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

A malignant rectal carcinoid metastatic to the liver presents a formidable challenge. The uniformly fatal course in patients with liver metastases (average survival of 2 years) justifies an aggressive approach. Although in an occasional patient the tumor is resectable, most are managed by chemotherapy, which generally is of limited effectiveness. Although certain drug combinations such as 5-fluorouracil and streptozotocin have achieved higher response rates, these responses are often brief (3 to 4 months) and poorly documented. Surgical hepatic dearterialization and, more recently, hepatic intraarterial embolization are quite effective in inducing regression in a variety of hepatic neoplasms, including metastatic carcinoids, but these are usually temporary. We have been timely instructed on the value of combined therapy by a patient who is a long-term survivor of a metastatic carcinoid to the liver. She is the only survivor among a group of 14 patients who had an average survival of 17 months. This patient emphasizes the benefit of combined hepatic dearterialization and chemotherapy in patients with metastatic carcinoid to the liver. She initially had intrahepatic infusion of 5-fluorouracil and streptozotocin through the surgically placed hepatic artery and portal vein catheters, but this was curtailed after 2 months because of catheter sepsis. She then had four sequential selective hepatic intraarterial embolizations with Gelfoam over a 16 month period. She also received systemic therapy with 5-fluorouracil and streptozotocin during a major portion of this period (10 months). Significant tumor regression was documented radiologically. Although she had another trial with intrahepatic chemotherapy infusion using surgically placed catheters, this was again discontinued because of catheter sepsis, and systemic chemotherapy was resumed. Currently, the patient is asymptomatic, has excellent performance status, and continues to show objective tumor regression on a program of systemic therapy with fluorodeoxyuridine and doxorubicin. She has survived more than 7 years with liver metastases from a rectal carcinoid.
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PMID:Malignant rectal carcinoid: a sequential multidisciplinary approach for successful treatment of hepatic metastases. 397 Mar 17

Renal arterial embolization is often used in the treatment of patients with renal cell carcinoma, either preoperatively to facilitate nephrectomy or as palliative therapy in advanced cases. Eighteen patients (18/58; 31%) underwent renal arterial embolization in our department since 1979, initial 10 cases with Gelfoam and steel coil (group G) and recent 8 cases with absolute ethanol (group A). Clinical studies of daily changes of symptoms and blood chemistry in both groups after embolization were compared and the results were as follows: Severe flank pain was noted immediately after embolization but thereafter well controlled without analgesics in group A. The patients in group G experienced no pain during the procedure of embolization but have had moderate flank pain of two or three days' duration with nausea and/or vomiting and required surgical procedure within a few days after embolization. Post embolization fever in group A was described as higher than that in group G significantly. Leukocytosis was noted to be persistent for up to seven days and blood chemistry showed transient marked elevations of GOT, GPT and LDH immediately after the procedure without significant value in both groups. Embolization to advanced tumor with many parasitic vessels or massive local invasion may not always be available for remaining of viable-appearing tumor cells in venous lumen, as if palliative treatment. Absolute ethanol may be more useful as the embolizing substance than Gelfoam and steel coil by reason of producing wide severe infarction of diseased kidney. Broad marked infarction due to renal arterial embolization may make pathological diagnosis difficult. Immunological effects of renal arterial embolization were not observed in short term patients survival.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Renal arterial embolization for renal cell carcinoma]. 402 78

The first reported cases of preoperatively embolized hemangiopericytomas are presented. Both lesions presented in the retroperitoneum where most lesions are now considered to be malignant. In the past, the highly vascular nature of these tumors has made resection in these areas difficult. Since the angiographic picture of hemangiopericytomas is now thought to be specific, it became feasible to add preoperative embolization to the overall management of these cases. In the first case, the diagnosis had been established 15 years previously. When first seen at Thomas Jefferson University Hospital, extensive bone destruction of the sacrum and lumbar vertebrae were present. Preoperative Gelfoam embolization aided in the palliative debulking of the tumor at operation. With this experience, preoperative embolization became part of the management in the second case and aided in the complete surgical removal of the tumor. Radiation therapy in the dosage of 5000 rad was given postoperatively in this case and should also be part of the treatment plan for these lesions.
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PMID:Preoperative embolization of retroperitoneal hemangiopericytomas as an aid in their removal. 618 Aug 22

"Ethibloc" has been used almost exclusively until now for embolization of tumors and bleeding vessels in the liver and kidney. Unlike with Gelfoam-particles, there is no recanalization. The resorption occurs so slowly that there is no interference with the necrosis of the embolized tumor. Due to its low viscosity, it passes catheters with thin lumina and fills the capillary bed of the tumor without danger danger of reaching the venous vessels. In this paper we describe a new technic of percutaneous catheter-embolization with Ethibloc using a coaxial catheter which we believe enhances safety and effectiveness. It has been successfully used in five patients. In the meantime two more patients have been treated successfully.
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PMID:Embolization with "Ethibloc" of vascular tumors and arteriovenous malformations in the head and neck. 618 30

Juvenile angiofibromas are benign, vascular, locally aggressive neoplasms that are preferably treated by surgical resection, or irradiation if surgery is not possible. Adequate surgery in the past has been limited by incomplete knowledge of the anatomy of the tumor and technical difficulties related to the vascularity. To better define the tumor, 12 patients with juvenile angiofibroma have been studied by axial and coronal high resolution computed tomography (CT). The extent of the neoplasm was better demonstrated by CT than by other techniques. Based on the CT findings, we propose an anatomic classification that is helpful in determining treatment methods. Nine patients were considered operable, and eight of these underwent preoperative embolization with Silastic spheres and Gelfoam. The preoperative embolization significantly reduced operative difficulty and the necessity for blood transfusions. Based on these cases, we believe the current radiographic management of juvenile angiofibromas should consist of plain films, CT, angiography and, in surgical cases, preoperative embolization.
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PMID:Radiographic management of juvenile angiofibromas. 626 68

Effect of tumor embolization is limited by parasitary blood supply. The influence of those collaterals should be decreased by transporting the embolization medium into the capillaries and tumor sinusoids. Controlled and safe capillary embolization is developed from studies of obtainable radiodensity, viscosity, and occlusion mechanism of Gelfoam-powder, IBC, and Ethibloc. The efficiency of these substances is compared to simple arterial ligation in experimental series with 400 Wistar rats. It is shown that ligation is comparable to insufficient capillary transport of the medium leaving islands of microscopically intact parenchyma. Easy application and total necrosis is guaranteed only by Ethibloc. Success of embolization is strictly volume dependent. Preinjected glucose is mandatory for homogenous distribution and peripheral transport.
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PMID:[Capillary embolization. Part I: occlusion of the entire arterial system of the rat kidney (author's transl)]. 626 69

In 8 cases of hepatocellular carcinoma, hepatectomy was performed after hepatic artery embolization with Gelfoam. Complete necrosis of the tumor was found in 4 of these cases. Compared with the tumors that showed incomplete necrosis, the tumor in the complete necrosis group were small, thickly encapsulated, and located at sites remote from collateral circulation. Angiography and computed tomography after embolization accurately demonstrated tumor necrosis or continued viability, as confirmed by examination of resected specimens.
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PMID:Transcatheter embolization of hepatocellular carcinoma: assessment of efficacy in cases of resection following embolization. 630 Sep 59

The authors report a case of needle tract implantation of hepatocellular carcinoma following percutaneous biopsy of the liver. The patient, a 62-year-old Japanese male, was found to have a small hepatocellular carcinoma diagnosed by needle biopsy; this was followed by transcatheter chemoembolization, a combination of transcatheter arterial infusion of adriamycin and transcatheter arterial embolization of Gelfoam, and right lobectomy. Eight months after the biopsy and the lobectomy, a nodule of hepatocellular carcinoma, measuring 3.5 cm in diameter, was found at the site of the previous biopsy and excised. The patient is doing well without further recurrence of tumor 23 months after the lobectomy and 15 months after the excision of the implanted tumor in the subcutis.
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PMID:Needle tract implantation of hepatocellular carcinoma after percutaneous liver biopsy. 630 17

A histopathologic study was done on livers from 14 patients who underwent surgery for hepatocellular carcinoma and who had been pretreated by a combination of intra-arterial embolization of Gelfoam (Upjohn) plus intra-arterial chemotherapy. This technique was effective as the excess vascularity of the tumor and the tumor bulk were reduced and resection was readily facilitated. For solitary tumors of less than 4 cm in diameter, this approach was particularly effective. As this combined treatment almost invariably leads to liquefaction and necrosis of the tumor, the likelihood of metastases is diminished.
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PMID:Transcatheter chemo-embolization effective for treating hepatocellular carcinoma. A histopathologic study. 632 3

Renal cell carcinoma tissue was cultured from 2 patients who underwent embolization of the tumor before surgery and from 2 patients who did not have the tumor embolized. A combination of small Gelfoam particles and polyvinyl alcohol foam particles (250-590 mu diameter) was used to devascularize maximally the tumors that were embolized. The tumor cells from all 4 patients grew in short-term tissue cultures and demonstrated histology and growth properties characteristic of tumor cells. Successful embolization of renal cell carcinomas may not completely infarct the primary tumor, and local tumor growth may continue.
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PMID:In vitro growth of renal cell carcinoma after preoperative renal infarction. 649 55


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