Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.076
Filtrar
1.
Anticancer Res ; 40(4): 2151-2156, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32234908

RESUMO

BACKGROUND/AIM: We compared patients with advanced gastric cancer [Union for International Cancer Control (UICC) III] versus patients with stage UICC IV and peritoneal carcinomatosis treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) versus patients with stage UICC IV treated without HIPEC to ascertain if CRS and HIPEC improve overall survival (OS). PATIENTS AND METHODS: We retrospectively analysed thirty-seven advanced gastric cancer patients who had been treated at our department from 2012 to 2017. The endpoint was median OS. RESULTS: Eighteen (49%) patients with UICC stage III showed a median OS of 37.4 months. Eight (21%) patients in the HIPEC group reached a median OS of 33.8 months. Median OS in the UICC IV group (11 patients, 30%) treated with a palliative concept was 6.2 months and therefore significantly worse (p=0.004). CONCLUSION: A systemic approach combined with CRS and HIPEC in selected stage IV gastric cancer patients improves the OS comparable to patients in UICC stage III.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Procedimentos Cirúrgicos de Citorredução/métodos , Hipertermia Induzida/métodos , Neoplasias Peritoneais/terapia , Neoplasias Gástricas/terapia , Idoso , Terapia Combinada , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Neoplasias Peritoneais/complicações , Estudos Retrospectivos , Neoplasias Gástricas/complicações , Resultado do Tratamento
2.
Zhonghua Wei Chang Wai Ke Za Zhi ; 22(11): 1051-1057, 2019 Nov 25.
Artigo em Chinês | MEDLINE | ID: mdl-31770836

RESUMO

Objective: To explore the short-term efficacy and prognosis of palliative surgical treatment for malignant bowel obstruction (MBO) caused by peritoneal metastasis of colorectal cancer (mCRC). Methods: A retrospective cohort study was conducted. The inclusion criteria for patients were as follows: (1) primary colorectal cancer; (2) massive peritoneal metastasis; (3)obstructive site located below Treitz ligament by imaging; (4) obstruction refractory to conservative treatment; (5) estimated rese survival time more than 2 months; (6) patients and their families had strong willingness for operation; (7) surgical treatment included stoma/bypass and debulking surgery. In accordance with the above criteria, clinicopathological data of 46 patients undergoing palliative surgery at Peking University Gastrointestinal Cancer Center, Unit III from January 2016 to October 2018 were retrospectively collected. Postoperative symptomatic relief rate, morbidity of complication within 30 days, complication classification (Clavien-Dindo classification), mortality and survival after operation were analyzed. Kaplan-Meier method was used to evaluate survival and Cox regression analysis was used to identify prognostic factors. Results: Among 46 patients, 30 were male and 16 were female with median age of 63 (19-87) years; 23 patients received stoma/bypass surgery (stoma/bypass group), and 23 cases received tumor debulking surgery (debulking group). The overall symptom relief rate was 76.1% (35/46), while symptom relief rate in the debulking group was 91.3% (21/23), which was significantly higher than 60.9% (14/23) in the stoma/bypass group (χ(2)=4.301, P=0.038). Postoperative complications occurred in 25 patients. The complication rate was 52.2% (12/23) in the debulking group and 56.5% (13/23) in the stoma/bypass group, without statistically significant difference (χ(2)=0.088, P=0.767). Morbidity of complication beyond grade III was 8.7% (2/23) and 13.0% (3/23) in the debulking group and stoma/bypass group respectively, without statistically significant difference (χ(2)=0.224, P=0.636). Four patients died within 30 days after operation, 2 (8.7%) in each group. Twenty-four patients underwent 1-8 cycles of chemotherapy ± targeting therapy (regimens: CapeOX ± Bevacizumab, FOLFOX/FOLFIRI ± Bevacizumab/Cetuximab), including 10 cases in the stoma/bypass group and 14 cases in the debulking group. Two patients of debulking group received postoperative radiotherapy and chemotherapy (50.6 Gy/22 f, with concurrent oral capecitabine). Till the last follow up of April 2019, 34 patients died (34/46, 73.9%) with a median overall survival time of 6.4 months, and the 6-month and 1-year survival rate was 54.5% and 29.2% respectively. The median survival time in the debulking group was significantly longer than that in the stoma/bypass group (11.5 months vs. 5.2 months, χ(2)=5.117, P=0.024). The median survival time of the 35 patients with symptomatic relief after operation was significant longer than that of 11 patients without relief (7.1 months vs 5.1 months, χ(2)=3.844, P=0.050). Multivariate analysis showed stoma/bypass surgery (HR=2.917, 95%CI:1.357-6.269, P=0.006) and greater omental metastasis (HR=4.060, 95%CI:1.419-11.617, P=0.009) were independent risk factors associated with prognosis of patients with MBO caused by peritoneal mCRC. Conclusions: For patients of MBO caused by peritoneal mCRC, tumor debulking surgery may achieve higher symptom relief rate and prolong survival. Greater omental metastasis indicates poor prognosis.


Assuntos
Neoplasias Colorretais/patologia , Obstrução Intestinal/cirurgia , Cuidados Paliativos , Neoplasias Peritoneais/secundário , Neoplasias Peritoneais/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Procedimentos Cirúrgicos de Citorredução , Feminino , Humanos , Obstrução Intestinal/etiologia , Masculino , Pessoa de Meia-Idade , Omento , Neoplasias Peritoneais/complicações , Neoplasias Peritoneais/tratamento farmacológico , Prognóstico , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
4.
Mymensingh Med J ; 28(3): 681-684, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31391444

RESUMO

Fibromatosis of mesentery is a very rare disease and only a few cases have been reported. Here we report a case of 40 year old man admitted on 16 October, 2017 in the Department of Surgery (Unit-3) of Mymensingh Medical College Hospital with history of recurrent abdominal pain and progressively enlarging intra-abdominal lump for 2 years. Out of different diagnostic dilemmas, finally we came to the conclusion of its being a mass lesion primarily arising from the mesentery and involving the adjoining gut according to the report of CT abdomen. Laparotomy was performed and a lump measuring about 18 cm × 20 cm arising from mesentery was found, in which distal part of jejunum and proximal part of ileum were embedded. The mass was excised with incorporated gut loops and histopathology report revealed fibromatosis of mesentery.


Assuntos
Fibromatose Abdominal , Neoplasias Peritoneais , Dor Abdominal/etiologia , Adulto , Fibromatose Abdominal/complicações , Fibromatose Abdominal/diagnóstico , Humanos , Masculino , Mesentério , Neoplasias Peritoneais/complicações , Neoplasias Peritoneais/diagnóstico
5.
BMJ Case Rep ; 12(8)2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31420427

RESUMO

Acute abdominal pain is a common symptom in young women. We describe a patient with acute illness and severe lower abdominal pain. Laboratory tests were normal except for mildly deranged inflammatory markers. No abnormalities were reported on abdominal ultrasonography and MRI, whereas diagnostic laparoscopy revealed a tumour located dorsally from the uterus. We resected the tumour and pathology results showed a well-differentiated papillary mesothelioma of the peritoneum (WDPMP). Microscopy showed evidence of acute ischaemia in the resected lesion, which was likely the cause of the acute abdominal pain. WDPMP is a rare disease that arises from the serous membranes which does not seem to have a relation to asbestos exposure. Generally, WDPMP has a mild clinical course and good long-term prognosis.


Assuntos
Dor Abdominal/diagnóstico , Dor Aguda/diagnóstico , Mesotelioma/diagnóstico , Neoplasias Peritoneais/diagnóstico , Dor Abdominal/etiologia , Dor Aguda/etiologia , Adulto , Feminino , Humanos , Mesotelioma/complicações , Neoplasias Peritoneais/complicações
6.
Ethiop J Health Sci ; 29(4): 529-532, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31447527

RESUMO

Background: A lipoma of the small bowel mesentery is a rare clinical entity. It rarely causes intestinal obstruction mainly due to volvulus. Case: We report a case of a 25 years old male who presented with acute exacerbation of abdominal pain, nausea and vomiting. Plain abdominal x-ray showed complete small bowel obstruction. At laparotomy, there was small bowel volvulus with a big yellow mass as an axis. Enbloc resection and end-to-end ileal anastomosis was done. Conclusion: Mesenteric lipoma are rare. They should be considered in cases of long standing abdominal pain.


Assuntos
Volvo Intestinal/etiologia , Lipoma/complicações , Mesentério , Neoplasias Peritoneais/complicações , Dor Abdominal/etiologia , Adulto , Humanos , Obstrução Intestinal/diagnóstico , Obstrução Intestinal/etiologia , Obstrução Intestinal/patologia , Obstrução Intestinal/cirurgia , Volvo Intestinal/diagnóstico , Volvo Intestinal/patologia , Volvo Intestinal/cirurgia , Lipoma/diagnóstico , Lipoma/patologia , Lipoma/cirurgia , Masculino , Mesentério/patologia , Mesentério/cirurgia , Neoplasias Peritoneais/diagnóstico , Neoplasias Peritoneais/patologia , Neoplasias Peritoneais/cirurgia
7.
Cancer Sci ; 110(9): 2933-2940, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31278877

RESUMO

Chemotherapy has been the treatment of choice for unresectable peritoneal dissemination; however, it is difficult to eradicate such tumors because of poor drug delivery. To solve this issue, we developed FF-10832 as liposome-encapsulated gemcitabine to maintain a high concentration of gemcitabine in peritoneal tumors from the circulation and ascites. A syngeneic mouse model of peritoneal dissemination using murine Colon26 cell line was selected to compare the drug efficacy and pharmacokinetics of FF-10832 with those of gemcitabine. Despite the single intravenous administration, FF-10832 treatment enabled long-term survival of the lethal model mice as compared with those treated with gemcitabine. Pharmacokinetic analysis clarified that FF-10832 could achieve a more effective gemcitabine delivery to peritoneal tumors owing to better stability in the circulation and ascites. The novel liposome-encapsulated gemcitabine FF-10832 may be a curative therapeutic tool for cancer patients with unresectable peritoneal dissemination via the effective delivery of gemcitabine to target tumors.


Assuntos
Antimetabólitos Antineoplásicos/administração & dosagem , Ascite/metabolismo , Desoxicitidina/análogos & derivados , Neoplasias Peritoneais/tratamento farmacológico , Peritônio/patologia , Animais , Antimetabólitos Antineoplásicos/farmacocinética , Ascite/etiologia , Linhagem Celular Tumoral/transplante , Desoxicitidina/administração & dosagem , Desoxicitidina/farmacocinética , Modelos Animais de Doenças , Avaliação Pré-Clínica de Medicamentos , Estabilidade de Medicamentos , Feminino , Humanos , Injeções Intravenosas , Estimativa de Kaplan-Meier , Lipossomos , Camundongos , Camundongos Endogâmicos BALB C , Neoplasias Peritoneais/complicações , Neoplasias Peritoneais/mortalidade , Neoplasias Peritoneais/patologia , Distribuição Tecidual , Resultado do Tratamento
8.
Gan To Kagaku Ryoho ; 46(6): 1081-1083, 2019 Jun.
Artigo em Japonês | MEDLINE | ID: mdl-31273181

RESUMO

The present case involved a man aged about 70 years. He visited our hospital with the main complaint of abdominal pain. We diagnosed him with intestinal obstruction, and we decided to perform surgery. White knot sections were spread inside the abdominal cavity, and the small intestine appeared as a single block. This block was resected and examined for peritoneal mesothelioma. Peritoneal mesothelioma is thought to have incubation period of 20-25 years after exposure to asbestos, and the number of affected patients will increase in the future. In some cases, peritoneal mesothelioma occurs only in the peritoneum; therefore, diagnosis often becomes difficult. Once intestinal obstruction occurs, administering chemotherapy is difficult. Therefore, early diagnosis is thought to be very important.


Assuntos
Asbestos , Íleus , Mesotelioma , Neoplasias Peritoneais , Idoso , Humanos , Íleus/etiologia , Masculino , Mesotelioma/complicações , Neoplasias Peritoneais/complicações
9.
BMJ Case Rep ; 12(5)2019 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-31154350

RESUMO

A 23-year-old man presented to the emergency department with a history of recurrent episodes of subacute intestinal obstruction. Palpation revealed a firm, non-tender, mobile, non-pulsatile mass of size 8-10 cm with indistinct margins and smooth surface in the hypogastrium. Contrast-enhanced CT scan of the abdomen showed clumping of the small bowel loops within a well-defined membrane-like structure without dilatation or thickening of bowel loops. The patient underwent a laparotomy with incision of the membrane and separation of all the small bowel loops inside the cocoon. Abdominal cocoon is the idiopathic variety of sclerosing encapsulating peritonitis and is an unusual cause of acute or subacute intestinal obstruction. Clinical diagnosis is difficult because of non-specific symptoms. CT has facilitated accurate preoperative diagnosis, long before the patient presents with full-fledged symptoms of acute intestinal obstruction. CT scan plays a significant role in excluding the secondary causes and helps in patient management.


Assuntos
Adenocarcinoma/diagnóstico , Obstrução Intestinal/diagnóstico , Neoplasias Peritoneais/diagnóstico , Dor Abdominal/etiologia , Adenocarcinoma/complicações , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/cirurgia , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Obstrução Intestinal/complicações , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/cirurgia , Laparoscopia , Neoplasias Peritoneais/complicações , Neoplasias Peritoneais/diagnóstico por imagem , Neoplasias Peritoneais/cirurgia , Período Pré-Operatório , Tomografia Computadorizada por Raios X
10.
World J Surg Oncol ; 17(1): 99, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31196097

RESUMO

BACKGROUND: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal metastasis (PM) from colorectal cancer (CRC) has been reported to substantially improve the prognosis and the quality of life of patients in comparison to systemic chemotherapy or palliative approaches. This study aimed to demonstrate the safety and feasibility of hepatectomy for metachronous liver metastases from CRC following CRS and HIPEC for PM on the basis of three case reports. CASE PRESENTATION: We describe three cases involving patients who underwent hepatectomy for metachronous liver metastases from CRC after CRS and HIPEC for PM. All patients underwent CRS and HIPEC after primary tumor resection, and hepatectomy was performed for the metachronous liver metastases after CRS and HIPEC. The hepatectomy procedures for cases 1, 2, and 3 were left hemihepatectomy and partial resection of S5, posterior sectionectomy, and left-lateral sectionectomy and partial resection of S5 and S8, respectively. Although adhesion of surrounding organs to the liver surface was observed on a broad level, dissections and hepatectomy could be performed safely. No recurrence was detected in cases 1 and 2 after hepatectomy. In case 3, liver metastases were detected from the time of the initial diagnosis of the primary tumor, and complete remission was achieved once with systemic chemotherapy. Although we performed hepatectomy for the recurrence of liver metastases after complete remission, early re-recurrence was observed after hepatectomy. CONCLUSIONS: Hepatectomy for metachronous liver metastases after CRS and HIPEC for PM could be a multi-modality treatment option for CRC recurrence.


Assuntos
Quimioterapia do Câncer por Perfusão Regional/métodos , Neoplasias Colorretais/terapia , Procedimentos Cirúrgicos de Citorredução/métodos , Hipertermia Induzida/métodos , Neoplasias Hepáticas/cirurgia , Segunda Neoplasia Primária/cirurgia , Neoplasias Peritoneais/terapia , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Colorretais/complicações , Neoplasias Colorretais/patologia , Terapia Combinada , Feminino , Hepatectomia , Humanos , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/secundário , Masculino , Pessoa de Meia-Idade , Segunda Neoplasia Primária/complicações , Segunda Neoplasia Primária/secundário , Neoplasias Peritoneais/complicações , Neoplasias Peritoneais/secundário , Prognóstico
11.
Ther Apher Dial ; 23(3): 237-241, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31025830

RESUMO

Cell-free and concentrated ascites reinfusion therapy (CART) by internal filtration pressure method (internal method) and external filtration pressure method (external method) using the same cancerous ascites was performed. The rate of rise in circuit pressure and recovered components were compared between the two methods. The factors related to circuit pressure rise were also researched. In both methods, circuit pressure rose in 50% of cases. The recovery rates of IgG, IgA, IgM, and haptoglobin were significantly higher for the internal method than for the external method, whereas the recovery rate of α1 -antitrypsin was significantly lower in the internal method than in the external method. The levels of IL-6, haptoglobin, α1 -antitrypsin, and fibrinogen/fibrindegradation products (FDP) in the original ascites were significantly higher in the group wherein circuit pressure rose than in that without circuit pressure rise. These proteins might be related to the rise in circuit pressure.


Assuntos
Ascite/terapia , Sistema Livre de Células , Segurança do Paciente , Lavagem Peritoneal/métodos , Neoplasias Peritoneais/complicações , Idoso , Ascite/patologia , Líquido Ascítico/patologia , Estudos de Coortes , Feminino , Filtração/métodos , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Lavagem Peritoneal/instrumentação , Neoplasias Peritoneais/patologia , Pressão , Estudos Retrospectivos , Medição de Risco , Resultado do Tratamento
12.
Fertil Steril ; 111(6): 1259-1261, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31030890

RESUMO

OBJECTIVE: To describe laparoscopic management of a case of leyomiomatosis peritonealis disseminata associated with ovarian endometriosis. DESIGN: Surgical video article. SETTING: Academic hospital. PATIENT: We present a case of a 30-year-old woman referred to our clinic for abdominal and pelvic pain and dyspareunia. A hysteroscopic myomectomy was reported as previous surgical history. At ultrasound examination, a left ovarian cyst of 4 cm suspected for typical endometrioma and a mild hydroureteronephrosis of left kidney were revealed. The patient was scheduled for laparoscopic surgery. INTERVENTIONS: During laparoscopy, multiple nodules were found simulating widespread metastases involving colon, small bowel, omentum, right diaphragmatic dome, gastric surface, vesico-uterine area and abdominal peritoneum. Several biopsies and a peritoneal washing were performed, suspecting a peritoneal carcinomatosis. The histological frozen section examination revealed a possible benign disease, requiring further immunohistochemical study that diagnosed leiomyomatosis peritonealis. A second laparoscopy was then performed after one month. Enucleation of the left ovarian endometriotic cyst with classic stripping technique was performed. The left ureter was compressed by a fibrotic nodule of 5 cm that was isolated and removed. Operating time was 80 minutes. The postoperative course was uneventful and the patient was discharged on postoperative day 2. MAIN OUTCOME MEASURES: Description of a case of leiomyomatosis peritonealis disseminata in a patient with no previous history of intra-abdominal morcellation. RESULTS: The removal of the left ovarian endometriotic cyst and the periureteral nodule was successfully performed. The patient reported good health conditions without hydroureteronephrosis at six months follow up visit. CONCLUSIONS: Leiomyomatosis peritonealis disseminata is a rare clinical disorder characterized by proliferation of nodules, consisted by smooth muscle cells. The association of this condition with endometriosis has been described in other studies. Despite several medical therapies have been proposed (chemotherapy, aromatase inhibitor, gonadotropin-releasing hormone agonist), surgical excision remains a good option, frequently performed for symptoms palliation. Laparoscopic approach might be considered the procedure of choice in case of symptomatic women with leiomyomatosis peritonealis disseminata.


Assuntos
Endometriose/cirurgia , Histeroscopia , Leiomiomatose/cirurgia , Doenças Ovarianas/cirurgia , Neoplasias Peritoneais/cirurgia , Miomectomia Uterina/métodos , Adulto , Endometriose/complicações , Endometriose/patologia , Feminino , Humanos , Leiomiomatose/complicações , Leiomiomatose/patologia , Doenças Ovarianas/complicações , Doenças Ovarianas/patologia , Neoplasias Peritoneais/complicações , Neoplasias Peritoneais/secundário , Resultado do Tratamento
13.
Ther Apher Dial ; 23(3): 242-247, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31033167

RESUMO

Cell-free and concentrated ascites reinfusion therapy (CART) is used to treat malignant ascites. However, the qualities of albumin in malignant ascites, such as antioxidative activity, may decrease owing to oxidative stress caused by cancer cells and inflammatory reactions. We investigated the fraction percentages of mercaptalbumin (HMA%, reduced form) and non-mercaptalbumin (HNA%, oxidized form) in malignant ascites from 21 patients who received CART and compared the HMA% in the malignant ascites and human serum albumin (HSA) preparations. HMA% of albumin in malignant ascites (22.5%) was significantly lower than that in HSA preparation (42.2%). To ensure a high HMA%, we added L-cysteine to the paracentesis-treated ascites followed by dialysis 1 h later. As a result, the HMA% of albumin in malignant ascites was increased to 59.1%. Our results suggest that using this method in CART will improve patient's albumin quality.


Assuntos
Ascite/patologia , Sistema Livre de Células , Lavagem Peritoneal/métodos , Neoplasias Peritoneais/complicações , Albumina Sérica Humana/análise , Idoso , Ascite/etiologia , Líquido Ascítico/patologia , Estudos de Coortes , Feminino , Filtração/métodos , Hospitais Universitários , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Neoplasias Peritoneais/patologia , Prognóstico , Estudos Retrospectivos , Resultado do Tratamento
14.
J Nucl Med Technol ; 47(2): 173-174, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31019037

RESUMO

We report a case of concurrent nodular fasciitis and incidental giant intraperitoneal lipoma diagnosed on whole-body 18F-FDG PET/CT, an imaging modality that has the advantage of being able to detect unsuspected lesions.


Assuntos
Fasciite/complicações , Fluordesoxiglucose F18 , Lipoma/complicações , Lipoma/diagnóstico por imagem , Neoplasias Peritoneais/complicações , Neoplasias Peritoneais/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Adulto , Feminino , Humanos , Achados Incidentais
15.
Medicine (Baltimore) ; 98(2): e14115, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30633226

RESUMO

RATIONALE: Mesenteric fibromatosis is a rare benign neoplasm with a tendency to spread and recur locally, without metastasis. It may present with a wide spectrum of clinical features; however, onset as a perforation is extremely rare. PATIENT CONCERNS: The present patient was an 18-year-old female with a 10-hour history of increasing abdominal pain that arose suddenly with nausea and vomiting. She had experienced an appendectomy 2 years before this admission. DIAGNOSES: A gastrointestinal perforation was initially suspected on the basis of complaints and physical examination. The patient was thoroughly investigated for further diagnosis. Computed tomography showed a large well-defined intra-abdominal mass measuring 7.1 × 6.7 × 5.9 cm in the right lower quadrant, with adjacent small intestine compression and free intraperitoneal air. Then, the patient underwent a laparotomy. Finally, postoperative pathology and immunohistochemistry confirmed mesenteric fibromatosis, with a consecutive perforation from ileum to the bottom of tumor. INTERVENTIONS: The patient has been treated by a resection of the mass with the adhesive small intestine, without chemotherapy or radiotherapy postoperatively. OUTCOMES: The patient had an uneventful postoperative recovery. Three months after surgery, the patient reviewed the colonoscopy, no intestinal polyps were noted. The present case has been followed up for 17 months without tumor recurrence. LESSONS: Our case illustrates another possible cause of acute abdominal pain. Although rare, treating physicians should maintain a high suspicion index while managing a patient with an abdominal mass and pain. Close follow-up is essential because of the high incidence of local tumor recurrence.


Assuntos
Abdome Agudo/etiologia , Fibroma/diagnóstico , Doenças do Íleo/etiologia , Perfuração Intestinal/etiologia , Mesentério , Neoplasias Peritoneais/diagnóstico , Adolescente , Feminino , Fibroma/complicações , Humanos , Doenças do Íleo/diagnóstico , Perfuração Intestinal/diagnóstico , Neoplasias Peritoneais/complicações
17.
Cancer Biol Ther ; 20(1): 8-14, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30252568

RESUMO

Gastrointestinal stromal tumors (GISTs) are very uncommon in pediatric patients, and they are distinct clinical-pathological and molecular deviations from their adult counterparts. Most pediatric GISTs lack the c-kit or platelet-derived growth factor receptor alpha (PDGFRA) genes mutations. To date, there is no published standard guidelines available for the best treatment of pediatric GISTs, especially for infant GIST. Therefore, we report a case of 4-month-old infant with GIST of mesocolon without KIT/PDGFRA mutation. We also review the clinical, biological, and genetic features of pediatric GISTs and re-think several questions that could affect clinical practice.


Assuntos
Hemorragia Gastrointestinal/etiologia , Tumores do Estroma Gastrointestinal/diagnóstico , Mesocolo/patologia , Neoplasias Peritoneais/diagnóstico , Quimioterapia Adjuvante/métodos , Evolução Fatal , Tumores do Estroma Gastrointestinal/complicações , Tumores do Estroma Gastrointestinal/terapia , Humanos , Mesilato de Imatinib/uso terapêutico , Lactente , Masculino , Mesocolo/diagnóstico por imagem , Mesocolo/cirurgia , Neoplasias Peritoneais/complicações , Neoplasias Peritoneais/terapia , Tomografia Computadorizada por Raios X
19.
Eur J Surg Oncol ; 45(3): 389-393, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30594405

RESUMO

INTRODUCTION: Patients with peritoneal carcinomatosis who do not have curative treatment options often develop acute obstructive symptoms and when conservative management fails, surgical treatment is the remaining option. However, palliative surgery is associated with high morbidity and mortality and the chance of success is unclear. The aim of this study was to evaluate outcomes of palliative surgery and to provide guidance for surgeons, medical oncologists and patients in their decision-making. METHODS: All consecutive patients who underwent palliative surgery for acute obstruction caused by peritoneal carcinomatosis between January 2005 and October 2017 where identified. RESULTS: In total 148 patients underwent surgery. Primary malignancy was colorectal cancer (28.4%), neuroendocrine tumor (20.3%), ovarian cancer (14.2%) or 'other' (37.2%). Median length of postoperative hospital stay was 16 days (IQR 9-24). More than half (58.1%) of the patients developed postoperative complications, 29.1% developed ≥2 complications. In-hospital mortality was 8.8%. Readmission (56.1%) and re-obstruction (35.0%) were common. Median overall survival was 119 days (IQR 48-420). Patients with a neuroendocrine tumor had a significantly better overall survival compared to other primary malignancies (p < 0.001). Patients who developed an obstruction during or within 6 months after treatment with chemotherapy had a worse overall survival (p < 0.001), compared to patients treated with chemotherapy longer than 6 months ago, or patients not treated with chemotherapy. CONCLUSION: Palliative surgery is associated with high rates of complications and readmission and re-obstruction are common. Comfort care is often a better option than surgery, especially in patients with disease progression under recent treatment with chemotherapy.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/métodos , Obstrução Intestinal/etiologia , Cuidados Paliativos/métodos , Neoplasias Peritoneais/complicações , Complicações Pós-Operatórias/epidemiologia , Doença Aguda , Idoso , Feminino , Seguimentos , Humanos , Obstrução Intestinal/diagnóstico , Obstrução Intestinal/cirurgia , Masculino , Pessoa de Meia-Idade , Morbidade/tendências , Países Baixos/epidemiologia , Neoplasias Peritoneais/diagnóstico , Neoplasias Peritoneais/cirurgia , Estudos Retrospectivos , Taxa de Sobrevida/tendências
20.
Medicine (Baltimore) ; 97(48): e13446, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30508962

RESUMO

RATIONALE: Liposarcoma (LPS) is a rare malignant soft-tissue tumor. Management of LPS is relatively difficult, because there are no characteristic symptoms, or biomarkers, nor any established effective treatment. Hence, the report of the accumulation of each LPS case is necessary. We experienced an extremely rare case of torsion caused by a primary small bowel mesentery LPS. PATIENT'S CONCERN: A 70-year-old male consulted our hospital with the complaints of abdominal pain and sudden vomiting. DIAGNOSIS: No lump could be palpated, and tumor markers tested were within normal limits. However, computed tomography revealed an intestinal obstruction caused by torsion of the small bowel due to an LPS tumor. INTERVENTIONS: After decompression of the intestinal obstruction by use of an ileus tube, surgical treatment was performed with rapidity. OUTCOME: The torsion was found to be caused by the tumor that originated from the small bowel mesentery. The tumor was resected along with a portion of the small bowel. The growth of adipose tissues of various sizes and containing atypical cells was detected by histopathological examination. Also, immunohistochemical examination resulted in positive immuno-reactions for MDM2, CDK4, and p16INK4, which indicated the tumor to be a de-differentiated LPS. The patient was discharged on postoperative day 14 without any complications, and no recurrence of the tumor was observed at 5 years after the operation. LESSONS: LPS should be considered in differential diagnosis of bowel torsion, and careful management is required because of the high possibility of recurrence. Patients should be followed carefully for at least 5 years, and further accumulation of data will be required in order to establish the appropriate management of LPS.


Assuntos
Neoplasias Intestinais/complicações , Obstrução Intestinal/etiologia , Lipossarcoma/complicações , Mesentério/patologia , Neoplasias Peritoneais/complicações , Idoso , Diagnóstico Diferencial , Humanos , Neoplasias Intestinais/diagnóstico , Neoplasias Intestinais/patologia , Obstrução Intestinal/diagnóstico , Obstrução Intestinal/patologia , Volvo Intestinal/diagnóstico , Volvo Intestinal/etiologia , Intestino Delgado/patologia , Lipossarcoma/diagnóstico , Masculino , Neoplasias Peritoneais/diagnóstico , Neoplasias Peritoneais/patologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA