1/12. 131I-meta-iodobenzylguanidine in the management of metastatic midgut carcinoid tumors.The management of metastatic neuroendocrine tumors incorporates multimodal therapy with surgery, biotherapy, and chemotherapy. Tumor-targeted therapies using radiolabeled octreotide and metaiodobenzylguanidine (mIBG) represent a novel treatment approach. The aim of this study was to evaluate the effectiveness of 131I-mIBG in the treatment of metastatic midgut carcinoid tumors. survival outcomes were assessed for patients treated at two regional cancer centers and then compared. One center used 131I-mIBG routinely in the management of metastatic carcinoid tumors (center A), and the other did not use this modality (center B). Only patients with histologically proven metastatic carcinoid tumor shown, or thought most likely, to be of midgut origin were included in the study. During the period 1980 to 2002, a series of 58 patients from center A with metastatic carcinoid tumor arising from the midgut underwent multimodality therapy with the addition of 131I-mIBG. Their median age was 64 years. The median dose of 131I-mIBG administered was 6751 MBq, and there was an average of 2.8 treatments per patient. During the same period, 58 patients with metastatic carcinoid were treated at center B with similar multimodality therapy without the use of 131I-mIBG therapy. Their median age was 65 years. Survivals at 3 and 5 years were 77% and 63%, respectively (95% CI 47-75), for group A. The 3- and 5-year survivals for group B were 56% and 47% (95% CI 34-59), respectively. The mean follow-up was 6.6 years for group A and 5.0 years for group B. Although retrospective in nature, this study suggests that the addition of 131I-mIBG therapy to the treatment protocol of patients with metastatic midgut carcinoid tumors prolongs survival.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/12. Double jejunal intussusception in an adult with chronic subileus due to a giant lipoma: a case report.We present a case of a 40-year-old male with a clinical history of intermittent intestinal occlusion, abdominal pain and moderate weight loss. physical examination and laboratory tests were unremarkable. diagnostic imaging including CT, MR and small-bowel barium x-rays provided evidence of a jejunal lesion of an unknown nature downstream of the ligament of Treitz. Only at surgery was it possible to identify a double intussusception due to a giant stalked polyp which the histological examination revealed to be a submucosal lipoma.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/12. Cystic lymphangioma of the jejunal mesentery in an adult: a case report.We herein describe the case of a 27-year-old female, who presented with a large mass of the upper left abdominal cavity discovered incidentally, through an annual health examination. Preoperative studies including abdominal ultrasonography and magnetic resonance imaging were performed, but they could not accurately determine the nature of the tumor. At laparotomy, a large cystic tumor of the small bowel mesentery was found. Histopathologic examination diagnosed the tumor as a cystic lymphangioma. Although lymphangiomas are rare, especially in the abdomen of adults, they may sometimes present as acute abdomen, causing complications that require emergent surgery.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/12. Metastasis of hepatocellular carcinoma to the proximal jejunum manifested by occult gastrointestinal bleeding.A 31-yr-old man, who had received left hepatic lobectomy for a ruptured hepatocellular carcinoma 17 months previously, began to have elevation of serum alpha-fetoprotein and occult gastrointestinal bleeding. Abdominal computed tomography, angiography, ultrasonography, upper gastrointestinal panendoscopy, colon-fiberscopy and endoscopic retrograde cholangiopancreaticography failed to disclose any recurrent intrahepatic tumor or bleeder in the gastrointestinal tract. However, a barium meal study revealed an intussusception with a suspicious nodular lesion in the proximal jejunum as the leading edge, which, after laparotomy, was proven to be a metastatic hepatocellular carcinoma and the cause of the gastrointestinal bleeding. The serosal side of this lesion was free from cancer involvement and there was no peritoneal implantation or lymph node involvement. The metastasis is probably hematogenous. The extremely unusual location involved by hepatocellular carcinoma in this patient signifies the ubiquitous nature of metastasis in this cancer.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/12. Malignant lymphoma and malignant angioendotheliomatosis: one disease.A patient was diagnosed as having angioendotheliomatosis proliferans systemisata (APS) based on characteristic clinical and histologic features. A few days later, malignant lymphoma involving the gut was discovered. Immunohistochemical and electronmicroscopic studies confirmed the nonendothelial and lymphoid nature of intravascular tumor cells. This is the sixth case in which malignant lymphoma has been shown to involve the vessels of the skin (and probably of other organs) in a pattern identical to that seen in APS.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/12. Polypoid gastric heterotopy of the small intestine in a patient with primary hyperparathyroidism and alpha-1-antitrypsin deficiency belonging to a MEA-family. With particular reference to the ultrastructure of the epithelial cells.A patient with a solitary polypoid gastric heterotopy in the jejunum and severe bleeding as a complication is described. Previous reports on this rare disorder and the conditions of its development are discussed. The patient belongs to a family with multiple endocrine adenomatosis (MEA), some members of which had an alpha-1-antitrypsin deficiency. The association between the familial disease and the gastric heterotopy in this case might be another argument for the assumed congenital nature of the latter. The polyp was studied by means of light and electron microscopy. It was mostly lined by fundic mucosa and only partially by antral mucosa. Focal foveolar hyperplasia, cysts and lymphoplasmacellular infiltration of the mucosa are regarded as secondary tissue alteration. Parietal cells, chief and endocrine cells were identified. The parietal cells were in the nonsecreting state and appeared in two distinct forms which are described in detail.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/12. Pulmonary rhabdomyosarcoma with isolated small bowel metastasis. A report of a case with immunohistochemical and ultrastructural studies.A unique case of pulmonary rhabdomyosarcoma with an isolated, symptomatic small bowel metastasis is presented. The tumor affected the middle lobe, and was treated with a right pneumonectomy. Eleven months after the operation, an isolated small bowel metastasis, which produced intestinal obstruction, was resected. The patient is currently alive, 11 months after operation. The myogenous nature of the tumor was confirmed by the immunohistochemical demonstration of myoglobin in the pulmonary and enteric lesion by the ultrastructural findings of poorly developed sarcomeres.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/12. Extramedullary plasmacytoma of the small intestine: a case report studied with electron microscopy and immunoperoxidase technique.A well-documented case of solitary extramedullary plasmacytoma located in the small intestine is presented. The patient underwent local resection of the tumor, and shows no signs of local recurrence or dissemination of the disease after a five-year follow-up. The pathologic nature of plasma cell tumors is discussed, and it is concluded that the demonstration of intracytoplasmatic immunoglobulin is essential for the exact classification of plasma cell neoplasms.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/12. An ultrastructural study of a jejunal inflammatory fibroid polyp.Ultrastructural appearances of a small intestinal inflammatory fibroid polyp are reported. There is a vascular scaffolding, with interstices which contain regular and fibrous long-spacing type collagen, condensed lamellar basement membrane fibroblasts, basophils, some eosinophils and histiocytes. In addition other cells less easily characterized but believed to be of an endothelial and primitive mesenchymal cell nature are recognized. Possible origins of the polyp are considered.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/12. Cystic lymphangioma of stomach and jejunum: report of one case.A case of cystic lymphangioma of stomach and jejunum is reported. The patient, a woman aged 58, was referred to the hospital for a melena of 4 days duration, which was interpreted as related to an old history of hypertrophic gastritis and duodenal ulcer. A conservative treatment with transfusions, cimetidine i.v., and gastric washout with antacids was started, but the hemorrhage appeared unresponsive, so an explorative laparotomy was performed. At the operation a soft pliable cystic mass in the anterior wall of the stomach was found; a smaller one was felt in the second jejunal loop. A Billroth II gastroduodenal resection was performed. The diagnosis of nature was only microscopic. At 9 months follow-up the patient is well, free of the disease.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
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