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)

After experiencing intermittent episodes of abdominal pain for two years, a 28-year-old woman developed partial small bowel obstruction. Barium enema and colonoscopy revealed the source of obstruction to be an apparent cecal carcinoma. At exploratory laparotomy a primary adenocarcinoma of the appendix with bilateral Krukenberg ovarian metastases was found. This is a rare occurrence and, to our knowledge, the first well-documented case in the English literature. These case also demonstrates difficulties in the preoperative diagnosis of adenocarcinoma of the appendix.
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PMID:Primary mucinous adenocarcinoma of the appendix with bilateral Krukenberg ovarian tumors. 21 Mar 9

There is a relatively long delay in diagnosis of malignant tumors of the small bowel and operation is often carried out too late. These tumors cause symptoms in about 90% of the cases (according to our own experiences in 20 of 21 cases). In the discussion of the symptoms there is a description given that might be a help for "earlier thinking of it". Anamnesis and exploratory laparotomy are of paramount importance for the diagnosis in time. Operation carried out in time leeds to a relatively favourable prognosis. Out of 5 patients who did not have metastases at the time of operation there are 3 alive for longer than 8 years post operationem. From the German literature of the past 10 years (288 cases) the following data were subsumized in a table: radical resection, operation mortality, 5-year-survival, delay of diagnosis, ileus/perforation, diagnosis by barium studies of the small bowel.
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PMID:[Primary small-intestinal neoplasms. Discussion of own experiences and of the literature]. 38 70

Five cases of early gastric carcinoma were diagnosed during a one-year period at the Henderson General Hospital, Hamilton, Ontario, Canada. All five patients were symptomatic and were diagnosed by a combination of endoscopy, roentgenology, brush cytology, and biopsy specimens. No cases of early gastric carcinoma were diagnosed in our hospital in the preceding ten years. A total of 75% of the cytological preparations were positive and all five biopsy specimens showed carcinoma. The ulcerated or type III lesion was present in three cases. No lymph node metastases were present in the gastrectomy specimens. The increasing rate of detection of early gastric carcinoma is attributed to the use of upper gastrointestinal endoscopy, air-contrast barium meal examinations, cytology, and multiple biopsy specimens.
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PMID:Early gastric carcinoma: value of combined use of endoscopy, air contrast x-ray films, cytology, and multiple biopsy specimens. 57

During a four year period, 53 patients with malignant melanoma underwent extensive pretreatment radiographic evaluation for detection of occult extranodal metastatic disease. This included chest x-ray with tomography, upper G.I. series with small bowel follow through, barium enama, intravenous pyelogram, and radio-nuclide scans of the brain, liver and bone. All occult metastatic disease in asymptomatic patients was discovered on routine chest x-ray examination. There were three false positive examinations, which necessitated further diagnostic tests but there was no change in the final treatment decision. There was no alteration in the management of the remainder of the patients on the basis of the pretreatment radiographic evaluation.
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PMID:Pretreatment radiographic evaluation of patients with malignant melanoma. 66 89

A case of metastatic melanoma of the stomach is reported with illustrative endoscopic and radiographic findings. Metastatic melanoma of the stomach may present with vague gastrointestinal symptoms, abdominal pain, or gastrointestinal bleeding. A history of melanoma may not be readily obtainable. When gastrointestinal symptoms occur in a patient with known melanoma, gastric metastases should be considered. Polypoid or target lesions are frequently seen on barium x-ray study. Small bowel roentgenograms should be obtained. Endoscopy, cytologic study, brushing, and biopsy may yield the diagnosis. The prognosis is poor. Surgery should be performed only to relieve significant symptoms.
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PMID:Metastatic melanoma of the stomach: the endoscopic and roentgenographic findings and review of the literature. 84 97

Charts of 566 patients admitted to the Surgery Branch, National Cancer Institute over a five year period were reviewed. Routine upper gastrointestinal series was performed in 453 patients; barium enemas in 490; and proctosigmoidoscopies in 342. Upper gastrointestinal series detected no metastases or second primary malignancies but delineated the extent of large intra-abdominal tumors. Barium enema and proctosigmoidoscopy together revealed three unsuspected primary colonic tumors (1.2% in patients over 50 years of age). Sigmoidoscopy and examination of the stool for occult blood would have detected the same patients. Barium enema may be limited to surgical cancer patients in whom the extent of local tumor invasion is to be defined and to older patients in whom colonic tumors are suspected. Neither UGIS nor barium enema appear to be of value as a routine preoperative screening test in surgical cancer patients.
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PMID:Barium enema, proctosigmoidoscopy and upper gastrointestinal series in the preoperative evaluation of the cancer patient. 85 53

A retrospective review of experience with small-bowel obstruction at the University Hospital in Birmingham for a ten-year period (January 1963 through December 1972) revealed 465 episodes of obstruction in 415 patients. The mortality was 4% in obstruction due to adhesions, and 28% in obstruction caused by carcinoma; overall mortality was 8%. Intra-abdominal adhesions were the cause of 69% of cases. Malignant obstruction (mostly from metastatic disease) was the second most common cause of obstruction, and external hernia was third. Delay in diagnosis and inappropriately prolonged used of long intestinal tubes added to the mortality and can be avoided. We suggest a plan for prompt, consistent diagnosis and recommend more liberal use of the barium meal in questionable cases.
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PMID:Small-bowel obstruction: a review of 465 cases. 93 2

The authors report 8 cases of lympho-reticulosarcoma of the colon and emphasize the rareness of this tumour (10 percent of cases) compared with other localisations in the stomach and small intestine. Whether primary or secondary, lymphosarcoma of the colon has various radiological appearances, depending on the mode of development of the sarcoma in the wall of the colon. Mainly sub-mucosal, it may remain localised or extend to the whole of the colon, predominating in the ileo-coecal and recto-sigmoid regions. Localised tumour forms present either in the form of large polycyclic lacunae, sometimes invaginated or as vast ulcerations with irregular nodular margin, or as due to parietal infiltration and exoluminal development of the tumour mass and neighbouring adenopathy. It is sometimes confused with carcinoma of the colon, e.g. vegetating carcinoma, colloid carcinoma, or peritoneal metastases, or with a regional abscess, e.g. appendix abscess or diverticulosis. The correct diagnosis is made on operation. The extensive colonic forms rarely take on the appearance of lymphoid pseudopolyposis, more often that of a very unusual nodular form formed of hazy lenticular lacunae. It may be confused with nodular colitis, it differs from this, however, by the absence of ulceration, changes in caliber and the persistance of normal haustration, a reticulated appearance of the mucosal outline during evacuation of the barium. In all cases, the discovery of a colonic lympho-reticulosarcoma implies complete digestive radiological investigation in order to seek gastric, duodenal or intestinal localisations, together with a search for other extra-digestive localisations. In fact, the great diffusion of the lesions modifies the prognosis and the therapeutic attitude. These lymphosarcomas and reticulosarcomas of the colon have a similar pathological and radiological appearance but differ by their sensitivity to treatment with cobalt, as reticulosarcomas are more resistant.
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PMID:[Pathological, clinical and radiological study of colonic lympho-reticulosarcoma. Report of 8 cases (author's transl)]. 109 45

Villous tumors of the duodenum are rare, but treatment may be problematic because of their association with invasive adenocarcinoma. Two cases of villous tumor of the duodenum are described and 39 other reported cases are reviewed. Presenting symptoms were bleeding 27%; obstruction 24%; jaundice 22% and vague dyspepsia 20%. Diagnosis may be made by radiographic barium contrast evaluation of the duodenum, especially with the addition of air contrast hypotonic studies and by fibro-optic endoscopy. Twenty-seven per cent of villous tumors of the duodenum are associated with adenocarcinoma. Invasive tumor is more common in patients over 50 years old (35%), in tumors of the third and fourth portions of the duodenum (44%) and in tumors over 4 cm in diameter (30%). Local excision is the treatment of choice for benign lesions. Pancreatico-duodenectomy is recommended for tumors which include invasive carcinoma in patients without distal metastases.
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PMID:Villous tumors of the duodenum. 111 48

Three types of involvement of the rectum and recto-sigmoid by carcinoma of the prostate are reviewed through an analysis of eight cases. A fourth type with subserosal metastatic implant of the proximal sigmoid may occasionally be encountered. The roentgenographic findings are not pathognomonic, but are characteristic of extrinsic involvement of the bowel wall. When clinical symptoms are predominantly related to the bowel, carcinoma of the prostate is usually advanced. All patients presented with bone metastases, uretero-hydronephorsis, lack of function of one kidney, or both bone metastases and urinary tract obstruction. Rectoscopy and biopsy are helpful. However, biopsy specimens often show non-diagnostic features in secondary malignancy. Correct diagnosis is important, since there is a difference in treatment of primary carcinoma and of secondary involvement of the rectum by prostatic carcinoma. A diagnostic challenge exists if the patient is evaluated by barium enema examination for primary bowel symptoms, in particular, large bowel obstruction. At this time intravenous pyelography and bone survey for metastases may not be available to suggest the correct diagnosis. More widespread use of barium enema examinations in the evaluation of advanced carcinoma of the prostate is suggested, since the type of rectal disease shown on barium enema study was not clinically suspected in five of eight patients. The prognosis is usually unfavorable because of advanced carcinoma. Survival often does not exceed several months to one year. However, one of our patients is still well after three years of hormonal therapy.
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PMID:Rectal and sigmoid involvement secondary to carcinoma of the prostate. 123 60


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