National Cancer Institute®
Last Modified: August 1, 2002
UI - 12137849
AU - Chen CH; Cheng HL; Tong YC; Pan CC
TI - Spontaneous pyeloduodenal fistula: an unusual presentation in advanced renal transitional cell carcinoma.
SO - Urology 2002 Aug;60(2):345
AD - Department of Urology, National Cheng Kung University Hospital and Medical College, Tainan, Taiwan.
Spontaneous pyeloduodenal fistula is extremely rare. Most of the etiologies belong to chronic renal inflammatory disease, especially in patients with renal calculi. In published studies, only 2 cases have been reported in association with renal malignancy. We report a case of spontaneous pyeloduodenal fistula associated with transitional cell carcinoma, which has not been previously described in published reports.
UI - 1415098
AU - Kadakia SC; Parker A; Canales L
TI - Metastatic tumors to the upper gastrointestinal tract: endoscopic experience.
SO - Am J Gastroenterol 1992 Oct;87(10):1418-23
AD - Department of Medicine, Brooke Army Medical Center, San Antonio 78234-6200.
Metastatic tumors to the upper gastrointestinal tract were identified by esophagogastroduodenoscopy in 14 patients. Malignant melanoma, breast cancer, and lung cancer were the most common primary cancers in four, three, and three patients, respectively. Osteogenic sarcoma, renal cell carcinoma, Meckel cell carcinoma of the skin, and germ-cell tumor were the primary cancer in the remaining four. The esophagus was involved in three patients, the stomach in 13, duodenum in four, and papilla of Vater in one. Upper gastrointestinal bleeding and anemia were the most common presenting features. There was correlation between symptoms and endoscopic findings in all patients. Involvement of gastrointestinal tract at endoscopy was the initial and only evidence of metastases in all patients without evidence of metastases elsewhere, as evidenced by other diagnostic tests in any of these patients. Endoscopic biopsies and/or brush cytology provided histologic diagnosis in all 14 patients. The endoscopic and nonendoscopic literature regarding metastases to the upper gastrointestinal tract is reviewed.
UI - 12070607
AU - Kushima R; Stolte M; Dirks K; Vieth M; Okabe H; Borchard F; Hattori T
TI - Gastric-type adenocarcinoma of the duodenal second portion histogenetically associated with hyperplasia and gastric-foveolar metaplasia of Brunner's glands.
SO - Virchows Arch 2002 Jun;440(6):655-9
AD - Department of Clinical Laboratory Medicine, Shiga University of Medical Science, Seta, Otsu, Shiga 520-2192 Japan. email@example.com
We report a case of a pedunculated polyp with a focus of gastric-type adenocarcinoma arising in the opposite side of the papilla Vater of the duodenal second portion. The carcinoma was surrounded by lobules of hyperplastic Brunner's glands. Immunohistochemically the carcinoma tissue showed both gastric foveolar-type mucin ( MUC5AC) and pyloric/Brunner's gland-type mucin ( MUC6), in which proliferating cells positive for MIB-1 (Ki-67) were scattered diffusely. Most of the hyperplastic Brunner's glands were positive for MUC6, while cells toward the lumen in the superficial layer were positive for MUC5AC and MIB-1. This directional pattern of differentiation of Brunner's glands has recently been demonstrated by our group in the histogenetic course of gastric metaplasia originating directly from Brunner's glands. Therefore the present carcinoma is thought to have developed under induction of gastric-foveolar differentiation in a manner very similar to that of gastric metaplasia in hyperplastic Brunner's glands.
UI - 12170708
AU - Takashima H; Kimura H; Nakamura H; Myojo S; Okuyama Y; Sugeta N; Yagi N;
TI - Kutsumi H; Suyama Y; Fujimoto S; Hosokawa Y [A case of AFP producing endocrine cell carcinoma of the duodenum]
SO - Nippon Shokakibyo Gakkai Zasshi 2002 Jul;99(7):798-802
AD - Kyoto First Red Cross Hospital.
UI - 12170712
AU - Maeda N; Mitsuda A; Koda M; Koda M; Hosoda A; Shiota G; Murawaki Y; Suou
TI - T; Kawasaki H [A case of gastrointestinal stromal tumor of the duodenum with increased color flow signals]
SO - Nippon Shokakibyo Gakkai Zasshi 2002 Jul;99(7):820-7
AD - Second Department of Internal Medicine, Tottori University Faculty of Medicine.
UI - 12173378
AU - Luna-Perez P; Rodriguez-Ramirez SE; De la Barrera MG; Zeferino M;
TI - Labastida S Multivisceral resection for colon cancer.
SO - J Surg Oncol 2002 Jun;80(2):100-4
AD - Colorectal Service, Surgical Oncology Department, Hospital de Oncologia, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico, D.F., Mexico.
BACKGROUND: There is a lack of appropriate information in regard to the optimal treatment for colon cancer infiltrating neighboring organs. OBJECTIVES: The objective of this study is to analyze treatment results and to identify the risk factors of death by cancer in these patients. METHODS: A retrospective analysis of 40 patients with colon cancer infiltrating neighboring organs without distant metastases was carried out. Patterns of recurrence and 5-year survival were analyzed. RESULTS: The study included 20 males and 20 females with a median age of 51.5 years. Primary tumor location was as follows: right colon (n = 15); transverse colon (n = 5); left colon (n = 7), and sigmoid (n = 13). In 17 patients, the colon tumor infiltrated the abdominal wall alone or together with neighboring organs and in 23 patients, one or more neighboring organs were infiltrated. Eleven patients (27.5%) developed postoperative complications. Two patients (5%) died during the postoperative period. Microscopic tumor infiltration was demonstrated in 29 patients (72.5%). Tumor stage was as follows: T3,N0 (n = 8); T3,N+ (n = 3); T4,N0 (n = 16), and T4,N+ (n = 13). Overall 5-year survival was 45%. Multivariate analysis shows that the unfavorable risk factors for 5-year survival were neoplastic cell infiltration to neighboring organs, age > 50 years, and lymph node metastases. CONCLUSIONS: The main risk factors for cancer-related failure are neoplastic infiltration to neighboring organs, age > 50 years, and lymph node metastases. In T4 colon cancer, the recurrence pattern was found at local, peritoneal, and distant sites.
UI - 12086896
AU - Zyromski NJ; Kendrick ML; Nagorney DM; Grant CS; Donohue JH; Farnell MB;
TI - Thompson GB; Farley DR; Sarr MG Duodenal carcinoid tumors: how aggressive should we be?
SO - J Gastrointest Surg 2001 Nov-Dec;5(6):588-93
AD - Gastroenterology Research Unit and Department of Surgery, Mayo Clinic, Rochester, Minn. 55905, USA.
Duodenal carcinoid tumors are uncommon. It is not known whether they behave more like carcinoid tumors in the appendix (indolent course) or those in the ileum (often virulent)-crucial information for determining the need for radical resection. A retrospective review at our tertiary referral center (from 1976 to 1999) identified 27 patients with primary duodenal carcinoid lesions, excluding functional islet cell tumors. Endoscopic biopsy provided the diagnosis in 78% of patients. Treatment was by endoscopic excision (n = 11), transduodenal excision (n = 8), pancreaticoduodenectomy (n = 3), segmental distal duodenectomy (n = 2), or palliative operation (n = 2). One patient did not undergo operation because of comorbidity. Eighteen of 19 patients with tumors smaller than 2 cm remained disease free after local (endoscopic or transduodenal) excision. The exception was a patient with a small periampullary carcinoid lesion. In contrast, all four patients with carcinoid tumors 2 cm or larger who were resected for cure developed a recurrence (2 to 9 years postoperatively). We conclude that duodenal carcinoid tumors smaller than 2 cm may be excised locally; to ensure complete resection we recommend open transduodenal excision for tumors between 1 and 2 cm. Endoscopic follow-up is indicated. It is unclear whether patients with larger tumors benefit from more aggressive locoregional resection. Ampullary/periampullary carcinoid tumors should be considered separately, as their behavior is unpredictable.
UI - 11782611
AU - Poggi MM; Cong PJ; Coleman CN; Jaffe ES
TI - Low-grade follicular lymphoma of the small intestine.
SO - J Clin Gastroenterol 2002 Feb;34(2):155-9
AD - Radiation Oncology Sciences Program, National Institutes of Health, National Cancer Institute, Bethesda, Maryland, USA. firstname.lastname@example.org
BACKGROUND: Although the gastrointestinal tract is the most common site of extranodal non-Hodgkin's lymphoma (NHL), primary small intestine lymphomas remain relatively rare, especially localized low-grade follicular B-cell lymphomas. When lymphomas do occur at this site, most are high grade and require aggressive therapy. We report three cases of small intestinal follicular lymphoma diagnosed on endoscopic biopsy and review the clinical history, pathologic features, and treatment outcome. STUDY: A review of the medical records and pathology from three cases of small intestine follicular NHL was performed. The pathology specimens were formalin-fixed, paraffin-embedded tissues processed for routine microscopic examination, immunohistochemical staining, and molecular analysis. RESULTS: Histologic and immunophenotypical studies were diagnostic of grade 1 follicular lymphoma (Revised European-American Lymphoma classification/World Health Organization classification). All cases expressed bcl-2 protein, and polymerase chain reaction analysis supported the diagnosis in two cases with adequate DNA. With 23.3 months' median follow-up, one untreated and one treated patient were alive without symptoms; a third untreated patient died of a nonlymphoma cause. CONCLUSION: Isolated indolent lymphomas of the small intestine are rare. Accurate pathologic staging and histologic classification are paramount in delineating treatment options.
UI - 12001676
AU - Patiutko IuI; Badalian KhV
TI - [Surgical treatment of endocrine-cell tumors of hepato-pancreatic-duodenal zone (comment of the editor)]
SO - Khirurgiia (Mosk) 2002;(4):17-21
Endocrine-cell tumors of hepatopancreatoduodenal zone are rare diseases. Their rate doesn't exceed 1-4% of all tumors of this location. 79 patients with endocrine-cell tumors of hepatopancreatoduodenal zone were treated, 67 of them underwent surgical treatment (operability was 67.1%) Radical operations were performed in 45 patients (gastropancreatoduodenal resection--17, distal resection of the pancreas--16, tumor enucleation--5, hemihepatectomy--3, liver resection--4). Prognosis of endocrine-cell tumors of hepatopancreatoduodenal zone is relatively favorable. In radically operated patients the presence of metastases to lymph nodes doesn't influence long-term results which are better than ones of chemo- or radiotherapy. Correlation between long-term results of surgery and age of patients, tumor sizes and its histologic structure was not revealed. Radicality of surgery is the only factor influencing prognosis. It is necessary to expand indications for extended operations, and to perform multi-stage operations in some cases of recurrences.
UI - 11972225
AU - Izzidien AY; Davies RA; Masoud AG; Kibru S; Abuhamed A; Lodhi JS; Abid
TI - G; Jouanroyee A The use of ultrasound to demonstrate small bowel polyps in a patient with Peutz-Jeghers syndrome.
SO - Surg Endosc 2002 Apr;16(4):715
AD - Department of Surgery, Prince Charles Hospital, Merthyr Tydfil CF47 9DT, Wales, UK. email@example.com
A 21-year-old woman presented to the accident and emergency department with a 2-day history of lower abdominal pain. Her lips had the stigma of melanosis. Previously, she had received a diagnosis of Peutz-Jeghers syndrome, although no polyps had been detected in small and large bowel barium studies performed approximately 8 years before. Clinically, the patient had mild deep lower abdominal tenderness, and a mass was palpable in the suprapubic region. Urgent ultrasound showed ileoileal intussusception and small polyps in the lumen of the small bowel. At laparotomy, ileoileal intussusception was confirmed. It was not possible to reduce it because of nonviable small bowel, so 20 cm of the ileum, including the intussusception, was excised. After this, intraoperative enteroscopy was performed, showing further polyps in the small bowel distal and proximal to the intussusception, which were excised locally. Only a few reports in the literature describe ultrasound used to diagnose to condition. Intraoperative enteroscopy has been recommended as the treatment of choice because it allows identification of polyps that previously would have been missed.
UI - 12053225
AU - van Geenen RC; Keyzer-Dekker CM; van Tienhoven G; Obertop H; Gouma DJ
TI - Pain management of patients with unresectable peripancreatic carcinoma.
SO - World J Surg 2002 Jun;26(6):715-20
AD - Department of Surgery, Academic Medical Center, Meibergdreef 9, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
In patients with unresectable peripancreatic carcinoma, pain is generally treated with pain medication or with a celiac plexus blockade. Radiotherapy has also been reported to reduce pain. The efficacy of these treatment modalities is still under discussion. The aim of this study was to analyze the effects of the various types of pain management on patients who underwent palliative bypass surgery for unresectable 1998 a series of 98 patients underwent palliative bypass surgery, mostly for unresectable disease found during exploration. Patients were divided into three groups: palliative bypass surgery (BP), palliative bypass surgery with an intraoperative celiac plexus blockade (CPB), and palliative bypass surgery with or without celiac plexus blockade followed by high-dose conformal radiotherapy (RT). Radiotherapy was performed only in selected patients with locally advanced disease and without metastases, implying a better prognosis of the last group. The pain medication consumption, pain medication-free survival, hospital-free survival, and overall survival were analyzed. The preoperative consumption of pain medication was significantly higher in the CPB group than in the BP or RT group. The postoperative consumption of pain medication in the CPB, BP, and RT groups increased during follow-up from 15%, 17%, and 13% before surgery to 52%, 57%, and 46%, respectively, at three-fourths of the survival time (NS). This increase in consumption of pain medication was not different in the three groups. In the RT group the median pain medication-free survival was significantly longer than in the BP or CPB group (9.3 vs. 3.1 and 3.3 months; p = 0.02). The median hospital-free survival and median overall survival were significantly longer in the RT group than in the CPB group (10.3 vs. 6.8 months, p = 0.01; and 7.1 vs. 10.8 months, p = 0.01). Celiac plexus blockade as pain management did not result in an increase of the pain medication-free survival or overall survival. Therefore a positive effect of a celiac plexus blockade on pain could not be confirmed in the present study. Radiotherapy resulted in increased pain-medication survival, hospital-free survival, and overall survival compared to celiac plexus blockade. These effects are probably partly related to patient selection.
UI - 12192021
AU - Anonymous
TI - Case record of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 26-2002. An 87-year-old woman with abdominal pain, vomiting, bloody diarrhea, and an abdominal mass.
SO - N Engl J Med 2002 Aug 22;347(8):601-6
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