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Query: UMLS:C0027651 (tumor)
 685,946 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One hundred eighteen patients with metastatic carcinoid tumor were randomized to treatment with streptozotocin combined with cyclophosphamide or with 5-fluorouracil (5-FU). Commonly experienced side effects were nausea, vomiting, leukopenia, thrombocytopenia, and nephrotoxicity. Objective response rates among eligible and evaluable patients treated with the 5-FU combination was 14 of 42 (33%) and with the cyclophosphamide combination, 12 of 47 (26%). Among those patients with carcinoids primary to the small bowel the respective response rates were 44% and 37%. The overall response rates for patients with carcinoids of pulmonary or unknown origin were only 12% and 17%. There was no significant difference in patient survival between the two treatment arms. Among 11 patients who received crossover therapy with 5-FU alone there were two responders. There were no responders among eight patients treated with cyclophosphamide alone. Urinary 5HIAA excretion proved to be a useful biologic marker in these patients that correlated well with the observed measurements of tumor bulk. Median survival times from the diagnosis of unresectable malignant disease related to sites of origin of carcinoid tumor were the following: small bowel, 28.4 months; pancreas, 24.0 months; lung, 15.1 months; and unknown origin, 9.0 months. Metastatic carcinoid tumor is a malignant disease susceptible to chemotherapeutic approaches and continued investigation of the therapy of these neoplasms should be strongly encouraged.
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PMID:Combination chemotherapy trials in metastatic carcinoid tumor and the malignant carcinoid syndrome. 9 82

We evaluated plasma growth hormone (GH) and plasma prolactin (PRL) levels in ten patients with metastatic carcinoid tumors and the carcinoid syndrome ("active tumors") and seven patients with metastatic carcinoid tumors without the carcinoid syndrome ("inactive tumors"). The patients with active tumors had elevated serum serotonin levels and increased urinary 5-hydroxyindoleacetic acid (5-HIAA) while these values were normal in patients with inactive tumors. Forty-five per cent of patients with active tumors had elevated fasting plasma GH levels that were either not suppressed or showed a paradoxical increase in response to I.V. glucose. There was a positive correlation between the plasma GH levels and serotonin production by the tumor. Twenty-eight per cent of patients with inactive tumors had elevated fasting plasma GH levels. GH levels were decreased by the administration of serotonin antagonists in some but not all of the patients. Parachlorophenylalanine (PCPA) an inhibitor of serotonin synthesis caused a paradoxical rise in GH levels. GH release in response to insulin hypoglycemia was normal. Plasma prolactin levels were normal in most of the patients with metastatic carcinoid tumors. PCPA administration did not systematically alter plasma prolactin levels. We conclude that elevated plasma GH levels are frequently present in patients with the carcinoid syndrome. Both serotonin produced by the tumors and the tumor itself may be responsible for the elevated GH levels.
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PMID:Growth hormone and prolactin secretion in the carcinoid syndrome. 12 43

Fifty-seven thymomas, defined as neoplasms of the epithelial-reticular framework cells of the thymus, were assessed in respect to histologic type, inclusive of there ultrastructural aspects. The median age of the 57 patients was 40.4 years, with a range of 2 1/2--72 years. All neoplasms were located in the anterior mediastinum. The tumours in 40 cases were encapsulated and without invasion of adjacent tissue or implants (equal to non-invasive thymomas). The tumors in 17 cases were invasive of adjacent tissue, particularly mediastinal pleura, pericard and trachea. Six of 57 patients (equal to 10.5%) with thymomas have had a thoracic and supraclavicular lymph node metastasis, and osteolytic metastases in the vertebrae and sternum. Thirty-seven (equal to 64.9%) were so-called lympho-epithelial, 7 (equal to 12.3%) pure epithelial, 4 (equal to 7.0%) atypical (or anaplastic) with granulomatous focuses, 3 (equal to 5.3%) carcinoid and one (equal to 1.8%) seminomatous tumors. One patient have had a thymic cyst as a tumor-like conditions of the thymus, and four patients (equal to 7.0%) have had a thymo-lipoma. The histologic type of thymoma had no proof value in predicting prognosis with the exception of the so-called atypical or anaplastic thymoma. The fine structural aspects of thymomas and the fine structural differential diagnosis of anterior mediastinal tumors are discussed.
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PMID:[A comparative clinical and pathological study on the classification and prognostic features of 57 thymomas. I. Microscopy and ultrastructural pathology (author's transl)]. 14 45

Report on a bronchial adenoma in the right lobus inferior pulmonalis (autopsy: histological bronchial adenoma from carcinoid type) of uncommon size and with growth till now not described. The tumor was diagnosed clinically and histologically 4 years before death of the patient, but was not operated. The tumor has continuously infiltrated the left atrium cordis via a vena pulmonalis. This case is stressing the decisive importance of the early diagnosis of bronchial adenoma.
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PMID:[Bronchial adenoma with uncommon growth (author's transl)]. 15 Jul 7

Gastrointestinal cancer has proved exceedingly resistant to chemotherapy efforts. 5-Fluorouracil (5-FU) accepted as standard treatment, has provided only infrequent and incomplete antitumor effects. Other drugs as the nitrosoureas BCNU and CCNU or Mitomycin C do not match the effectiveness of 5-FU. Improvement in frequency of tumor regression have been recorded for gastric carcinoma with combinations of 5-FU and BCNU and 5-FU, adriamycin and Mitomycin C and for colorectal carcinoma with combination of 5-FU, methyl-CCNU and vincristine. There are also suggestions that such combination chemotherapy may produce increased survival when compared to untreated patients. The combination of 5-FU and streptozotocin in carcinoid tumors or adriamycin in primary hepatoma may be of some effectiveness.
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PMID:[Chemotherapy of gastrointestinal cancer (author's transl)]. 15 93

Of 112 000 patients undergoing surgery between 1952 and 1973, 67 had a primary tumor of the small intestine. 22 patients had a benign tumor, 8 a carcinoid, 21 carcinoma and 15 sarcoma. Benign tumors were more frequent in the duodenum and ileum, carcinoids in the terminal ileum and carcinomas in the duodenum and jejunum. Sarcomas were found equally in all parts of the small intestine. The most common symptom for all types of the tumor was variable pain in the abdomen. Loss of weight occurred only in patients with carcinomas and sarcomas; heavy intestinal blood loss was most common in patients with benign tumors. Benign tumors often show invagination, while sarcomas cause occlusive ileus or perforation. All duodenal tumors show heavy intestinal bleeding but hematemesis is rare. Emergency surgery was necessary in 42% of patients with benign tumors or sarcoma and in 30% of patients with carcinoma. Five-year survival in patients with benign tumors is excellent (100%). Compared to this, five-year survival in patients with carcinoma, sarcoma or carcinoids is only 15%.
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PMID:[Complications in primary tumors of the small intestine]. 16 32

The infusion of calcium results in the release of gastrin, calcitonin, and serotonin from certain nonbeta islet cell tumors of the pancreas, medullary carcinomas of the thyroid, and carcinoid tumors, respectively. In this study, intravenous infusion of either calcium chloride or calcium aluconate in a patient with an islet-cell carcinoma resulted in a simultaneous rise in plasma immunoreactive insulin and proinsulin, and concurrent hypoglycemia. After resection of the tumor, calcium infusion caused no change in these parameters. Similarly, calcium infusion caused no change in plasma insulin or glucose in normal volunteers. The response of this tumor suggests that calcium infusion may be a useful provocative test to detect insulin-secreting neoplasia. A derangement of the stimulus-secretion coupling mechanism for insulin in the tumor cells may be responsible for their abnormal sensitivity to calcium ion.
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PMID:Insulin and proinsulin release during calcium infusion in a patient with islet-cell tumor. 16 54

Although advanced gastrointestinal cancer is the most commonplace problem encountered by the medical oncologist, this group of diseases has proved exceedingly resistant to past chemotherapy efforts. 5-Fluorouracil (5-FU), accepted by some as standard treatment, had provided only infrequent, incomplete, and fleeting antitumor effects, which are probably more than counterbalanced by its gastrointestinal, mucocutaneous, and hematologic antihost effects. There is no evidence that any manipulation of route or schedule of administration provides any improvement in the therapeutic ratio of 5-FU. There is no evidence that this drug contributes to patient survival when used at any stage of any type of gastrointestinal carcinoma. The search for alternative single drugs to 5-FU has been disappointing. The nitrosoureas and Mitomycin C produce occasional regressions, but they do not match the meager effectiveness of 5-FU; and they, in addition, present the difficult problem of cumulative bone marrow suppression. Recent trials with combination regimens have given some indication that the long stalemate in chemotherapy of gastrointestinal cancer may be breaking. Substantial improvements in frequency of tumor regression have been recorded for gastric carcinoma with combinations of 5-FU and BCNU, 5-FU and methyl CCNU, and 5-FU, Mitomycin C, and cytosine arabinoside; for colorectal carcinoma, with the combination of 5-FU, methyl CCNU, and vincristine; and for carcinoid tumors and islet cell carcinomas, with the combination of 5-FU and Streptozotocin. There are also suggestion that such combination chemotherapy with response rates in the 30 to 50% range may produce increased survival when compared to the untreated patient and patients treated with single-drug regimens. While the accomplishments of chemotherapy for the gastrointestinal cancer patient remain less than spectacular there is nevertheless realistic hope that a respectable contribution can now be made to multidisciplinary efforts applied at a stage of disease with minimal tumor burden.
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PMID:Clinical management of advanced gastrointestinal cancer. 16 61

Using advanced gastric adenocarcinoma and carcinoid as human material and gastric adenocarcinoma in rats induced by MNNG and in mice by localized X-irradiation of the stomach as experimental material, a pathological study was made on the relationship of gastric endocrine cells to gastric cancer. The results of the present study suggest that most of the endocrine cells in the cancer tissue are derived from the differentiation of cancer cells. Therefore, the following three may be given as the aformentioned relationship, that is, 1) carcinoid of endocrine cell origin, 2) endocrine cell carcinoma showing undifferentiated adenocarcinoma, and 3) endocrine cell cloning developed from the differentiation of cancer cell of adenocarcinoma. There is the possibility that most of 2) are of 3) origin and thus 2) and 3) should be discriminated from 1), having a functioning tumor in rare cases. The significance of reactive hyperplasia of endocrine cells in the non-metaplastic mucosa of the stomach around cancer and atypical epithelium is not yet determined, but that of EC cell seems at least to be related with the development of intestinal metaplasia in the gastric mucosa.
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PMID:The relationship of gastrointestinal endocrine cells to gastric epithelial changes with special reference to gastric cancer. 17 Jul 85

A 51-year-old woman with typical Cushing's syndrome of about 9 years duration was shown to have a gastric carcinoid tumor. Plasma levels of ACTH and cortisol were elevated and lacked the normal diurnal rhythm. Urinary excretion of steroids was unaffected by the administration of either metyrapone or dexamethasone. Fluctuation in urinary steroid excretion, as well as transient hypokalemic alkalosis and glycosuria suggested periodic hormonogenesis. The extirpated gastric carcinoid was shown to contain immunoreactive ACTH and beta-MSH. However, the biologic ACTH activity was undetectable by in vivo steroidogenic assay. By gel filtration, it was demonstrated that both tumor and plasma ACTH was predominately "big" ACTH. Although postoperatively she developed hypoadrenocorticism severe enough to require ACTH treatment, her pituitary-adrenal function was gradually restored. This is the first documented case of ectopic ACTH syndrome caused by gastric carcinoid in which successful cure was achieved by surgery.
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PMID:Gastric carcinoid with ectopic production of ACTH and beta-MSH. 17 2


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