1/100. Treatment of upper abdominal malignancies with organ cluster procedures.Upper abdominal exenteration for upper abdominal malignancies was carried out in 15 patients with removal of the liver, spleen, pancreas, duodendum, all or part of the stomach, proximal jejunum and ascending and transverse colon. Organ replacement was with the liver, pancreas and duodenum plus, in some cases, a short segment of jejunum. Eleven of the 15 patients survived for more than 4 months; 2 died, after 61/2 and 10 months, of recurrent tumor. Of the 9 patients who are surviving after 61/2 to 14 months, recurrent tumor is suspected in only 1 and proven in none. Four patients with sarcomas and carcinoid tumors (2 each) have had no recurrences. The other 5 survivors had duct cell cancers (3 examples), a cholangiocarcinoma (1 example), and a hepatoma (1 example). The experience so far supports further cautious trials with this drastic cancer operation.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
2/100. Malignancies in pediatric patients with ataxia telangiectasia.BACKGROUND: patients with ataxia telangiectasia (AT), known to have an inherent increased susceptibility to the development of cancer, may present with malignancies that are unusual for the patient's age, are often difficult to diagnose clinically and radiographically and respond poorly to conventional therapy. MATERIALS AND methods: We reviewed the clinical presentation and imaging studies of 12 AT patients who developed malignancies. RESULTS: Eight of the twelve patients developed non-Hodgkin's lymphoma (CNS, thorax, bone), two developed Hodgkin's disease, and two were diagnosed with gastrointestinal mucinous adenocarcinoma. CONCLUSION: The lymphomas were commonly extra nodal, and infiltrative rather than mass-like. The recognition of the tumors was often delayed due to confusion with the known infectious complications in AT patients.- - - - - - - - - - ranking = 4.1043685554105keywords = adenocarcinoma, carcinoma (Clic here for more details about this article) |
3/100. Correlation between clinical course and CEA levels during chemotherapy.In order to evaluate the correlation between clinical progress and CEA levels in gastroenteric tumours, particularly during chemotherapeutic treatment, CEA assay was performed on 330 patients (126 with gastric neoplasms, 204 with large bowel carcinoma). 175 out of these had a pre-operative assay. Moreover CEA test positivity (CEA larger than or equal to 5 ng/ml according to the technique employed by us) is higher in colon neoplasms compared with gastric neoplasms and in adenocarcinomas in comparison with undifferentiated forms; besides it depends on the pathologic stage. In colon tumours CEA test showed a higher positivity for left than for right forms (66.6% versus 38%). 240 patients were followed up with repeated CEA assays: the following observations were made: a - After radical surgery 72% of the patients shows normalized CEA values. b - In 198 patients who underwent radical surgery, not requiring chemotherapy, there was a close correlation between CEA levels and clinical evolution in 98% of the cases. c - 60 out of 68 patients (88%) submitted to chemotherapy for advanced neoplasms show a close correlation between CEA response to the chemotherapy and clinical response (p less than 0.001). These investigations stress, above all, the importance of CEA test to monitor the treatments performed (surgical and chemotherapeutic) and to adopt, eventually, more effective chemotherapeutic modalities.- - - - - - - - - - ranking = 5.1043685554105keywords = adenocarcinoma, carcinoma (Clic here for more details about this article) |
4/100. Percutaneous endoscopic duodenostomy: the relief of obstruction in advanced gastric carcinoma.nausea and vomiting in patients with advanced gastric malignancy and mechanical obstruction are distressing and difficult to manage. We describe a patient with linitis plastica and gastric stasis who was treated with a percutaneous endoscopic duodenostomy as the stomach could not be used for percutaneous endoscopic gastrostomy (PEG) formation. A Conflo PEG tube was inserted into the second part of the duodenum using the Ponsky-Gauderer technique without complication. The patient experienced excellent symptomatic relief and tolerated enteral nutrition extremely well, regaining some weight. This manoeuvre can produce effective symptom palliation allowing the patient to be managed at home during the terminal phase of their illness.- - - - - - - - - - ranking = 4keywords = carcinoma (Clic here for more details about this article) |
5/100. Amphicrine tumor.The term amphicrine refers to cells, and tumors, which show both exocrine and endocrine features. Author s aim was to analyse the characteristics of these neoplasms. 40 suspicious cases were reviewed. Mucin-stains (PAS, diastase-PAS, Stains-all, Alcian-blue), immunohistochemistry (antibodies against Neuron-Specific Enolase (NSE), and chromogranin a (CGA), and electronmicroscopic studies were performed to demonstrate exocrine and/or endocrine features of the tumor cells. By means of these methods, 16 cases turned out to be amphicrine tumors. Among them, there were 4 sinonasal, 1 bronchial, 1 mediastinal, 8 gastrointestinal and 2 suprarenal gland neoplasms. In connection to the subject, a brief review is given of amphicrine tumor, regarding its etiological and pathological aspects. These tumors form a distinct clinicopathological entity and should be separated from both neuroendocrine tumors and adenocarcinomas.- - - - - - - - - - ranking = 4.1043685554105keywords = adenocarcinoma, carcinoma (Clic here for more details about this article) |
6/100. Comparative microsatellite analysis in discerning origin of disseminated tumor: the case of a patient with malignant ascites and a history of multiple tumors.The origin of metastatic carcinoma is now always easily resolved on the basis of conventional dinical and pathological parameters, particularly in patients with more than 1 primary tumor. When 1 of the tumors is a renal cell carcinoma, the clinical picture is further confounded by the tendency of these tumors to be locally silent, to metastasize to unusual sites, and to disseminate long after removal of the primary tumor. We compared tumors for loss (ie, deletion) of loci on chromosomal arms 3p, 5q, 11q, and 18q in a patient with a malignant ascites fluid, a remote history of renal and colonic neoplasms, and a strong clinical suspicion of disseminated gastrointestinal adenocarcinoma. dna from microdissected tumors and normal tissues was subjected to polymerase chain reaction-based microsatellite analysis. Even though the clinical picture suggested a gastrointestinal origin, comparison of genetic alterations clearly showed that the malignant ascites represented recurrence of the renal cell carcinoma. The malignant ascites and the primary renal cell carcinoma showed identical patterns of allelic loss at all loci tested. In contrast, the malignant ascites and colonic adenoma showed discordant patterns of allelic loss. Comparative microsatellite analysis provides a rapid genetic approach for discerning the origin of metastatic tumor spread. This may be a useful diagnostic adjunct when tumor origin is not clear on clinical or morphological grounds. In some instances, it may even provide a reasonable alternative to an extensive and costly conventional work-up.- - - - - - - - - - ranking = 8.1043685554105keywords = adenocarcinoma, carcinoma (Clic here for more details about this article) |
7/100. circadian rhythm-modulated chemotherapy with high dose 5-fluorouracil against gastrointestinal cancers: evaluation and case report.Circadian variations in chemotherapy toxicity and antitumor effects were investigated in experimental and clinical studies. In the experimental study, Balb/c mice bearing murine colon carcinoma Colon 26 were treated with 4 injections of 5-fluorouracil (5-FU) (80 mg/kg) at 0000 Hours After light On (HALO), 0600 HALO, 1200 HALO and 1800 HALO. The antitumor effect of treatment at 0000 HALO (early resting phase) group was significantly better with lower toxicity than the 1200 HALO (early activity phase) group, resulting in significantly longer survival (p < 0.05). In the clinical study, the effect of circadian rhythm-modulated 5-FU plus leucovorin therapy was evaluated in an end-stage patient with recurrent gastric carcinoma. After continuous weekly infusion of 5-FU (1000 mg/m2/day x 2) was stopped because of its gastrointestinal toxicity, circadian rhythm-modulated chemotherapy (CRMC) was performed changing the dose of 5-FU to 666 mg/m2/day during the daytime (0500 to 1700) and to 1333 mg/m2/day from evening to night (1700 to 0500). The patient persevered with the 23 CRMC course without any signs of severe side effects and survived for nearly a year, suggesting the potential effect of CRMC in minimizing toxicity and prolonging survival.- - - - - - - - - - ranking = 2keywords = carcinoma (Clic here for more details about this article) |
8/100. Signet ring adenocarcinoma metastatic to the bronchus and mimicking goblet cell hyperplasia. A case report.BACKGROUND: goblet cells in the lower respiratory tract are metaplastic bronchial epithelial cells usually associated with asthma or chronic bronchitis. goblet cells acquire their name by a tendency to distend with mucus, with subsequent distortion in cell shape. Due to similarity of shape, metaplastic goblet cells and signet ring cells can be easily confused in cytologic samples. CASE: A 55-year-old male with a history of gastrointestinal adenocarcinoma underwent brushing, washing and biopsy of a bronchial lesion. The bronchial wash and brush samples showed a very cellular specimen, with large aggregates of distended columnar cells. These were arranged in long strips, thick bundles and occasional three-dimensional aggregates. Some aggregates contained numerous rounded cells with markedly distended cytoplasm. The rounded cells were slightly larger than the distended columnar cells. These cells had a relatively large but innocuous-appearing nucleus displaced to the periphery of the cell. The corresponding bronchial biopsy revealed signet ring adenocarcinoma, presumably metastatic from the gastrointestinal primary. CONCLUSION: Signet ring adenocarcinoma, either primary or metastatic, can be difficult to diagnose in cytologic and histologic specimens. There are numerous mimics of signet ring cells, both benign and neoplastic. In respiratory cytologic specimens, one of the benign imposters is goblet cell metaplasia.- - - - - - - - - - ranking = 28.730579887873keywords = adenocarcinoma, carcinoma (Clic here for more details about this article) |
9/100. Endosonographic examination of gastrointestinal anastomoses with suspected locoregional tumor recurrence.BACKGROUND: Endoscopic ultrasound is considered one of the best tools for the preoperative staging of esophageal, gastric, and rectal carcinoma. Depending on the individual investigator, the sensitivity of preoperative tumor staging by endosonography of the upper gastrointestinal tract (GEUS) is 80-92% for gastric carcinoma and 86-95% for esophageal carcinoma. However, the sensitivity and specificity of endosonography for the staging of lymph node metastases is less accurate. The accuracy of rectal endosonography (REUS) is approximately 90% for tumor assessment and approximately 80% for the detection of lymph node metastases. In this study, we address the question of whether endosonography enables the surgeon to distinguish scar tissue, which is rather homogeneous and echo-rich, from changes such as an anastomositis or a locoregional tumor recurrence, which are typically non-inhomogeneous and echo-poor. methods: During a 24-months period, we studied patients enrolled in a special tumor follow-up care program by either upper gastrointestinal (GEUS, n = 37 patients) or rectal endosonography (REUS, n = 49 patients) for exclusion of a locoregional tumor recurrence. In each patient, local tumor recurrence was suspected because of either medical history, clinical examination, or other diagnostic procedures. RESULTS: As in previous studies, our retrospective analysis revealed that endosonography has a high sensitivity in the detection of local tumor recurrences (>90%) for both GEUS and REUS. CONCLUSION: endosonography is a highly accurate means of detecting local tumor recurrence.- - - - - - - - - - ranking = 3keywords = carcinoma (Clic here for more details about this article) |
10/100. Local recurrence of renal cell carcinoma causing massive gastrointestinal bleeding: a report of two patients who underwent surgical resection.We report two cases of local recurrence of renal cell carcinoma, which invaded the gastrointestinal tract. The intervals to local recurrence after primary nephrectomies were 5 and 13 years. Both cases developed massive gastrointestinal bleeding. blood transfusions and arterial embolization were performed; however, continuous melena prevented improvement in their general condition. Although distant metastases were observed in both cases, tumor resections combined with intestine invasion were performed. Although this surgical approach does not significantly improve the prognosis, even in patients who have remaining metastatic lesions, it may provide palliation and improve the quality of survival.- - - - - - - - - - ranking = 5keywords = carcinoma (Clic here for more details about this article) |
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