Cases reported "Stomach Neoplasms"

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1/7. Coexistent gastric MALT lymphoma and Kaposi sarcoma in an hiv positive patient.

    A 47 year old hiv positive male presented with haematemesis and epigastric pain. A gastrectomy was performed for intractable bleeding. The cause of the haematemesis proved to be a Kaposi sarcoma of the stomach which had resulted in mucosal ulceration. Several other smaller foci of Kaposi sarcoma were also present. Coexistent with the Kaposi sarcoma was a dense lymphoid infiltrate with lymphoid follicles and reactive germinal centres. Centrocyte-like cells caused marked effacement and destruction of gastric glands with the formation of lymphoepithelial lesions, typical of a MALT lymphoma. These cells were of B cell lineage and some expressed the hiv antigen, p24. Follicular dendritic cells and macrophages within germinal centres were also p24 positive. immunohistochemistry and in situ hybridisation did not detect Epstein-Barr virus. Although helicobacter pylori was not identified by light microscopy in the sections sampled, this does not preclude its possible role, with other cofactors such as hiv, in the causation of the MALT lymphoma.
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keywords = haematemesis
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2/7. Leiomyoblastoma of the stomach.

    A case of gastric leiomyoblastoma in a 37 year old male is presented. The patient presented with 3 episodes of melaena requiring blood transfusion on one occasion. There was no associated haematemesis, abdominal pain, obstruction or a palpable lump. The tumor was sessile and completely intraluminal with superficial ulceration displaying distinctive histologic features. Seven years after partial gastrectomy the patient has remained asymptomatic.
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keywords = haematemesis
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3/7. Gastric epithelioid haemangioendothelioma: a rare cause of upper gastrointestinal bleeding.

    Vascular tumours of the stomach are rare, representing 0.9%-3.3% of all gastric neoplasms. A 58 year old man was admitted as an emergency with a one day history of haematemesis and melaena. He underwent an emergency laparotomy for a tumour in the lesser curve of the stomach. The tumour showed the characteristic histological and immunohistochemical features of epithelioid haemangioendothelioma. Surgery in the form of wide excision seems to be the treatment of choice for this rare neoplasm. This case highlights the difficulty in diagnosing this rare tumour preoperatively and emphasises the need for long term follow up in view of its uncertain metastatic potential.
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keywords = haematemesis
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4/7. Case report: octreotide as an adjunct to embolisation in the management of recurrent bleeding upper gastrointestinal metastases from primary renal cell cancer.

    The recommended treatment for patients with severe bleeding from upper gastrointestinal (GI) metastases is embolisation. We report a case in which despite adequate embolisation major haemorrhage from renal cell carcinoma (RCC) gastric metastases continually recurred. During a severe bleed refractory to embolisation octreotide was used to control and prevent further bleeding. No further episodes of severe haemorrhage occurred over the following 23 months since starting treatment. octreotide has been observed to be effective both in the acute management of persistent haemorrhage and in prevention of subsequent haematemesis from GI metastatic RCC.
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keywords = haematemesis
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5/7. Unusual presentation of choriocarcinoma. A case report.

    We report the management of a case of malignant trophoblastic disease which presented initially as a haematemesis and melaena from a gastric metastasis. The patient had had a tubal sterilization 4 years previously. The management of trophoblastic disease in general is also discussed, and the importance of chemotherapy is stressed.
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keywords = haematemesis
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6/7. Intramucosal carcinoma of the gastric antrum complicating Menetrier's disease.

    A 48-year-old man presented with haematemesis and was found to have Menetrier's disease. Three and a half years later early gastric cancer was detected at routine follow-up endoscopy. This is the first report of the development of early gastric cancer during follow-up in a case of Menetrier's disease. It is probable that patients with Menetrier's disease are at increased risk of gastric cancer, and should have regular endoscopic follow-up with gastric biopsy.
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keywords = haematemesis
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7/7. Massive lethal cerebral bleeding in a patient with melanoma without intracranial metastasis.

    The case history is reported of a patient with melanoma and advanced metastases, who died from massive cerebral bleeding. The lethal event was not caused by intracerebral metastasis but by thrombocytopenia. depression of the bone marrow resulted from tumour infiltration of the skeleton, chemotherapy and vertebral irradiation. An increase of intracranial pressure triggered the cerebral bleeding, caused by haematemesis from a gastric metastasis directly preceding sudden somnolence.
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keywords = haematemesis
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