Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although carcinoid tumors in association with multiple endocrine neoplasia syndrome (MEN) has been well described, thymic carcinoid in association with MEN is extremely rare (only 23 cases in the world literature). A patient with thymic carcinoid and MEN-I was treated with surgical resection and postoperative radiation therapy, which was later followed by subtotal parathyroidectomy for hyperparathyroidism. Four years later, a symptomatic recurrence of his thymic carcinoid was resected from below his right clavicle. Six years after his original operation, the patient came to the hospital with pancreatitis, and a 5 cm, distal, pancreatic metastasis was resected. He now has symptomatic paraspinal and pleural metastases and is receiving somatostatin. Review of the world's literature shows that the majority of patients with thymic carcinoid and MEN-I are men with an average age of 37 years. Their clinical course is indolent, and surgery represents the only means of cure. Adjuvant chemotherapy and radiation therapy confer no survival advantage. The surgical decision making involved in treating a patient with thymic carcinoid and hyperparathyroidism associated with MEN is also discussed.
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PMID:Thymic carcinoid in association with MEN syndromes. 135 92

A case of primary pancreatic enterochromaffin cell (EC cell) carcinoid tumor in a 66-yr-old Japanese man is presented. The markedly dilated main pancreatic duct was noticed at the time of an incidental ultrasonogram during hospitalization for diabetes mellitus. Endoscopic retrograde pancreatography showed stenosis of the main pancreatic duct at the body of the pancreas and dilated pancreatic ducts distal to the obstruction. A distal pancreatectomy was performed, together with splenectomy. Macroscopically, the main pancreatic duct was compressed by a fibrous mass around the duct, and the pancreatic ducts distal to the tumor were markedly dilated. Histologically, the tumor was composed of uniform round cells, proliferating in small nests or trabeculae. The tumor cells were strongly positive with both Grimelius and Fontana-Masson stains. The immunohistochemical study disclosed the tumor cells to be positive for serotonin and chromogranin. This is a rare case of primary pancreatic EC cell carcinoid tumor with obstructive pancreatitis.
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PMID:Carcinoid tumor of the pancreas with obstructive pancreatitis. 153 73

Octreotide is an analogue of somatostatin. Like endogenous somatostatin, it exerts a potent inhibitory effect on the release of anterior pituitary growth hormone and thyroid-stimulating hormone, and peptides of the gastroenteropancreatic endocrine system, while overcoming some of the shortcomings of exogenously administered somatostatin, namely a short duration of action, a need for intravenous administration and postinfusion rebound hypersecretion of hormone. Clinical studies have shown that octreotide is effective in the treatment of acromegaly and thyrotrophinomas. In comparative trials octreotide was significantly superior to bromocriptine in patients with acromegaly. Octreotide also appears to provide a significant advantage over existing therapies in the management of the carcinoid syndrome and offers considerable therapeutic potential in reversing carcinoid crises which may be life-threatening. Trials in patients with tumours producing vasoactive intestinal peptide demonstrated that octreotide may be an effective first-line choice for this condition, which has usually metastasised and become refractory to traditional symptomatic therapy. In limited studies in patients with high-output secretory diarrhoea, including cryptosporidium-related diarrhoea associated with AIDS and in patients with small bowel fistulas, octreotide has been shown to be effective in reducing stool/fistula output. However, well-designed clinical trials are still required to confirm its long term usefulness in these disorders. Similarly, although the use of octreotide in other conditions such as neonatal hypoglycaemia caused by nesidioblastosis, reactive pancreatitis, insulin-dependent diabetes mellitus, postprandial hypotension and the dumping syndrome has provided encouraging preliminary results, more studies are needed to clarify the place of octreotide in their treatment. Overall, octreotide appears to be well tolerated with the most frequently reported reactions being pain at the site of injection and gastrointestinal symptoms such as abdominal cramps, nausea, bloating, flatulence, diarrhoea and steatorrhoea. These adverse effects usually abate with time. Additionally, octreotide, like endogenous somatostatin, may also result in cholelithiasis, presumably by altering fat absorption and possibly by decreasing motility of the gallbladder. Thus, octreotide represents a new departure from traditional therapies in the treatment of various pathophysiological states associated with excessive peptide production and secretion. It offers a significant advantage over existing therapies in the medical management of patients with acromegaly, thyrotrophinomas, the carcinoid syndrome, tumours producing vasoactive intestinal peptide and severe secretory diarrhoea in whom conventional management options have either become exhausted or have provided suboptimal symptomatic relief.
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PMID:Octreotide. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in conditions associated with excessive peptide secretion. 268 36

A patient with hepatic metastases from a carcinoid tumor was treated by hepatic artery embolization and developed pancreatitis. A subsequent computed tomography scan (CT) demonstrated evidence of pancreatic embolization. The CT findings are reviewed as well as the probable mechanism of the development of pancreatitis.
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PMID:Inadvertent pancreatic embolization as a complication of hepatic carcinoid treatment--computed tomography appearance. 281 85

We report on a patient with a carcinoid tumour of the ampulla of Vater and review the 33 known cases of the literature with regard to clinical presentation, morphology and therapy. As it is apparent from the location of the tumour, obstructive jaundice, pancreatitis and nonspecific upper abdominal complaints are the most frequent symptoms. The ampullary carcinoid belongs histogenetically to the APUD cell system with the ability of multiple endocrine activity. The expression of somatostatin peptide and neuron-specific enolase are the most common histopathological findings. A systemic function of these hormones, however, has not yet been shown. For diagnostic purposes in surgical pathology we found synaptophysin and chromogranin A to be important markers. For surgical treatment, partial duodenopancreatectomy remains the current therapy of choise, if the tumour exceeds two centimeters in diameter.
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PMID:[Carcinoid tumor of the ampulla of Vater. Morphology, diagnosis and therapy of a rare papilla tumor]. 305 8

The first report of a carcinoid tumour of the ampulla of Vater causing acute pancreatitis is presented. The pancreatitis resulted from ampullary obstruction and diversion of the bile through the pancreas. Endoscopic retrograde cholangiopancreatography established the correct diagnosis, making this the first occasion in which a carcinoid tumour of the ampulla of Vater has been correctly diagnosed before surgery.
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PMID:Carcinoid tumour of the ampulla of Vater presenting as acute pancreatitis. 367 58

Spasms of the mesenteric and renal arteries are of great concern to the radiologist specialized in angiography. In most cases, they appear to be of iatrogenic origin, due to difficulties in selective catheterization and especially in superselective catheterization of the mesenteric and renal arteries. In this case, spasm may be a most unwelcome side-effect. In other less frequent cases, spasms appear as indirect signs of an underlying spasmogenic disease, such as G. I. tract carcinoid, pheochromocytoma, pancreatitis or poisoning such as ergotism or digitalis overdosage. Most of all, it may occur during some non-occlusive intestinal ischemias. On the other hand, spasm can be considered as a way of treatment, especially in cases of G. I. bleeding, particularly due to ulcerations.
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PMID:[Spasm of the renal and digestive arteries. Radiologic aspect]. 716 70

A 30-yr-old female with a carcinoid tumor of the ampulla of Vater is discussed. This rare tumor presented in an unusual fashion with isolated pancreatitis in the absence of cholestasis. The correct diagnosis was made preoperatively by endoscopic retrograde cholangiography with biopsies. Surgical removal led to complete resolution of symptoms. The importance of considering less common structural lesions such as ampullary carcinoids in the differential diagnosis of pancreatitis in patients without identifiable risk factors is stressed.
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PMID:Carcinoid of the ampulla of Vater presenting as acute pancreatitis. 973 69

Since the development of synthetic somatostatin analogues, several therapeutic applications for somatostatin receptor agonist molecules have been defined. Established applications for somatostatin analogue treatment include pituitary tumours (growth hormone and thyrotropin-secreting adenomas), neuroendocrine tumours of the pancreas and gastrointestinal tract (so-called carcinoid tumours, vasoactive intestinal tumours) and gastroenterological conditions (pancreatitis, gastrointestinal bleedings, refractory diarrhoeas, pancreatic and intestinal fistulas, diarrhoea in AIDS). Further areas for development of somatostatin analogue therapy include obesity, polycystic ovary syndrome and diabetes mellitus, dysmetabolic conditions that are often interrelated. The challenge for the future will be to transform results from clinical trials conducted in heterogeneous clinical situations into novel options of somatostatin analogue use. Since obesity and diabetes mellitus both are disorders of marked heterogeneity, the subgroup of patients that will benefit most from somatostatin analogue treatment has yet to be defined. In addition, the development of more universal ligands covering all of the known somatostatin receptor molecules as well as receptor subtype specific agents is currently underway. The establishment of slow-release depot formulations of octreotide and lanreotide has already provided a more acceptable and consistent delivery mechanism. Use of biodegradable polymer microsphere formulations provides the basis for the development of novel applications, which include hyperinsulinaemia, obesity and polycystic ovary syndrome as components of the dysmetabolic syndrome. The most developed thus far is the use of octreotide in hyperinsulinaemic forms of obesity and in distinct stages of diabetic retinopathy.
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PMID:The therapeutic potential of somatostatin receptor ligands in the treatment of obesity and diabetes. 1294 94

A patient with von Recklinghausen syndrome presented with multiple attacks of pancreatitis. Evaluation using computed tomography, endoscopic retrograde cholangiopancreatography, and endosonography revealed an ampullary carcinoid. The patient underwent a pylorus-sparing Whipple resection, and is doing well after 30 months of follow-up. This is the second reported case of ampullary carcinoid presenting with pancreatitis in a patient with von Recklinghausen syndrome.
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PMID:Ampullary carcinoid tumor presenting as acute pancreatitis in a patient with von Recklinghausen's disease: case report and review of the literature. 1455 65


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