1/7. Coexisting carcinoid tumors in familial adenomatous polyposis-associated upper intestinal adenomas.Upper gastrointestinal polyps and extraintestinal tumors are well recognized in association with familial adenomatous polyposis (FAP). Although carcinoid tumors have been reported in association with sporadic colonic neoplasms and ulcerative colitis, to date, carcinoids have not been reported in association with FAP. We report a patient with FAP who has recurrent carcinoid tumors located at the bases of duodenal adenomas. The genetic basis of carcinoid neoplasms is still uncertain. This report may represent the clinical effect of the APC gene mutation on the enterochromaffin cell line manifesting as recurrent carcinoid tumors in physical association with intestinal adenomas. Future genetic analysis and epidemiological studies may be of value in determining whether a true association exists.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/7. Carcinoid of the papilla of Vater; a case report.A 68-year-old Japanese man, without any symptoms, was found to have a carcinoid tumor of the ampulla of vater. A physical examination indicated no anemia or jaundice and no abnormal findings at all in the chest or abdomen. Except for glucose intolerance, the routine laboratory data were normal. An endoscopic biopsy was performed that suggested malignant tumor cells. There were no signs of carcinoid syndrome. A pylorus-preserving pancreatoduodenectomy with extensive lymph node dissection was performed. Histological and immunohistochemical studies resulted in the diagnosis of a carcinoid of the papilla of Vater, without regional lymph node metastases. Although postoperative, an anastomotic leakage of pancreaticogastrostomy was noted; the pancreatic fistula was closed seven weeks later to use the somatostatin analogue.- - - - - - - - - - ranking = 15.773899646475keywords = physical examination, physical (Clic here for more details about this article) |
3/7. Multiple gastrointestinal stromal tumors and synchronous ileal carcinoids.BACKGROUND: A 74-year-old African-American male presented with a 3-day history of hematemesis and melena. The patient reported no abdominal pain, constitutional symptoms, bright red blood per rectum, constipation, or diarrhea. His physical examination and medical history were unremarkable except for benign prostatic hypertrophy. An esophagogastroduodenoscopy showed a 3 x 2 x 2 cm smooth round mass in the cardia, 2 cm distal to the gastroesophageal junction. biopsy of the mass revealed an ulcerated tumor composed of spindle cells. immunohistochemistry showed positive staining for a number of biochemical markers, including KIT, Ki-67 and smooth muscle actin, but was negative for the markers S100 and desmin. A gastric-wedge resection revealed an ulcerated 4.5 cm mass in the stomach, and exploration of the abdomen revealed two ileal carcinoid tumors, jejunal diverticula and reactive mesenteric lymphadenopathy. INVESTIGATIONS: Esophagogastroduodenoscopy, biopsy, CT scan, immunohistochemistry, dna microarray analysis and quantitative reverse transcriptase-PCR. diagnosis: Multiple gastrointestinal stromal tumors occurring concomitantly with ileal carcinoids. MANAGEMENT: Gastric-wedge resection and segmental resection.- - - - - - - - - - ranking = 15.773899646475keywords = physical examination, physical (Clic here for more details about this article) |
4/7. Preoperative diagnosis of acromegaly by growth hormone-releasing factor radioimmunoassay.acromegaly was diagnosed in a 37-year-old woman with classical physical and biochemical findings; an enlarged sella on computed tomography suggested the presence of a pituitary macroadenoma. Radiologic evidence of a lung mass prompted radioimmunoassay of plasma growth hormone-releasing factor (7,500 pg/ml; normal less than 100 pg/ml). After resection of a bronchial carcinoid, which stained positive for growth hormone-releasing factor, circulating growth hormone-releasing factor levels normalized. Subsequently, her clinical, biochemical, and radiologic evidence for acromegaly resolved. This case represents the first reported use of the human pancreatic growth hormone-releasing factor 1-40 radioimmunoassay to preoperatively diagnose this rare etiology of acromegaly.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/7. Carcinoid tumors of the middle ear.Carcinoid tumors of the middle ear are rare lesions that represent a class within the spectrum of adenomatous neoplasms. We present four cases that were diagnosed and treated at our institution since 1973, and review the pool of 12 cases in regard to their presentation, symptomatology, physical examination, audiometric and radiographic evaluations, operative procedure and findings, histopathology, and postoperative course. Successful treatment of these low-grade malignancies requires complete excision of the tumor mass, along with the ossicles if they are involved with disease, in order to prevent local recurrence. Although locally invasive, these tumors have a low propensity for distant metastasis. The diagnosis of carcinoid tumor should be considered in all cases of adenomatous neoplasms of the middle ear and mastoid.- - - - - - - - - - ranking = 15.773899646475keywords = physical examination, physical (Clic here for more details about this article) |
6/7. carcinoid tumor: an extremely unusual presacral lesion. Report of a case.PURPOSE: Use of endorectal ultrasonography in preoperative evaluation of a presacral lesion is demonstrated. METHOD: The natural history, presentation, evaluation, and treatment of presacral lesions in adult patients are presented. The case of a female patient with a presacral carcinoid tumor is presented and discussed. RESULTS: The patient underwent preoperative evaluation including physical examination, hematologic studies, proctosigmoidoscopy, magnetic resonance imaging, computed tomographic scanning, and endorectal ultrasonography. ultrasonography proved to be extremely valuable in differentiating tumor compression from tumor invasion of the rectal wall. The patient underwent en bloc excision of the lesion, surrounding tissue, and coccyx. Pathologic diagnosis was carcinoid tumor, possibly replacing a presacral lymph node. Postoperative complete gastrointestinal tract work-up and urinary 5-hydroxyindoleacetic acid analysis along with preoperative imaging revealed no evidence of synchronous lesions or additional metastases. CONCLUSIONS: Presacral lesions are extremely rare entities. The role of endorectal ultrasonography has not been clearly defined. This case demonstrates the value of this simple and safe imaging procedure in detecting bowel wall compression vs. invasion, greatly assisting in planning an operative approach.- - - - - - - - - - ranking = 15.773899646475keywords = physical examination, physical (Clic here for more details about this article) |
7/7. carcinoid tumor metastatic to the breast.breast metastases from nonmammary malignant neoplasms are uncommon, accounting for approximately 2% of breast tumors. There are 13 cases reported in the literature of carcinoid tumor metastatic to the breast, and more than half of these cases were misdiagnosed pathologically and treated as primary breast carcinoma, even in cases with a medical record of carcinoid tumor. We describe a patient with a history of asthma and diarrhea who presented to the University of arkansas for Medical Sciences, Little Rock, with an exacerbation of the asthma. The results of routine physical examination revealed a mass in the left breast. A diagnosis of carcinoid tumor metastatic to the breast was made after a partial mastectomy was performed. The differential diagnosis between primary carcinoid tumor of the breast and carcinoid tumor metastatic to the breast is often controversial in surgical pathology. Diagnoses need to be made correlating clinical and histological examination in difficult cases in which there is not a diagnosis of carcinoid tumor elsewhere. Accurate diagnosis of breast metastases is important to avoid unnecessary treatment.- - - - - - - - - - ranking = 15.773899646475keywords = physical examination, physical (Clic here for more details about this article) |