circular mass arising in the anal canal. Histological examination of biopsy specimens confirmed a diagnosis of moderately differentiated squamous cell carcinoma. Enhanced computed tomography revealed anal cancer invading the levator ani and the vagina, with lymph-node, multiple hepatic, and pulmonary metastases. The patient received two cycle of chemoradiotherapy with S-1 plus low-dose cisplatin with rest for 4 weeks, leading to complete response of the primary lesion and a partial response of the metastatic lesions. Each cycle included oral S-1 (120 mg/body; day 1-21), cisplatin (10 mg/body; day 1-5, 8-12) and radiotherapy (2 Gy/day; day 1-5, 8-12, 15-19). Adverse effects of treatment were mild perineal skin erosion and mild appetite loss, but no hematologic toxicity. Although the patient died 16 months after first admission, chemoradiotherapy with S-1 plus cisplatin is potentially effective for the management of advanced anal cancer.
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PMID:Clinical experience with chemoradiotherapy comprising S-1 plus low-dose cisplatin in a patient with stage IV anal cancer. 2211 Feb 31

We report here a case of rapidly progressing anorectal malignant melanoma. A 66-year-old man was admitted to our hospital due to bowel abnormalities and anal pain. Detailed gastrointestinal examination revealed a nigrities-like type 1 tumor that occupied a semicircle in the intestinal lumen from the lower rectum to the anatomical anal canal. We diagnosed anorectal malignant melanoma from a biopsy of the tumor. For the first time, we performed abdominoperineal resection. DAV-feron chemotherapy was administered from 18 days after the operation. However, multiple liver metastases, multiple lung metastases, and multiple skin metastases appeared in the early phase after the operation. Metastases increased rapidly and the patient died 138 days after the operation.
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PMID:[A case of rapidly progressing anorectal malignant melanoma]. 2326 54

Herein, we present a case of advanced rectal cancer surgically resected after chemotherapy. A 65-year-old woman presented with anal pain, and rectal cancer extending beyond the anus was diagnosed. The primary tumor was a well-differentiated adenocarcinoma with a KRAS mutation. Computed tomography revealed cancer invasion into the vagina and sacral and coccygeal bones, and cancer metastases to the bilateral inguinal lymph nodes and the left lung. Sigmoid colostomy and subcutaneous venous port insertion were performed. The patient was treated with modified oxaliplatin, leucovorin, and 5- fluorouracil (FOLFOX6) plus bevacizumab. She showed a partial response according to the Response Evaluation Criteria in Solid Tumors after 13 courses of chemotherapy. The primary tumor was then resected via posterior pelvic exenteration, bilateral inguinal lymphadenectomy, and sacral/coccygeal resection. Histological examination of the resected specimens revealed moderately differentiated adenocarcinoma with vaginal invasion. Metastasis to a right inguinal lymph node was observed. The pathological stage was ypT4bN0M1b, ypStage IV according to the tumor-node-metastasis system of the eighth edition of the Japanese Classification of Colorectal Carcinoma. The pathological response grade of the tumor after chemotherapy was determined to be Grade 1b.
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PMID:[Surgical resection after chemotherapy for advanced rectal cancer - report of a case]. 2573 Dec 56


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