1/10. A case of watery diarrhea, hypokalemia and hypercalcemia associated with nonulcerogenic islet cell tumor of the pancreas.A case of watery diarrhea, hypokalemia and hypercalcemia associated with an islet cell tumor was described. A 62-year old man exhibited frequent watery diarrhea and hypokalemia for two years. He had no peptic ulcer and serum gastrin level was normal. His serum calcium was abnormally high and serum phosphate was lowered. He had secretin-like activity in his plasma. autopsy revealed a small islet cell tumor in the pancreas and several metastatic masses in the liver. Microscopic examination revealed the tumor cell was not beta, alpha nor D cells. By electron microscopy the secretion granules of the tumor cell resembled those of S, M and T cells. It was not possible to decide which of the tree cell types was responsible for the pancreatic cholera.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
2/10. Primary pulmonary hemangiopericytoma: early local recurrence after perioperative rupture of the giant tumor mass (two cases).We report two recent observations of giant hemangiopericytoma of the lung, one in a 4-year-old child and another in a 65-year-old man. There were no specific clinical signs, but the radiologic appearance was rather characteristic in both cases, as were the histologic findings. pneumonectomy was carried out, complicated in each case by rupture of the fragile, incomplete pseudocapsule and diffuse dissemination of necrotic tumor tissue in the operative field and opposite bronchial tree. Outcome was fatal in both cases within a few months, with extensive, rapidly growing metastases in the subcutaneous scar tissue of the thoracotomy and in the other lung and in one case with diffuse diaphragmatic and intraabdominal metastases. These two observations will offer some guidelines for better understanding of this rare localization of hemangiopericytoma, its natural history, and its optimal treatment, with special reference to the malignant potential and local recurrence rate.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
3/10. somatostatinoma: a case report and review of the literature.Somatostatinomas are rare endocrine tumors that were first described in 1977. In addition to the present case report, there have been 31 cases reported in the literature. We have reviewed the literature to integrate the symptoms, physical findings, diagnostic tests, treatment, and length of survival of these patients. Although the symptoms that occurred in the majority of cases were those that are seen in most patients with intra-abdominal neoplasms, symptoms relating to the presence of excess circulating somatostatin--diabetes, maldigestion, and cholelithiasis--were frequently seen. Physical findings and the results of diagnostic tests were usually nonspecific. The majority of the patients underwent radical surgical procedures (Whipple procedure or pancreatic resection). The pancreas was the most frequent site of involvement (21/31 cases), but primaries in the duodenum, ampulla of vater, cystic duct, and jejunum have been described as well. Metastases were most frequently seen in the liver and lymph nodes. Chemotherapeutic agents were administered to 10 patients, usually as adjuvant therapy, and appear to be useful in treating recurrent and metastatic disease. The one-year survival of these patients is 48%, which is better than that for patients with carcinoma of the pancreas or biliary tree. Therefore, it is important that the diagnosis of somatostinoma be made so that the patient may be treated accordingly and followed by serial somatostatin levels for evidence of metastasis or recurrent disease.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
4/10. Disseminated bombesin-producing carcinoid tumor of pulmonary origin.A case of a bombesin-producing carcinoid tumor of the lung is reported. Morphologically, the tumor was a typical argentaffinic carcinoid which contained bombesin as demonstrated by diffuse granular cytoplasmic staining using the immunoperoxidase method. Electron microscopy revealed dense-core granules measuring 100-150 nm, consistent with bombesin-containing endocrine cells. In man, bombesin-producing endocrine cells are found predominantly in the bronchopulmonary tree and scattered throughout the intestinal tract. The majority of previously reported bombesin-producing tumors have arisen, as in this case, in the lung; thus the demonstration of bombesin-like immunoreactivity in a widely metastatic tumor should direct the search for a primary lesion to the lung. bombesin is known to have gastrin-releasing hormone activity. The presence of a gastric ulcer in the present patient raised the possibility of a bombesin-mediated Zollinger-Ellison-like syndrome, an association not previously described.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
5/10. Bronchial adenoma: a malignant misnomer.Bronchial adenomas are a histologically and clinically diverse group of respiratory tract neoplasms arising from mucous glands and ducts of the tracheobronchial tree. They represent 1% of pulmonary malignancies. The traditional concept of a single, histologically benign form is challenged and the malignant potential of these tumors is stressed. Three main cell types with their characteristic histopathologic and clinical features are discussed: carcinoid, adenoid cystic carcinoma, and mucoepidermoid carcinoma. A case of bronchial carcinoid with hepatic metastases is reported, emphasizing the malignant potential of this controversial group of tumors. The appropriate diagnostic evaluation is outlined and aggressive surgical management is stressed. Chemotherapy and radiation therapy which are reserved mainly for palliation do not add to overall five year survival rates.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
6/10. Percutaneously placed biliary stents in the management of malignant biliary obstruction.The management of malignant obstruction of the biliary tree is difficult and often unsuccessful. Advances in the technique of percutaneous transhepatic catheterization have made possible the nonoperative internal drainage of obstructed lesions. We report successful decompression of ten patients with unresectable biliary neoplasms using percutaneously placed internal biliary stents.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
7/10. Metastatic colon carcinoma simulating primary bile duct carcinoma via endoscopic cholangiography.A case of metastatic colon carcinoma simulating primary bile duct carcinoma is presented. The radiographic similarities via endoscopic retrograde cholangiopancreatography include bile duct narrowing and mucosal destruction. A distinguishing feature, however, is failure of the intrahepatic bile ducts to dilate in metastatic carcinoma to the biliary tree.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
8/10. The protean gastrointestinal manifestations of metastatic breast carcinoma.Metastatic breast carcinoma commonly remains silent for many years following initial diagnosis and mastectomy, and then appears as metastases at various locations. Gastrointestinal involvement is not uncommon and includes any site along the whole length of the gut, the liver, and the biliary tree; it occasionally simulates other diseases and causes difficulty in diagnosis. The radiographic features and differential diagnoses are discussed.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
9/10. Unusual presentation of bronchogenic carcinoma: case report and review of the literature.Although blood spread of pulmonary malignancy presumably occurs through microembolization, frank embolization of tumor fragments is uncommon. The first reported case of bronchogenic carcinoma appearing as a peripheral arterial embolus is described. The patient, a 64-year-old female, had acute ischemia of the left leg secondary to tumor embolism to the left profunda femoris and popliteal arteries. Shortly after embolectomy, she suffered atelectasis of the whole left lung from an epitheloid carcinoma in the left main bronchus. Twenty-eight cases of frank tumor embolism to the arterial tree occurring during the course of a noncardiac malignancy have been reported. None, however, occurred as an initial event. Pulmonary metastasis in patients with advanced malignancy was the source of the arterial emboli in 45% (13/29) of reported cases, but bronchogenic carcinoma was the original cell type in 38% (11/29) of cases. In general, arterial tumor embolism is a complication of advanced malignancy usually originating from one of multiple pulmonary metastases. This first case report of tumor embolism to a lower extremity occurring as the initial event in the clinical course of a bronchogenic carcinoma serves to emphasize the protein manifestations of malignant disease.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
10/10. Relief of malignant obstructive jaundice by percutaneous insertion of a permanent prosthesis in the biliary tree.Twelve patients with malignant obstruction of the biliary tree were treated by dilating the lesion percutaneously and inserting an internal large-bore teflon prosthesis in place bridging the the stricture. All 12 patients had unresectable neoplasms. The procedure was devised because existing modes of palliation using surgical techniques are associated with significant mortality or mobidity. There are also many problems with nonsurgical catheter drainage. decompression was achieved in all 12 patients as shown radiographically by passage of contrast into the duodenum. Disappearance of pruitus was achieved in seven of seven patients, and in 10 of 12 disappearance of jaundice (bilirubin, before prosthesis, 18.4 /- 4.5 mg/dl [mean /- 1 SD], bilirubin 1 month after prosthesis, 1.8 /- 0.6 mg/dl [mean /- 1 SD], P less than 0.001) with improvement of general clinical status was achieved. Percutaneous placement of a permanent biliary tract prosthesis is safe and effective for the palliative decompression of malignant biliary tract obstruction.- - - - - - - - - - ranking = 5keywords = tree (Clic here for more details about this article) |
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