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

Granular-cell tumors (GCT), also called Abrikossof's tumors, are generally benign, ubiquitous tumors. An original case of granular-cell tumor of the esophagus is reported. The symptoms included dysphagia and pyrosis. Fiberendoscopy showed a peptic esophageal stenosis with ulcerations confirmed by biopsy. CT showed a round thickening of the esophageal wall, localized in height. This lesion had previously been the object of several dilatation attempts. Esophagectomy with esogastric anastomosis in the thorax was performed. The histological study allowed diagnosing a granular-cell tumor, though one of a very peculiar type: misleading symptoms, tumor infiltrating the whole height of the esophagus and a circular area. Ninety cases of granular-cell tumors are reported in the literature; they are associated with a cancer of the air passages or of the digestive tract in 11% of cases. The cancer often appears secondarily, which requires lengthy surveillance. We do not know if this association is directly related or accidental. We have found no identical case of such a lesion, involving both the whole circumference and the whole height of the esophagus, in the literature.
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PMID:[Abrikossof's tumor of the esophagus. An original case. Review of the literature]. 133 16

A 51 year-old woman with vomitus, intermittent epigastric pain and heartburn had chronic sideropenic anemia. Gastroscopy revealed a subcardial, submucosal tumor. The tumor was removed totally by endoscopic polypectomy. Histologically it was identified as a carcinoid. The endocrinologic examination showed hypergastrinemia caused by chronic atrophic gastritis. The association of this gastric carcinoid with chronic atrophic gastritis type A, hypergastrinemia, hyperplasia of the gastrin-producing antral cells and micronodular hyperplasia of endocrine cells in the gastric fundus, confirms the hypothesis about the pathogenesis of these extremely rare gastric tumors.
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PMID:[Gastric carcinoid in chronic atrophic gastritis with hypergastrinemia]. 203 30

The efficacy and side-effects of megestrol acetate and medroxyprogesterone acetate in postmenopausal patients with advanced breast cancer were compared in a prospectively randomized study. The dosage of MA was 2 X 80 mg p.o. or MPA 2 X 500 mg p.o. daily, given as a secondary hormonal treatment, mostly after previous treatment with tamoxifen. Ninety-eight patients entered the study and 92 were evaluable for effect, 48 patients on MA and 44 on MPA. Age, main tumor site and prior treatment were not different, but there was a preponderance of ER-negative tumors in the MA group. Responses appeared to be more frequent in the MPA-treated group (25% vs. 43%), predominantly in bone lesions, 12% for MA and 45% for MPA. Median progression-free survival was comparable, 15 vs. 10 months, and overall survival was not different (20 vs. 16 months). Toxicity was frequent, occurring in 83% vs. 74% of patients: increased appetite, nausea and dizziness in more than 20%, and a preponderance of pyrosis and breathlessness on MA and hot flashes, sweating and tremors on MPA. Cushingoid symptoms were present in about a quarter of the patients treated for more than 3 months. The occurrence of thrombo-embolic episodes and cardiovascular events was evenly distributed. Patients on MPA had more often increase in body weight, systolic blood pressure and serum creatinine than those treated with MA. It is concluded that MPA may be more effective for treatment of bone metastases, at the expense of more progestational side-effects. The occurrence of Cushingoid effects is frequent but similar in both arms, while the incidence of cardiovascular or thrombo-embolic events cannot be related to the use of either compound.
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PMID:A randomized comparison of megestrol acetate (MA) and medroxyprogesterone acetate (MPA) in patients with advanced breast cancer. 214 91

A patient with a giant leiomyoma of the esophagus (1235 g) presented with persistent cough, intermittent fever, nocturnal pyrosis, and intermittent dysphagia for solid foods. Reconstruction after extirpation of the distal esophagus, the tumor, and the proximal stomach involved a Collis gastroplasty and a Nissen fundoplication using stapling technique. This combination of operations after resection was used to assure the best functional result possible in a young man with benign disease.
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PMID:Giant leiomyoma of the esophagus. 663 58

Esophageal diseases frequently cause symptoms such as heartburn, epigastric pain and dysphagia. This article discusses the indications, techniques and limitations of currently available diagnostic procedures. Investigation of symptoms should proceed in a logical stepwise manner, beginning with endoscopy to exclude esophagitis or neoplasia. Symptoms due to acid reflux can be identified by 24h esophageal pH-metry to document a temporal association between symptoms and episodes of esophageal acidification. Stationary or ambulatory manometric recording of esophageal pressures can be used to diagnose esophageal motor disorders such as achalasia, nutcracker esophagus, diffuse esophageal spasm, or dysfunction of the upper or lower esophageal sphincter. Combined 24 h pH-manometry should be used to test the temporal association between pain, reflux, or abnormal motility in patients with non-cardiac chest pain. Video-fluoroscopy is the most appropriate technique to diagnose swallowing disorders. Pulmonary aspiration of gastro-esophageal reflux can be documented with scintigraphy.
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PMID:[Motility disorders and assessment methods of the esophagus]. 821 Oct 52

History taking is the first step in the evaluation of a patient. An analysis of the information obtained provides the basis for the choice and order of diagnostic tests. In addition, it provides the clinician with the necessary information to determine the relevance of "abnormal tests" to the patient's problem. Dysphagia is a reliable symptom that indicates an abnormality in the swallowing mechanism. The history should contain a detailed description of the symptoms associated with dysphagia from the onset. Especially relevant are questions to determine if dysphagia is experienced every day or intermittently, with solid food or liquids or both, as well as presence and timing of associated symptoms such as, choking, coughing and regurgitation, changes in speech, heartburn and chest pain. It is clinically useful to divide swallowing into three phases: oral, pharyngeal and esophageal. Oral dysphagia is usually due to a neurologic disorder, decreased salivary flow or painful oropharyngeal lesions. Pharyngeal dysphagia is most frequently caused by neuromuscular disorders and less frequently by a Zenker's diverticulum, neoplasm or a mucosal web. Esophageal dysphagia is caused by a structural narrowing, such as produced by a peptic stricture, neoplasm or a Schatzki's ring or by a primary motility abnormality, such as achalasia or diffuse esophageal spasm or by motility abnormalities produced by inflammation caused by gastroesophageal reflux, medication-induced esophageal ulceration or infectious esophagitis.
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PMID:Art and science of history taking in the patient with difficulty swallowing. 846 26

Barrett's oesophagus is the eponym applied to the columnar epithelium-lined lower oesophagus which is acquired as a complication of chronic gastro-oesophageal reflux (GER). Various complications seen in the Barrett's oesophagus, such as peptic ulcer, stricture, adenocarcinoma are named as Barrett's ulcer, Barrett's stricture-and Barrett's carcinoma, respectively. It is now generally accepted that Barrett's oesophagus is an acquired condition resulting from chronic repetitive GER. The frequency of Barrett's oesophagus seems to be higher in Caucasian than in Oriental or Negro populations. There is a tendency towards increasing prevalence rates all over the world, including Taiwan, due to the Westernization of diet, rapid growth in the elderly population, obesity etc. Almost 6% of the patients who manifest heartburn in GI clinics in Taiwan now suffer from GER, which is almost similar to the 7% reported by Nabel, (USA) in 1976. During the last 30 years, the incidence of esophageal adenocarcinoma has increased rapidly. Patients with Barrett's oesophagus have an increased risk of developing oesophageal adenocarcinoma and should be kept under surveillance. Regular follow-up, at least twice a year or preferably, every 2-3 months, for those patients with SCE using endoscopic surveillance and biopsy for those with severe dysphasia (oesophageal columnar intraepithelial neoplasia) in the surrounding area to detect Barrett's oesophagus cancer, is very important.
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PMID:Review: Barrett's oesophagus in Taiwan. 919 7

Of all oesophageal tumours benign tumours account for less than 10%, of which 4% are leiomyomas. These tumours are most frequently asymptomatic, mostly localized in the lower oesophageal third. The most frequent symptoms, if any, are the following: dysphagia, unspecific retrostemal pain, heartburn, and occasionally, weight loss. Tumour enucleation is a therapy of choice in patients with oesophageal leiomyoma. In case of successful surgical removal, the prognosis is good and complains are practically eliminated. A male patient, aged 53, with paroxysmal tachycardia, in whom transhiatal enucleation was carried out in order to remove a large oesophageal leiomyoma after which cardiac complains were eliminated, is reported.
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PMID:[Leiomyoma of the esophagus. Case report]. 922 18

A 68-year-old man visited our hospital because of heartburn. A firm mass was palpated in the left upper abdominal quadrant. Ultrasonography and computed tomography revealed a large left sided retroperitoneal tumor. A barium enema examination showed shallow irregularly depressed or elevated lesions. Colonoscopy revealed an irregularly shaped ulcer and multiple submucosal masses suggesting invasion by an extrinsic malignant tumor. Although colonoscopic biopsy was negative, a resected tumor was histologically diagnosed as a malignant fibrous histiocytoma (MFH). When such varigated lesions are detected in the colon, MFH should be considered, and an attempt to sample the submucosal layer may be necessary.
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PMID:Retroperitoneal malignant fibrous histiocytoma causing variegated colonic lesions. 963 Jan 97

A 66-year-old man was referred to our institute for investigation of heartburn and epigastralgia. Endoscopic examination demonstrated a type 4' gastric cancer which occupied the whole stomach. At laparotomy, multiple small nodules were found in the spleen which were diagnosed as metastases of the gastric cancer. Thus, total gastrectomy with distal pancreatectomy, splenectomy, cholecystectomy, and left adrenalectomy, combined with D4 lymph node dissection, was performed. Microscopic examination of the tumor revealed tubular and mucinous adenocarcinoma which invaded the muscularis propria. Sarcoid reactions were observed in the submucosa adjacent to the carcinoma tissue. Only one lymph node from station no. 8a demonstrated tumor metastasis, while those from station nos. 1, 2, 7, 8, 9, 10, 11, 13, and 16 revealed sarcoid reactions without tumor metastases. Subsequently, the multiple small nodules that had been presumed to be splenic metastases at laparotomy were found to be sarcoid reactions similar to those seen in the submucosa and regional lymph nodes. Since no skin or ocular lesions indicative of systemic sarcoidosis were seen in this patient, a diagnosis of advanced gastric cancer associated with sarcoid reactions was established. To our knowledge, there have been no previous reports regarding an association between sarcoid reactions in the spleen and gastric cancer.
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PMID:Gastric cancer with sarcoid reactions in the regional lymph nodes, the stomach wall, and the splenic parenchyma: report of a case. 1038 71


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