1/51. Brief case report. Metastatic leiomyosarcoma of the liver.A case of metastatic leiomyosarcoma of the liver was presented. The clinical, radiological, pathologic and therapeutic aspects are mentioned.- - - - - - - - - - ranking = 1keywords = liver (Clic here for more details about this article) |
2/51. Ileal carcinoid tumor complicating carcinoid heart disease and secondary retroperitoneal fibrosis.A 70-year-old man with metastatic liver tumors showed carcinoid syndrome with clinical symptoms of facial flushing, palpitation, dyspnea, and an itching sensation. Regurgitation of the tricuspid and aortic valves was observed by echocardiography. An elevated serum level of serotonin and a high urine excretion of serotonin metabolites were confirmed. autopsy confirmed a serotonin-immunoreactive 1 cm ileal carcinoid tumor with metastasis to the liver, bone and peritoneum. The tumor cells were argyrophilic but not argentaffin, and showed erythrophagocytosis in the primary lesion. All the four heart valves and bilateral atrial endocardium showed fibromyxoid thickening, indicating the association of carcinoid heart disease. Desmoplastic reaction with deposition of sulfated acid mucopolysaccharides was also observed in the retroperitoneal space (secondary retroperitoneal fibrosis). Stenosis of the bilateral ureters and inferior mesenteric artery provoked hydronephrosis and lethal ischemic necrosis of the left-sided colon, respectively. Rarity of functioning ileal carcinoid tumor and pathogenesis of systemic fibroplasia are discussed.- - - - - - - - - - ranking = 0.4keywords = liver (Clic here for more details about this article) |
3/51. adenocarcinoma of the ileum producing carbohydrate antigen 19-9: report of a case.We report herein the case of an 81-year-old woman found to have small intestinal carcinoma producing carbohydrate antigen (CA)19-9, in whom recurrence on the abdominal wall was strongly suspected 4 months after resection. She presented to our hospital with acute abdominal pain with severe anemia. Marked serum elevation of CA19-9 to 164.8 U/ml suggested a progression to malignancy. A fluorography using an ileus tube revealed an abnormal mucosal pattern. An exploratory laparotomy showed an incomplete annular constrictive Borrmann type 2 tumor, located approximately 190 cm from Treitz's ligament, without any signs of peritoneal or hepatic metastases. Histological examination confirmed a diagnosis of papillotubular adenocarcinoma without metastases of the regional lymph nodes. CA19-9 antigenicity was detected in the cytoplasm and on the surface of the cancer cells, using the monoclonal CA19-9 antibody, NS19-9. In this report, we demonstrate the CA19-9 productivity and distribution of the cancer tissues in relation to their prognosis.- - - - - - - - - - ranking = 0.22485560184559keywords = hepatic (Clic here for more details about this article) |
4/51. Complete histological regression of metastatic carcinoid tumour after treatment with octreotide.A 69-year-old woman was admitted with facial flushing, weight loss and intermittent diarrhoea. Urinary 5-hydroxyindole-acetic acid (5-HIAA) level was elevated at 200 micromol/24 h (normal: < 50). Computerized tomography (CT) demonstrated multiple enhancing liver metastases with biopsy proven carcinoid metastases with no evidence of primary tumour at this stage. octreotide was initiated, resulting in marked improvement in carcinoid symptoms. Nine years later, she presented with abdominal pain and slightly deranged liver function tests. Repeat colonoscopy at this stage, showed an ileal tumour causing impending obstruction, necessitating urgent right hemicolectomy. histology demonstrated primary carcinoid tumour. She continued on octreotide. Three years later at the age of 81 years, she suffered a fatal haemorrhagic stroke. autopsy revealed complete regression of hepatic carcinoid metastases.- - - - - - - - - - ranking = 0.62485560184559keywords = hepatic, liver (Clic here for more details about this article) |
5/51. Malignancy in slow motion: diagnosis of biochemically apparent, but otherwise occult persistent disease 21 years after resection of a carcinoid tumour of the terminal ileum.Carcinoid tumors may relapse after a long time span following initial diagnosis, and relapse might be clinically inapparent despite biochemical indications due to a low sensitivity of conventional methods. We present the case of a patient who had biochemical indication for hidden disease persistence for more than two decades. In 1978, a 39-year-old man underwent surgery for a carcinoid tumour of the ileum measuring 3.5 cm with multiple local lymph-node metastases. After surgery, however, serotonin- and urinary 5-hydroxy-indole-acetic-acid (5-HIAA) remained markedly elevated, and persisted over more than 20 years at levels between 600 and 950 ng/ml for serum serotonin (normal range 40-400 ng/ml) and 29-35 mg/24 h for 5-HIAA (normal range 2-9 mg/24 h). Despite this, regular radiological follow-up, including sonography and CT-scan, did not reveal the location of suspected malignancy until 1999, when the patient was re-admitted to our hospital for a hypertensive episode. CT-scanning of the abdomen showed a singular lesion within the liver, which was verified as recurrence of the carcinoid by fine needle biopsy. somatostatin receptor scintigraphy using (111)In-DTPA-D-Phe1-octreotide revealed a second lesion within the liver along with local recurrence at the anastomosis, which was verified by surgery. While the propensity for late relapse of ileal carcinoids has repeatedly been demonstrated, a case with biochemical signs of disease persistence over a time span of 21 years before final diagnosis is unusual. In addition, our case reflects the low sensitivity of conventional radiological evaluation for localization of carcinoid tumours as compared to somatostatin receptor scanning.- - - - - - - - - - ranking = 0.4keywords = liver (Clic here for more details about this article) |
6/51. Giant cell carcinoma of the liver: occurrence in a patient with ileal carcinoid, medullary breast carcinoma and pulmonary aspergillosis.Pure giant cell carcinoma of the liver is a rare tumor that is usually associated with cirrhosis. Its occurrence in a young woman without evidence of cirrhosis, and in association with two other uncommon tumors, is described in this report.- - - - - - - - - - ranking = 1keywords = liver (Clic here for more details about this article) |
7/51. Post-transplant malignant lymphoma with monoclonal immunoglobulin gene rearrangement and polyclonal Epstein-Barr virus episomes.This report describes the case of an 8 year old boy who developed ileocecal B cell lymphoma after liver transplantation. The patient underwent orthotopic liver transplantation for biliary atresia and had been given immunosuppressive drugs--cyclosporin A and tacrolimus hydrate. Six years after the liver transplantation, the patient had a sudden onset of fever and abdominal pain. Necropsy revealed an ileocecal mass that was a B cell lymphoma. Epstein-Barr virus (EBV) encoded rna 1 was demonstrated in lymphoma cells and hyperplastic follicular germinal centre cells in various tissues. Although monoclonal immunoglobulin gene rearrangement was detected in the liver, EBV episomes were of polyclonal origin and lytic forms of EBV were also demonstrated by Southern blotting. Immunohistochemically, lymphoma cells were positive for p53 but negative for latent membrane protein 1 and EBV nuclear antigen 2. These findings suggested that this B cell lymphoma might have occurred sporadically, regardless of EBV infection.- - - - - - - - - - ranking = 0.8keywords = liver (Clic here for more details about this article) |
8/51. adenocarcinoma with extensive neuroendocrine differentiation arising in an ileal diverticulum: report of a case.A 62-year-old man presented with right-sided abdominal pain. Radiologic examinations disclosed a solid tumor in the ileocecal mesentery that obstructed the right ureter, thus resulting in urinary extravasation. An en bloc tumor resection with the ascending colon, the terminal ileum, and a portion of the right ureter was performed. Histopathologically, the tumor was adenocarcinoma with extensive neuroendocrine differentiation which had arisen in an ileal diverticulum. The patient developed metastases to the lymph nodes, liver, and brain, and died 18 months after surgery.- - - - - - - - - - ranking = 0.2keywords = liver (Clic here for more details about this article) |
9/51. Peritoneal implanted hepatocellular carcinoma with rupture after TACE presented as acute appendicitis.We are reporting a rare case of peritoneal implanted hepatocellular carcinoma with rupture after transarterial chemoembolization mimicking acute appendicitis. A 45-year-old male patient presented with fever and manifestations of acute appendicitis. He received transarterial chemoembolization for hepatocellular carcinoma two months before. Emergent exploratory laparotomy revealed a normal appendix, a ruptured nodule located at the serosal surface of the terminal ileum with hemoperitoneum, and ruptured hepatocellular carcinoma at the junction of segments 4 and 8 of the liver. There was no peritoneal carcinomatosis, direct invasion to the surrounding tissue, or lymph node involvement. Postoperative course was uneventful. Histopathological examination of the resected nodule revealed metastatic hepatocellular carcinoma.- - - - - - - - - - ranking = 0.2keywords = liver (Clic here for more details about this article) |
10/51. Chemoembolization in the treatment of metastatic ileocolic carcinoid.Carcinoid tumours are enigmatic, slow growing malignancies, which occur most frequently (74%) in the gastrointestinal tract. Symptoms of the carcinoid syndrome (flushing and diarrhoea) are infrequent, occurring in approximately 10% of the patients with small bowel carcinoid. A 45-year-old patient with multiple liver metastases, diagnosed in 1994 with nonHodgkin's lymphoma after undergoing surgery for a distal ileal tumour, was referred to us by the Department of Haematology. At that moment the issue of a differential diagnosis with a carcinoid tumour arose, due to the long evolution and lack of evidence to support the initial diagnosis. The carcinoid syndrome was in fact present (the patient experiencing flush after small amounts of alcohol and emotions) and also we identified elevated values of 5HIAA. Reevaluation of the histologic sections of the ileal tumour as well as an ultrasound guided fine needle aspiration of an intrahepatic lesion confirmed the diagnosis of "carcinoid tumour". This conclusion lead to new therapeutic options for this patient. One of the main therapeutic options used in treating multiple liver metastases from a carcinoid tumour is chemoembolization and this case offered an excellent opportunity to present this therapy.- - - - - - - - - - ranking = 0.62485560184559keywords = hepatic, liver (Clic here for more details about this article) |
| | Next -> |