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PubMed1988

Gastrointestinal and hepatobiliary neoplasms in AIDS.

There is an increased frequency of Kaposi's sarcoma and non-Hodgkin's lymphomas in patients with AIDS. These "opportunistic malignancies" establish the diagnosis of AIDS in an HIV-positive patient and are associated with a high likelihood of gastrointestinal and hepatobiliary involvement. Kaposi's sarcoma is a multicentric cutaneous spindle-cell tumor that is associated with luminal lesions in at least 40 per cent of patients. Gastrointestinal KS is usually asymptomatic but may rarely bleed or obstruct. Treatment of KS with either radiation or chemotherapy can reduce tumor bulk, without affecting survival. Non-Hodgkin's lymphomas in AIDS are B-cell neoplasms composed of either noncleaved or blast cells, similar to those seen in Burkitt's lymphoma. The tumors are usually highly aggressive and present in extranodal sites in the majority of cases. Primary or secondary gastrointestinal involvement is frequent, with hepatic and rectal tumors being particularly common. Unlike KS, gastrointestinal lymphomas are usually symptomatic. Obstruction, perforation, and bleeding can occur in patients with luminal involvement. Jaundice due to hepatic infiltration or biliary obstruction may be seen. Treatment with chemotherapy is usually indicated because of the rapid progression of the tumor, although no prolongation of survival has been demonstrated. There may also be an increased incidence of Hodgkin's disease and anorectal neoplasia in patients with AIDS; however, these malignancies do not establish the diagnosis of AIDS in an HIV-positive patient.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Surgical aspects of Clostridium septicum septicemia.

Clostridium septicum is a virulent cause of gas gangrene and sepsis. Although thought to be rare, a survey of our affiliated hospitals for a recent five-year period disclosed eight cases. Seven of the eight had an occult malignant neoplasm. The eighth patient was thought to be preleukemic. All seven malignant neoplasms involved the gastrointestinal tract. Four patients were admitted with gangrene of an extremity, three with abdominal pain, and one with both. In four patients, C septicum septicemia appeared in an extremity before the underlying gastrointestinal malignant neoplasm was recognized. Four patients had surgical therapy and two survived; four received medical therapy and one survived. Patients who have C septicum septicemia should be assumed to harbor an underlying malignant neoplasm until proved otherwise.

Aged↗
PubMed1995

Clinicopathological relevance of the association between gastrointestinal and sebaceous neoplasms: the Muir-Torre syndrome.

The association between sebaceous neoplasms of the skin and visceral cancers, known as Muir-Torre syndrome, is described in three patients, including one with an extensive history of cancer in his family. The first patient, a 54-year-old man, developed multiple sebaceous adenomas, epitheliomas, and carcinomas in association with a colonic carcinoma 6 years after cardiac transplantation. Family history in this patient disclosed colon cancer in 17 relatives. The second patient was a 51-year-old man who had recurrent adenocarcinoma of the sigmoid colon, adenocarcinoma arising in Barrett's esophagus, and sebaceous epithelioma during a period of 15 years. The third patient was a 90-year-old man with a sebaceous adenoma followed 5 months later by adenocarcinoma of the sigmoid colon with liver metastases. Muir-Torre syndrome in 129 other patients published in the literature is reviewed. Although it is a rare disease, Muir-Torre syndrome requires recognition because skin lesions may be the first sign of the syndrome and this may lead to early diagnosis of associated visceral cancers. Moreover, because this syndrome appears to be inherited, family members should be screened for visceral cancer, especially colorectal adenocarcinoma.

Adenocarcinoma, Sebaceous↗
PubMed1996

Recurrent lower gastrointestinal hemorrhage: ileal neoplasm diagnosed by scintigraphy with Tc 99m red blood cells and angiography.

A 71-year-old man with recurrent lower gastrointestinal bleeding had negative colonoscopic findings on three occasions. Preoperative diagnosis of a large stromal tumor in the right lower quadrant was based on scintigraphy with tagged red blood cells and mesenteric arteriographic features. The use of nuclear scintigraphy in the diagnosis and evaluation of stromal tumor of unknown malignant potential has not been previously described.

Aged↗