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At least 919 records · Page 51Linked to original sources
PubMed2003

Surgical treatment of small bowel cancer: a 20-year single institution experience.

Small bowel malignancies are rare. The aims of this study were to evaluate the outcomes associated with surgical therapy for small bowel cancers and to define prognostic factors. The medical records of 96 consecutive patients with primary small bowel cancer (excluding lymphoma) treated at our institution over a 20 year period were reviewed. Survival was analyzed using the Kaplan-Meier method (mean follow-up period 57 months). Mean patient age was 56 years, and 58% of patients were male. Sixty percent of patients had an adenocarcinoma, 21% had a sarcoma, and 19% had a carcinoid tumor. The percentages of patients who underwent complete (curative) resection were 51%, 90%, and 50% for those with adenocarcinoma, sarcoma, and carcinoid tumor, respectively. For patients with adenocarcinoma who underwent curative resection, tumor (T) and node (N) stages were significant prognostic factors predicting overall survival. For patients with sarcomas who underwent curative resection, tumor grade was a significant prognostic factor predicting overall survival. The prognosis for patients with small intestinal carcinoid tumors is uniformly favorable. The prognosis for patients with sarcomas and adenocarcinomas is generally poor, although long-term survival is achieved by patients with favorable prognostic factors.

Adenocarcinoma↗
PubMed1992

Cutaneous manifestations of gastrointestinal disorders. Part I.

This article reviews the cutaneous manifestations of gastrointestinal tract diseases. In part I, the gastrointestinal tract polyposis syndromes and gastrointestinal tract malignancies will be discussed. The cutaneous manifestations of inflammatory bowel disorders, vascular disorders of the gastrointestinal tract, celiac disease and bowel-associated dermatosis-arthritis syndrome will be discussed in part II. For each entity, a brief summary of the gastrointestinal tract (and other extracutaneous) manifestations is given. This is followed by a detailed discussion of the cutaneous signs. Current guidelines for the investigation and management of these diseases are presented.

Humans↗
PubMed2005

Initial experience of videocapsule endoscopy for diagnosing small-bowel tumors in patients with GI polyposis syndromes.

BACKGROUND: Small-bowel tumors frequently occur in familial adenomatous polyposis and other GI polyposis syndromes. These tumors are difficult to detect with conventional techniques. Our aim was to assess the utility of videocapsule endoscopy in the detection of small-bowel tumors in this setting. METHODS: We examined 19 familial adenomatous polyposis patients and 3 patients with either Peutz-Jeghers syndrome, hyperplastic polyposis, or Cowden disease. OBSERVATIONS: Prevalence of small-bowel polyps on videocapsule endoscopy was 59% in all patients, 52.6% in familial adenomatous polyposis patients, and 75% in a subgroup of familial adenomatous polyposis patients with exon 15 mutations. Videocapsule endoscopy was safe and well tolerated in all patients. CONCLUSIONS: Videocapsule endoscopy has a high yield in detecting small-bowel tumors in patients with GI polyposis syndromes. It may be especially indicated in familial adenomatous polyposis patients with the aggressive phenotype of the disease, e.g., mutations in exon 15.

Adenomatous Polyposis Coli↗
PubMed1994

Palliation of malignant intestinal obstruction using octreotide.

Vomiting due to malignant intestinal obstruction is an unpleasant terminal event in many cancer patients, which responds poorly to conventional therapies. Somatostatin and its long-acting analogues reduce intestinal secretion. For this reason, octreotide was used in a phase I/II study of patients with intractable vomiting secondary to intestinal obstruction due to malignant disease. Vomiting was controlled or the volume of nasogastric aspirate was markedly reduced in 18 of 24 (75%) patients receiving a subcutaneous infusion of octreotide (median initial dose 300, range 100-600 micrograms/day) for a median of 9.4 (range 1-38) days. A further 2 patients had partial relief of their symptoms. Octreotide is an effective treatment of nausea and vomiting due to malignant bowel obstruction.

Adult↗
PubMed2000

Combination analysis of genetic alterations and cell proliferation in small intestinal carcinomas.

We analyzed K-ras and p53 mutations, microsatellite instability (MSI), and loss of heterozygosity (LOH) using the polymerase chain reaction (PCR) methods, as well as p53 expression and the Ki-67 labeling index (LI) using immunohistochemistry in 10 duodenal and 10 jejunal/ileal carcinomas. K-ras mutations were detected in two duodenal (20%) and three jejunal/ileal (30%) carcinomas and p53 mutations in one (10%) and three (30%), respectively. LOH of 17p was detected in two duodenal (20%) and two jejunal/ileal (20%) carcinomas and p53 expression in four duodenal (40%) and four jejunal/ileal (40%). One duodenal (10%) and two jejunal/ileal (20%) carcinomas demonstrated MSI. LOH of APC was detected in three jejunal/ileal (30%), but none of the duodenal carcinomas. The Ki-67 LI was 44% in duodenal and 52.6% in jejunal/ileal carcinomas. A subset of small intestinal carcinomas showed involvement of K-ras and p53 mutations, LOH of APC, and MSI. A difference was also apparent for LOH of APC between duodenal and jejunal/ileal carcinomas.

Adult↗
PubMed2002

Severe intestinal bleeding caused by intestinal metastases of a primary angiosarcome of the thyroid gland.

A 75 year old male presented with gastrointestinal bleeding after resection of both upper lobes of the lungs because of metastases. One year ago an angiosarcoma was the reason for a complete removal of the thyroid gland. In esophago-gastro-duodenoscopy we found multiple hemorrhagically stained polyploids lesions in the postbulbar duodenum and jejunum. Colonoscopy showed isolated polyploid lesions of the right flexura. Because of persistent gastrointestinal bleeding a diagnostic laparotomy was done. Intraoperative intestinoscopy demonstrated multiple bleeding metastasis. To remove many of the bleeding lesions two longer intestinal segments of the jejunum and ileum were resected. The histology of the metastases showed arrangements of polygonal cells with prominent nucleoli and atypical mitosis. Immunohistochemistry identified CD 31, vimentin and factor VIII associated antigen. There was an erosion of the superficial intestinal mucosal cells with resulting hemorrhage; same histology had been found in the thyroid gland and the right upper lobe of lung. Eight days after surgery the patient died because of respiratory and circulatory insufficiency.

Aged↗
PubMedDate not supplied

Malignant tumors of the small intestine.

SUMMARY: Malignant tumors of the small bowel are unusual and account for only 1% to 5% of all gastrointestinal tract malignancies. Thirteen cases of malignant tumors of the small bowel identified at the VAMC in Puerto Rico from January 1999 to September 2001 and a review of the literature are presented. The mean age of our cases was 67 (range: 45-78). Vague abdominal pain, nausea, vomiting, and melena were the most frequently reported symptoms. The average time from first symptoms to diagnosis was 3.2 months. A positive test for occult blood or hypochromic microcytic anemia was invariably present. Hyperbilirubinemia and increased alkaline phosphatase were warning signs that allowed earlier diagnosis in patients with duodenal tumors. Fifty-four percent of the lesions were detected by endoscopic examination while 46% relied on radiographic studies. Eleven had carcinomas and two malignant gastrointestinal stromal tumors. Neither carcinoids nor lymphomas were identified. Our report of thirteen cases of malignant small bowel tumors is unusual and exhibits differences with the previously reported data. The cases were identified in a limited Hispanic population in a short period of time. Aggressive evaluation and a high suspicion of these malignancies should be entertained whenever subtle symptoms and unexplained gastrointestinal blood loss are assessed.

Adenocarcinoma↗
PubMed1983

Synchronous carcinomas of the large intestine.

Sixty-one (3.0%) of 2029 patients managed operatively for carcinoma of the large intestine had synchronous carcinomas. In 47 (77.0%) of the 61 patients the carcinomas were in the same or adjacent segment(s) of large intestine. Adenomatous polyps were present in 18 (30%) patients compared to 269 (14%) of 1968 patients with a single cancer. A curative resection was performed in 40 of 61 patients, palliative resection in 16 and a non-resection palliative operation in five. Two patients required proctocolectomy and eight subtotal colectomy with ileorectal anastomosis. Cancer specific survival for the entire group and for those treated by curative resection did not differ significantly from that of patients with a single carcinoma. It is concluded that: (1) the presence of a second carcinoma does not significantly alter the survival prospects; (2) both pre-operative large intestinal examination and careful operative palpation of the entire large intestine should be performed, and (3) the significantly higher incidence of adenomatous polyps in patients with synchronous carcinomas is consistent with the polyp/cancer sequence hypothesis.

Adult↗
PubMed1986

Lymphoma of the small intestine.

In a group of 179 patients with small bowel tumours presenting over a 10 year period, lymphomas (20%) were the second most common group. The tumour was usually a white mass and was usually resectable. Eighty-one per cent of patients had regional invasion or metastasis at the time of surgery. Treatment was by surgery and radiotherapy for regional disease. If patients survived 2 years they were usually cured. The overall survival rate was 57%. Fresh tissue for expert histology is essential. Histological review by an experienced panel revealed many tumours previously classified as undifferentiated and several anaplastic carcinomata to be lymphoma. It has been recommended that the criteria for intestinal lymphoma be revised.

Adolescent↗
PubMed1990

The role of bowel surgery in the primary treatment of epithelial ovarian cancer.

Between January 1, 1979 and May 1, 1988, 24 of 192 patients treated for epithelial ovarian cancer underwent bowel surgery during primary therapy. It was found that survival was independent of this variable and depended largely upon the amount of residual disease following laparotomy. There was a major complication rate of 8% after primary bowel surgery, and this did not protect against the subsequent development of bowel obstruction. In conclusion, it is felt that bowel resection and anastomosis should only be undertaken if the patient is to be left with minimal or no macroscopic disease at completion of surgery.

Adult↗