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PubMed1989

[Radiologic analysis of 51 cases of neuroblastoma].

The X-ray findings in 51 cases of neuroblastoma were analysed. The aim of plain film of abdomen is to search for fine sandy calcifications in the abdominal mass, paravertebral widening at lower thoracic region, and bone metastases. Displacement and deformity of kidney by extrinsic pressure seen in IVU are useful in differentiating an extrarenal tumor from intrarenal one. Ultrasound and CT are superior to IVU in localization diagnosis and defining the extent of abdominal neuroblastoma. Thoracic neuroblastoma usually manifests as a posterior mediastinal tumor associated with rib changes and the chest film remains valuable in diagnosis of this condition. It is mandatory to screen the patient for skeletal metastases radiographically and to investigate the bone marrow, and urine VMA whenever abnormalities are found in abdominal or thoracic imaging. The significance of combined imaging techniques in staging of neuroblastoma was discussed, and a simple diagnostic approach was proposed.

Abdominal Neoplasms↗
PubMed1988

Full thickness abdominal wall resection for recurrent and metastatic neoplasms. A report of three cases.

Full thickness infiltration of the abdominal wall by intraabdominal cancer, especially after effective prior therapy, is frequently considered a sign of inoperability. Such patients are treated with irradiation, chemotherapy, or locally destructive means (laser, cryosurgery) with limited success. Full thickness resection of portions of the abdominal wall has not been widely used in such settings because of concerns regarding abdominal wall reconstruction and also because of the perceived noncurative nature of such "radical" procedures. While long-term prognosis in patients with abdominal wall infiltration by cancer depends upon various factors, technical considerations regarding reconstruction need not prevent effective local palliative therapy. Bridging large defects can be successfully accomplished by using available synthetic material of a durable, inert nature. Polyprophylene (Marlex) mesh, a readily available and inexpensive inert fabric, meets all desirable features for such use. This paper details the successful treatment of three patients in whom recurrent carcinoma infiltrated the full thickness of the abdominal wall and caused intractable pain. In all three, full thickness portions of the abdominal wall were resected, segments of intestine and of urinary bladder were also excised, and the defects were closed using a double layer of polypropylene mesh. Complete relief of pain was accomplished and the cosmetic and functional results were excellent. Illustration A depicts procedure in patients one and two. Illustration B depicts procedure in patient three.

Abdominal Muscles↗
PubMed1976

Tumor imaging in children.

Twnty-six children suspected of having malignant diseases were examined by Gallium-67 scintigraphy. The scintigrams were pathologic in the 20 children with final diagnoses of malignancy. The lesions visualized by scintigraphy were 12 primary tumors and eight cases of local recurrence or dissemination of cancer. Gallium-67 did not accumulate in a hematoma of the liver, and scintigraphy was normal in five children with no clinical evidence of tumor recurrence. Several cases are reported and the clinical value of 67Ca scintigraphy for detection and control of childhood neoplasms is emphasized.

Abdominal Neoplasms↗
PubMed2000

Immunohistochemical detection of cytokeratin and epithelial membrane antigen in leiomyosarcoma: a systematic study of 100 cases.

Although 'aberrant' expression of the epithelial markers, cytokeratin (CK) and epithelial membrane antigen (EMA), in leiomyosarcoma has been described previously, there has not been a study of this phenomenon with clinicopathological correlation in a large series of lesions at different anatomical sites. We investigated systematically the immunohistochemical reactivity for CK and EMA in 100 cases of leiomyosarcoma. CK and EMA were positive in 38% and 44% of the cases, respectively. Although staining was usually focal, extensive immunoreactivity was observed in 11% with CK and 6% with EMA. There was no correlation between immunoreactivity for CK and EMA in leiomyosarcomas and non-neoplastic smooth muscle at the same location. Immunoreactivity for CK and EMA was not correlated with the location, age, sex, histological grade, or histological features, except for more frequent EMA positivity in vascular and uterine tumors than in soft tissue cases. These results indicate that CK and/or EMA-positive leiomyosarcomas do not have distinctive clinicopathological features differing from those of negative cases. However, the considerable frequency of immunoreactivity for these epithelial markers in leiomyosarcoma, occasionally with diffuse and strong immunopositivity, should be recognized as a potentially serious diagnostic pitfall in the differential diagnosis of other malignant spindle cell neoplasms.

Abdominal Neoplasms↗
PubMed1989

[Cystic lymphangiomas of the abdomen. CT and US findings].

Cystic lymphangiomas of the abdomen are an uncommon kind of hamartoma. Their diagnosis is often difficult and calls for an accurate differential diagnosis of this disease and such lesions as cystic pancreatic neoplasms, pseudocysts, hematomas, abscesses and urinomas. Eight cases of abdominal lymphangioma are reported, in patients ranging 35 to 68 years; all lesions were uni/multilocular containing serous fluid. Lymphangiomas were located in the retroperitoneal space (3 cases), in the mesenteric bed (3 cases), close to the left lumbar ureter (1 case), and on the left colon wall (1 case); the symptoms were little characteristic, mostly due to pressure on the adjacent organs. Both CT and US were able to detect and evaluate the lesions; in particular, CT provided also with exact topography. A small lymphangioma in the left colon was revealed only by barium enema. In 2 huge retroperitoneal lymphangiomas the diagnostic evaluation was improved by the use of CT-guided fine-needle biopsy; in patients with mesenteric lesions angiography was employed, also for surgical planning. Lymphography was never performed because CT and US proved the best diagnostic procedures. All patients underwent surgery, whose results confirmed the previous diagnosis, but for the patient with para-ureteral location the surgeon thought nephrectomy necessary.

Abdominal Neoplasms↗
PubMed1993

Relationship between paraaortic lymph node involvement and intraperitoneal spread in patients with ovarian cancer--a multivariate analysis.

In 125 patients with epithelial ovarian cancer (FIGO stages I-IV), 32 (26%) had paraaortic lymph node (PAN) metastases. The estimated 5-year survival rate of PAN-negative patients was 71%, while that of PAN-positive patients was 17% (P < 0.0001). Positive rates of PAN metastasis at each stage level, based only on intraperitoneal spread of the disease, were 2% for stage I, 9% for stage II, 43% for stage III, and 87% for stage IV. According to univariate analysis, histological grade, and all disease site parameters examined, such as subdiaphragmatic surface, liver and spleen capsule, intestines and mesentery, omentum, pelvic peritoneum, sigmoid colon and rectum, uterus and tubes, and peritoneal cytology, showed a statistically significant correlation to the presence of PAN metastasis. Multivariate analysis using the logistic regression model revealed that the omental involvement, uterine and tubal involvement, and histological grade were independently correlated with PAN metastasis. The relative risk of PAN metastasis in the patients with these three factors is 18.5 times higher than that in patients without these factors. The present data suggested that, for the disease with omental and/or uterine and tubal involvement, surgical evaluation of PAN is mandatory in order to perform correct FIGO staging.

Abdominal Neoplasms↗
PubMed1993

Bidirectional spread of disease via the subperitoneal space: the lower abdomen and left pelvis.

In early fetal life a persistent interconnection between the peritoneum and retroperitoneum of the abdomen and pelvis is formed--the subperitoneal space (SS). This paper serves to complete the description of the specific anatomical nuances of the SS as they relate to the bidirectional direct spread of disease in the left lower abdomen and pelvis. Described are the two avenues of communication (central and lateral pathways) within this portion of the SS. Selected cases illustrating the bidirectional spread of disease processes within this portion of the SS are reported.

Abdominal Neoplasms↗
PubMed1988

Imaging the direct bidirectional spread of disease between the abdomen and the female pelvis via the subperitoneal space.

This report expands the concept of the subperitoneal space (SS) as the potential conduit for direct spread of disease in the abdomen to include the female pelvis. The normal anatomy of the SS in the lower abdomen, the female pelvis, and its uninterrupted continuation between the abdomen and pelvis are demonstrated by several imaging modalities. Surgically proven cases of bidirectional spread of disease between the abdomen and female pelvis are reported. The unifying concept of the interrelationship formed by the SS provides an understanding of the basic concepts of the pathways of direct spread of disease and the pathogenesis of the clinical presentation of disease distant from its site of origin.

Abdomen↗
PubMed1994

Abdominal wall desmoid mimicking intra-abdominal mass: MR features.

A case of abdominal wall desmoid which enlarged toward the liver and mimicked an intra-abdominal tumor is presented. T*2-weighted MR images clearly demonstrated the tumor's continuity with the rectus abdominis muscle. The case presented suggests MRI may provide more valuable information concerning the origin of a right-upper-quadrant mass than CT does. However, the nature of the signals and attachment which this case showed were so unusual for desmoids that this case has not been diagnosed accurately.

Abdominal Muscles↗
PubMed1998

[First clinical results of ultrafast, contrast-enhanced 2-phase 3D-angiography of the abdomen].

PURPOSE: To assess the utility of breath-hold abdominal ultrafast three-dimensional (3D) gadolinium-enhanced dual-phase magnetic resonance angiography (MRA). MATERIAL AND METHODS: 125 patients with various abdominal pathologies were imaged using a breath-hold ultrafast gadolinium-enhanced dual-phase 3D-MRA technique. RESULTS: 119 (95%) of 125 MRA's were of good or excellent quality. The sensitivity in the detection of renal artery stenoses as well as stenoses of the celiac trunk and the superior mesenteric artery was 100%. Accessory renal arteries (n = 9) and replaced hepatic arteries (n = 4) were reliably detected by MRA. In 24 (71%) of 34 cases MR-angiographic delineation of the spleno-portal system and hepatic veins was superior compared to conventional angiography. CONCLUSION: Breath-hold gadolinium-enhanced dual-phase 3D-MRA has the potential to replace conventional angiography in the abdomen.

Abdomen↗
PubMed1983

Advantages of coronal ultrasonography in evaluating the neonatal retroperitoneum.

Good demonstration of retroperitoneal structures in the neonate can be obtained with real-time coronal ultrasonography. Advantages of coronal scanning include limited manipulation of the infant, less hindrance from monitoring devices or tubes when positioning the scanning probe, and improved visualization of retroperitoneal structures due to less interference by bowel gas. Retroperitoneal structures are displayed in conventional frontal anatomic relationships, which may facilitate recognition of renal ectopia and evaluation of abdominal masses. The authors' experience in evaluation of the neonatal retroperitoneum with coronal ultrasonography is presented.

Abdominal Neoplasms↗
PubMed1999

Injuries of large vessels in high stage neuroblastoma surgery. A case report.

Complete resection of the primary lesion in stage III neuroblastoma improves survival Neuroblastoma has a tendency towards surrounding and infiltrating the large vessels, leading to injuries during tumor resection. We operated on a stage III neuroblastoma, which resulted in the right and left common iliac artery and vein damage. The right common iliac artery and, veins were repaired by end to end anastomosis. There was a long gap between the two ends of the left common iliac artery and it was repaired using a mesenteric vein (marginal vein of the colon) graft. Digital subtraction angiography performed 6 months after the operation did not reveal any stenosis or aneurysmatic changes in the anastomoses. We conclude that short segments of large vessels may be sacrificed during the resection of neuroblastomas invading the vessel wall, and the resulting defects may be repaired by end to end anastomosis, or even by substituting mesenteric vein grafts, for the purpose of total or near total removal

Abdominal Neoplasms↗