1/21. Diffuse metastatic infiltration of a carcinoma into skeletal muscle.Skeletal muscle is one of the most unusual sites of metastasis from any malignancy. We report a patient with rapidly progressive contractures due to metastatic infiltration of a carcinoma of unknown origin into the skeletal muscle. This 61-year-old man presented with a 1-month history of rapidly evolving, painful restriction of mobility of his right arm and his legs. Computed tomography showed diffuse metastatic nodules in all muscles, particularly in the hip abductors. Muscle biopsy revealed extensive infiltration of the muscle with carcinoma cells.- - - - - - - - - - ranking = 1keywords = tract (Clic here for more details about this article) |
2/21. Data to the clinical manifestation of the Krukenberg tumour.Ovarian cancer is one of the most frequent malignant tumours in the female population. The screening of this tumour type is unsolved. The tumours are usually diagnosed in the advanced stage; thus the results of survival are unfavourable. Their histopathological appearance has a wide variety, with the occurrence of numerous metastatic forms. In these metastatic cases the choice of treatment is more difficult and prognosis is also worse. Among the metastatic tumours, the primary tumours of the gastrointestinal tract occur the most frequently. They are known as the Krukenberg tumour. Authors present two cases of Krukenberg tumours in order to summarize our knowledge on this rare tumour type and to give some practical advice.- - - - - - - - - - ranking = 16.798991480578keywords = gastrointestinal tract, tract (Clic here for more details about this article) |
3/21. Nodal metastases with unknown primary--an unusual presentation of carcinoid tumor.Carcinoid tumors arise from neuroendocrine cells and produce their symptoms mainly through secreted amines, and by a local desmoplastic response. The critical issue in the management of advanced carcinoid tumors is preservation of quality of life and symptomatic relief. This is because of the characteristic indolent growth which makes survival a secondary consideration, and the relative rarity of the condition. Although systemic therapy has been shown to improve symptoms, true survival benefit has not been established. We present a case of carcinoid tumor that has metastasized to mesenteric nodes, and probably other locations, with an occult primary site. The patient remains completely asymptomatic and continues to enjoy a normal lifestyle. No references were found in the literature concerning the management of asymptomatic, but metastatic carcinoids. This case thus constitutes a unique situation in which further treatment may not be beneficial and may even be harmful. Nevertheless, additional treatment is an important consideration in view of the known poor survival of those with metastatic disease versus localized, resectable tumor. However, the concept of medical therapy to improve survival in an asymptomatic individual, though theoretically attractive, has little precedence. In this article we have tried to address the therapeutic dilemma posed by this unusual clinical scenario.- - - - - - - - - - ranking = 1keywords = tract (Clic here for more details about this article) |
4/21. Basaloid squamous carcinoma in the liver.This report concerns a 46-year-old female who presented with 3 months of abdominal pain and underwent a right hemi-hepatectomy for a 27 x 25 x 15 cm, centrally necrotic tumor that showed histological, immunohistochemical and ultrastructural features typical of a basaloid squamous carcinoma (BSC). A primary tumor at another site was not diagnosed and she died of disease 2 years later after several intra-abdominal recurrences. The entity of BSC was first described in 1986 and is a rare, poorly differentiated variant of squamous cell carcinoma occurring in various sites including the upper aerodigestive tract, esophagus, lung, anus, cervix and thymus. It has never been reported arising in the liver. It has characteristic histological, immunohistochemical and ultrastructural features and is associated with a poor prognosis. Whilst no other primary tumor was diagnosed, it is not possible to substantiate that this is a primary hepatic tumor in the absence of an autopsy examination to exclude an occult malignancy in another site.- - - - - - - - - - ranking = 1keywords = tract (Clic here for more details about this article) |
5/21. Hematospermia as the presenting symptom of metastatic malignant melanoma of unknown primary origin.The presence of blood in the ejaculate is alarming to patients and may arise from many sources in the genitourinary tract. Fortunately, hematospermia is rarely due to underlying malignancy and only necessitates further evaluation with continued symptoms. We report a case of persistent hematospermia in a man with human immunodeficiency virus caused by metastatic malignant melanoma to both seminal vesicles. The evaluation included pelvic magnetic resonance imaging and transrectal ultrasound-guided biopsy. Metastases to the brain were subsequently discovered, but a primary source for the melanoma could not be identified. This is the first reported case of isolated involvement of the seminal vesicles with malignant melanoma and underscores the potential for serious disease presenting as hematospermia.- - - - - - - - - - ranking = 1keywords = tract (Clic here for more details about this article) |
6/21. Intestinal proliferation and delayed intestinal transit in a patient with a GLP-1-, GLP-2- and PYY-producing neuroendocrine carcinoma.glucagon-like peptides (GLP) 1 and 2 are hormones derived from the post-translational processing of proglucagon in the intestinal L cells that influence intestinal motility and small bowel growth, respectively. We describe a patient with a neuroendocrine tumor of unknown primary origin with peritoneal carcinomatosis and diffuse liver metastases, who presented with constipation and nocturnal itching for over 3 years. Small bowel follow-through showed decreased small intestinal motility and marked intestinal hypertrophy. Biopsies from mesenterial lymph nodes showed, histologically, a well-differentiated neuroendocrine tumor (G1), with positive immunostaining for chromogranin a, GLP-1, GLP-2 and polypeptide YY (PYY). Jejunal biopsy demonstrated marked intestinal mucosal hypertrophy. HPLC analysis combined with RIA of tumor and serum extracts revealed that the tumor was producing and releasing fasting levels of GLP-1 of 738 /-20.7 pg/ml (normal levels (nl) <100 pg/ml), GLP-2 of 3,150 /-9 pg/ml (nl <100 pg/ml) as well as PYY 550 pg/ml (nl <100 pg/ml). octreotide administration decreased levels of GLP-1 and GLP-2 and reduced small intestinal transit time from 150 to 50 min. However, tumor growth was not inhibited by octreotide, interferon or dacarbazine therapy and the patient died 8 months later. This is the first case report demonstrating the overproduction of GLP-1, GLP-2 and PYY from an neuroendocrine tumor, in a patient with intestinal hypertrophy and delayed intestinal transit time.- - - - - - - - - - ranking = 1keywords = tract (Clic here for more details about this article) |
7/21. Ileal malignant melanoma presenting as a mass with aneurysmal dilatation: a case report.Malignant melanoma is the most common metastatic tumor of the gastrointestinal tract and can present with fairly common constitutional symptoms. A 36-yr-old woman was found to have a secondary malignant melanoma in the terminal ileum with profuse aneurysmal dilatation, which is not the typical presentation of the malignant melanoma in the small intestine. Radiologic studies revealed a large tumor involving the distal ileum with aneurysmal dilatations having afferent and efferent loops, which needed to be differentiated from malignant lymphoma and other gastrointestinal tumors. Exploratory laparotomy was done, and we found a huge mass with plentiful aneurysmal dilatations; much the same of the findings from the previous studies. Segmental resection with the surrounding omentum was done followed by end-to-end anastomosis between both ends of the remaining ileum. She had been free from any evidence of the local or systemic recurrence for one year after the completion of eighteen months of the subcutaneous interferon treatment; postoperatively however, the occurrence of metastatic mass at the right axilla rendered us from complete resection due to severe penetration into the vital nerves and vessels in the axilla.- - - - - - - - - - ranking = 16.798991480578keywords = gastrointestinal tract, tract (Clic here for more details about this article) |
8/21. prostate cancer metastatic to the stomach. Clinical aspects and endoscopic diagnosis.Although prostate carcinoma is the most common malignancy in males, it rarely involves the gastrointestinal (GI) tract. We report the first case of endoscopically diagnosed prostate carcinoma metastatic to the stomach in an 88-year-old man whose heralding symptoms were nausea, vomiting, and epigastric pain. The initial diagnosis was not suggested at presentation, but an upper endoscopy and biopsy suggested adenocarcinoma of uncertain primary site subsequently confirmed to be of prostatic origin by immunohistochemical staining. We review the clinical aspects and endoscopic diagnosis of this condition.- - - - - - - - - - ranking = 1keywords = tract (Clic here for more details about this article) |
9/21. Esophageal acanthosis nigricans in association with adenocarcinoma from an unknown primary site.A case of acanthosis nigricans with esophageal involvement is presented. Six months after the patient's initial examination, metastatic adenocarcinoma from an unknown primary site was discovered. This represents the ninth reported case of esophageal acanthosis nigricans; six of the eight previously described cases were in association with malignancy localized to the gastrointestinal tract. Esophageal acanthosis nigricans may be a more specific marker for associated malignancy than cutaneous or oral mucosal manifestations. If present, esophageal acanthosis nigricans may serve as an indication for an extensive search for occult malignancy.- - - - - - - - - - ranking = 16.798991480578keywords = gastrointestinal tract, tract (Clic here for more details about this article) |
10/21. Cytoreductive surgery in the management of malignant ascites from adenocarcinoma of unknown primary (ACUP).A case report is presented of a 62-year-old man with adenocarcinoma of unknown primary (ACUP) who was admitted with massive ascites from intraperitoneal carcinomatosis secondary to a gastrointestinal tract malignancy. A computed tomography scan of the abdomen and pelvis confirmed extensive neoplasm. A near-total omentectomy was performed, and he was given postoperative systemic chemotherapy. Although his expected survival was 3 to 6 months, he lived 20 months, enjoying a good quality of life until the end. Cytoreductive surgery should be offered to some patients with peritoneal carcinomatosis because it may provide significant palliation.- - - - - - - - - - ranking = 16.798991480578keywords = gastrointestinal tract, tract (Clic here for more details about this article) |
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