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At least 433 records · Page 24Linked to original sources
PubMed1994

[The perforation of the small intestine into the free peritoneum revealing Crohn disease].

A new case of Crohn's disease was discovered due to a perforation of the small bowel into the free peritoneum. We recall the epidemiological, clinical and pathogenic features of this rare incident. On the basis of the data in the literature, we propose a discussion of the surgical techniques used. Resection appears to be preferred Anastomosis is usually performed later except in exceptional selected cases.

Anastomosis, Surgical↗
PubMedDate not supplied

Surfactant protein A and lamellar bodies: a homologous secretory function of peritoneum, synovium, and lung.

OBJECTIVE: To review recent discoveries on the existence of lamellar body secreting cells in extrapulmonary sites with respect to their constitution as a previously unrecognized coherent biological system and to evaluate the role of mesothelial research in peritoneal dialysis in initiating this new field of medical research. DATA SOURCES: Studies in the literature on the production and metabolism of pulmonary surfactant with respect to lamellar bodies and surfactant protein A (SP-A). Published investigations on the identification of lamellar bodies and SP-A in extrapulmonary sites and their possible role in systemic expression of autoimmune disorders. RESULTS: It is now established that lamellar bodies of identical periodicity and ultrastructural geometry are present in lung (type II pneumocytes), serosal mesothelium (peritoneum, pleura, and pericardium), and joints (type A and type B synoviocytes). Not only pulmonary lamellar bodies but those at extrapulmonary sites are found in association with SP-A, while SP-A or SP-A-like proteins are present in measurable quantities in normal serosal fluids. These findings have disclosed totally new avenues of research into multisystem disorders, where for the first time an organelle and associated protein provide a link between diverse tissues affected by rheumatoid disease. Evidence of shared epitopes between SP-A and mycobacterial 65-kD heat shock protein indicates a possible etiologic mechanism. CONCLUSIONS: A hitherto ultrastructurally hidden system of lamellar body secretion is now being revealed as a major biological system which appears to subserve surfactant, lubricant, surface protection, and sealant functions in body surfaces and tissue interfaces. This new frontier was born out of investigations into the hitherto neglected biology of peritoneal mesothelium, research which was vital for advancing the therapy of peritoneal dialysis and for preservation of the dialyzing membrane.

Autoantigens↗
PubMed1976

[Use of heterogenic peritoneum in surgical treatment of ankylosis of the temporomandibular joint].

Thirty patients were operated upon after the authors' technic. In 23 patients the mandibular branch was made thinner after the method described, and caps from the heterogenous tissue were employed. The mandibular motion was found to be quite adequate, terms of the follow-up from 2 to 18 years. In 7 patients oblique osteotomy of the mandibular branch was performed with interposition of the fissure with a heterogenous peritoneum leaf. The mandibular motion was satisfactory.

Animals↗
PubMed1996

Syndrome of inappropriate antidiuretic hormone secretion in papillary serous surface carcinoma of the peritoneum.

A case of syndrome of inappropriate antidiuretic hormone secretion (SIADH) in a patient with suboptimally cytoreduced stage III papillary serous surface carcinoma of the peritoneum is described. After the primary surgery, the patient refused further therapy. Within a month bilateral pleural effusions and abdominal ascites compelled the patient to accept treatment with carboplatin and cyclophosphamide. Ten days following the chemotherapy, she was admitted in a disoriented state with serum sodium of 117-mEq/L. During the evaluation, treatment, and subsequent follow-up, the diagnosis of SIADH was confirmed. Numerous disease processes have been associated with the development of SIADH; however, there have been few reports in gynecologic malignancies. Possible etiology and clinical management of this patient are briefly discussed.

Aged↗
PubMed1990

Well-differentiated papillary mesothelioma of the peritoneum. A clinicopathologic study of 22 cases.

Twenty-two cases of well-differentiated papillary mesothelioma of the peritoneum (WDPMP) are described. Eighteen of the 22 patients were women. The peritoneal tumor was usually multifocal. Many of the tumors appear to be indolent or inactive and for practical purposes are benign. However, a few patients receiving adjuvant therapy have died under circumstances that make it difficult to determine whether the tumor was responsible for the death. It is suggested that adjuvant therapy be withheld from patients with WDPMP, unless there is clear evidence of progression. The cause of these rare tumors is not apparent, although three patients had had possible exposure to asbestos and two were sisters.

Adult↗
PubMed1994

Psammocarcinoma of the peritoneum.

The cytologic and histologic features of two cases of psammocarcinoma of the peritoneum are reported. The previously proposed histologic diagnostic criteria for this tumor are expanded in order to accommodate the present two cases. The cytologic features of this tumor have not previously been reported.

Aged↗
PubMed2005

Extrathoracic solitary fibrous tumor of the pelvic peritoneum with central malignant degeneration on CT and MRI.

We describe a 61-year-old man who presented with an extrathoracic solitary fibrous tumor (SFT) of the pelvic peritoneum with central malignant degeneration as seen on computed tomography (CT), magnetic resonance imaging (MRI), and histopathology. When a central focus of heterogeneity and variable contrast enhancement are identified within a fibrous tumor of the pelvis on CT or MRI, malignant degeneration of an extrathoracic SFT, although rare, should be considered as a diagnostic possibility.

Humans↗
PubMed1979

Malignant mesothelioma presenting in the pleura and peritoneum.

Malignant mesothelioma presenting in the pleura and peritoneum is described in a middle-aged man. The patient lacked significant asbestos exposure which is not unexpected from both the clinical literature and animal inhalation tumor data. Computerized axial tomographic correlation is provided. Partial remission was achieved with the administration of adriamycin and DTIC.

Adult↗
PubMed1984

Primary pedunculated fibrosarcoma of the peritoneum: a case report.

Fibrosarcoma is a primitive, mesenchymal tumor frequently arising from superficially located soft tissues. A case of a primary intraperitoneal, pedunculated fibrosarcoma is reported, initially presenting as an abdominal mass protruding into a large incisional hernia of the anterior abdominal wall. Despite total tumor resection, multiple intraperitoneal tumor nodules of varying sizes were found and resected six months and one year later. The patient died 18 months after the first surgical intervention. This case illustrates the highly malignant behavior and poor prognosis of fibrosarcomas of the peritoneum.

Aged↗
PubMed1995

Primary extrauterine müllerian adenosarcoma of the peritoneum.

A case of an extrauterine Müllerian adenosarcoma of the pelvic peritoneum is described. The patient, a 16-year-old girl, presented with abdominal distension and pain. At laparotomy, a tumor was found originating from the left pelvic side wall. Light microscopic examination revealed a Müllerian adenosarcoma. Postoperatively she was treated with polychemotherapy. Seventy months after initial presentation she is still free of tumor.

Adenosarcoma↗
PubMed1998

Recurrent psammocarcinoma of the peritoneum with complete response to tamoxifen therapy.

Psammocarcinoma is a rare type of serous carcinoma arising from the ovary or peritoneum, characterized by massive psammoma body formation, invasiveness, and low-grade cytological features. A case of primary peritoneal psammocarcinoma is presented. Aspects of clinical presentation, diagnosis, and management are described. Emphasis is placed on successful management of recurrent disease using tamoxifen therapy.

Antineoplastic Agents, Hormonal↗
PubMed1998

Experience with platinum-paclitaxel chemotherapy in the initial management of papillary serous carcinoma of the peritoneum.

OBJECTIVE: The objective of this study was to assess the activity and toxicity of combination platinum-paclitaxel chemotherapy in the initial management of patients with papillary serous carcinoma of the peritoneum (PSCP). METHODS: Patients initially treated at The Cleveland Clinic Foundation (CCF) for PSCP with platinum-paclitaxel combination chemotherapy regimens were identified and clinical information was abstracted by chart review. Toxicity data, progression-free survival, and overall survival were determined. RESULTS: Thirty-eight patients (36 Stage IIIC and 2 Stage IV) were identified. All chemotherapy was administered as outpatient infusions. All patients received paclitaxel (135 or 175 mg/m2) and 12 received cisplatin and 26 carboplatin. Two hundred thirty-two cycles were administered, with only three (1.3%) episodes of grade 3 toxicity and no grade 4 toxicity. Ninety-two percent of patients experienced at least a 50% reduction in their CA-125 levels and 55% experienced a greater than 90% reduction. Median progression-free survival (Kaplan-Meier) was 15 months and median overall survival was 40 months. Survival for optimally debulked patients (median not yet reached with median follow-up of 24 months) was significantly better than for suboptimally debulked patients (median 32.8 months) (P = 0.012). CONCLUSION: Platinum-paclitaxel chemotherapy regimens have substantial utility in the initial management of PSCP patients. The toxicity profile is modest. Carboplatin or cisplatin in conjunction with paclitaxel is the current first-line recommended chemotherapy for PSCP.

Adult↗
PubMed2000

Genetic alterations of the WT1 gene in papillary serous carcinoma of the peritoneum.

OBJECTIVE: The Wilms' tumor (WT1) gene product is consistently detectable in both normal ovarian germinal epithelium and human mesothelium. Ovarian carcinomas frequently exhibit alterations in WT1 function. Papillary serous carcinoma of the peritoneum (PSCP) is believed to develop de novo from the peritoneal lining (mesothelium) of the pelvis and abdomen. The purpose of this study was to determine if genetic alterations of the WT1 gene are associated with the development of PSCP. METHODS: Normal and tumor tissue specimens were retrieved from patients with stage III and IV PSCP (n = 38) and serous epithelial ovarian carcinoma (n = 38). Immunohistochemistry was performed using the anti-WT1 (C-19) antibody. Loss of heterozygosity (LOH) was performed at the WT1 locus. Clinical data were obtained and correlated with molecular findings. RESULTS: Loss of normal WT1 expression was detected in 18 (51%) of 35 PSCP specimens and 18 (53%) of 34 ovarian carcinoma specimens. Six (27%) of 22 PSCP specimens and 3 (13%) of 24 ovarian carcinoma specimens had LOH at the WT1 locus (P = 0.27). Normal WT1 gene expression was maintained in 86% of tumors exhibiting LOH. Genetic alterations of the WT1 gene were not predictive of survival, nor were they associated with other clinical or molecular factors. CONCLUSIONS: Genetic alterations of the WT1 gene are associated with the development of PSCP. The loss of normal WT1 gene expression is a common event in both PSCP and advanced ovarian carcinoma, likely resulting from down-regulation by other regulatory factors-not from inactivating gene mutation and subsequent allelic loss.

Adult↗
PubMed2000

ras gene activation and infrequent mutation in papillary serous carcinoma of the peritoneum.

OBJECTIVE: The ras genes are a well-studied family of proto-oncogenes whose involvement in many cancers has been delineated. However, K-ras mutations have not previously been examined in papillary serous carcinoma of the peritoneum (PSCP), a tumor which resembles serous epithelial ovarian carcinoma (SEOC) both in histology and epidemiology. In this study we examine the role of the K-ras oncogene in PSCP compared to SEOC. METHODS: Using single-strand conformational polymorphism analysis and cycle sequencing protocols, we evaluated our collection of 51 cases of PSCP for K-ras mutations and compared these findings with the experience in SEOC. We then examined 5 cases of PSCP for activation of ras proteins and MAP kinase to evaluate the potential involvement of the ras pathway in PSCP tumorigenesis. RESULTS: We found only one K-ras mutation in our 51 cases (2%) of PSCP compared to three mutations in 46 cases (6.5%) of high-grade, late-stage SEOC. This was not significantly different (P > 0.10). In the single PSCP case with a K-ras mutation, the mutation was found in only one of five tumor sites tested. All four mutations involved a single nucleotide alteration in codon 12 (GGT to GTT, Gly to Val). To evaluate the ras pathway in PSCP, we used the known activated ras binding domain on Raf-1 to perform an assay to test for activated ras. We identified ras activation in 4 of 5 PSCP cases tested and, to confirm that the activation was functional, we tested and found similar activation of MAP kinase, a downstream mediator for K-ras expression. CONCLUSIONS: K-ras mutations occur at low rates in both PSCP and high-grade, late-stage SEOC, and therefore K-ras mutations are not involved in the development of these two diseases. Finding the mutation in only one of multiple tumor sites in the PSCP case supports growing evidence for a multifocal origin of PSCP. Our findings of ras activation in four of five cases of PSCP suggest that ras activation by mechanisms other than genetic mutation is important for PSCP tumorigenesis.

Cystadenocarcinoma, Papillary↗
PubMed2002

Papillary serous carcinoma of the peritoneum coexisting with or after endometrial carcinoma.

OBJECTIVE: Papillary serous carcinoma of the peritoneum (PSCP) coexisting with, or after, endometrial carcinoma (EC) is an extremely rare condition with no documented patient series. The aim of this investigation was to describe our experience in treating five patients diagnosed with PSCP synchronously with EC and two others who developed PSCP metachronously after EC. METHODS: In this retrospective study, we reviewed and analyzed the clinical and pathological data of seven patients diagnosed and managed over a 10-year period. The diagnosis of PSCP was mostly based on the inclusionary criteria of the Gynecologic Oncology Group [1]. Disease stages were determined using the FIGO criteria for epithelial ovarian cancer (EOC) and endometrial carcinomas [2]. The treatment for PSCP was similar to that for advanced EOC and immunohistochemical studies were performed using archival material for PSCP and EC in order to determine p53, Bcl-2, HER2, and estrogen and progesterone receptor (ER, PR) status. Germline mutation analyses were performed for the two most common mutations pertaining to BRCA1 and the one most common mutation pertaining to BRCA2 genes only. RESULTS: Five patients with PSCP and synchronous EC initially underwent surgical treatment. The remaining two underwent surgery originally for EC and, thereafter, for metachronous PSCP. All seven patients had advanced stages (III or IV) of PSCP and stage I only EC. At the time of analysis, four patients were alive. p53, Bcl-2, ER, and PR were found to have been expressed in various rates in both or one of the neoplasms. However, no HER2 was found to have been expressed, either in PSCP or in EC. All germline mutation analyses were negative. CONCLUSIONS: The results obtained in this study show that PSCP can occur either synchronously or metachronously with lower stage EC that is associated with advanced disease stages. We suggest that this clinical form of PSCP with synchronous or metachronous EC is a very aggressive and lethal clinical form and differs markedly from the vast majority of multiple gynecologic neoplasms of the upper genital canal diagnosed in the ovarian-endometrial group, of which EOC are mostly diagnosed as stage I diseases with high-rate cures.

Aged↗
PubMed1985

Reflex adrenergic inhibition of colonic motility in anesthetized rat caused by nociceptive stimuli of peritoneum. An alpha 2-adrenoceptor-mediated response.

Nociceptive stimulation of the peritoneum inhibits colonic motility via a sympathoadrenergic reflex. This sympathetic reflex most probably induces the inhibition indirectly via a presynaptic blockade of cholinergic transmission. To further clarify this reflex, colonic motility was continuously recorded by a volume method in rats exposed to nociceptive abdominal stimulation and intravenous drug administration. Intraabdominally applied HCl inhibited colonic motility, which was unaffected by nonselective beta-adrenoceptor blockade (propranolol). However, the nonselective alpha-adrenoceptor antagonist phentolamine and the selective alpha 2-adrenoceptor antagonist yohimbine restored motility. Spontaneous colonic motility was unaffected by the nonselective beta-adrenoceptor agonist (isoproterenol) and the selective alpha 1-adrenoceptor agonist (L-phenylephrine). On the other hand, a nonselective alpha-agonist (noradrenaline) and a selective alpha 2-adrenoceptor agonist (clonidine) inhibited spontaneous colonic motility. It is suggested that in the rat sympathetic reflex inhibition of colonic motility caused by abdominal nociception is mediated via presynaptic alpha 2-adrenoceptors inhibiting the excitatory cholinergic neurons.

Animals↗
PubMed1996

Cystic mesothelioma of the peritoneum.

We report a case of cystic mesothelioma of the peritoneum (CMP), a rare tumor. The magnetic resonance imaging (MRI) findings and the histochemical features were studied. The patient was an 18-year-old women who presented with upper abdominal pain. Abdominal ultrasonography and computed tomography showed a well defined cystic mass with a solid papillary projection in its lumen. MRI of the cyst showed high intensity on T2- and proton weighted images and low intensity on T1-weighted images, and the solid projection showed low intensity on T2- and proton-weighted images and slight low intensity on T1-weighted images, on which it was well enhanced. The lesion was suspected to be a benign cyst, such as a hemangioma, lymphangioma, or a splenic or pancreatic cyst. Complete surgical resection was performed. The resected specimen consisted of a unilocular cystic mass, with a solid projection, weighing 260 g and measuring 10 cm in diameter. The final diagnosis, arrived at by histopathological examination, was low-grade malignant CMP. The tumor cells were strongly positive for keratin, weakly positive for vimentin, and negative for epithelial membranous antigen. The patient is now well and symptom-free with no recurrence 19 months after operation. CMP is a rare tumor; only 12 cases have previously been reported in Japan.

Adolescent↗