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PubMed1992

[Secondary adenocarcinoma of the ovary and problems in diagnosis].

In a group of 10 secondary ovarian adenocarcinomas primary tumours were verified by biopsy in colorectal region (8 cases), once in gall bladder and once in appendix. The age of patients varied between 36 up to 60 years. The lesion was unilateral in 8 cases, bilateral in two. Six colorectal adenocarcinoma secondaries reminded a bit of endometroid carcinoma. Two colorectal and a gall bladder carcinoma secondaries resembled ovarian mucinous cystadenocarcinoma. Signet ring cells were not present. Appendical mucinous cystadenocarcinoma produced a metastasis that was alike borderline ovarian mucinous cystadenoma. Intracellular mucin reaction was negative or focally positive in former 6 cases, a diffuse positivity was found in 4 cases.

Adenocarcinoma↗
PubMed2003

Multiple AIDS-related malignancies just in the era of potent antiretroviral therapy. A rare but intriguing finding.

Two exceedingly rare cases of dual AIDS-associated neoplasms (Kaposi's sarcoma and non-Hodgkin's lymphoma), occurring in a short time as AIDS-defining diseases of two HIV-infected patients treated with highly active antiretroviral therapy (HAART) are reported and discussed in light of evidence from the available literature. A slowly progressive increase in neoplastic complications following the introduction of HAART and the consequent decline of opportunistic infections such as the main AIDS-related disorders has been observed, and combined cancer diseases may be expected in the next few years, due to the persistent dysregulation of the immune system, or a possible involvement of oncoviruses and HIV itself in the pathogenesis of HIV-associated cancer.

Acquired Immunodeficiency Syndrome↗
PubMed2004

[Gastrointestinal stromal tumors: clinical, pathologic features and effectiveness of new diagnostic criteria].

BACKGROUND/AIMS: The effective and reproducible diagnostic parameters for differentiating benign from malignant gastrointestinal stromal tumors (GISTs) are still not clear. In this study, GISTs were diagnosed and classified by immunohistochemistry and their clinical and pathologic features were investigated. GISTs were re-evaluated by Amin's and NIH's criteria, and prognostic relevance of these two criteria were compared. METHODS: Fifty cases of gastrointestinal mesenchymal tumor diagnosed from May 1990 to February 2000, were evaluated by immunohistochemical staining for CD117, CD34, smooth muscle actin, and S-100 protein. GISTs were diagnosed according to Amin's and NIH's criteria. The relationship between the prognosis and diagnosis based on Amin's or NIH's classification were analyzed. RESULTS: Thirty cases of gastrointestinal mesenchymal tumors were diagnosed as GISTs. The stomach (40%) and small bowel (40%) were the most common origin for GISTs. Immunophenotypically, null, myoid, neural, combined type were 70.0%, 10.0%, 16.7% and 3.3%, respectively. Seven cases showed metastasis and one case showed recurrence. According to Amin's criteria, 5 benign, 8 borderline and 17 malignant tumors were diagnosed. The NIH's criteria showed 2 very low risk, 6 low risk, 7 intermediate risk, and 15 high risk tumors. Metastasis or recurrence of GISTs had no significant relationship with malignancy according to Amin's criteria (p=0.4069) but had significant correlation with high risk tumor based on NIH's criteria. (p=0.0352). CONCLUSIONS: GISTs showing local invasion, distant metastasis or recurrence were related with high risk tumors based on NIH's criteria. NIH's criteria might be better reliable scheme than Amin's for predicting the prognosis of GISTs.

Adult↗
PubMed2004

Significance of incidental 18F-FDG accumulations in the gastrointestinal tract in PET/CT: correlation with endoscopic and histopathologic results.

UNLABELLED: This study was undertaken to identify the clinical value of incidentally detected lesions (IDLs) in the gastrointestinal tract (GIT) with (18)F-FDG PET/CT. METHODS: The reported database of 3,281 patients who underwent partial-body (18)F-FDG PET/CT scans from April 2001 to September 2003 was reviewed. Patients with incidental (18)F-FDG accumulations in the GIT that were associated with concomitant abnormal soft-tissue density or wall thickening on the native CT were evaluated. Incidental PET/CT findings were correlated with endoscopic and histopathologic results. RESULTS: According to our selection criteria, 98 (3%) of the 3,281 patients had an IDL of the GIT on (18)F-FDG PET/CT. Correlative endoscopic findings were available in 69 (70%) of 98 patients. Of these, 13 patients (19%) were harboring newly occurring cancers of the GIT in addition to preexisting aerodigestive tract tumors (n = 12) and malignant melanoma (n = 1). Twenty-nine (42%) patients were identified with precancerous lesions, such as advanced colonic adenomas (n = 27), Barrett's esophagus (n = 1), and intestinal metaplasia of the gastric mucosa (n = 1). Inflammatory and other benign GIT lesions were detected in 12 (17%) and 6 (8%) patients, respectively. In 9 (13%) patients, PET/CT was false-positive, showing normal findings in subsequent endoscopic examinations. In 20 (28%) of 69 patients, PET/CT findings had a relevant impact on the clinical management. Twenty-nine (30%) of the 98 patients were not subject to a further endoscopic examination because of the extent and nature of the primary tumor (n = 17), loss to follow-up (n = 7), death shortly after PET (n = 3), and patient unwillingness (n = 2). CONCLUSION: Although IDLs of the GIT on (18)F-FDG PET/CT scans are found only in about 3% of cases, they are associated with a substantial risk of an underlying cancerous or precancerous lesion. Early identification of these occult lesions may have a major impact on the patients' management and outcome.

Aged↗
PubMed2005

[Accuracy of endoscopic ultrasonographic impression compared with pathologic diagnosis in gastrointestinal submucosal tumors].

BACKGROUND/AIMS: Endoscopic ultrasonography (EUS) is a valuable imaging modality for the evaluation of gastrointestinal submucosal tumor (SMT). EUS is helpful in assessing the layer of origin, tumor diameter, shape, border characteristics, and internal echo patterns of SMTs and thus makes it possible to predict histologic diagnosis with educated guess. However, some studies have found no significant differences in EUS features between benign and malignant mesenchymal tumors. By comparing EUS impressions with histologic diagnosis, we evaluated the accuracy of EUS in differential diagnosis of gastrointestinal SMTs. METHODS: 58 cases of gastrointestinal SMTs with both EUS findings and pathologic reports were compared retrospectively from August 2001 to September 2003. RESULTS: 34 patients had lesions in the stomach and 13, 8, 3 in the esophagus, duodenum, and colon respectively. Benign lesions were predominant (46 of 58). The EUS and pathologic diagnosis coincided in 46/58 (79.3%) of the cases. Use of EUS led to the correct diagnosis in 7/9 (77.8%) of malignant GISTs (gastrointestinal stromal tumor) and leiomyosarcomas. Two small malignant gastric GISTs were diagnosed as benign with EUS. CONCLUSIONS: EUS is a useful tool in the differential diagnosis of gastrointestinal SMTs and predicting malignant lesions. However, some malignant GISTs were diagnosed as benign tumor with EUS examination.

Adult↗
PubMedDate not supplied

A multidisciplinary approach to gastrointestinal bleeding in cancer patients.

Gastrointestinal bleeding remains one of the most challenging areas in medicine today, especially in the patient with cancer. New techniques and technology have added much to the diagnosis and management of gastrointestinal bleeding. Although gastroenterologists remain at the center of the evaluation of these patients, the incorporation of new techniques has meant that interventional radiologists and nuclear medicine specialists often have important roles in assessing and treating these patients as well. Because patients with cancer are members of a unique group, gastrointestinal bleeding may also require intervention by surgical oncologists, medical oncologists, and radiation oncologists. This review will address the multidisciplinary approach required for the proper diagnosis and management of gastrointestinal bleeding in patients with cancer.

Angiodysplasia↗
PubMed1998

[FTIR study on the normal and tumor gastrointestinal tissues].

Series of cancer tissues and corresponding normal tissues of gastrointestinal tract (stomach, colon, esophagus) were studied by FTIR technique and the results showed the analogy of the spectra for the cancer tissues, while the spectra of normal tissues can be classified into three kinds. The secondary structures of protein were obtained by using deconvolution and curve-fitting techniques with Amide I bands and the results showed that the contents of alpha -helix and beta-sheet are different between the normal and cancer tissues.

Connective Tissue↗
PubMed1992

Leiomyosarcoma of the small intestine associated with von Recklinghausen's disease: report of a case.

A 54-year-old woman with intestinal multiple smooth muscle tumors including leiomyosarcoma, epithelioid leiomyoma, and leiomyomas in association with von Recklinghausen's disease is reported. Thirteen years after the excision of an intestinal leiomyosarcoma, another leiomyosarcoma arose in a different area of the jejunum and was also completely resected. Although leiomyomas are occasionally recognized in patients with von Recklinghausen's disease and a gastrointestinal neoplasm, there have been no other reports of leiomyosarcomas. Careful observation of the tumor is necessary and, if a rapid increase in tumor size is recognized, malignant tumor may have arisen and early surgical treatment is required.

Aortography↗
PubMed2005

[Is the invasive approach for all the upper gastrointestinal mesenchymal tumors necessary?].

BACKGROUND/AIMS: Mesenchymal tumors are the most frequent submucosal tumors in gastrointestinal trail. We reviewed the mesenchymal tumors which are confirmed by pathology to examine whether the invasive approach of all mesenchymal tumors is necessary. METHODS: This study was performed on fifty-nine patients who has mesenchymal tumors confirmed by endoscopic or surgical resection from January 2000 to June 2004. RESULTS: Mesenchymal tumors consisted of thirty-six gastrointestinal stromal tumors (GISTs), 20 leiomyomas and 3 schwannomas. All the esophageal tumors were leiomyoma (12/12, 100%). In stomach, there were 32 GISTs (76.2%), 7 leiomyomas (16.7%) and 3 schwannomas (7.1%). And there were 4 GISTs (80.0%) and 1 leiomyoma (20.0%) in duodenum. Tumors less than 1 cm in maximal diameter were leiomyoma or GISTs with very low risk of aggressive behavior. 56.1% of the tumors larger than 1 cm consisted of low, intermediate or high risk GISTs. CONCLUSIONS: Biopsy must be considered according to its size and anatomic location of mesenchymal tumors. The invasive approach for every esophageal submucosal tumor is not necessary unless the size is very large, because most of them are benign in nature. However, the gastric submucosal tumor with more than 1 cm in diameter should be carefully and regularly followed up or biopsied because it cannot be assumed to be benign for any GIST more than 1 cm in size at the present time, safely.

Adult↗
PubMed1992

[Treatment of metastatic brain tumors: effect of surgery of multiple metastatic brain tumors and systemic metastasis with special reference to quality of life].

To assess the efficacy of surgical resection of brain metastases from patients with multiple brain metastases or/and with other systemic metastases, the authors analysed treatment results of 90 cases of metastatic brain tumors. The patients were divided into three groups. Group A (nine cases): Patients with single brain tumor and their primary cancers were well controlled. Their brain tumors were removed surgically and followed by radiation. Their mean survival time was 17.0 months, and 14.6 months were independent (Karnofsky score greater than or equal to 70) in cases of lung cancer. Five patients (55.6%) improved by treatment. Group B (21 cases): Patients with multiple brain metastases or/and with systemic metastases. Their brain tumor(s) which gave rise to neurological symptoms were surgically removed in order to improve their quality of life. In cases of lung cancer, mean survival time was 9.5 months and 7.1 months were independent. 11 patients (52.3%) improved by treatment. Group C (60 cases): Patients treated conservatively. Their mean survival time was 4.9 months and 2.7 months were independent in cases of lung cancer. Only 13 patients (21.7%) improved by treatment. However 23 (38.3%) deteriorated in their quality of life during treatment. Two patients of this group had single brain tumor and their primary cancers were controlled well. They refused surgery. Their mean survival time was 13.0 months, and 7.0 months were independent. These times were statistically shorter than group A. Seven patients had similar systemic and neurological states as those in group B. Their mean survival time was 5.0 months and 3.0 months were independent. These times were also statistically shorter than those in group B.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain Neoplasms↗
PubMed2005

[CD117 contribution in the diagnosic of mesenchymal tumors of the digestive tract].

UNLABELLED: Gastrointestinal stromal tumor (GIST) is a new distinct entity defined as CDI 17 or c-kit positive mesenchymal tumors, originaling in gastrointestinal pacemaker cells known as interstitial cells of Cajal. This study evaluate the percentage of GIST previously diagnosed as mesenchymal tumors in our hospital during 11 years. METHODS: A total of 30 surgically resected gastrointestinal tumor specimens were collected from January 1990 to December 2000 in the pathology laboratory of la Rabta Jospital. Immunohistochemical studies were performed on these tumors with antibodies of CD 117, smooth muscle actin (SMA) and protein S-100. RESULTS: Among the 30 tumors, 26 (86.6%) were CD117 positive and were classified as gastrointestinal stromal tumors. Among the 26 GIST, SMA was positive in 11 tumors (42.3%), 6 tumors (23%) expressed protein S-100. The 4 tumors classified as non-GIST were leiomyomas with the following immunohistochemical characteristics: CD117-negative with strong SMA-positive and protein S100 negative status. CONCLUSIONS: The majority (86.6%) of mesenchymal gastrointestinal tumors were GIST, except for a smalls groups of smooth muscle tumors.

Actins↗
PubMedDate not supplied

[The incidence of somatostatin receptors in human neoplasms in the light of ex vivo-in vitro studies].

Human neoplastic cells express and often even over-express the somatostatin receptors (sstr). It concerns not only pituitary tumors and the so-called neuroendocrine tumors of the gut, but many other neoplasms, including the non-endocrine cancers. The incidence of sstr is important because it determines the possibility of treatment with SST (somatostatin) analogs. The examination of sstr is possible under the in vivo conditions, by means of the receptor scintigraphy using the radiolabeled SST analogs. The receptors can be also examined under the ex vivo-in vitro conditions, using the post-surgical or biopsy specimens. Among the in vitro (ex vivo) methods, the immunohistochemical investigation with specific anti-receptor antibodies seems to be particularly useful for routine clinical diagnostics. This review presents the data, obtained by means of different in vitro techniques, on the incidence of five sstr subtypes in the different human tumors, deriving from endocrine glands, diffuse neuroendocrine cells as well as in neoplasms considered as non-endocrine.

Animals↗
PubMed2006

Expression of chemoresistance-related proteins in alpha-fetoprotein-producing adenocarcinoma of the digestive organs.

alpha-fetoprotein-producing adenocarcinoma of the digestive organs (APAD) is known to show a poor prognosis. To clarify the characteristics of chemoresistance in APAD, three proteins of fluoropyrimidine chemotherapy association [dihydropyrimidine dehydrogenase (DPD), thymidine phosphorylase (TP) and thymidylate synthase (TS)] and one protein of cisplatin association [metallothionein (MT)] were immunohistochemically evaluated. Tissue samples were taken from 12 AFP-positive gastric cancers and 94 AFP-negative gastric cancers. Four AFP-positive cancer xenografts (one colonic, two pancreatic, and one biliary tract) and 17 AFP-negative cancer xenografts were also examined. In gastric cancers, high expression of TP was observed in 30% of AFP-negative tumors but in none of AFP-positive tumors (p=0.03). High expression of MT was found in 30% of AFP-negative tumors but in only one of the AFP-positive tumors. The TP-low and MT-low phenotype was noted in 92% of AFP-positive tumors and in 46% of AFP-negative tumors (p=0.004). None of the AFP-positive cancer xenografts revealed high TP expression and only one showed high MT expression. In the cellular level, TP and MT were scarcely co-expressed with AFP in either gastric cancer or xenograft series, using double immunostaining and serial sectioning techniques. There were no significant differences in the expression of DPD and TS between AFP-positive group and -negative group. However, DPD was frequently co-expressed with AFP in poorly differentiated medullary areas of the AFP-positive gastric cancers. The data presented herein suggest that APAD should be sensitive to cisplatin, but resistant to capecitabine and 5'-deoxyfluorouridine, fluoropyrimidines which are converted to 5-fluorouracil by TP. S-1, a fluoropyrimidine containing a strong DPD inhibitor, may be effective for AFP-positive gastric cancers with poorly differentiated medullary growth pattern.

Adenocarcinoma↗
PubMed2007

Notch signaling in gastrointestinal tract (review).

Notch signaling is one of key pathways constituting the stem cell signaling network. DLL1, DLL3, DLL4, JAG1 and JAG2 with DSL domain are typical Notch ligands, while DNER, F3/Contactin and NB-3 without DSL domain are atypical Notch ligands. Notch-ligand binding to NOTCH1, NOTCH2, NOTCH3 or NOTCH4 receptor induces the receptor proteolysis by metalloprotease and gamma-secretase to release Notch intracellular domain (NICD). Typical Notch ligands transduce signals to the CSL-NICD-Mastermind complex for the maintenance of stem or progenitor (transit-amplifying) cells through transcriptional activation of HES1, HES5, HES7, HEY1, HEY2 and HEYL genes, and also to the NF-kappaB-NICD complex for the augmentation of NF-kappaB signaling. Atypical Notch ligands transduce signals to the CSL-NICD-Deltex complex for the differentiation of progenitor cells through MAG transcriptional activation. Notch signals are transduced to the canonical pathway (CSL-NICD-Mastermind signaling cascade) or the non-canonical pathway (NF-kappaB-NICD and CSL-NICD-Deltex signaling cascades) based on the expression profile of Notch ligands, Notch receptors, and Notch signaling modifiers. Canonical Notch signaling is activated in the stem or progenitor domain of gastrointestinal epithelium, such as basal layer in esophagus and lower part of the crypt in colon. Notch signaling to inhibit secretory cell differentiation is oncogenic in gastric cancer and colorectal cancer, while Notch signaling to promote keratinocyte differentiation is anti-oncogenic in esophageal squamous cell carcinoma (SCC). Single nucleotide polymorphism (SNP), epigenetic change, and genetic alteration of genes encoding Notch signaling-associated molecules will be utilized as biomarkers for gastrointestinal cancer. gamma-Secretase inhibitors, functioning as Notch signaling inhibitors, will be applied as anti-cancer drugs for gastric cancer and colorectal cancer.

Gastrointestinal Neoplasms↗