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

An exemplary case of a 67-year-old patient with multiple cutaneous metastases of a pulmonary carcinoid primary tumor is presented. The cardinal symptom was severe painfulness of the skin tumors. With chemotherapy the tumor disease advanced. In presenting this case and providing a review of the literature, the primary importance of surgery even in the case of a metastasizing carcinoid is emphasized.
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PMID:[Clinical features and treatment of cutaneous carcinoid]. 210 26

The authors carried out a retrospective study of 32 patients (23 M, 9 F) with carcinoid tumors who were diagnosed and treated at Harlem Hospital Center, New York, from 1967 to 1988. All the patients were black and the commonest sites were the ileum (28.1%), rectosigmoid and rectum (21.9%), and the appendix and lung (15.6% each). Metastasis correlated with site, size, and depth of the primary tumor and occurred in 12 patients (38%), most frequently to the regional lymph nodes and liver. Carcinoid syndrome developed in 12.5% (3 F, 1 M). Surgical resection for cure or palliation was the mainstay of treatment. Overall 5 year survival rate was 66%, and for those with metastases was 0%. The poorer survival rates are probably related to the socioeconomic status of our patient population. The only observed racial difference compared to other series is the preponderance of males, and the disproportionately higher ratio of females with the carcinoid syndrome.
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PMID:Carcinoid tumors. 225 Apr 76

314 patients with liver metastases were admitted to the Department of Surgery. University of Angers, from 1963 to 1983. The primary sites include tumors of the colon and rectum (129 patients), pancreas (74 patients), stomach (51 patients), extrahepatic bile ducts (38 patients), esophagus (7 patients), small intestine (4 patients), ovaries (4 patients), kidney (3 patients) and 4 malignant melanomas. Surgical management of liver metastases was hepatectomy (23 cases) or wedge resection (4 cases) when metastases were solitary or multiple but unilateral, selective (2 patients), total (4 patients), temporary (4 patients), desarterialization or regional intraarterial chimiotherapy (12 patients) were performed for non resectable metastases. Most of the resections (22 cases) were done for apparently solitary metastases from colorectal cancer, while a palliative treatment was utilized for some hypervascular deposits from renal, ovarian and endocrine primary tumors. The operative mortality rate was 4 per cent (2 of 49 patients): one right, and one left hepatectomies. Nine patients survived more than 2 years after liver resection, two lived more than 4 years; the longest survival (62 months) occurred after plurisegmentectomies for carcinoid metastases. The results of palliative surgery were deceptive, 14 patients died within one year, 2 patients survived 2 years, and 1 patient had a 68 months survival after liver desarterialization for carcinoid metastases. We conclude that an agressive surgical approach in the treatment of solitary or multiple resectable liver metastases is based upon several tenets. The primary tumor, when the site is the colon or the rectum preferendly must be well differentiated, Dukes B class, especially with no evidence of extrahepatic metastases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Surgical possibilities in the treatment of hepatic metastases]. 240 48

69 patients with different tumors (colorectal, melanoma, testicle, ovary, bladder, carcinoid, lungs) were investigated by radioimmunoscintigraphy. The corresponding antibodies or their F(ab')2 fragments against CEA (n = 30), melanoma antigen (n = 25), TPA (n = 6), beta-HCG (n = 5), HMFG-2 (n = 2) and CEA/CA 19-9 (n = 1) were selected on the basis of immunohistochemical investigations of the primary tumors. The precision was 62%, and the number of false-negative findings was 32%. Additional clinical information (detection or exclusion of a suspected recurrence) could be obtained in 22 patients. From these results, it can be concluded that the corresponding tumor antibodies should be selected on the basis of immunohistochemical investigations of the primary tumor before performing radioimmunoscintigraphy to screen for recurrences or metastases.
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PMID:[Scintigraphic detection of malignancies with radioactively labelled tumor antibodies. Clinical results based on immunohistochemical research]. 243 96

Mesenteric ischemia associated with carcinoid tumors often presents with nonspecific abdominal pain and is usually due to mesenteric branch artery occlusion caused by elastic vascular sclerosis. Mesenteric ischemia was defined by the operative findings of cyanosis or infarction. Eleven patients with intraabdominal metastatic carcinoid tumor were evaluated by angiography. Angiographic narrowing and occlusion of multiple peripheral jejunal and ileal intramesenteric branch arteries was present in 3 patients with mesenteric ischemia, but also occurred in 5 of 8 patients without mesenteric ischemia. Other angiographic abnormalities included staining of the primary tumor (5) or metastases (6), tenting of small mesenteric vessels (5), and occlusion of draining mesenteric veins (2). We conclude that in patients with midgut carcinoid tumors, angiographic narrowing and occlusion of peripheral mesenteric arteries most likely represents elastic vascular sclerosis, is indicative of mesenteric invasion of tumor, but correlates poorly with the presence of ischemia in the subtended bowel. Alternatively, a normal selective arteriogram should exclude mesenteric ischemia as the cause of abnormal pain.
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PMID:Limitations of angiography for mesenteric ischemia caused by midgut carcinoid tumors. 250 47

In the Pittsburgh series of 1,000 orthotopic liver transplants (OLTx), from January 1981 to July 1987, the indication for transplantation in five patients consisted of unresectable hepatic metastases arising from endocrine tumors of gastrointestinal origin: glucagonoma, two patients; carcinoid, two, and gastrinoma, one patient. Three patients underwent resection of the primary tumor (two distal pancreatectomies and one ileal resection) at the time of the hepatic transplantation. All patients underwent extensive nodal dissection. Three of the five patients are alive with no evidence of residual disease after a median follow-up study of 12 months. Hepatic transplantation broadens the concept of radical excision of tumor and may be considered as a potential therapeutic approach for some highly selected instances of unresectable hepatic metastases arising from endocrine tumors of the intestine and pancreas.
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PMID:Transplantation of the liver for metastatic endocrine tumors of the intestine and pancreas. 253 98

The morphological examination of 228 small-cell carcinomas and carcinoids of the lung, and evaluation of carcinoid tumor cataplasia versus posttreatment survival identified well-, moderately and poorly differentiated carcinoids. Well- and moderately differentiated tumors have a favorable clinical course and prognosis, though they tend to metastasize. Poorly differentiated carcinoids are characterized by an unfavorable course which is virtually similar to that of small-cell cancer. Prognosis of both malignancies was found to depend on primary tumor size and degree of regional lymph node involvement. Treatment should be determined by histologic type and degree of tumor extension. Well- and moderately differentiated carcinoids and the locoregional form of small-cell cancer make the case for surgery (which should be a component of combination treatment in the latter case). Complex and combination therapy should be used for poorly differentiated carcinoid and extended small-cell cancer.
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PMID:[The prognosis of small-cell cancer and malignant carcinoid of the lung]. 253 66

We reviewed the computerized tomographic features of pathologically proven metastases to the ovary in 12 patients. Serial CT scans were available in nine of the 12 patients--before removal of the ovaries in five cases (showing typical growth characteristics of these metastases) and afterward in six (showing common patterns of tumor progression). Primary neoplasms metastasizing to the ovary included adenocarcinoma of the colon (seven), stomach (two), appendix (one), and endometrium (one), and carcinoid tumor (one). On CT, metastases to the ovary were large lobulated or oval masses with cystic and solid components. Nine were bilateral and three were unilateral. Three patterns of ovarian enlargement were seen: macrocystic (six), microcystic (three), and predominantly solid enlargement with necrosis (three). Other associated CT findings included carcinomatosis, hydronephrosis, ascites, liver metastases, and lymphadenopathy. The primary tumor in patients without a prior history of malignancy was identifiable retrospectively on CT in four of the five cases.
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PMID:Krukenberg tumors: CT features and growth characteristics. 215 42

An unusual case of carcinoid tumor of the ileum is presented where a metastatic deposit in the spine was removed 10 years before the primary lesion could be detected. The primary tumor was 3 cm in diameter with a hepatic metastasis, however, the patient was completely asymptomatic, and the lesions were only discovered accidentally. The discussion illustrates the diagnostic difficulties of small bowel carcinoids and that surgery as the only curative treatment has a role to play even in advanced stages. Understanding the pathological basis of this uncommon tumor is essential for the choice of most appropriate treatment.
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PMID:A carcinoid tumor of the ileum. A case report and a brief review of the relevant literature. Case report. 260 13

Eighty-two patients with pathologically proved carcinoid tumors were examined with iodine-131 metaio-dobenzylguanidine (MIBG) scintigraphy. Localization scores of I-131 MIBG accumulation in the primary tumor or metastatic site ranged from 0 to 3+ on the basis of comparison with normal liver. I-131 MIBG uptake varied greatly in different patients with carcinoid tumors. The localization scores in known tumor sites were related to the location of the primary tumor in the stomach (1-3+ in two of five patients), pancreas (1-3+ in four of five patients), cecum (3+ in two of two patients), appendix (0 in one of one patient), jejunum (0 in one of one patient), Meckel diverticulum (3+ in one of one patient), terminal ileum (2-3+ in 19 of 28 patients), bronchus (3+ in one of nine patients), thymus (1+ in one of two patients), and unknown (2-3+ in 18 of 28 patients). Tumors of midgut origin concentrated I-131 MIBG more frequently than those of foregut origin. Uptake of I-131 MIBG was more likely if neurohumor levels, particularly serum serotonin, were elevated. There was no relationship of I-131 MIBG uptake to carcinoid syndrome. I-131 MIBG is useful in the determination of the location and extent of some carcinoid tumors, particularly those of midgut origin.
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PMID:Carcinoid tumors: iodine-131 MIBG scintigraphy. 277 75


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