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At least 775 records · Page 43Linked to original sources
PubMed1998

Sudden profound hypoxaemia in the intensive care unit--a case report.

Acute hypoxaemia is a life-threatening emergency. Diagnosis of the exact aetiology maybe complicated by the presence of pre-existing lung conditions. A case report is presented of a non-intubated patient with a pre-existing lung tumour who developed sudden profound hypoxaemia 3 days after emergency abdominal surgery. Definitive aetiological diagnosis was delayed due to chest X-ray features suggestive of compression and erosion of tumour tissue into the airway. Emergency computerised tomography (CT) imaging however revealed mucous plugging leading to massive atelectasis as the main aetiology.

Carcinoma↗
PubMed2026

Characterization of small intestinal neuroendocrine tumorlets.

Small intestine neuroendocrine tumors (SI-NETs) frequently present as multifocal primaries. We commonly observe microscopic lesions in the superficial layer of the small intestine of SI-NET patients. We aimed to define them as small intestinal neuroendocrine tumorlets (SINTs) and explore their clinical and biological significance. Twenty multifocal and twenty unifocal SI-NETs patients who received resection at a single institution were retrospectively reviewed. Four hundred and forty six archived pathological slides were examined for microscopic lesions located in the lamina propria, muscularis mucosa, and superficial submucosa. Clinicopathological associations and progression-free survival were analyzed. Previously published genomic data were re-analyzed. SINTs were identified in 50% of multifocal and 30% of unifocal SI-NET patients. Median SINT size was 95 μm, with a median distance of 2.2 mm from the nearest mass. Compared to the 'true unifocal' group (unifocal without SINT), the 'multifocal-spectrum' group (multifocal or unifocal with SINT) had higher BMI (median: 27.6 vs 22.8, P = 0.0060), higher rates of perineural invasion (OR: 5.5, P = 0.044), larger mesenteric mass (median: 2.6 vs 1.6 cm, P = 0.034), and more advanced pT stage (pT3 or pT4, OR: 7.2, P = 0.018). Genomic re-analysis suggested that 13% of cells in multifocal primary tumors could share clonal origins, possibly indicating clonal spread via SINTs. SINTs may serve as a new biomarker for multifocal spectrum with local aggressiveness. The actual frequency of multifocal SI-NET may be higher than currently recognized in clinical practice. Further studies are needed to validate their prognostic and biological significance.

Humans↗
PubMed1976

Malignant lymphoma of the small intestine in multiple family members: association with an immunologic deficiency.

Four cases of malignant lymphoma all in male members of a family are described. In three of the affected individuals the primary tumor arose in the small intestine and in the other the site of origin was the retroperitoneum. Immunologic studies were carried out on the two surviving patients and on all other living members of their families. Low levels of immunoglobulins were found in one of the affected boys. During a recurrence of the tumor, the other boy showed temporary partial impairment of cellular immunity as measured by failure to react to delayed hypersensitivity skin tests, although lymphocyte transformation studies were normal. Nine months after treatment was completed his response to skin tests was normal. No immunologic defect was detected in the studies of the non-involved family members. The histologic appearance of the tumors was similar in the tissue sections which were available for review from three of the four patients; the tumor was classified as a malignant lymphoma, diffuse, mixed cell type (lymphocytic and histiocytic).

Agammaglobulinemia↗
PubMed1977

Small bowel perforation secondary to metastatic carcinoma of the lung.

This is a report of small bowel perforation secondary to a metastasis from a primary adenocarcinoma of lung in a 62-year-old woman five months after resection of the primary tumor. She had received radiation therapy and corticosteroids after surgery. Features of this and five previously reported cases are discussed. Modern therapy may alter the course of pulmonary cancer resulting in more frequent observation of this rare complication.

Adenocarcinoma↗
PubMed1981

Effect of major small bowel resection on dimethylhydrazine-induced bowel carcinogenesis.

We have investigated the effect of distal small bowel resection on chemically induced tumors of the gastrointestinal tract in Wistar/Furth (W/Fu) rats. Dimethylhydrazine (DMH) (20 mg/kg sc once weekly x 16) was commenced 3 months after rats underwent resection of the distal 30 cm of small bowel (one-third resection) or after sham small bowel resection (controls). Fifty weeks after the start of DMH administration, tumors were found in 15 of 25 animals who underwent small bowel resection compared to 9 of 31 animals in the control group (P less than 0.05). After small bowel resection, 8 of 15 tumors occurred at the site of anastomosis but no anastomotic tumors were seen after sham resection. In addition, tumors were larger and more invasive after small bowel resection. These data indicate that major small bowel resection potentiates DMH induced-intestinal carcinogenesis.

Adenocarcinoma↗
PubMed1996

Carcinogenicity of the anticancer topoisomerase inhibitor, amsacrine, in Wistar rats.

Amsacrine is an antineoplastic drug used in the treatment of acute adult leukemias. To assess its carcinogenic potential, groups of 50 male and 50 female rats were administered amsacrine by lateral tail vein injection at 0 (vehicle control), 0.25, 1, or 3 mg/kg once daily for 5 days, followed by a 23-day recovery period. This cycle of dosing and recovery was repeated a total of six times. The animals were then maintained without dosing for an 18-month observation period. During the dosing phase, signs of toxicity were limited to the 3 mg/kg animals and included alopecia, diarrhea, injection site lesions, and skin and subcutaneous nodules. Statistically significant reductions in body weight gain and food consumption also occurred at 3 mg/kg during each 5-day dosing period followed by recovery during the latter 3 weeks of each cycle. Except for skin and subcutaneous nodules, signs of toxicity in the 3 mg/kg animals ultimately disappeared during the 18-month observation phase. Survival at study termination for the vehicle control, 0.25, 1, and 3 mg/kg groups was 56, 52, 34, and 0%, respectively, in males, and 64, 48, 54, and 4%, respectively, in females. Mortality was primarily due to bone marrow suppression during the dosing phase, chronic progressive nephropathy, or development of tumors. Incidences of the following tumors were significantly increased in the 3 mg/kg groups of both sexes (Fisher exact test, two-tailed, p < 0.01): all malignancies; all tumors of the small intestine, adenocarcinoma and adenoma of the small intestine, all tumors of the skin, and squamous cell papilloma. Other tumor incidences that were significantly increased in the 3 mg/kg males were thymoma and multiple neoplastic histotypes of the skin and adnexa including basal cell tumor, fibroma, sebaceous gland adenoma, and squamous cell carcinoma. A disproportionate number of the skin tumors were located on the tail, suggesting a localized tissue concentration effect. In the 3 mg/kg females, significantly increased tumor incidences also included all tumors of the mammary gland, adenocarcinoma of the mammary gland, all tumors of the uterine horn, and endometrial stromal polyps of the uterine horn. The 1 mg/kg males had significantly increased incidences of all tumors of the small intestine and skin, adenocarcinoma of the small intestine, and fibroma of the skin. Fibroma of the skin was also significantly increased in the 0.25 mg/kg males. Incidences of all tumors and all benign tumors were significantly increased in the 1 mg/kg females. There were no significantly increased tumor incidences in the 0.25 mg/kg females. The results of this study show that amsacrine is carcinogenic in Wistar rats. Target organs for tumorigenicity include small intestine, skin, mammary gland, thymus, and uterus.

Amsacrine↗
PubMed1975

[Differentialdiagnosis and surgical treatment of the familial intestinal polyposis (author's transl)].

Between 1959 and 1974 we observed 18 patients with familial intestinal polyposis. 4 patients were from one family. Two brothers refused the operation and died 7 respectively 8 years after diagnosis had been made. The typical symptoms, the diagnostic procedure and the therapy are demonstrated. We prefer the proctocolectomy (eventually with the "Kock-Ileostoma"), because we observed a lot of recidivs after ileorectostomy. The prognosis of the familial intestinal polyposis is good, if the operation is performed early (also in cases of carcinomatosis). Only those patients died, who rejected the operation or were operated too late.

Adolescent↗
PubMed1988

Intussusception secondary to squamous carcinoma of the lung.

This report describes unusual radiologic and pathologic findings in a patient with multiple small bowel metastases from squamous cell carcinoma of the lung. The diagnostic work-up revealed a large, pleural-based, right lung mass, a large left adrenal mass, two ulcerated small bowel masses, and a unique giant peduncular mass that caused intermittent intussusception. A pertinent review of the literature is presented.

Carcinoma, Squamous Cell↗
PubMed1990

A case of multiple cavernous hemangioma of the small intestine and clinical review of the Japanese literature.

We report a case of multiple cavernous hemangioma of the small intestine which was diagnosed definitively before operation. A 33-yr-old male was found to have multiple polypoid lesions in the small intestine during examination for recurrent iron deficiency anemia. Plain X-ray film of the abdomen revealed multiple calcifications in the middle to lower region, suggestive of cavernous hemangioma, which was further confirmed by angiography and scintigraphy with Tc 99m-labeled red blood cells. Endoscopy during surgery was used to determine the extent of surgical resection. Seventy-three cases of hemangioma of the small intestine were reported in Japan between 1953 and 1988 and their clinical features were reviewed.

Adult↗
PubMed1996

Progression of metastases and symptom improvement from laparotomy in midgut carcinoid tumors.

A total of 121 consecutive patients with midgut carcinoid tumors underwent regular clinical control and 158 laparotomies for abdominal symptoms with 1 to 11 years (mean 5.2 years) of follow-up. Metastases were present in 93% of the patients at study inclusion and developed at initially uninvolved sites with an overall probability of 0.38. Patients without initial tumor spread developed mesenteric or liver metastases with the probability of 0.25 (mean delay 12 years), whereas those with mesenteric metastases exhibited a probability 0.56 to develop liver metastases (mean delay 6.1 years). Spread to extraabdominal sites in patients with mesenteric and liver metastases exhibited a probability of 0.22 (mean delay 4.3 years), and this spread was especially frequent (probability 0.60) in patients with only liver metastases at inclusion. Patients without the carcinoid syndrome (52%) mainly suffered from more or less episodic abdominal pain, nausea, and diarrhea. Marked mesenteric fibrosis detected at surgery (n = 59) generally was accompanied by symptoms of abdominal pain and weight loss, and it often required urgent intervention due to intestinal obstruction or ischemia. Complete or partial symptom alleviation was accomplished in 82% of the operated patients, and generally was most auspicious after primary acute or subacute procedures (n = 54). The complete or partial symptom improvements after surgery lasted for mean 5.3 years and tended to be longer after elective (n = 50) than acute operations. The findings substantiate encouraging results of laparotomy in a compromised cohort of patients with midgut carcinoid tumors. Because the patients also displayed a generally slow progression of metastases, liberal indications for laparotomy should prevail in symptomatic and possibly also asymptomatic individuals with midgut carcinoid tumors.

Abdominal Pain↗
PubMedDate not supplied

Case of optic nerve involvement in metastasis of a gastrointestinal stromal tumor.

BACKGROUND: The gastrointestinal stromal tumor (GIST) belongs to the leiomyosarcoma or leiomyoma group, and metastasis of leiomyosarcoma to the orbit is extremely rare. The most common sign of the metastasis of leiomyosarcoma to the orbit is proptosis; the primary lesion is usually found in skin or soft tissue. CASE: A 60-year-old man, who had a history of multiple metastases of GIST, suffered sudden unilateral blindness. OBSERVATIONS: His history and computed tomographic scans suggested that the lesion was a metastasis of GIST to the cavernous sinus around the root of the optic nerve. CONCLUSION: To the best of our knowledge, this is the first case of metastasis of GIST to the orbit.

Fatal Outcome↗