Cases reported "Meningeal Carcinomatosis"

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1/9. carcinoma of the colon in children: a report of six new cases and a review of the literature.

    Of six children with carcinoma of the colon, none had ulcerative colitis or a family history of carcinoma of the colon or colonic polyposis. In 75 cases traced in the literature, a common early symptom of carcinoma of the colon in children is acute, crampy abdominal pain. At laparotomy for suspected appendictis, the possibility of the acute pain being due to carcinoma of the colon should be borne in mind. Otherwise the symptoms of carcinoma of the colon in children do not differ substantially from those in adults. The prognosis is unfavorable; in only 2.5% of the cases on record did the children survive 5 yr after the operation.
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2/9. adult Wilms' tumor presenting as acute abdomen with elevated serum lactate dehydrogenase-4 and -5 isoenzymes: case report.

    Wilms' tumor, an embryonic neoplasm, is the most frequent renal tumor in childhood but is rare in adults. The prognosis of adult Wilms' tumor is worse than pediatric Wilms' tumor. The preoperative diagnosis of adult Wilms' tumor is extremely difficult to make because diagnostic imaging techniques, such as intravenous pyelography, computed tomography, ultrasound, renal angiography, and nuclear magnetic resonance imaging, only confirm the presence of a renal mass. diagnosis usually depends on histological characteristics, such as the presence of blastemic, epithelial, and mesenchymal components. A 27-year-old female presented with acute abdomen and with elevated serum lactate dehydrogenase (LDH) at 212 U/l (normal range: 47-140), and 2 of 5 LDH isoenzymes, namely LDH-4 at 13.6% (normal range: 6.8%-10.2%) and LDH-5 at 20% (normal range: 6.5%-9.7%). In this patient, stage I Wilms' tumor was managed by radical nephrectomy. The levels of LDH returned to its normal range. In conclusion, in cases of acute abdomen with a renal mass in young adults, the possibility of Wilms' tumor should be considered. serum LDH and its isoenzymes, LDH-4 and LDH-5, could be used as tumor markers for either differential diagnosis or monitoring the response of treatment.
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3/9. A case of "silent" pheochromocytoma presenting as spontaneous retroperitoneal hematoma.

    pheochromocytoma of the adrenal gland can be the cause of massive and lethal retroperitoneal haemorrhage presenting as acute abdomen. Here we report a case of retroperitoneal hematoma, with concomitant peritoneal spillage, due to the spontaneous rupture of a silent pheochromocytoma. The main clinical findings of this disease will be described. Therapy and prognosis will be also discussed.
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4/9. Meckel's diverticulitis secondary to carcinoid tumor: an unusual presentation of the acute abdomen in an adult.

    This case reports the concomitant findings of carcinoid tumor within a Meckel's diverticulum presenting as an acute abdomen in an adult male. Most Meckel's diverticula remain asymptomatic throughout life, and symptomatic diverticula are virtually nonexistent in older adults. Meckel's diverticulitis is clinically indistinguishable from acute appendicitis, and abnormal or symptomatic diverticula are generally resected. Surgical treatment of Meckel's diverticula is recommended for children during exploration. However, resection is controversial in asymptomatic adults. Carcinoid tumors are the most common primary tumor of the small bowel. The duration of symptoms before diagnosis varies from 2 to 20 years, and half of all patients have incurable abdominal disease at first-look surgery. Metastatic events occur most commonly in the liver with a generally poor prognosis. Surgical resection is the treatment of choice. Both Meckel's diverticula and carcinoid tumor are rare clinical entities, and carcinoid tumors occurring within a Meckel's diverticulum are even more uncommon. Thus, the natural history is difficult to predict and treatment recommendations vary. Solitary, localized, asymptomatic nodules less than 1 cm are generally managed with diverticulectomy or segmental resection. Larger or multiple lesions require wide excision of bowel and mesentery, and hepatic resection may be required for metastatic disease.
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5/9. Small bowel intussusception due to metastatic malignant melanoma. A case report.

    Small bowel metastatic deposits attributed to malignant melanoma are found in 2-5% of patients with malignant melanoma of the skin. Ileo-ileo intussusception caused by metastatic melanoma is a very rare condition. The prognosis of metastatic melanoma is poor. We report a case of a cutaneous malignant melanoma which metastasised to the small bowel causing enteroenteric intussusception. This case refers to a 66-year-old male patient who underwent surgery for suspected enteric intussusception. This diagnosis was suggested by computer tomography scan. The patient had had previous surgery for a primary malignant melanoma in the eyelid of the right eye. Segmental intestinal resection with regional lymph node dissection and ileo-ileo anastomosis was performed. Metastatic melanoma in the gastrointestinal tract should be suspected in patients with history of melanoma of the skin and acute gastrointestinal symptoms. Immediate laparotomy and excision of the affected bowel segment is the appropriate treatment.
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6/9. Abdominal crisis due to metastasizing lung carcinoma to the small bowel.

    A rare case of small-bowel perforation due to metastasizing primary bronchogenic carcinoma is reported. A 64-year-old man presented with acute abdominal crisis from perforation of a metastatic focus in the wall of the small intestine. A 13-cm segment of small bowel, containing a firm mass which surrounded a 1.0 X 2.0-cm perforation, was resected. Because of widespread metastases, the patient received only palliative treatment. He died 27 days after admission. Perforation of a metastatic focus in the small bowel is considered a late complication of carcinoma and indicates a very poor prognosis. This is only the eighth reported case of such a complication of metastasizing lung carcinoma.
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7/9. intestinal obstruction at the onset of acute lymphoblastic leukemia in a child.

    Surgical complications need not be fatal in acute leukemia. If these are promptly diagnosed and properly treated, the prognosis will improve. This report deals with a case of acute lymphoblastic leukemia presenting with an acute abdomen following surgery for choledochal cyst. A peripheral blood smear and examination of the bone marrow revealed acute lymphoblastic leukemia. The child received transfusions of blood and platelets. Pretreatment with prednisolone was started as therapy for leukemia, and 2 days later, the patient underwent surgery. Therapy was continued until the general condition allowed a more aggressive form of treatment. Complete remission was achieved, and the patient is still in good health 48 months after diagnosis and 15 months after discontinuation of treatment. The favorable outcome in this child shows that prompt surgery is sometimes an essential step in the treatment of childhood leukemia.
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8/9. emergency treatment of the complications of giant liver hemangiomas.

    The authors discuss the problems of emergency treatment of cavernous hemangiomas of the liver. Five cases were observed and treated with different techniques, ligation of the hepatic artery, excision of the mass, embolization of the hepatic artery. The results of these procedures were strongly influenced by the patient's previous state. Treatment was successful in three patients, while the procedure adopted was able to stop the hemorrage in the other two patients. The physical state was very important for the prognosis; the two patients arriving at our Institute in deep shock both died.
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9/9. diagnosis and outcome of bowel infarction on an acute medical service.

    Twenty patients with surgically or pathologically documented bowel infarction are compared with seven patients who were believed to have bowel infarction but had negative findings at laparotomy. The presentation of verified bowel infarction was nonspecific; abdominal pain, tenderness, and distension were the most common, occurring in 15 patients. No physical finding or laboratory test distinguished bowel infarction from mimicking conditions. patients in both groups had an extremely poor prognosis. An approach to management is suggested.
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