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

The medullary carcinoma of the thyroid plays a special role among the thyroid carcinomas due to his histiogenesis and endocrinologic behaviour. The symptoms like familiar occurrence, simultaneous pheochromocytoma, calcitonin-production, para-neoplastic syndroms with ACTH-production and the commonly associated diarrhea are discussed. The biological behavior of the tumor is presented reviewing the literature.
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PMID:[Medullary carcinoma of the thyroid (author's transl)]. 92 9

Medullary carcinoma is an unusual malignant neoplasm. The cell of origin is considered to be the C-cell which is derived from the ultimobranchial body and neural crest. The tumor is solid and has characteristic amyloid in the stroma. The lesion usually presents as a neck mass, and multicentricity is not unusual. In some patients diarrhea may be an important presenting symptom. Serum calcitonin is typically elevated and is important in the diagnostic confirmation. About 10 percent of the cases are part of a familial endocrine syndrome which includes pheochromocytomas, mucosal neuromas, and other endocrine gland adenomas. Frequent multicentricity and early cervical lymphatic and systemic metastases necessitate total thyroidectomy and radical neck dissection. Prognosis varies from a rapid demise to long term survival.
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PMID:Medullary carcinoma of the thyroid. 96 25

Decreased serum albumin levels are commonly observed in patients with carcinoid tumor, who also show several characteristic clinical and biochemical abnormalities. A large comparative study on a group of 96 carcinoid patients was performed with the purpose of identifying some of the mechanisms leading to hypoalbuminemia in patients with this form of cancer, and thereby to shed light on the cause of hypoalbuminemia of cancer in general. Serum albumin values were compared with a number of clinical parameters (including extent of liver metastases, severity of diarrhea, degree of right heart failure, and extent of gastrointestinal surgery) and of laboratory data (prothrombin time, BSP retention, serum transferrin concentration, hematocrit value, and daily urine excretion of 5-hydroxy-indoleacetic acid). In several patients the gastrointestinal protein loss was assessed by the 51Cr-albumin technique, whereas albumin renewal and distribution were evaluated by the use of 125I-albumin. The data obtained showed that the main factors in determining decreased serum albumin levels in patients with carcinoids are both reduced synthesis and increased loss of the protein. The hepatic synthetic defect appears to be related to a progressive decrease in the number of functioning liver cells; the origin of the gastrointestinal protein loss may be related to the obvious tumor involvement of the gut wall, as well as to the pharmacologically-induced diarrhea. Right heart failure occurring as a result of the carcinoid heart disease may be an additional cause for gastrointestinal protein loss in patients with carcinoid tumor.
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PMID:Pathophysiology of hypoalbuminemia associated with carcinoid tumor. 97 3

Eighteen endocrine pancreatic tumors were examined for the occurrence of cells producing insulin, glucagon, gastrin, human pancreatic polypeptide (HPP), and vasoactive intestinal polypeptide (VIP) and for A1 cells. More than half of the tumors were mixed, i.e., they contained more than one type of hormone-producing cell. The clinical symptoms were attributable only to one of the hormones produced by the mixed tumors. Three of four tumors causing the watery diarrhea syndrome contained both VIP and HPP cells. In one such tumor there was a strong predominance of HPP cells; the serum HPP levels of this patient were a thousandfold elevated, whereas her VIP levels were within the normal range. Several lines of evidence point to HPP as a possible agent causing the watery diarrhea syndrome. In many of our patients, HPP cells hyperplasia was present in the extratumoral pancreas. Such hyperplasia may give rise to the raised serum HPP levels seen in many patients having endocrine pancreatic tumors.
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PMID:Occurrence of human pancreatic polypeptide in pancreatic endocrine tumors. Possible implication in the watery diarrhea syndrome. 99 36

The WDHA syndrome characterized by watery diarrhea, hypokalemia, and achlorhydria is being diagnosed with increasing frequency. The diagnosis has been made to date only due to severe clinical symptomatology. In a review of the literature gastrin, secretin, glucagon, enteroglucagon, gastric inhibitory peptide (GIP), vasoactive intestinal peptide (VIP), and prostaglandins have been variously suggested as a possible etiologic agent for this syndrome. A case of the WDHA syndrome is reported in which hormonal assays of the serum preoperatively and two years postoperatively and tumor for many of the proposed agents is performed. A discussion of possible cross-reactivity among these similary structured polypeptides in the radioimmunoassays systems is used to explain the multitude of possible hormonal agents presented in the literature. Standardization of the VIP assays will result in increasing diagnosis of this diseases state prior to its fulminant clinical presentation.
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PMID:The VIPoma: further confirmation of VIP as the hormonal agent in the WDHA syndrome. 99 69

Tumoral secretions and pathophysiology of diarrhea were studied in 1 patient with pancreatic cholera. High concentrations of vasoactive intestinal peptide were found in both systemic blood and tumoral extracts, together with increased plasma levels of calcitonin and protaglandins E and Falpha. Gastric inhibitory peptide and gastrointestinal and pancreatic hormones were absent from the tumor, except for small amounts of glucagon, and their blood levels were normal. Decreased basal but normal pentagastrin-stimulated gastric acid secretion, normal basal and secretin-stimulated pancreatic secretion, increased volume of gallbladder bile with high bicarbonate, and low bile salt concentrations were observed, but the electrolyte content and flow rate of fluid passing the duodenojejunal junction were within normal limits. Small intestine was found to be the origin of the water and electrolyte fasting losses. Jejunum was the site of bicarbonate secretion. Jejunal glucose and leucine-stimulated water and sodium transports were also strikingly decreased, whereas the absorption rates of the sugar and amino acid were normal. Colon reabsorbed high amounts of water and sodium but increased potassium losses. Biological effects of vasoactive intestinal peptide may explain most of the patient's upper digestive secretion abnormalities and small intestinal function impairments, whereas secondary aldosteronism might explain the modified colonic function.
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PMID:Pancreatic cholera. Sudies on tumoral secretions and pathophysiology of diarrhea. 109 88

In certain clinical situations, fiberoptic colonoscopy has proved most useful and effective as a diagnostic and therapeutic tool. Colonscopy is indicated to remove polyps when feasible and to rule out the presence of toher polyps or tumors undetected by barium enema. Patients with cancer of the colon should have preoperative colonoscopy to rule out the presence of undetected polyps or metachronous cancer. Follow-up examinations are important to insure against residual cancer or recurrence after colonscopic removal of sessile, premalianant, or malignant polypoid lesions, and to evaluate certain patients who have increased risk of polyp or tumor formation. Colonscopy usually can explain persistent, localized abnormalities detected by barium enema (ie, "filling defects") and provide a definitive diagnosis in cases of unexplained rectal bleeding or diarrhea despite negative sigmoidoscopic and barium studies. In experienced hands, this technic is safe, confortable, and effective in avoiding laparotomy to remove clinically significant polyps and in providing definitive diagnosis in many clinical situations.
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PMID:Indications for fiberoptic colonscopy. 109 59

Our thirteen year experience with villous adenomas of the colon and rectum, embracing 264 patients, is reported. The average age of patients was sixty-two years with an almost equal sex distribution. Seventy-two per cent of the lesions occurred in the rectum and rectosigmoid and the most frequent symptoms were rectal bleeding and diarrhea. A positive correlation between size of adenoma and incidence of malignancy was noted. Although 55 per cent of the lesions were malignant, only 22 per cent harbored invasive carcinoma and only 10 per cent of the deaths were due to metastatic carcinoma. It is concluded that in the absence of invasive carcinoma, the clinical behavior of this tumor is relatively benign and a more conservative approach to the surgical management of this neoplasm should be encouraged.
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PMID:Villous adenomas of the colon and rectum. 120 Feb 90

Five cases of leiomyosarcoma of the colon are presented along with a review of the literature. In our cases the presenting symptoms and signs included abdominal pain, diarrhea, weight loss, blood in stools and abdominal mass. Anemia was present in four cases. Roentgenologically, an intraluminal tumor with obstruction was found in two cases, paralytic ileum in one and two cases were reported as "negative". At surgery there were peritoneal implants in three cases, metastases to the liver in two cases and perforation of the tumor in one case. Only diagnostic or palliative surgery was performed in all cases. All patients died of tumor within 15 months. The clinicopathological findings are similar to those reported by others in patients with extensive disease.
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PMID:Leiomyosarcoma of the colon exclusive of the rectum. 121 86

A report from a medium-sized community hospital of 4 additional cases of hepatocellular adenoma is presented. Of these, 3 were pedunculated tumors. A 29-year-old woman, gravida 7, had been taking Enovid-E for 8 years. After 3 attacks of epigastric pain a mass was detected in her right upper abdomen. Surgical exploration revealed the mass pedunculated from the right hepatic lobe. The mass was excised. 3 years later a liver scan was normal. The histological appearance of the tissue resembled mature hepatic architecture without protal areas or bile ducts. A 34-year-old woman, gravida 4, para 2, had been taking Enovid-E for 6 years. She previously had had a partial thyroidectomy for carcinoma of the thyroid and later radical neck dissection for metastatic thyroid carcinoma. A mass was detected in the right abdomen. At operation, a pedunculated mass was found attached to the right hepatic lobe with 2 smaller nodules. All lesions were excised. The microscopic picture was similar to that of the other patient. A 24-year-old woman, gravida 4, para 3, had been taking Oracon for 1 year. Upper abdominal pain, vomiting, and diarrhea were complained of. An upper abdominal mass was present. At operation, a 9 cm mass was excised. The histology was the same as in the previous cases. A 28-year-old woman, gravida 2, para 1, had been taking Ovulen for 5 years. An abdominal mass was present. Surgical exploration revealed a nodular mass pedunculated from the left lobe of the liver. The mass was excised. Histological appearance was similar to the other 3 tumors. Of 42 other reported cases of similar tumors, the mean age was 27.3 years. About 40% had been admitted as emergency cases with hemoperitoneum. Almost 20% had complained of upper abdominal pain. A palpable mass was usually present. Multiple nodules were found in 13% of cases. For nonemergency cases, selective hepatic angiography has been a reliable method of diagnosis. The treatment has been resection of the tumor when feasible. However, regression of tumors has occurred when exogenous hormone influence ceased. The outcome has been fatal in 8 cases. The low incidence of this tumor is not considered sufficient cause to justify discontinuing use of oral contraceptives.
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PMID:Hepatocellular adenoma and oral contraceptives. 127 46


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