National Cancer Institute®
Last Modified: September 1, 2002
UI - 12126355
AU - Sarkar N; Kejariwal D; Roy S
TI - Isolated duodenal metastasis from breast carcinoma.
SO - J Assoc Physicians India 2002 Jul;50():962-3
AD - Department of Medicine, IPGMER and SSKM Hospital, Calcutta.
Small bowel neoplasms comprise 0.1% of all malignancies. Of these one-third are duodenal, mainly primary. Isolated duodenal secondaries arising on account of haematogenous spread is rare. Our case of duodenal obstruction due to an isolated duodenal metastasis as a result of haematogenous spread from breast carcinoma is unique in the literature.
UI - 11873636
AU - Ansalone M; Aragiusto G; Romagnuolo G; Scardi F; Damiano I; Ambrosino F;
TI - Giovine S [Upper gastrointestinal hemorrhage of unusual etiology: clinical case and technical note]
SO - G Chir 2001 Nov-Dec;22(11-12):385-8
AD - Unita Operativa di Chirurgia d'Urgenza e Pronto Soccorso, Azienda Ospedaliera di Rilievo Nazionale A. Cardarelli, Napoli.
The Authors report a case of upper digestive tract haemorrhage at atypical side, the diagnosis being often difficult as well as therapeutical options, particularly referent to the surgical solutions adopted.
UI - 11890346
AU - Ajisaka H; Fujita H; Kaji M; Maeda K; Yabushita K; Konishi K; Uchiyama
TI - A; Miwa A Treatment of patients with gastric cancer and duodenal invasion.
SO - Int Surg 2001 Jan-Mar;86(1):9-13
AD - Department of Surgery, Toyama Prefectural Central Hospital, Japan.
We retrospectively examined clinicopathologic features of gastric cancer with duodenal invasion to clarify the effect of surgical treatment that include pancreaticoduodenectomy (PD). Among 2504 patients with gastric cancer, 69 (2.8%) who had gastric cancer and duodenal invasion resected by surgical treatment were investigated. The mode of the duodenal invasion was grouped into three categories: mucosal type, submucosal type, and nodal type. Mucosal type is invasion of the duodenal mucosal layer, submucosal type is invasion of the submucosal layer or deeper, and nodal type is invasion from nodal metastatic lesions around the pancreatic head. The 5-year survival rates of curative PD and curative gastrectomy were 37.3% and 33.8%, respectively. Despite the incidence of adjacent tissue infiltration and significantly higher duodenal invasion average length in cases with PD than in cases with gastrectomy, there was no significant difference in the survival curves. However, the prognoses of the cases with nodal-type invasion were significantly poorer, and all these patients died within 2 years, regardless of whether curative PD had been performed. Curative PD improves the prognosis of cases with long duodenal invasion or pancreas infiltration except for nodal-type duodenal invasion.
UI - 12085045
AU - Iwasaki Y; Tagaya N; Tomita S; Fujimori T; Kubota K
TI - Primary ileal mucinous adenocarcinoma.
SO - Gastrointest Endosc 2002 Jul;56(1):111
AD - Dokkyo University School of Medicine, Tochigi, Japan.
UI - 11091248
AU - Morii Y; Arita T; Shimoda K; Yasuda K; Matsui Y; Inomata M; Kitano S
TI - Jejunal interposition to prevent postgastrectomy syndromes.
SO - Br J Surg 2000 Nov;87(11):1576-9
AD - Surgery Division, Arita Gastrointestinal Hospital, Oita, Japan.
BACKGROUND: Postgastrectomy syndromes include reflux gastritis and oesophagitis, dumping syndrome, intractable diarrhoea and afferent loop interposition has been used following distal gastrectomy. The aim of this study was to evaluate the benefit of this procedure. METHODS: A consecutive series of 42 patients who underwent distal gastrectomy for gastric cancer was studied. Twenty-two patients had a Billroth I RESULTS: The mean operating time was 260 min for Billroth I and 352 min for jejunal interposition. No serious postoperative complications arose. Reflux gastritis occurred in 19 patients after Billroth I but in none after jejunal interposition. Five patients in the Billroth I group had complaints consistent with dumping syndrome, compared with none after jejunal interposition. The barium gastric emptying time was significantly shorter after Billroth I (mean(s.d.) 269(225)s) than after jejunal interposition (736(479) s) (P < 0.01). CONCLUSION: Jejunal interposition prevented reflux gastritis and inhibited rapid gastric emptying. Postgastrectomy syndromes were effectively prevented by this reconstruction procedure.
UI - 12151696
AU - Pranesh N
TI - Lymphoma in an ileostomy.
SO - Postgrad Med J 2002 Jun;78(920):368-9
AD - Department of Surgery, Milton Keynes General Hospital, Standing Way, Eaglestone, Milton Keynes MK6 5LD, UK. firstname.lastname@example.org
Lymphoma developing in an ileostomy is an extremely rare complication. The presentation is similar to the commoner, yet still rare, adenocarcinoma but the staging and management of the condition differs.
UI - 12169995
AU - Christodoulou D; Skopelitou AS; Katsanos KH; Katsios C; Agnantis N;
TI - Price A; Kappas A; Tsianos EV Small bowel adenocarcinoma presenting as a first manifestation of Crohn's disease: report of a case, and a literature review.
SO - Eur J Gastroenterol Hepatol 2002 Jul;14(7):805-10
AD - Department of Internal Medicine, Hepato-Gastroenterology Unit, School of Medicine, University of Ioannina, Ioannina 451 10, Greece.
Small bowel Crohn's disease has been related to an increased incidence of small bowel adenocarcinoma, but the total number of reported cases is small. We present an interesting case of a young male patient with nephrolithiasis in childhood, an atypical intermittent history of diarrhoea also since his childhood, who developed obstructive ileus and underwent an urgent operation. The operation revealed a stenosis of the ileum owing to a mass, which proved to be a small bowel adenocarcinoma. One month later, the patient underwent a curative surgical resection of the tumour with additional lymphadenectomy, followed by chemotherapy for 6 months. Since then, the patient had mild diarrhoea but enteroclysis was normal. Approximately 2 years after the resection of the tumour, a new ileocolonoscopy demonstrated deep ulcerations of the terminal ileum and the adjacent area of the colon as well as anal ulcerations. The new biopsy specimens were convincing for Crohn's disease. There were no signs of residual or relapsing cancer. There is growing evidence that Crohn's disease is one of the triggering factors for the development of small bowel adenocarcinoma. Underlying Crohn's disease should be suspected in a young patient with an atypical history of diarrhoea and small bowel adenocarcinoma.
UI - 11941295
AU - Russo A; Buccianelli E; Aloise F; Veltroni A
TI - [Malignant carcinoid of the last ileal ansa. Report on 2 consecutive clinical cases]
SO - Minerva Chir 2002 Apr;57(2):203-11
AD - Area a Gestione Sperimentale della Valdinievole, Unita Operativa di Chirurgia Generale, ASL n. 3, Pistoia, Presidio Ospedaliero SS. Cosma e Damiano, Pescia (Pistoia), Italy.
Carcinoid tumors are very rare neoplasms, arising from enterochromaffin cells, classified in Apud system, exhibiting an intermediate malignancy, because of their long lasting clinical silence and low evolution to advanced stage. At the same time, these features unfortunately cause a high incidence of lymphatic and liver metastases, visible at first diagnostic approach, which are also determined by aspecific symptoms and signs, especially involving jejunal and ileal carcinoids, as the two cases described, and by very frequent absence, in current clinical practice, of pathognomonic carcinoid syndrome. Two carcinoids located into the distal ileal ansa, strictly adjacent to the ileocecal valve, are reported; the first tumor, accompanied by lymphonodal positivity, the second by a solitary hepatic metastasis, requiring segmentectomy of the liver, in addition to right hemicolectomy.
UI - 12142981
AU - Dorffner R; Neumann C; Gergely I; Stimakovits J; Renner R
TI - [First experience with a non-covered CHOO enteral stent in the stomach,duodenum, and jejunum]
SO - Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 2002 Aug;174(8):1018-21
AD - Rontgenabteilung, Osterreich, Germany.
AIM: To evaluate the technical performance of the non-covered CHOO enteral stent in the stomach, duodenum and jejunum. METHODS: In 8 patients (two men, 6 women) with malignant tumors of the stomach (n = 4), duodenum (n = 3) and jejunum (n = 1) stent implantation was performed under fluoroscopic control. In two patients endoscopy was needed additionally. The patients were followed for 1 to 168 days. RESULTS: Stent implantation was technically successful in 7 of 8 patients. In 6 patients symptoms improved. In two patients a second stent implantation was necessary 35 and 161 days after primary implantation, respectively. There was no stent migration or tumor ingrowth. CONCLUSION: The implantation of the non-covered CHOO enteral stent into the upper gastrointestinal tract is safe and effective.
UI - 12122722
AU - Giuly J; Monges B; Picaud R; Giuly D; Leroux C; Cat RN
TI - [Recklinghausen's disease and gastrointestinal stromal tumors]
SO - Ann Chir 2002 Jun;127(6):477-9
AD - Clinique Fallen, boulevard Val-Pre, 13400 Aubagne, France.
Gastro-intestinal stromal tumors associated with Recklinghausen's disease should be considered in the current concept of the stromal tumors with reference to recent advances in immuno-chemistry. In this setting, there is an high potential of maluignancy. For the treatment of these lesions, surgery is the main tool. Frequency of malignant digestive diseases associated with Recklinghausen disease should be kept in mind.
UI - 12164092
AU - Lee JG; Kim JS; Kim HJ; Kim ST; Yeon JE; Byun KS; Kim JS; Bak YT; Lee CH
TI - Simultaneous duodenal and colon masses as late presentation of metastatic renal cell carcinoma.
SO - Korean J Intern Med 2002 Jun;17(2):143-6
AD - Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea.
We report a case of pathologically proven simultaneous duodenal and colonic metastases about four years after nephrectomy for mixed clear and granular cell type renal cell carcinoma (RCC). A 76-year-old female patient who had undergone a left radical nephrectomy 4 years previously for RCC presented with a 1-month history of dyspepsia and pain in the right upper abdomen. An abdominopelvic CT scan showed circumferential wall thickening with high enhancement at the second portion of the duodenum and additional enhancement of an irregular protruding mass into the lumen of the ascending colon. A gastroscopy showed a large and ulcerative protruding mass nearly obstructing the second portion of the duodenum. A colonoscopy revealed a polypoid, nodular and purplish mass in the ascending colon. Microscopy of the biopsy specimen showed the features identical to those of the RCC which was resected 4 years earlier in this patient. We believe this to be the first case illustrating a metastatic renal cell carcinoma as simultaneous duodenal and colon masses.
UI - 12202676
AU - Chim CS; Lam CC; Nicholls JM; Ooi GC; Kwong YL
TI - Unusual hematologic malignancies. Case 3. CNS involvement in CD56-positive intestinal gamma/delta T-cell lymphoma.
SO - J Clin Oncol 2002 Sep 1;20(17):3742-4
AD - Queen Mary Hospital, Hong Kong.
UI - 12145603
AU - Norton ID; Gostout CJ; Baron TH; Geller A; Petersen BT; Wiersema MJ
TI - Safety and outcome of endoscopic snare excision of the major duodenal papilla.
SO - Gastrointest Endosc 2002 Aug;56(2):239-43
AD - Developmental Endoscopy Unit, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota 55902, USA.
BACKGROUND: The optimal management of adenoma of the major duodenal papilla is not established. Options include surgical excision, endoscopic ablative techniques, snare excision, and observation with periodic biopsies. The aims of this retrospective study were to determine the safety and outcome of snare excision of the papilla. METHODS: Twenty-eight snare excisions of the papilla were performed in 26 patients. Sixteen had familial adenomatous polyposis. In 22 procedures, a minisnare was used, and in 6 cases a prototype snare was designed for excision of the papilla. Pancreatic stents were placed as a prophylactic measure at the discretion of the endoscopist (n = 10). RESULTS: Histopathologically, resected tissue included 25 adenomas, 1 inflammatory polyp, 1 invasive malignancy, and 1 normal papilla. Immediate complications were minor bleeding (n = 2), mild pancreatitis (n = 4) and a duodenal perforation (n = 1). The presence (n = 10) or absence (n = 18) of a pancreatic stent did not correlate with subsequent pancreatitis (2 in each group, p = NS). Follow-up was available for 21 patients (median, 9 months; range, 2-32 months). Pancreatic duct stenosis at the papillectomy site resulted in pancreatitis in 2 patients (17%) at, respectively, 4 months and 24 months. Follow-up endoscopy revealed recurrent/residual adenomatous tissue in 2 (10%). CONCLUSIONS: Snare excision of the major duodenal papilla was well tolerated. Most complications were mild except for a small duodenal perforation. Stenosis of the pancreatic duct orifice with pancreatitis may be a late complication.
UI - 12074083
AU - Chrysos E; Athanasakis E; Vassilakis JS; Zoras O; Xynos E
TI - Total colectomy and J-pouch ileorectal anastomosis for obstructed tumours of the rectosigmoid junction.
SO - ANZ J Surg 2002 Feb;72(2):92-4
AD - Department of General Surgery, University Hospital of Heraklion, Medical School, University of Crete, Greece. email@example.com
BACKGROUND: Subtotal colectomy with ileosigmoid or ileorectal anastomosis is one of the standard procedures for obstructed tumours of the left colon. The lower the level of the anastomosis, the greater the number of bowel motions per day. The aim of the present study was to assess whether an ileal pouch-rectal anastomosis is associated with fewer bowel motions per day. METHODS: In four patients with obstructed carcinoma of the rectosigmoid junction and upper rectum, a total colectomy with removal of the upper rectum for adequate tumour clearance was used, followed by construction of a 10 cm ileal J-pouch that was subsequently anastomosed to the distal rectal stump. RESULTS: Postoperative recovery was uneventful in all patients. At 3 months postoperatively, anorectal manometry showed anal resting and squeeze pressures at lower normal limits and a neorectal capacity ranging from 160 to 310 mL. One year postoperatively, all patients experienced one to three normal bowel motions daily and no episodes of incontinence. CONCLUSIONS: Total colectomy with ileal J-pouch-rectal anastomosis is a reasonable operative alternative in cases with obstructed tumours of the rectosigmoid junction, which necessitate removal of the upper rectum.
UI - 12185648
AU - Padilla D; Cubo T; Garcia M; Ortega G; Ramia JM; Martin J; Pardo R;
TI - Lopez A; Hernandez Calvo J [Clinicopathological and immunohistochemical characteristics of stromal sarcoma of the duodenum]
SO - Rev Esp Enferm Dig 2002 Feb;94(2):104-5
UI - 12145671
AU - Diculescu M; Atanasiu C; Arbanas T; Croitoru A; Mihalcea A; Becheanu G;
TI - Costinean S; Gheorghe L; Capsa R Chemoembolization in the treatment of metastatic ileocolic carcinoid.
SO - Rom J Gastroenterol 2002 Jun;11(2):141-7
AD - Centre of Gastroenterology and Hepatology, Fundeni Clinical Institute, Sos. Fundeni no. 258, 72437 Bucharest, Romania.
Carcinoid tumours are enigmatic, slow growing malignancies, which occur most frequently (74%) in the gastrointestinal tract. Symptoms of the carcinoid syndrome (flushing and diarrhoea) are infrequent, occurring in approximately 10% of the patients with small bowel carcinoid. A 45-year-old patient with multiple liver metastases, diagnosed in 1994 with nonHodgkin's lymphoma after undergoing surgery for a distal ileal tumour, was referred to us by the Department of Haematology. At that moment the issue of a differential diagnosis with a carcinoid tumour arose, due to the long evolution and lack of evidence to support the initial diagnosis. The carcinoid syndrome was in fact present (the patient experiencing flush after small amounts of alcohol and emotions) and also we identified elevated values of 5HIAA. Reevaluation of the histologic sections of the ileal tumour as well as an ultrasound guided fine needle aspiration of an intrahepatic lesion confirmed the diagnosis of "carcinoid tumour". This conclusion lead to new therapeutic options for this patient. One of the main therapeutic options used in treating multiple liver metastases from a carcinoid tumour is chemoembolization and this case offered an excellent opportunity to present this therapy.
UI - 12195006
AU - Van Eeden S; Nederlof PM; Taal BG; Offerhaus GJ; Van Velthuysen ML
TI - A tumour with a neuroendocrine and papillary serous component: two or a pair?
SO - J Clin Pathol 2002 Sep;55(9):710-4
AD - Academic Medical Center, Department of Pathology, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. S.firstname.lastname@example.org
AIMS: To examine the clonal origin of a tumour, made up of a neuroendocrine component and a papillary serous component by comparing the pattern of loss of heterozygosity (LOH) and the immunohistochemical protein expression of both components. METHODS/RESULTS: A 70 year old woman, known to have a metastasised neuroendocrine carcinoma, underwent resection of the distal part of the ileum because of obstruction by a mesenterial mass. The macroscopically homogeneous mesenterial mass consisted histologically of an admixture of a neuroendocrine component and a papillary serous carcinoma. Loss of heterozygosity (LOH) analysis of both components with a panel of 15 polymorphic microsatellite markers showed a distinctive pattern of LOH, and both components showed LOH on chromosome 4q and 17, but involving different alleles at the same locus. Moreover, both components showed different immunohistochemical staining patterns for neuroendocrine markers, cytokeratin 7, carcinoembryonic antigen, and CA125. CONCLUSION: Both LOH analysis of the neuroendocrine and papillary serous components of this tumour and the immunohistochemical profile of both components are consistent with a different clonal origin. The tumour is probably a collision tumour, in which the papillary serous carcinoma must have been of peritoneal origin because necropsy revealed a normal uterus and normal ovaries.
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