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Journal of the American College of... Nov 2019Palpable abdominal masses may arise from the abdominal cavity or the abdominal wall. The differential diagnosis is broad for each variant ranging from benign lipomas,... (Review)
Review
Palpable abdominal masses may arise from the abdominal cavity or the abdominal wall. The differential diagnosis is broad for each variant ranging from benign lipomas, inflammatory processes, to malignant tumors. The imaging approach to diagnosis varies by location. For intra-abdominal masses, contrast-enhanced CT and ultrasound examination have demonstrated accuracy. For abdominal wall masses, which may arise from muscle, subcutaneous tissue, or connective tissue, MRI, CT, and ultrasound all provide diagnostic value. This publication reviews the current evidence supporting the imaging approach to diagnosis of palpable abdominal masses for two variants: suspected intra-abdominal neoplasm and suspected abdominal wall masses. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
Topics: Abdominal Cavity; Abdominal Neoplasms; Contrast Media; Diagnostic Imaging; Evidence-Based Medicine; Female; Humans; Magnetic Resonance Imaging; Male; Positron Emission Tomography Computed Tomography; Practice Guidelines as Topic; Quality Control; Sensitivity and Specificity; Societies, Medical; Tomography, X-Ray Computed; Ultrasonography, Doppler; United States
PubMed: 31685106
DOI: 10.1016/j.jacr.2019.05.014 -
American Journal of Surgery Jan 2013Radical tumor resection and immediate lower abdominal wall reconstruction in patients with aggressive neoplasm invading full-thickness abdominal wall are challenging...
BACKGROUND
Radical tumor resection and immediate lower abdominal wall reconstruction in patients with aggressive neoplasm invading full-thickness abdominal wall are challenging because of their close proximity and possible invasion to bone and great vessels, as well as consequent giant defect.
METHODS
Data on 16 patients were reviewed retrospectively. Radical neoplasm resection and immediate abdominal wall reconstruction using the combined technique of intraperitoneal mesh placement, sublay technique, pedicled great omentum flap, and rotation skin graft were performed.
RESULTS
Sixteen patients underwent radical abdominal wall neoplasm resection, achieving clear margin of >3 cm. The mean size of consequent giant defect was 226.5 ± 65.5 cm(2), with a mean polypropylene mesh size of 160.7 ± 40.5 cm(2) and a mean compound mesh size of 330.8 ± 100.2 cm(2). Sixteen patients had a mean follow-up duration of 32.5 ± 12.5 months. Four patients developed incisional infections, and 1 patient died of several metastatic lesions 24 months postoperatively. No ventral hernia and abdominal wall recurrence were observed.
CONCLUSIONS
Radical neoplasm resection and immediate abdominal wall reconstruction are appropriate for patients with aggressive neoplasm in the lower abdominal wall.
Topics: Abdominal Neoplasms; Abdominal Wall; Abdominal Wound Closure Techniques; Adenocarcinoma; Dermatofibrosarcoma; Female; Fibromatosis, Aggressive; Humans; Male; Middle Aged; Negative-Pressure Wound Therapy; Polypropylenes; Retrospective Studies; Surgical Flaps; Surgical Mesh; Surgical Wound Infection
PubMed: 22794707
DOI: 10.1016/j.amjsurg.2012.04.007 -
Cancer Feb 1965
Topics: Abdominal Neoplasms; Adolescent; Antineoplastic Agents; Drug Therapy; Extremities; Geriatrics; Head and Neck Neoplasms; Hemangiopericytoma; Mouth Neoplasms; Neoplasms; Pelvic Neoplasms; Retroperitoneal Neoplasms; Surgical Procedures, Operative
PubMed: 14254081
DOI: 10.1002/1097-0142(196502)18:2<249::aid-cncr2820180217>3.0.co;2-m -
Cancer May 1971
Topics: Abdominal Neoplasms; Adolescent; Adult; Female; Fibroma; Humans; Intestinal Neoplasms; Male; Middle Aged; Neoplasm Recurrence, Local; Retroperitoneal Neoplasms
PubMed: 5581505
DOI: 10.1002/1097-0142(197105)27:5<1041::aid-cncr2820270506>3.0.co;2-e -
The Urologic Clinics of North America Jun 1977Neuroblastoma is the most common solid malignant tumor in children. The prognosis is poor, and despite varying chemotherapy and radiation regimens, its status has not... (Review)
Review
Neuroblastoma is the most common solid malignant tumor in children. The prognosis is poor, and despite varying chemotherapy and radiation regimens, its status has not been altered much in the past 20 years. Seventy per cent of the patients have abdominal neuroblastomas, which carry the worst prognosis of all the possible sites for the disease. Seventy per cent of the patients have metastases at the time of diagnosis. Survival is best in children under one year of age and in those patients (8 per cent) who are fortunate enough to have only stage I disease. Stage IV disease has only a 3 per cent survival rate. Surgical removal of the tumor is still the primary therapy; irradiation is of significant benefit in patients with stage III disease. Immunotherapy offers an optimistic modality for future improvement in survival rates.
Topics: Abdominal Neoplasms; Adrenal Gland Neoplasms; Age Factors; Child, Preschool; Head and Neck Neoplasms; Humans; Infant; Infant, Newborn; Neoplasm Metastasis; Neuroblastoma; Thoracic Neoplasms
PubMed: 331618
DOI: No ID Found -
RoFo : Fortschritte Auf Dem Gebiete Der... Nov 2020
Topics: Abdominal Neoplasms; Contrast Media; Diagnosis, Differential; Humans; Liposarcoma; Liposarcoma, Myxoid; Magnetic Resonance Imaging; Muscle Neoplasms; Neoplasm Grading; Pelvic Neoplasms; Retroperitoneal Neoplasms; Soft Tissue Neoplasms; Tomography, X-Ray Computed
PubMed: 32106323
DOI: 10.1055/a-1108-1961 -
Oncology Research and Treatment 2022Resection of large anterior abdominal wall tumors causes large full-thickness abdominal wall defects, and the repair of these defects remains a challenging point.
BACKGROUND
Resection of large anterior abdominal wall tumors causes large full-thickness abdominal wall defects, and the repair of these defects remains a challenging point.
METHODS
Between July 2016 and February 2021, we retrospectively reviewed the internal database registry of the Oncology Center, Mansoura University (OCMU), Egypt, for patients with large abdominal wall defects after abdominal wall tumors resection and repair with omental flaps and synthetic polypropylene (PP) mesh. Thirty-two patients met the inclusion criteria. They were analyzed for demographics and operative data including defect size, mesh size, intra-abdominal tumor extension, and postoperative outcomes and complications.
RESULTS
Thirty-Two patients with abdominal wall neoplasm underwent local resection in our center and the defect was closed with an omental flap and PP mesh. The mean operative time was 143.75 ± 30.77 min. The mean size of the abdominal wall defect was 50.8 cm2 (range: 25-90 cm2). The meshes used in reconstruction had a mean size of 89.5 cm2 (range: 55-130 cm2). The median follow-up period of the patients was 13.5 months (range: 5-54 months). Postoperative complications included infection (n = 4 cases), seroma (n = 2 cases), hematoma (n = 1 case), and abnormal sensation (n = 5 cases). Tumor recurrence was reported in 2 cases, and no cases developed incisional hernia during the follow-up period.
CONCLUSION
Immediate use of omental flap with synthetic PP mesh for reconstruction of abdominal wall defects is a feasible technique and has avoided the complications associated with the use of synthetic mesh alone.
Topics: Abdominal Neoplasms; Abdominal Wall; Humans; Neoplasm Recurrence, Local; Polypropylenes; Postoperative Complications; Retrospective Studies; Surgical Flaps; Surgical Mesh
PubMed: 35537417
DOI: 10.1159/000524871 -
Radiographics : a Review Publication of... Oct 2020Technologic advances in chromosomal analysis and DNA sequencing have enabled genome-wide analysis of cancer cells, yielding considerable data on the genetic basis of... (Review)
Review
Technologic advances in chromosomal analysis and DNA sequencing have enabled genome-wide analysis of cancer cells, yielding considerable data on the genetic basis of malignancies. Evolving knowledge of tumor genetics and oncologic pathways has led to a better understanding of histopathologic features, tumor classification, tumor biologic characteristics, and imaging findings and discovery of targeted therapeutic agents. Radiogenomics is a rapidly evolving field of imaging research aimed at correlating imaging features with gene mutations and gene expression patterns, and it may provide surrogate imaging biomarkers that may supplant genetic tests and be used to predict treatment response and prognosis and guide personalized treatment options. Multidetector CT, multiparametric MRI, and PET with use of multiple radiotracers are some of the imaging techniques commonly used to assess radiogenomic associations. Select abdominal malignancies demonstrate characteristic imaging features that correspond to gene mutations. Recent advances have enabled us to understand the genetics of steatotic and nonsteatotic hepatocellular adenomas, a plethora of morphologic-molecular subtypes of hepatic malignancies, a variety of clear cell and non-clear cell renal cell carcinomas, a myriad of hereditary and sporadic exocrine and neuroendocrine tumors of the pancreas, and the development of targeted therapeutic agents for gastrointestinal stromal tumors based on characteristic gene mutations. Mutations associated with aggressive phenotypes of these malignancies can sometimes be predicted on the basis of their imaging characteristics. Radiologists should be familiar with the genetics and pathogenesis of common cancers that have associated imaging biomarkers, which can help them be integral members of the cancer management team and guide clinicians and pathologists. RSNA, 2020 See discussion on this article by Luna (pp 1627-1630).
Topics: Abdominal Neoplasms; Biomarkers, Tumor; Genes, Neoplasm; Genetic Predisposition to Disease; Genomics; Humans; Mutation; Phenotype
PubMed: 33001791
DOI: 10.1148/rg.2020200042 -
Diagnostic and Interventional Radiology... May 2020The incidence of abdominal and pelvic cancer in pregnancy is low, but it is rising as the population of pregnant women gets older. Depending on disease stage,... (Review)
Review
The incidence of abdominal and pelvic cancer in pregnancy is low, but it is rising as the population of pregnant women gets older. Depending on disease stage, gestational age and patient's preference, active surveillance as well as surgery and chemotherapy are feasible options during pregnancy. Correct diagnosis and staging of the tumor is crucial for choosing the best therapeutic approach. Moreover, a reproducible modality to assess the treatment response is requested. Magnetic resonance imaging (MRI) is commonly used with good results for the local staging and treatment response evaluation of most abdominal and pelvic cancers in nonpregnant patients, and it is considered relatively safe during pregnancy. The purpose of this article is to analyze the most relevant topics regarding the use of MRI in pregnant women with abdominal and pelvic cancer. We discuss MRI safety during pregnancy, including the use of gadolinium-based contrast agents (GBCAs), how to prepare the patient for the exam and MRI technique. This will be followed by a brief review on the most common malignancies diagnosed during pregnancy and their MRI appearance.
Topics: Abdomen; Abdominal Neoplasms; Adult; Contrast Media; Female; Gestational Age; Humans; Incidence; Magnetic Resonance Imaging; Neoplasm Staging; Patient Positioning; Patient Preference; Pelvic Neoplasms; Pelvis; Precision Medicine; Pregnancy; Radiologists; Safety; Watchful Waiting
PubMed: 32071031
DOI: 10.5152/dir.2019.19343 -
Clinical Techniques in Small Animal... Feb 1998The principles of abdominal oncologic surgery parallel the general principles of all types of oncologic surgery with some variations peculiar to the abdomen. Due to the... (Review)
Review
The principles of abdominal oncologic surgery parallel the general principles of all types of oncologic surgery with some variations peculiar to the abdomen. Due to the presence of multiple organ systems within the abdominal cavity, many types of cancer can develop. The surgeon must be prepared to perform several different abdominal procedures depending on the organ system involved and the extent of the cancer. The surgeon as oncologist must be aware of the tumor type, its expected behavior, and current treatment options. This article describes the principles of performing cancer surgery, including preparation for abdominal exploration, methods to facilitate tumor removal, and ways of avoiding tumor recurrence.
Topics: Abdomen; Abdominal Neoplasms; Animals; Guidelines as Topic; Neoplasm Staging; Postoperative Care; Surgery, Veterinary; Surgical Staplers
PubMed: 9634347
DOI: 10.1016/S1096-2867(98)80026-1