Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sixty-six patients with primary adenocarcinomas of the duodenum recorded by the Swedish Cancer Register during 1958-1973 are reviewed. The mean age was 66 years, and female:male ratio 1.2:1.0. The predominant symptom was duodenal obstruction. Correct diagnosis was made in 68% by conventional barium meal examination. Hypoton duodenography and duodenoscopy are necessary diagnostic aids. In 25% of the patients the diagnosis was first made at postmortem examination. Thirty-two patients had metastases at first diagnosis. Forty-three per cent were radically operated and 43% palliatively. The operative mortality after curative operations was 25% with no difference correlated to operative methods with the exception of pure polyp extirpation where no patient died. The overall one-year survival was 67% and five-year 18%. There was a tendency for longer survival time for patients with more distally situated carcinomas. Duodenopancreatectomy gave a longer survival time than duodenal resection.
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PMID:Primary carcinoma of the duodenum. 735 73

A mass associated with the gastrointestinal tract was detected by sonography in 33 patients. Etiologies included primary or metastatic tumor; intussusception; inflammation secondary to bowel infarction, pancreatitis, or irradiation; and a dilated, fluid-filled gut related to retained gastric contents, obstruction, ileus, or an ileal bypass. Mesenteric or omental changes were identified with inflammation and frequently with metastatic disease. The diagnosis was confirmed by repeat sonography, abdominal radiography, barium examination of the small bowel, computed tomography, surgery, or autopsy. Ultrasound patterns are characteristic in tumor, intussusception, and inflammation; specific features allowing differentiation between tumor and inflammation are described. Colonic haustra, valvulae conniventes, or bowel contours and peristalsis on real-time sonography are helpful in identifying fluid-filled bowel loops.
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PMID:Ultrasound patterns of disorders affecting the gastrointestinal tract. 736 Sep 50

A 53-year-old woman presented with symptoms of weight loss, diarrhea, and melena. A barium enema with endoscopy revealed multiple colonic polyps which were shown histologically to be metastatic deposits of poorly differentiated adenocarcinoma. The primary tumor, a poorly differentiated gastric adenocarcinoma, had been resected 11 years earlier. This appears to be only the second published report of polypoid colonic metastases from gastric adenocarcinoma.
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PMID:Metastases from gastric adenocarcinoma presenting as multiple colonic polyps: report of a case. 751 12

A surveillance programme comprising either colonoscopy of sigmoidoscopy plus barium enema every 2-3 years was instituted in 50 hereditary nonpolyposis colorectal cancer (HNPCC) families. The families included 238 patients with colorectal cancer (CRC) (mean age at diagnosis: 43.7 years; range: 16-86 years). These patients had 597 first-degree relatives of whom 493 could be traced and 388 (79%) accepted the invitation for screening. The control group were relatives (index patients) with symptomatic CRC. The average follow-up duration was 5 years (1-20 years). Screening led to the detection of adenomas in 33 patients and CRC in 11 patients. Pathological examination revealed 1 Dukes' A, 7 Dukes' B and 3 Dukes' C cancers. In contrast, among the control group 47% had advanced CRC (Dukes' C or distant metastases). The 5-year survival of the screen-detected cases was 87% versus 63% in the control group. Of the 11 CRC cases in the screening group, 4 were detected within 1-4 years after a negative colonic examination. A large proportion of the polyps found in the screening and control groups showed a villous growth pattern and/or a high degree of dysplasia. We conclude that periodic examination of HNPCC families allows the detection of cancer at an earlier stage than in patients not under surveillance. Because of the possibly more aggressive nature of polyps associated with HNPCC, we recommend a screening interval of 1-2 years.
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PMID:Hereditary nonpolyposis colorectal cancer: results of long-term surveillance in 50 families. 757 10

Primary adenocarcinoma of the jejunum which accounts for only approximately 3% of all gastrointestinal tract malignancies, is distinctly unusual. Ovarian metastasis from a jejunal cancer is extremely rare. It has significant therapeutic and prognostic implications to differentiate primary ovarian carcinoma from metastatic disease to the ovary. A 49-year-old Japanese woman presented with intermittent nausea, vomiting, and palpable abdominal mass. Pelvic examination and imaging studies revealed a huge ovarian tumor, suspicious for malignancy. Upper GI series and barium enema were unremarkable. Exploratory laparotomy was done for presumed primary ovarian malignancy. Mucinous adenocarcinoma of the right ovary, measuring 25 x 18 x 12 cm, without other intraabdominal dissemination was found. Exploration of the upper abdomen revealed an annular constriction of the jejunum 30 cm distal to the ligament of Treitz. Partial jejunectomy with end-to-end anastomosis was done. Metastatic ovarian cancer from the primary jejunal adenocarcinoma was confirmed microscopically. Although small bowel malignancy is uncommon, small bowel follow-through examination or enteroclysis may be indicated in patients with positive stool for occult blood who have no abnormality in the upper gastrointestinal series and barium enema. In addition to the imaging studies, thorough exploration of the entire abdominal cavity is necessary at ceiliotomy in patients with ovarian malignancy to distinguish primary ovarian cancer from metastatic disease to the ovary.
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PMID:Primary jejunal adenocarcinoma masquerading as a primary ovarian malignancy. 778 80

Endoscopic polypectomy should be applied only for early colorectal carcinomas. Intramucosal carcinoma do not have a risk of lymph node metastases. However, there is an about 10% risk of lymph node metastases among carcinomas showing submucosal invasion (sm carcinoma). When risk factors revealed to be positive after polypectomy, subsequent surgical resection of the large bowel with lymph nodes dissection is needed, because these sm carcinomas are considered to have a high risk of lymph node metastases. Therefore, accurate diagnosis of depth of invasion is essential to prevent subsequent surgical resection following endoscopic polypectomy. Endoscopy, barium enema and endoscopic ultrasonography (EUS) are all considered to be effective for an accurate diagnosis of depth of invasion. Endoscopic polypectomy includes hot biopsy, snare polypectomy and endoscopic mucosal resection (EMR). Appropriate maneuver must be chosen, considering the characteristics of the lesion. Major complications after endoscopic polypectomy are bleeding and perforation of the large bowel. Including an establishment of a new risk factors, further efforts must be made to prevent unnecessary additional surgical resection of the large bowel following endoscopic polypectomy.
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PMID:[Endoscopic treatment of colorectal cancer]. 785 93

Early colorectal cancer produces no symptom, thus justifying efforts at detection in screening programs. Symptoms are usually secondary to obstruction, local invasion, perforation or bleeding. Any fecal bleeding must be investigated to rule out a colorectal cancer. The initial imaging study to identify a colorectal cancer is often colonoscopy, which is frequently supplemented with a double contrast barium enema. Once the presence of cancer is histologically proven, the preoperative evaluation includes detection of hepatic and extrahepatic spread, especially with ultrasound and CT scan. Endorectal ultrasonography has been shown to be a significant advance for staging rectal cancer. It provides the best staging in selecting patients for preservation of sphincter function and for adjuvant therapies. The most useful prognostic factors in tumors without distant metastases are the depth of tumor extension, the number of positive lymph nodes and the histologic grade. Preoperative CEA level, vascular invasion and ploidy are also important prognostic factors.
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PMID:[Diagnosis and staging of colorectal cancers]. 787 60

Squamous cell carcinoma of the esophagus is a tumor with poor prognosis; it is usually in an advanced state when first diagnosed. Because a multimodal treatment approach is currently used, proper tumor staging is essential to determine whether therapy should be directed toward cure or palliation. Important prognostic features of squamous cell carcinoma include the depth of tumor infiltration into or through the esophageal wall and the presence of distant metastases. Imaging strategies should not be limited to visualization of the tumor but also should be directed toward accurate pretreatment staging. In this article, the authors review the use of barium swallow, CT scans, and endoscopic ultrasonography both alone and in combination to visualize and stage esophageal carcinoma. The strengths and limitations of each modality are also discussed.
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PMID:Esophageal squamous carcinoma. 797 7

We have evaluated the effect of mitomycin 6 mg/m2, ifosfamide 3 g/m2, and cisplatin 50 mg/m2 (MIC) in two groups of patients with squamous or undifferentiated carcinoma of the oesophagus, as either preoperative or primary treatment. Response was assessed by barium swallow, CT scan, and measurement of metastases where present. Toxicity was acceptable and there were no chemotherapy related deaths. In the operated group, five of 23 patients (22%) showed a complete response (three confirmed histologically) and nine (39%) showed a partial response following two courses of MIC. Resection was completed in 21 patients, with three hospital deaths (14%). Of the 18 patients who were discharged from hospital, eight have died at 4-24 months (median 13) from the start of treatment and 10 are alive at 5-35 months, with known recurrence in one. In the non-operated group, five of 20 patients (25%) showed a response, one complete, following one to four (mean 2.6) courses of MIC. Nineteen patients have died (at median 5 months), and one, who had a complete response, is alive and free from disease at 29 months. Neo-adjuvant therapy with MIC in squamous carcinoma of the oesophagus has shown encouraging early results, with acceptable toxicity.
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PMID:A phase II study of mitomycin, ifosfamide and cisplatin in operable and inoperable squamous cell carcinoma of the oesophagus. 801 79

An adolescent patient with Ewing's sarcoma, who had undergone three previous thoracotomies for pulmonary metastases, presented with two further left-sided pulmonary metastases, measuring 5 mm and 10 mm in diameter. Chemotherapeutic options were limited, and pulmonary irradiation was inadvisable because of compromised respiratory function. Surgical resection was the favored therapeutic option. A method of accurately localizing the small lesions was devised, using a percutaneous needling technique under computed tomography guidance and the injection of barium and methylene blue. This localization enabled resection of the lesions, with minimal excision and manipulation of the surrounding normal parenchyma. This technique is useful for removal of small impalpable metastases when other modalities of therapy are not appropriate.
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PMID:Percutaneous localization of small pulmonary metastases, enabling limited resection. 803 84


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