[Laparoscopy is not suitable in malignant tumors. Risk of neoplasm seeding by instrument].
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The pertinent radiologic findings in two cases of a recently described tumor, intraabdominal desmoplastic small cell tumor, are presented. This is an aggressive, usually lethal malignant neoplasm of the peritoneum occurring in boys and young men with a marked predilection for intraperitoneal spread. In both cases, CT or MR demonstrated a necrotic intraperitoneal mass with peritoneal metastases. Given the limited differential diagnosis, intraabdominal desmoplastic small cell tumor should be strongly considered as a diagnosis of an intraperitoneal neoplasm in young males.
BACKGROUND: Tamoxifen and toremifene have been used in patients with advanced desmoid tumours with response rates of 51%. METHODS: We developed an experimental model of desmoid tumour cells in tissue culture to study their effect. Four cell lines were established in tissue culture. All native and corresponding cultured tumours were oestrogen receptor negative. Tumour 1 was from a 22 year old with familial adenomatous polyposis (FAP) and recurrent abdominal wall desmoid tumours. She remains disease free on tamoxifen 4 years following surgery. Both her mother and sister also have shown regression of their FAP-associated desmoid tumours at the menopause and on tamoxifen, respectively. We assessed the effect of tamoxifen on desmoid tumours in tissue culture at 780 ng/mL. The results were assessed by cell density counting. RESULTS: Tumours 1 and 2 have responded with an approximately. 50% reduction in growth to tamoxifen at 780 ng/mL. CONCLUSIONS: This apparent growth inhibitory effect of tamoxifen on two desmoid tumour cell lines appears to be independent of oestrogen and correlates with the in vivo effect of tamoxifen on three desmoid tumours in an FAP family.
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A case of pleural mesothelioma spread by its contiguity with the left retrocavitary region causing pain in the homolateral half of the abdomen is described in a subject who had received a rib injury several months earlier. Instrumental examinations revealed pleural lesions with effusion and a left paravertebral mass.
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Authors present a case of cystic lymphangioma of the abdomen in an adult patient. Pre-operative investigations are based on ultrasound and computed tomography since plain films, excretory urograms and barium enema are less helpful. Opportunity of such a diagnosis in adult is not frequent.
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Lymphographic opacification of the abdominal nodes is only partial, and it is therefore useful to have available another examination for the diagnosis of lymphadenopathies. Echography would seem to merit an important role since out of a series of 100 patients, it led to a positive and confirmed diagnosis in 78% of cases with 22% of errors, including 4% of false positives. In almost 20% of cases, echography gave additional information to that of lymphography, this justifying the simultaneous application of both examinations, either diagnostically or in the context of the surveillance of treatment. Lymphadenopathies are regularly visible from a diameter of 3 cm upwards, their structure is generally very slightly echogenic only and they may be perfectly precisely located. Problems of differential diagnosis are minimal if the technique is applied carefully, by contrast the appearance of lymphadenopathies is very similar and offers no indication as to the aetiology.
OBJECTIVE: The purpose of this study was to evaluate the doubling time, frequency, and features on dynamic CT of extrahepatic needle tract implantation of malignant neoplasms after sonographically guided percutaneous biopsy for hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Between January 1997 and June 2003, 1,055 patients underwent sonographically guided percutaneous biopsy for HCC. The serial changes of implanted tumor volume were estimated on retrospective review of CT, and their doubling times were calculated from the two CT scans showing the first and last visible implanted tumors. The frequency of extrahepatic needle tract implantation of malignant neoplasms was evaluated overall and according to the type of needle used. The CT features of the implanted tumors were examined with regard to size, number, location, morphology, and enhancement pattern. RESULTS: The mean doubling time of extrahepatic needle tract implantation of malignant neoplasms after sonographically guided percutaneous biopsy was 112 days (range, 22-415 days). The mean time interval between biopsy and the emergence of the implanted tumor on CT was 267 days (range, 116-619 days). The overall frequency was 0.76% (8/1,055). The frequencies according to the type of needle were 1.3% (8/622) for the group treated with the end-cutting needle and 0% (0/433) for the group treated with the tru-cut needle; these frequencies differ from each other with statistical significance (p < 0.05, Fisher's exact test). Fifteen of the 17 implanted tumors were round or oval enhancing nodules along the needle tract, and 13 showed persistent enhancement on equilibrium phase images. CONCLUSION: The doubling times of extrahepatic needle tract implantation of malignant neoplasms after sonographically guided percutaneous biopsy for HCC were similar to those of typical HCCs in the liver on CT-based analysis. The frequency was relatively low, and their CT features were similar to those reported previously.
As a complementary and individualised method CT of the pediatric chest and abdomen facilitates or permits correct diagnosis. Evaluation of neoplasms is the most frequent indication and includes precise definition of the site of origin, the extent of disease and of possible metastases. Moreover, monitoring of the treatment and follow-up studies are made much easier. Traumatic lesions of parenchymal organs are easily estimated with high accuracy. However, the relevant contribution provided by the computer-tomographic cross-sectional display has to be carefully weighed against the effort required for and possible adverse reactions induced by the examination, which altogether may be considered as slightly rather than non-invasive, including the genetic risk of radiation.
Urachal carcinoma is a rare neoplasm with the majority of cases reported in the urologic literature. Because of its presentation as an intra-abdominal mass with involvement of adjacent structures the general surgeon may be consulted early in the diagnostic evaluation. One should be aware of this entity as early recognition and appropriate surgery provides the best opportunity for long-term survival. Herein we describe a typical case, appropriate evaluation, and review of the literature.
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