Gene/Protein Disease Symptom Drug Enzyme Compound
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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

Seventy-two lung and 25 liver metastases were excised after radical local removal of the primary tumor. The 5-year survival rate was 41% and the 10-year survival rate 22% for patients in whom lung metastases had been excised. After the removal of liver metastases the 5-year and 10-year survival rates were 36% and 29% respectively. It is concluded that lung or liver metastases should be excised in certain defined cases. Pathologic fractures caused by bone metastases are stabilized by palliative internal fixation. In the cases of bone metastases, cure can only be expected when they are caused by hypernephroid and thyroid carcinomas.
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PMID:[Extirpation of metastases (author's transl)]. 6 96

Carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), and carcinoplacental alkaline phosphatase (CPALP) were detected simultaneously in the sera and body fluids of two male patients with gastric carcinoma matestatic to the liver. At autopsy, widely disseminated gastric cancer of Borrmann III type with liver metastases was revealed in both bases. Histologically, they were moderately differentiated tubular and papillary adenocarcinomas with marked cellular atypia and necrosis. In Case 1, the properties of CPALP were identical to Nagao type CPALP, and in Case 2 the Variant type CPALP. Using immunofluorescence, CEA and CPALP were demonstrated in both primary and metastatic cells. However, only in Case 2 was AFP observed in some of the primary tumor cells.
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PMID:Carcinoembryonic antigen, alpha-fetoprotein and carcinoplacental alkaline phosphatase in gastric carcinoma metastatic to the liver. 7 44

Extrahepatic biliary obstruction can be caused by cancer metastatic from the colon to the lymph nodes adjacent to the bile duct. This report details our experience with eight such cases treated at the Massachusetts General Hospital in the last seven years. The interval between resection of the primary tumor and appearance of jaundice averaged 13 months. The location of the obstruction, preferably defined preoperatively by cholangiography, was low on the common duct in three cases and high in the porta hepatis in five. Relief of biliary obstruction was accomplished by biliary-enteric bypass (four cases), internal biliary stenting by permanent indwelling tube (two cases), or by portal irradiation (two cases). In addition to palliating the symptoms of obstructive jaundice, the period of comfortable survival appears to have been extended: the bypassed patients lived 13-38 months. Erosion of tumor into the duodenum, with resulting gastrointestinal hemorrhage, was an additional problem in three patients. Our overall experience illustrates the value of distinguishing this subgroup of patients from the larger number whose jaundice results from extensive liver metastases, and of treating aggressively those with extrahepatic biliary obstruction.
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PMID:Extrahepatic biliary obstruction by metastatic colon carcinoma. 8 27

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

In 90 patients with known extra-hepatic malignancy the liver was examined for metastases. The diagnostic value of clinical information, blood examinations, 99mTc scintiscan, and laparoscopy for the diagnosis of the liver metastases was evaluated. Clinical data (age, sex, time since onset of symptoms and localisation of primary tumor) are of no diagnostic value. The most reliable blood tests are alkaline phosphatase (AP) and GOT. The probability of liver metastastases rises with increasingly abnormal values of AP and GOT. However, the probability is not much greater in cases with highly abnormal values than in cases with only moderate elevation of AP and GOT. Diagnostic accuracy of AP is optimal by using a cutoff point of 76 U/l (sensitivity 79%, specificity 64%). Bilirubin, prothrombin time, haemoglobin and blood sedimentation rate are of very little value. Combinations of AP with these blood tests does not improve diagnostic accuracy. Therefore, it is not useful to determine more blood tests than AP alone. Informed reading of liver scans has a specificity of 75% and a sensitivity of 91%. Blind reading of scans has a sensitivity of 94% and a specificity of 95%. This diagnostic accuracy cannot be improved by additional blood tests. Laparscopy has a sensitivity of 85% and a specificity of 95%. Scanning and laparoscopy are complementary methods. When optimal diagnostic accuracy is required both methods should be used.
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PMID:[Liver metastases: diagnostic value of blood tests, scintiscanning, and laparoscopy (author's transl)]. 13 43

Extensive hormonal evaluation was performed in a girl with adrenal carcinoma during the primary tumor stage, following adrenalectomy, during the period when metastases were evident and while on treatment with o,p'-DDD. At the age of 14 months a diagnosis of congenital adrenal hyperplasia was made and treatment with dexamethasone (0.125 to 0.25 mg/day) resulted in a fall-off in growth rate, normal advancement in bone age, decrease in virilization and suppression of 17- ketosteroid excretion which continued until 4 3/12 years of age when virilization increased. At five years of age elevated serum and urinary androgen levels unsuppressible with dexamethasone were noted. Following removal of a large right adrenal carcinoma, serum and urinary hormone levels returned to normal. There months following surgery, liver metastases were documented associated with elevated levels of serum androgens. With o,p'-DDD treatment, serum dehydroepiandrosterone sulfate (DS) and urinary 17-ketosteroid (17-KS) excretion fell rapidly while there was a delay in the fall of free androgens. The persistence of free steroid secretion with decreased formation of DS suggests that the o,p'-DDD may have altered sulfatase activity before causing tumor necrosis and total decrease in steroidogenesis.
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PMID:Virilizing adrenal tumor in a child suppressed with dexamethasone for three years. Effect of o,p'-DDD on serum and urinary androgens. 13 87

A 64-yr-old female presented with severe osteoporosis and easy bruisability of over 2-yr duration. Biopsy of a neck mass revealed medullary carcinoma of the thyroid. Subsequently, lymphangitic pulmonary metastases were demonstrated which had been present radiographically for at least 4 yr. Basal serum calcitonin was markedly elevated and increased during calcium infusion. The diagnosis of ectopic ACTH syndrome was first entertained when hypokalemic alkalosis was observed during evaluation of her carcinoma. Elevated urinary 17-hydroxycorticosteroids, 17-ketosteroids, plasma cortisol, and immunoreactive plasma ACTH levels were documented. Adrenal steroidogenesis seemed to suppress on high dose dexamethasone. The primary tumor and its metastases contained high concentrations of immunoreactive ACTH and beta-melanocyte-stimulating hormone. Hepatic metastases contained extremely high concentrations of calcitonin. In contrast to the usual presentation of the ectopic ACTH syndrome as primarily hypokalemic alkalosis and glucose intolerance, patients with relatively benign and indolent ACTH-secreting tumors, such as certain cases of medullary carcinoma of the thyroid, may present with more typical signs and symptoms of Cushing's syndrome. The more pronounced cushingoid features in this latter group presumably reflects a more prolonged period of exposure to elevated glucocorticoid levels. Ten cases of ACTH-secreting medullary carcinoma of the thyroid from the literature are discussed. Extopic ACTH production by such tumors should be considered in the evaluation of patients with Cushing's syndrome or unexplained severe osteopenia.
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PMID:ACTH-secreting medullary carcinoma of the thyroid presenting a severe idiopathic osteoporosis and senile purpura: report of a case and review of the literature. 23 64

The complete autopsies of 145 patients dying of colorectal cancer are reviewed. Isolated local or distant metastases are infrequent, compared to disseminated disease. Solitary local recurrences are most common after resection of rectal tumors. Right colon tumors spread to local and distant sites in 90% of autopsies, and to distant sites alone in 10%. Rectal tumors spread locally only in 25% of cases, to distant site alone in 25%, and to both in 50%. Regardless of the origin of the primary tumor, the liver is the most common site of metastasis, followed by the regional lymph nodes and the lungs. Two-thirds of the patients with right colon lesions died of liver metastases, and three-quarters of those with rectal tumors succumbed to disseminated disease. The current curative and palliative treatment of recurrent colorectal cancer in clinical medicine by surgery, radiotherapy, and chemotherapy is reviewed. It is suggested that an understanding of the anatomic patterns of cancer recurrence will increase in importance as advances in the modalities of treatment are made,
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PMID:The clinical correlation of an autopsy study of recurrent colorectal cancer. 44 5

In colorectal carcinoma at the time of primary operation a much higher rate of occult micrometastases in the liver is to take in account as it is evident by the frequency of intraoperative found metastases (10--20%. Micrometastases likely can to need 3 to 8 years till they have increased so that the finally stage of generalization is to state. The survival rate of patients with colorectal carcinoma and hepatic metastases -- without therapy of metastases -- is 6 to 8 months and not differs from the survival rate of these patients whose primary tumor was inoperable by local reason. The today usual diagnostic procedures in the postoperative follow up control are able to detect liver metastases in most cases only in an inopportune stage for therapy. Probably the analysis of carcinoembryonic antigen is a progress in this question. The unique chance to block up or eliminate the frequently suspected micrometastases seems to be the general use of a post-operative adjuvant chemotherapy.
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PMID:[Incidence and prognosis of metastases in colonic and rectal carcinomas]. 49 66


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