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

A 35-year-old man underwent a pancreatoduodenectomy for what proved to be chronic pancreatitis. He did well until 14 years later, when he presented with right upper quadrant pain and jaundice. At laparotomy, an adenocarcinoma was found in fibrous tissue obstructing the choledochoenteric anastomosis. The exact origin of the tumor, from pancreas or biliary tract, could not be ascertained. This case points out the difficulties in attempting to diagnose the etiology of jaundice in a patient who has had a pancreatoduodenectomy without doing a laparotomy. The importance of this diagnosis lies in the known occurrence of benign strictures at the choledochojejunostomy site after a pancreatoduodenectomy.
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PMID:Occurrence of an adenocarcinoma at the choledochoenteric anastomosis 14 years after pancreatoduodenectomy for benign disease. 83 May 84

Primary benign liver tumors are rare, however, the diagnosis should be considered in young women with right upper quadrant pain and an enlarged liver, expecially if they are taking oral contraceptives. These tumors are best resected promptly because of the frequency of spontaneous rupture. In the case reported, the patient was a 29-year-old housewife, gravida 1, para 1. Diarrhea of 8 years' duration was complained of. Anticholinergic sedatives and birth control pills were being used, and tetracycline, 250 mg daily, had been taken for acne for 5 years. A tender liver mass was palpable 3 cm below the ribs. Upper GI X-rays showed a mass displacing the small bowel. Liver scan showed an enlarged right lobe. At surgery a large encapsulated tumor of the right lobe of the liver was found. Subtotal hepatic lobectomy and cholecystectomy were done. The laboratory diagnosis was vascular liver tumor, type undetermined. Photographic reproductions illustrate histologic findings. Following surgery the diarrhea ceased and the patient has remained well. Hepatic angiography, although not done in this case, is considered to be a useful diagnostic method. Percutaneous liver biposy is contraindicated due to the vascular nature of these tumors.
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PMID:Hepatic adenoma and oral contraceptive therapy. 85 Oct 22

The causes of abdominal pain in patients with AIDS are different from those of the general population, and there are no guidelines as to which investigations are optimal. We reviewed our experience of 63 patients who presented with abdominal pain as the main reason for admission to the AIDS unit at St Stephen's and Westminster Hospital between January 1988 and January 1990. All patients were assessed within the same structured diagnostic programme. Thirty-five had upper abdominal pain, predominantly in the right upper quadrant in 27; seven had lower abdominal pain, which was concentrated in the right iliac fossa in three; 21 had diffuse abdominal pain. The causes of pain were determined satisfactorily in the majority of patients using routine gastroenterological investigations. The predominant site of pain had considerable predictive value in the diagnosis. The commonest cause of right upper quadrant pain was sclerosing cholangitis (17 of 27); endoscopic retrograde cholangio-pancreatography was necessary for a confident diagnosis. Diarrhoea was frequently associated (15 of 21) with diffuse abdominal pain; the commonest cause (six of 21) was cytomegalovirus colitis. Neoplasia was the cause of abdominal pain in eight patients. The other causes of abdominal pain and the utility of various investigations are discussed. An investigatory route which may provide maximum information has been suggested.
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PMID:Abdominal pain in HIV infection. 164 62

Renal oncocytoma was previously reported as a benign tumor arising from proximal tubular epithelial cells, but malignant potential with local invasion and distant metastasis has been emphasized in recent literature. It is difficult to differentiate it from renal cell carcinoma, but four typical angiographical signs may give suggestive evidence of the tumor. Radical nephrectomy with lymphadenectomy may be the choice of treatment, except in solitary kidney, bilateral tumors, or contralateral renal cell carcinoma. We report two female patients who were found incidentally to have renal tumors during a survey of right upper quadrant pain. Typical angiographic signs were found incidentally to have renal tumors during a survey of right upper quadrant pain. Typical angiographic signs were found in one patient, and atypical signs in the other. Three and eight years after radical nephrectomy with para-aortic lymphadenectomy, there has been no evidence of local recurrence or distant metastasis.
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PMID:Renal oncocytoma: report of two cases and review of literature. 187 66

From 1968-1985 a series of thirty-seven patients with primary hepatocellular carcinoma was collected from the tumor registry of the Fairfax County Hospital, in the metropolitan Washington, D.C. area. These patients were found to have a mean age at diagnosis of sixty-two (males) to sixty-six (females). Thirty per cent of patients were previously cirrhotic and nineteen per cent had a history of viral hepatitis. There were no patients with documented birth control pill or steroid use. The most common presenting symptoms were anorexia and right upper quadrant pain. Liver-spleen scan was the most commonly used diagnostic study, but by the 1980's CT scanning was usually diagnostic. Both alkaline phosphatase and serum glutamyloxalotransferase were reliably elevated in twenty-six of twenty-eight and twenty-one of twenty-four patients respectively. Forty-eight per cent of patients with tumor histology reported had multicentric tumors, thirty-eight per cent had nodular tumors, and fourteen per cent had diffuse disease. Survival was as dismal in this as in other studies with a mean of seventy-nine days. No significant difference was noted between cirrhotic and non-cirrhotic patients. Chemotherapy and radiation therapy did not significantly impact upon survival. Finally, a cohort analysis was done and a possibly significant peak in incidence of primary hepatocellular carcinoma was seen in men born from about 1911 through 1920. The authors noted that these males were in the group of draft eligible persons for World War II and questioned a link between veteran status and later development of HCC.
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PMID:Primary hepatocellular carcinoma: hospital based epidemiologic study. 196 92

The authors report 2 cases of hepatic lymphangioma observed in a 54-year-old woman, and in a 39-year-old man. These tumors were discovered upon ultrasound examination performed for jaundice due to viral hepatitis, and for abdominal right upper quadrant pain respectively. Computed tomography and angiography showed hypervascularized tumors. Diagnosis was established through surgical biopsy specimens. The clinical course was uneventful, during respectively the 9- and 3-year follow-up periods, respectively. From these and the 40 previously reported cases, the authors describe the different features of this unusual tumor.
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PMID:[Cavernous lymphangioma of the liver. A report of 2 cases and review of the literature]. 220 69

Clinical and laboratory evidence of an association of oral contraceptive (OC) use with the subsequent development of benign and malignant hepatobiliary neoplasia is growing. The authors present a case in which an adenoma within a large, multicentric anaplastic spindle cell carcinoma occurred in a woman with a long history of OC use. The patient, a 38-year-old gravida 2, para 2, was diagnosed following low-grade fevers and right upper quadrant pain. A partial hepatectomy was performed with no complications; however, a follow-up examination 2 months later revealed widespread intra-abdominal tumor recurrence histologically identical to the original tumor. Immunostaining for alpha 1 antitrypsin and keratin was strongly positive in tumor cells, indicating a biliary derivation. Electron microscopy indicated an epithelial derivation as well, including the presence of intracellular lumens, intermediary filaments, and numerous intercellular junctions. Estrogen and progesterone receptors were negative in the tumor. The tritiated thymidine labeling index was 5.05%, with an estimated potential doubling time of 11 days. This woman had no history of hepatitis, no family or personal history of neoplasms, and no known hepatotoxin exposure. The only medication used by the patient was Norlestrin, an OC containing 1 mg norethindrone and 50 mcg ethinyl estradiol that she had taken continuously for the past 8 years.
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PMID:Hepatic adenoma within a spindle cell carcinoma in a woman with a long history of oral contraceptives. 243 48

Epithelioid hemangioendothelioma in a young female is reported. Her symptoms were right upper quadrant pain and low-grade fever. Laboratory examinations showed an increased number of white blood cells and an elevated erythrocyte sedimentation rate. Plasma factor VIII:C was increased. The hepatic lesions were demonstrated as low-density areas by CT scan, and multiple nodules with central depression on the surface of the liver were identified by peritoneoscopy. The biopsy specimens showed spindle-shaped tumor cells set in the fibrous and myxohyalinous tissue. The tumor cells were positive for factor VIII-related antigen and Weibel-Palade bodies. The patient received transcatheter arterial embolization therapy using Gelfoam and mitomycin C following which the plasma level of factor VIII was normalized and regression of the tumors was observed.
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PMID:Hepatic epithelioid hemangioendothelioma in a young female. 369 Dec 79

ERC was initially performed on a patient with right upper quadrant pain and jaundice. The filling defect in the CHD was felt to be a tumor. A correct preoperative diagnosis of Mirizzi's syndrome was made by CT.
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PMID:Mirizzi syndrome simulating a tumor by ERC. 394 Aug 14

The possible association of hepatocellular carcinoma with oral contraceptive (OC) use is supported by the case of a 33-year old black female, gravida 5, para 4. She presented in April 1978 with right upper quadrant pain, nausea, vomiting, and fatty food intolerance. The case had been taking norethindrone, 1 mg with mestranol 0.05, for 2 years. There was no history of liver disease, alcohol abuse, or exposure to chemical toxins. The preoperative diagnosis was subacute cholecystitis; however, an unresectable primary liver tumor of both lobes was detected on surgery. OC use was discontinued, and the case refused chemotherapy. On December 1, 1978, she presented with a 9-week pregnancy which was aborted. Physical examination revealed an enlarged liver and mass in the upper right quadrant. The patient was readmitted December 11 with intractable pain and discharged. She died December 28, 1978. At autopsy the liver tumor appeared as a moderate to poorly differentiated hepatoma with irregular hyperchromatic nuclei. There was no evidence of coexistent benign lesions. The rapid progression of the disease following pregnancy suggests that hepatic growth was stimulated by the high estrogen levels of pregnancy. Earlier diagnosis and improved management are required in such cases. Ultrasonography can be used to confirm the presence of a mass, and liver scan or hepatic angiogram may be useful. Liver biopsy is required for definitive diagnosis. Treatment involves discontinuation of OC use and complete excision of the tumor where possible. If tumors have progressed beyond the stage of resectability, as in this case, the prognosis is poor.
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PMID:Hepatocellular carcinoma associated with oral contraceptive use and pregnancy. 629 72


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