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Query: UMLS:C0677930 (primary tumor)
 20,210 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a retrospective study at the University of Louisville Affiliated Hospitals, 42 patients with carcinoid tumors not arising in the anorectal area were identified in ten years (1962-1972). The ileum was the organ most frequently involved with primary tumor (28%). The nonappendiceal gastrointestinal tumors were multiple in 28%, metastatic in 66%, and associated with a second malignancy in 25%. Of the symptomatic small-bowel tumors, 83% were metastatic at the time of diagnosis. Carcinoid syndrome was observed in only two patients, both of whom had liver metastases and elevated urinary 5-HIAA levels. Resections for cure were done on 25 patients, palliative resections on six, and biopsy on six. Six tumors were from autopsy meterial. Among the 24 patients treated and followed up for five years, the survival rate was only 16%. In those patients having resection for cure, the five-year survival rate was 39%, exculding appendiceal tumors. The advanced stage of disease at time of discovery and the dismal prognosis for invasive carcinoids are contrary to many clinicians' impressions of the nature of carcinoid tumors but entirely consistent with several other recent reports (James Ewing Society meeting, April 1973).
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PMID:Clinical aspects of invasive carcinoid tumors. 5 Jun 23

Special features which enable preoperative differential diagnosis are dealt with in detail with reference to 44 patient with carcinoid of the digestive tract. Carcinoid of the appendix becomes noticable early with signs of acute or chronic appendicitis and in 94% of cases is operated on in good time. Angiography of the superior mesenteric artery shows a characteristic stellate figure in the mesenterium in carcinoid of the small intestine. In contrast to the primary tumor, liver metastases show intense vascularization in the angiogram. A rise in urinary excretion of 5-hydroxyindole acetic acid is pathognomonic for carcinoid, its determination permits the checking of operative radicality and shows the appearance of metastases early.
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PMID:[Carcinoid of the digestive tract. Diagnostic possibilities (author's transl)]. 10 77

Of 112 000 patients undergoing surgery between 1952 and 1973, 67 had a primary tumor of the small intestine. 22 patients had a benign tumor, 8 a carcinoid, 21 carcinoma and 15 sarcoma. Benign tumors were more frequent in the duodenum and ileum, carcinoids in the terminal ileum and carcinomas in the duodenum and jejunum. Sarcomas were found equally in all parts of the small intestine. The most common symptom for all types of the tumor was variable pain in the abdomen. Loss of weight occurred only in patients with carcinomas and sarcomas; heavy intestinal blood loss was most common in patients with benign tumors. Benign tumors often show invagination, while sarcomas cause occlusive ileus or perforation. All duodenal tumors show heavy intestinal bleeding but hematemesis is rare. Emergency surgery was necessary in 42% of patients with benign tumors or sarcoma and in 30% of patients with carcinoma. Five-year survival in patients with benign tumors is excellent (100%). Compared to this, five-year survival in patients with carcinoma, sarcoma or carcinoids is only 15%.
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PMID:[Complications in primary tumors of the small intestine]. 16 32

A metastasis from a bronchial carcinoid tumor presented as an isolated breast mass in a 58-year-old female. A review of the English literature revealed four cases of metastatic carcinoid to the breast that presented as an isolated breast mass. In each case, radical mastectomy was performed after the lesion had been interpreted clinically and pathologically as a primary carcinoma. When the primary tumor was excised, all cases had either regional lymph node or liver involvement. A mass was the usual presenting sign of the metastatic deposit. No metastasis was reported to be greater than 2 cm in diameter. No axillary lymph nodes were reported to contain tumor. Frozen section preparations may not be adequate to differentiate a primary carcinoma of the breast from a metastatic carcinoid tumor, thereby necessitating permanent sections, special stains, review of previously resected neoplasms, or electron microscopy. The first mammogram of a metastatic carcinoid to the breast is reported with this case.
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PMID:Breast metastasis: an unusual manifestation of a malignant carcinoid tumor. 33 42

Using two angiographically well documented cases the angiomorphological features of intestinal carcinoid tumors are described. One case is a carcinoid of the terminal ileum with hepatic metastases, the other case a cecal carcinoid without distant metastases. The primary tumor of the second case is strikingly hypervascular--most primary carcinoid tumors heretofore described in literature were hypovascular. In both cases is the mesentery afflicted in the typical manner indicating spread to local lymph nodes. By reviewing the literature the pathophysiologic mechanisms causing the anatomic changes are explained.
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PMID:[About the angiographic diagnosis of intestinal carcinoids (author's transl)]. 64 95

The cases are described of three patients with a carcinoid syndrome resulting from hepatic metastases of a carcinoid in the distal ileal tract. Treatment consisted in resection of the primary tumor and of the regional lymph-node metastases, combined with dearterialization of the liver. Apart from rapidly transient disorders of hepatic function, no postoperative complications occurred. Dearterialization should be regarded as a palliative operation and would appear to be beneficial. Optimally effective dearterialization may be achieved with the aid of peroperative angiography after the standard procedure. This will reveal any collaterals and anatomical variants that remain to be occluded. Postoperative mitigation of symptoms is the best parameter for evaluation of the efficacy of the dearterialization.
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PMID:Hepatic dearterialization for carcinoid syndrome due to liver metastases. 90 Sep 58

A report is given on two cases of metastasizing ileum carcinoid in which the arteriography of the superior mesenteric artery and the hepatic artery lead to a correct diagnosis while no clear result could be obtained by conventional X-ray examinations (gastrointestinal passage and Irigoscopy of the colon). In the first case, the vascular alterations in the lower ileum, combined with numerous hyper-vascularized metastases in the liver allowed to diagnose the primary tumor and to determine its type. In the second case, a correct diagnosis could be made alone bacuse of the specific vascular alterations indicating the carcinoid which was growing by infiltration (vascular star, missing parenchymatous charge, belated venous drainage, in the tumor region). In one case, a second primary tumor whose growth was accompanied only by little infiltration could be early diagnosed. All diagnoses were confirmed by surgical and anatomicopathological findings. In order to ameliorate the prognosis, bad until now, by an earlier diagnosis, arteriography should be used whenever a (metastasizing) small intestine carcinoid is suspected.
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PMID:[Angiographic diagnosis of small intestine carcinoids (author's transl)]. 91 3

A case is described of carcinoid tumor in the skin in which all efforts failed to discover a primary tumor in the internal organs. The possibility that this is a primary cutaneous carcinoid is discussed.
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PMID:A possible primary cutaneous carcinoid. 118 55

From 1970 until 1990, 8,958 cases of primary carcinoma of the lung were diagnosed at the Duke University Medical Center. During the same period, 126 patients (mean age, 53 +/- 13 years) were diagnosed with bronchial carcinoid. The overall survival was 78% for 5 years and 71% for 10 years. Surgical treatment in 106 patients included pneumonectomy (15), lobectomy (63 with 9 bronchoplastic procedures), stapled wedge resection (22), and bronchoscopic laser resection (6). The method of diagnosis was chest roentgenography (121), chest computed tomography (77), mediastinal tomography (31), bronchoscopy (81), bronchoscopic brushing and washing (50), bronchoscopic biopsy (40), transthoracic needle biopsy (27), thoracotomy (100), and autopsy (5). Univariate analysis of the medical history, presenting signs and symptoms, diagnostic test results, and pathologic data predicted improved survival (p less than 0.001) for: female sex (n = 58), asymptomatic presentation (n = 47), normal serum serotonin or urinary hydroxyindoleacetic acid levels (n = 76), peripheral location of the primary tumor (n = 50), pathologic stage I or II (n = 91), negative lymph nodes (n = 80), primary tumor 2 cm or less in diameter (n = 67), and typical histology (n = 80). No significance (p greater than 0.1) was observed for age, smoking history, race, family history of carcinoid, environmental exposure, or hemoptysis. The most important factors affecting survival defined by multivariate analysis were (p less than 0.01) pathologic stage, atypical histology, and asymptomatic presentation. Bronchial carcinoid tumors are unique, making up 1% to 2% of primary lung neoplasms and having an excellent prognosis after resection with a 95% 5-year and 93% 10-year survival for pathologic stage I disease.
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PMID:Bronchial carcinoid tumors: a retrospective analysis of 126 patients. 161 Feb 54

Generally, the results of liver transplantation for metastatic liver disease have not been favorable. One exception has been the unique group of neuroendocrine tumors, the slow growth of which allows liver transplantation to effectively palliate and control symptoms. We report two cases: (a) A 51-year-old man who underwent orthotopic liver transplantation and resection of the pancreatic primary tumor for a nonfunctioning malignant neuroendocrine tumor with features of both carcinoid and islet-cell glucagonoma remains symptom-free and without evidence of tumor recurrence at 13 months follow-up. (b) A 47-year-old man who underwent orthotopic liver transplantation and Whipple resection for a metastatic islet-cell tumor in the head of the pancreas is fully recovered at 5 months follow-up.
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PMID:Liver transplant for metastatic neuroendocrine tumor. 169 94


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