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

Primary neoplasms of the small bowel are unusual and constitute 1-5% of all gastrointestinal tract neoplasms. Preoperative diagnostic difficulties, frequent dissemination at the time of the diagnosis, and poor prognosis are characteristic of this pathology. During a period of 26 years we treated 61 patients with tumors of the small bowel, 44 malignant and 18 benign (1 patient had both). The most common symptoms were abdominal pain (62%), weight loss (41%), and gastro-intestinal bleeding (31%). More than half of the patients were treated as emergencies and among the remaining, the most useful diagnostic test was the small intestinal barium study. Seventeen patients were operated on for intestinal obstruction, 6 of them due to intussusception of the tumor, while 8 other patients presented with perforation and 7 with massive gastrointestinal bleeding. Leiomyoma was the most frequent benign lesion. Among malignancies lymphoma was encountered in 38.6%, followed by adenocarcinoma (29.6%) and leiomyosarcoma (22.8%). Lymphoma was predominant among Sephardic Jews. Curative procedures were attempted in all but one of the benign cases and in 21 of the malignant cases. At the time of surgery metastases were present in 23 patients. The postoperative mortality was high (20% and 14% in the benign and malignant groups, respectively) most probably due to the high incidence of emergency surgery in a high risk population. The prognosis of the malignant tumors was poor with a 5-year survival of 18%. Their disappointing course seems to be related to late diagnosis because of nonspecific symptoms and difficulty in bringing the tumor to the fore. Hopefully, a greater awareness will lead to an earlier diagnosis and improve the prognosis.
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PMID:Primary neoplasms of the small bowel. 154 77

This article reports on three patients with intestinal bleeding due to metastases from a nonseminomatous testicular tumor (NSTT) to the gastrointestinal tract. Involvement of the gastrointestinal tract is rare. The mode of spread is either by hematogenous dissemination or by direct extension from involved paraaortic lymph nodes. The symptoms of these patients are briefly described. Early recognition and efficient supportive care are essential in the management of such patients.
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PMID:Intestinal hemorrhages in patients with a nonseminomatous testicular tumor. 165 64

Heterotopic liver transplantation is an exceptional indication for acute or chronic liver disease. The authors report a case of auxiliary liver transplantation performed for end-stage alcoholic cirrhosis. The patient was contra-indicated for orthotopic transplantation because of poor general and nutritional status. The HLT was indicated because of intractable ascites, liver insufficiency and chronic encephalopathy. The operation was performed according to the technique described by Fortner. Liver function tests returned to normal within 3 days and the only postoperative complication were gastro-intestinal bleeding due to CMV viral infection. Liver function was assessed by HIDA scintigram which showed blood intake by the graft and atrophy of the native liver. The patient was discharged after 3 months. The follow-up is 17 months. At the 15th month control, liver CT showed multiple hypodense nodules biopsied and corresponding to metastasis from a probable pancreatic carcinoma. ERCP and morphologic explorations did not show the primary tumor. The authors discuss the indications of HLT, the rules of successful performance of HLT and the problem of the graft involvement by metastases.
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PMID:[Heterotopic hepatic transplantation. Apropos of a case treated in the terminal stage of decompensated alcoholic cirrhosis]. 178 38

Thirty duodenal and three upper-jejunal endocrine tumors are reported. Clinical manifestations included: a) the Zollinger-Ellison syndrome (10 cases); b) peptic ulcer disease in which hypergastrinemia was not documented (3 cases); c) cholestasis or cholelithiasis (4 cases); d) abdominal pain (4 cases); e) gastro-intestinal bleeding (1 case); f) celiac sprue (1 case). Ten further tumors were discovered incidentally, at autopsy or in pathological specimens after gastrectomy or duodenopan-createctomy. Histological pattern was trabecular in 19 cases, insular in 2 and mixed in ten cases. Two cases were typical ganglioneuromatous paragangliomas. All tumors were examined immunohistochemically. Twelve tumors contained gastrin, four somatostatin, six both of these peptides, one serotonin, two both gastrin and serotonin, and two tumors contained gastrin, serotonin and somatostatin. Ganglioneuromatous paragangliomas combined somatostatin and/or pancreatic polypeptide containing endocrine cells with protein-S100-positive Schwann cells. In four tumors no peptide or amine was demonstrated. Gastrin cell tumors (63.6% of our cases), both functionally active (gastrinomas) and clinically silent, predominated in the proximal duodenum, while somatostatin cell tumors (15.1%) and paragangliomas were mostly found in the periampullary region. Two tumors were classified as malignant on the basis of lymph node metastases, and both were jejunal gastrinomas associated with Zollinger-Ellison syndrome. Two somatostatin cell tumors had manifestations of von Recklinghausen's disease.
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PMID:Endocrine tumors of the duodenum and upper jejunum. A study of 33 cases with clinico-pathological characteristics and hormone content. 216 Apr 22

We have established a colon cancer-prone substrain in WF strain rats strictly bred by sister x brother mating for more than 20 years. Colon carcinomas were located only in the ascending colon with no remote metastases. Each incidence of colon carcinoma varied from 30 to 40% in the respective investigation. There was no apparent sex difference. Approximately 9% of colon carcinomas were associated with gastric carcinoma in the prepyloric region and they died within four months of age due to malnutrition and intestinal bleeding. There were a few cases of carcinomas of the terminal ileum and the rectum. All of these carcinomas from three different portions showed histologically well differentiated tubular adenocarcinoma. It was found that about 40% of colon carcinomas showed spontaneous regression in the period from four to twelve months old. We have also succeeded in establishing two lines of the transplantable colon carcinoma (C1 and C2) and the transplantable gastric carcinoma (S1 and S3) from those of spontaneous colon carcinomas and gastric carcinomas. Then recipient female rats inoculated intraperitoneally with these transplantable carcinomas newly developed adenocarcinomas of the corpus uteri, which had never been found in the rats of this strain. In addition, the transplantable tumor line of adenocarcinoma of the corpus uteri was also established (U2). When transplanted these tumors intraperitoneally (S1, S3, C1, C2 and U2), male and female recipient rats extremely increased in the incidence of carcinomas of the stomach and the colon. As far as female recipient rats were concerned, a large number of carcinomas of the corpus uteri were also found regardless of the derivation of tumors. We believe that the established colon cancer-prone rat strain (WF-Osaka) as well as those of transplantable tumor lines will open a further research fields and will be available as an animal model of colon cancer for human beings.
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PMID:A study on colon cancer-prone rats of WF-Osaka strain. 248 90

A study was carried out on 41 cases of early gastric cancer over a five year period (1983-1987) based on resected stomach specimens. Males (29) outnumbered females (12) by 2.4:1. Mean age was 63 years (Range 30-80 years), and there was an overwhelming Chinese preponderance (40, 97.6%). The indications for endoscopy were: dyspepsia (24, 58.5%), gastro-intestinal bleeding (14, 34.1%) and follow up of megaloblastic anaemia (3, 7.4%). The diagnosis of malignancy was unsuspected at endoscopy in 38 patients and the commonest finding was a chronic ulcer (35, 85.4%). Most of the lesions were located in the body (24, 58.5%) and along the lesser curvature (36, 87.8%). Depressed lesions (Type III and combined IIc + III) were the commonest macroscopic lesions. Intestinal type carcinoma was the commonest microscopic type (34, 82.9%). Submucosal infiltration was present in 19 (47.3%) and lymph node metastases in 4 (9.8%). There was only one death from carcinoma of the stomach (mortality 2.4%).
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PMID:Early gastric cancer in Singapore. 271 21

A 23-year-old man presented with intestinal bleeding due to an extraosseous osteosarcoma of the jejunum. A lesion was also found in the deltoid muscle, and other metachronous soft tissue sites developed subsequently. The presence of malignant osteoid was documented by immunohistochemical studies of one of the lesions. The patient died of metastatic disease 19 months after diagnosis, despite surgical resections and adjuvant chemotherapy. This unique presentation is discussed, and the literature concerning extraosseous osteosarcoma is reviewed.
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PMID:Extraosseous osteosarcoma presenting with intestinal hemorrhage: case report and literature review. 351 Sep 64

A mobile pedunculated polypoid tumor was endoscopically removed from the afferent jejunal loop after gastrojejunostomy of a 54-year-old patient with anamnestic evidence of intestinal bleeding. Histologically epithelial carcinoid-like as well as mesenchymal paraganglioma- and ganglioneuroma-like patterns are mixed in varying portions, characteristic for gangliocytic paraganglioma. Immunohistochemically, serotonin, neuron-specific enolase, cytokeratin, vimentin S-100 protein and neurofilament were demonstrable. Gangliocytic paragangliomas are almost exclusively observed in the second portion of the duodenum, especially around the papilla Vateri and only two have previously been reported in the jejunum. The histogenesis of the tumors is unclear, but they may probably be either hamartomas, hyperplastic or neoplastic proliferations of so called endodermal-neuroectodermal complexes. Although gangliocytic paragangliomas contain a carcinoid-like component, they behave in a benign fashion, and metastases or recidives have not been noticed. Tumors with a pedicle may be endoscopically removed without complications.
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PMID:[Pedunculated polypoid gangliocytic paraganglioma of the afferent jejunal loop of a Billroth II stomach]. 368 74

Repeated episodes of severe intestinal bleeding in a 55-year-old male were found to originate from multiple small carcinoid tumours of the ileum. Laparatomy was performed after extensive negative endoscopic and radiological investigation of the bleeding site, and five tumours, 6 to 15 mm in diameter, were found within a 40 cm bowel segment. The most distal tumour was situated 50 cm from the ileocaecal valve. The site of bleeding was erosion of the bowel mucosa at the largest tumour. The affected bowel was excised, including its mesentery with two lymph nodes containing small islands of metastatic carcinoid tumour. Otherwise no metastases were found.
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PMID:Severe gastrointestinal bleeding due to carcinoid tumour of the ileum. 697 14

The frequency of malign tumors in the small intestine was 1% of all malign tumors of the digestive tract. 4% of malign tumors found by autopsy in the digestive tract were located in the small intestine. 12 months passed between first symptoms and operative therapy. In 80% we found local or distant metastases. In only 5 of 11 cases a curative resection was attempted. A great number pf small intestine tumors were identified by autopsy for the first time. A curative resection depends on an early diagnosis. Ileus, massive bleeding, extreme weight loss and palpable mass are late physical findings. Obstipation, diarrhea, occult intestinal bleeding and abdominal pain indicate after subtle inquiry X-ray of the small intestine, gastroduodenoscopy and angiography. If there is no result an early laparotomy should be performed.
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PMID:[Primary small intestine malignancies]. 711 89


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