Cases reported "Small Cell Lung Carcinoma"

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1/11. Acute abdomen during adjuvant chemotherapy: superior mesenteric artery thrombosis associated with CMF chemotherapy.

    We report a case of superior mesenteric artery thrombosis in a 57-year-old woman undergoing chemotherapy for T1N1M0, breast cancer. Although cancer itself is associated with an increased risk of thrombotic events, treatment with chemotherapy and/or tamoxifen in breast cancer patients increases this risk. Most cases reported are of venous thromboembolism; arterial events are rare.
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2/11. pseudomyxoma peritonei.

    pseudomyxoma peritonei is a relatively rare and poorly understood condition in which mucus accumulates within the peritoneal cavity. The presence of cells in the mucin, either inflammatory or neoplastic, distinguishes it from simple acellular mucus ascites caused by mucinous spillage. There is widespread seeding of the peritoneal and omental surfaces with a heavy cancerous glaze. This is principally a complication of borderline or malignant neoplasm of the ovary and/or appendix. This paper describes two cases of previously healthy women who both presented with an acute abdomen, and were diagnosed postoperatively with pseudomyxoma peritonei. In addition, literature on the clinical presentation, diagnostic procedures, and treatment options has been briefly reviewed.
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3/11. Unusual causes of acute abdomen in a Nigerian hospital.

    Acute abdomen is the most common abdominal emergency associated with high morbidity and mortality in General surgical practice. Over a 7-year period, a study of unusual causes of acute abdomen was undertaken, with the aim of identifying these causes and outcome of operative management. Eleven cases were identified accounting for 4% of cases of acute abdomen seen during the period of the study. Four cases of liver diseases (33.3%) comprising 2 patients (16.7%) with ruptured primary liver cell carcinoma, 1 (one) case each of haemoperitoneum due to ruptured liver haemangioma and haemorrhagic disorders from liver cirrhosis. One patient had acute leukaemia with massive haemoperitoneum and acute abdomen. Five (45.5%) had gastrointestinal perforations; 1 patient (9%) each had multiple jejunal perforations, perforation of stomal ulcer at gastrojejunostomy site, perforation of gastric cancer; perforated carcinoid tumour of sigmoid colon and idiopathic perforation of the caecum. There was also a case of caecal volvulus. mortality was 7 patients (63.6%). All patients with liver pathology and acute leukaemia died. The cases of malignant tumour perforation were well and alive 4-6 years after the operation. CONCLUSION: Operation could have been avoided in 45.5% of these cases if the appropriate investigations, had been available and carried out.
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4/11. Internal hemorrhage caused by a twisted malignant ovarian dysgerminoma: ultrasonographic findings of a rare case and review of the literature.

    PURPOSE: Ovarian cancer presents as an acute abdomen very rarely. The purpose of the study is the description of a right ovarian malignant dysgerminoma presenting as an abdominal emergency. CASE: A 16-year-old white female presented with acute abdominal pain in the right iliac fossa. On physical examination the abdomen was acute and a mass in the right lower abdomen was palpated. The patient was sexually active and bimanual gynecological examination revealed the presence of a large lobulated solid tumor in the position of the right adnexa. Ultrasound examination showed the presence of a large, multilobulated, heterogeneous, predominantly solid pelvic mass. color flow imaging showed intratumoral flow signals. The uterus and the left ovary had normal size and echo-texture. Fluid was found in the cul-de-sac and in Morisson's space. An immediate exploratory laparotomy exposed the presence of a twisted right ovarian mass and intraperitoneal hemorrhage. A superficial tumoral vessel actively bleeding was seen. Peritoneal fluid was obtained for cytology. The intra-abdominal hemorrhage ceased when the ovarian pedicle was clamped. The patient underwent right salpingo-oophorectomy and biopsy of the omentum. Pathologic analysis revealed a malignant dysgerminoma of the right ovary, expanding to the mesosalpinx. Cytology was positive for malignancy. Postoperative CT scan of the upper and lower abdomen was negative. The patient was assigned to FIGO Stage IIC and referred for platinum-based chemotherapy. CONCLUSION: Ovarian malignant dysgerminoma may present as an acute abdomen because of torsion, passive blood congestion, rupture of superficial tumoral vessels and subsequent intra-abdominal hemorrhage. Ovarian dysgerminoma should be part of the differential diagnosis in a young woman with acute surgical abdomen and a solid heterogeneous pelvic mass detected by ultrasonographic scan.
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5/11. A case of metastatic squamous cell carcinoma of the hypopharynx manifesting as acute abdomen.

    INTRODUCTION: Squamous cell head and neck cancers are usually confined to local and regional sites but occasionally, patients may present with rare manifestations of distant metastases. CLINICAL PICTURE: A 23-year-old female was treated with concurrent chemo-radiotherapy for stage IVA post-cricoid squamous cell carcinoma. A month later, she presented with acute abdomen and was found to have extensive peritoneal nodules at laparotomy. intestinal obstruction soon followed. TREATMENT: She was managed conservatively for the intestinal obstruction and given weekly paclitaxel. OUTCOME: She continued to deteriorate and succumbed shortly after the diagnosis of carcinomatosis peritoneii. CONCLUSION: This rare and aggressive presentation reminds us to be cognizant of relapsed head and neck cancers manifesting atypically, and the need for more aggressive search of distant disease in at least some subgroups of head and neck cancer.
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6/11. Invasive pancreatic cancer presenting as gastrointestinal hemorrhage--a case report.

    Upper gastrointestinal hemorrhage is not uncommonly seen by the surgical practitioner. We present a case of a patient who presented with melena and syncope, who was subsequently found to have invasive metastatic pancreatic cancer as his source of bleed.
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7/11. Liver metastasis presenting as pneumoperitoneum.

    A 63-year-old man presented to the emergency department with sudden-onset abdominal pain. Chest radiography demonstrated pneumoperitoneum. At surgery, the source was found to be a ruptured hepatic abscess. Cultures grew clostridium perfringens, and biopsies confirmed metastasis of a previously resected pancreatic cancer. We document this rare cause of pneumoperitoneum and briefly review the literature on liver abscess as it relates to metastatic cancer.
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8/11. A case of bronchogenic carcinoma presenting with acute abdomen.

    Colonic metastasis of the bronchogenic carcinoma is quite rare. Here we document an extremely rare presentation of the lung cancer that presented with acute abdomen and was diagnosed as intestinal obstruction due to colon carcinoma initially. He underwent an urgent operation and the obliterating mass in the colon was resected and reported as "colon metastasis from epidermoid carcinoma probably of the lung". Afterwards bronchoscopy revealed an endobronchial lesion in the right lower lobe that was diagnosed as poorly differentiated squamous cell lung carcinoma. In this case, colon metastasis was diagnosed before the diagnosis of the primary disease.
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9/11. Bowel perforation from bevacizumab for the treatment of metastatic colon cancer: incidence, etiology, and management.

    Avastin (Bevacizumab) is a recently developed monoclonal antibody against vascular endothelial growth factor (VEGF) receptor that increases survival in patients with metastatic colorectal cancer. Bowel perforation is a known risk factor of unknown etiology associated with the use of Avastin. In this report, the incidence, risk factors, typical presentation, and management of patients with this complication is described.
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10/11. Surgical treatment of lung cancer in patients with human immunodeficiency virus.

    BACKGROUND. Since January 1986, more than 20 patients have been seen at the University of Miami/Jackson Memorial Medical Center and the Miami veterans Administration Medical Center with concurrent human immunodeficiency virus infection and bronchogenic carcinoma. Four of these patients were treated surgically with curative intent. methods. The histories, records, operative reports, and pathology reports of the 4 patients were reviewed. RESULTS. The 4 surgically treated patients had stage I T1 N0 M0 lung cancer. Three patients had T4 cell counts of less than 200/microL and were managed by lobectomy. These patients died 5, 3 1/2, and 5 months postoperatively. More recently, a fourth patient had a T4 cell count of 963/microL and was treated with wedge resection. He is currently alive 12 months postoperatively. CONCLUSIONS. It is concluded that surgically treated patients with lung cancer, human immunodeficiency virus infection, and T4 cell counts lower than 200/microL have high mortality and morbidity. Although it may be best to base surgical intervention on the stage of the patient's human immunodeficiency virus infection, further analysis is essential to determine which subgroup of human immunodeficiency virus-positive patients, if any, would benefit from surgical treatment of lung cancer.
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