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

Adult intussusception is rare, and the majority of cases has an underlying cause that requires surgical resection. We report a case of a 39 yr-old man with ileo-ileo-colic intussusception caused by ileal lipoma that was successfully managed by a laparoscopic-assisted surgical maneuver. Using a three-cannula technique, ileo-colic intussusception was reduced laparoscopically. Then, through a 4-cm transverse incision in the right lower quadrant abdomen, ileo-ileal intussusception was reduced manually, and a resection of the tumor-bearing ileal segment and end-to-end anastomosis was performed extracorporeally. Although the role of laparoscopy in managing intussusception is not clearly defined, laparoscopy may be an alternative approach to the surgical treatment of adult intussusception in selected cases.
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PMID:Laparoscopic-assisted resection of ileal lipoma causing ileo-ileo-colic intussusception. 1128 90

It is generally accepted that the abdominal angina develops only when at least two of the three splanchnic vessels-mesenteric arteries and the celiac trunk exhibit a critical obstruction. That common opinion does not, however, take into account anatomical variants of arteries supplying the blood to the intestines. We present a case of a wasted, 40 year old male with a wide spread arteriosclerosis and postprandial pain. The ultrasound examination revealed total occlusion of the superior mesenteric artery (SMA). Celiac trunk (CT) and inferior mesenteric artery (IMA) were patent. The ultrasound indicated that only one splanchic vessel was obstructed; the systemic disorder, the neoplasm, as well as the malabsorption were ruled out. An arteriography of the abdominal aorta and of splanchnic arteries confirmed patency of CT and IMA, also lack of flow in the SMA. Atypical origin of the middle colic artery originating from the bed of CT was also shown. Lack of collaterals between IMA and SMA, typically conducting a sufficient blood flow, resulted in a fully symptomatic abdominal angina. Symptoms were relieved following surgical revascularization.
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PMID:[Advanced abdominal angina due to atherosclerosis with atypical celiac arteries]. 1142 65

Previous studies on the distribution of positive lymph nodes have revealed that the colon should be resected 10 cm from the tumor on both sides and that the intermediate nodes along the main vessel should be dissected in patients with colon cancer. In rectal cancer, superior lymphatic spread along the inferior mesenteric artery (IMA) is the main metastatic route. The IMA should be dissected immediately after the bifurcation of the left colic artery, and the intermediate lymph nodes should be removed. The positive rate of the lateral lymph nodes is about 10%. The rate of local failure is high and the prognosis is poor in patients with positive lateral lymph nodes, even if the lateral lymph nodes have been dissected. However, it has been reported that lateral lymph node dissection combined with excision of the internal iliac vessels results in good disease-free survival in patients with positive lateral nodes. Therefore the indications for lateral node dissection remain controversial. Lymphatic spread into the mesorectum on the anal side has been shown to be an important factor in local failure. The mesorectum should be resected for up to 4 or 5 cm from the inferior tumor margin in middle rectal cancer, and the entire mesorectum should be removed in lower rectal cancer. Nerve tissue preserved in pelvic autonomic nerve-preserving surgery contains a small amount of lymphoid tissue and lymph nodes. Therefore the extent of lymph node dissection and the area of autonomic nerves to be preserved based on tumor site or tumor penetration remain controversial.
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PMID:[Optimal lymph node dissection for colorectal cancer]. 1143 14

We present the first reported case of spontaneous ruptured middle colic artery aneurysm in a patient who has concurrent hypervascular tumor which has a potential for rupturing. A 68-year-old Japanese man was admitted with abdominal pain and hypervascular renal tumor which developed in the subcapsular cortex and protruded outward. The next morning after admission, anemia rapidly progressed and severe abdominal pain developed. Emergency laparotomy was performed for a preliminary diagnosis of ruptured hypervascular renal tumor. However, the renal tumor was not ruptured but a ruptured middle colic artery aneurysm was found. The aneurysm measured 3.0 x 2.0 cm in greatest diameter and was resected. Three weeks later, nephrectomy for hypervascular renal tumor was electively performed. Histologically, the tumor was clear cell carcinoma. In the present case, the diagnosis of ruptured middle colic artery was extremely difficult.
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PMID:Spontaneous ruptured middle colic artery aneurysm with concurrent renal cell carcinoma. 1146 1

The Authors report a case recently observed of giant lipoma of the cecum. In according to all radiologic diagnostic procedures and for suspicion of colic neoplasm, they have performed a right emicolectomy.
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PMID:Giant cecal lipoma: a case report. 1181 44

The first description of hereditary non polyposis colorectal cancer goes back to Warthin's study in 1895. In 1966 two families with autosomal dominant predisposition to colon and endometrial cancer were found. This condition was defined initially as familial neoplasm syndrome, then Lynch syndrome, and at last hereditary non polyposis colorectal cancer (HNPCC). HNPCC is classically subdivided into Lynch syndrome I (characterized by predisposition to colorectal cancer with early age of onset, to cancer of the proximal colon, and excess of synchronous and metachronous cancer), and Lynch syndrome II (characterized by similar colic phenotype with augmented risk of extracolonic neoplasm). If all clinical characteristics are present, it is possible to suspect HNPCC: however, diagnosis is difficult. Histological and genetic features of colon cancer confirm the diagnosis of HNPCC. Surgical therapy of colic neoplasm is total colectomy. A careful screening of HNPCC family members is one of the cardinal point in prevention. Follow-up of these surgical patients is the same as for sporadic neoplasms.
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PMID:[Hereditary non polyposis colorectal cancer (HNPCC). A clinical and genetic entity]. 1183 61

A 43-year-old man complained that during the previous 2 years he had experienced a number of episodes of hepatic colic. After examination, we diagnosed a symptomatic cholelithiasis with a sclerosed and atrophic gallbladder. He underwent laparoscopic surgery. During the operation, we observed multiple peritoneal tumors that appeared to be metastases of a gallbladder cancer. The histological study demonstrated a benign chronic cholecystitis accompanied by multiple peritoneal cystic mesotheliomas, an extremely rare tumor in men. The etiology of cystic mesothelioma is still unclear. It has been suggested that they are really multiple inclusion cysts that result from a proliferative reaction within the peritoneal tissue; their continued proliferation might be caused by the continued persistence of an inciting factor. However, in our patient, the proliferation appeared to be related to an extensive peritoneal tissue reaction to the chronic gallbladder inflammatory process. We did not use sclerosing therapy because we had resected the gallbladder and most of the visible lesions laparoscopically; therefore, we had most likely eliminated the potential source of the inciting factor. Because it is very difficult during laparascopy to differentiate these benign quistic mesotheliomas from peritoneal metastases or tuberculous lesions, it is debatable whether the surgeon should continue or terminate the laparoscopic procedure in these ambivalent and potentially risky circumstances.
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PMID:Peritoneal cystic mesothelioma. 1196 60

The benefit of radical surgical resection of contiguously involved structures for locally advanced pancreatic cancer is unclear. The aim of this study was to examine patient outcome after extended pancreatic resection for locally advanced tumors and to determine if any subset of extended resection affected outcome. We retrospectively reviewed the records of 116 patients with adenocarcinoma of the pancreas, who underwent extirpative pancreatic surgery between 1987 and 2000. Of the 116 patients, 37 (32%) required resection of surrounding structures (group I), and 79 patients (68%) underwent standard pancreatic resections (group II). In all cases, all macroscopic disease was excised. In group I a total of 46 contiguously involved structures were resected: vascular in 25 patients (54%), mesocolon in 16 (35%) (colic vessels in 3, colon in 13), adrenal in three (7%), liver in one (2%), stomach in one (2%) (for a tumor in the tail of the pancreas), and multiple structures in four. Excision of regional blood vessels included the superior mesenteric vein and/or portal vein in 16, hepatic artery in five, and celiac axis in four. No differences between groups I and II were detected for any of the following parameters: age, sex, history of previous operation, estimated blood loss, or hospital stay. For the entire cohort the morbidity and mortality were 38% and 1.7%, respectively, and these rates were similar in the two groups. Adjuvant therapy was administered to more than 90% of patients in both groups. However, patients in group I were more likely to have received neoadjuvant therapy (76% vs. 42%, P = 0.001). Total pancreatectomy and distal pancreatectomy were more often performed in group I (P = 0.005). Additionally, the median operative time was longer (8.5 hours compared to 6.9 hours (P = 0.0004)). Both groups had similar rates of microscopically positive margins and involved lymph nodes, as well as total number of lymph nodes removed. The median survival was 26 months for patients in group I and 16 months for patients in group II (P = 0.08). The median disease-free survival for groups I and II was 16 months and 14 months, respectively (P = 0.88). In comparing patients in group I, who underwent vascular resection vs. mesocolon (colon or middle colic vessels) resection, the median survival was 26 months and 19 months, respectively (P = 0.12). We were unable to detect a difference in outcome for patients with locally advanced cancers requiring extended pancreatic resections compared to patients with standard resections. En bloc resection of involved surrounding structures, to completely extirpate all macroscopic disease, may be of benefit in selected patients with locally advanced disease, particularly when combined with preoperative chemoradiation therapy.
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PMID:En bloc resection for locally advanced cancer of the pancreas: is it worthwhile? 1199 99

Multilocular cystic nephroma is a relatively rare benign tumor of the kidney. An adult case of spontaneously ruptured multilocular cystic nephroma was reported. A 33-year-old woman who presented with a right flank colic attack. The preoperative diagnosis was spontaneously ruptured renal tumor. A right nephrectomy was performed. A multilocular cystic lesion, 10 cm in diameter, was found in the removed specimen, which had a hematoma inside and direct tumor extension into the renal pelvis. On microscopic examination, the surface of loculi was covered by a layer of hobnail epithelium, and septa were composed of fibrous tissue with dilated vessels, lacking in normal renal components. There were no signs of malignancy. The lesion extending into the renal pelvis showed the same microscopic findings. The final diagnosis was multilocular cystic nephroma. Two respects, spontaneous rupture and tumor extension into the renal pelvis, were unique to the present case. There has been no report of spontaneously ruptured mutilocular cystic nephroma. The tumor extension into the renal pelvis, however, has been found in several reports. This growth pattern might be one of the characteristics of this benign renal tumor.
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PMID:Spontaneously ruptured multilocular cystic nephroma. 1201 Mar 32

Colic metaplasia of the urinary bladder is a rare disease, secondary to a chronic irritative factor. In its minor form, it has the same clinical features as simple cystitis, but its major pseudoneoplastic form may be mistaken for bladder tumor. The diagnosis is essentially histological. Treatment is based on eradication of the irritative factor and of the resection of pseudoneoplastic form. Surgery is performed in the case of complications of this disease. The clinical course is unclear, requiring long-term surveillance. We report one case of colic-type glandular metaplasia of the urinary bladder in a 50 years-old patient. The clinical symptomatology was dominated by hematuria and pollakuria. A bladder neoplasm was highly suspected in ultrasound and endoscopic findings. The patient underwent a transurethral resection of the bladder tumor. Histological examination of of resection shavings revealed a colic-type glandular metaplasia.
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PMID:[Pseudo-tumoral colic metaplasia of the urinary bladder]. 1210 54


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