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Journal of Visceral Surgery Dec 2011Pheochromocytomas (PHEO) and paragangliomas (PGL) are tumors derived from the sympathetic and parasympathetic nervous system. The parasympathetic-associated... (Review)
Review
Pheochromocytomas (PHEO) and paragangliomas (PGL) are tumors derived from the sympathetic and parasympathetic nervous system. The parasympathetic-associated paragangliomas arising in the neck are usually non-functioning and are rarely encountered by general and visceral surgeons. The sympathetic-associated PHEO and PGL are usually functioning and most often arise in the abdomen. Because they harbor very specific characteristics (hypersecretion of catecholamines, familial origin in up to 30% of them, multiple locations, etc.) their perioperative management needs to be known by surgeons taking care of these patients in order to avoid operative disasters. Surgery can lead to perioperative hemodynamic modifications and sometimes catecholamine storm even in normotensive patients with PHEO and PGL. This emphasizes the need to exclude PHEO before any adrenal surgery as well as to medically prepare all patients with PHEO and PGL preoperatively. We review in this paper the pathophysiology and current perioperative management of patients with apparently sporadic PHEO and PGL.
Topics: Abdominal Neoplasms; Adrenal Gland Neoplasms; Diagnosis, Differential; Diagnostic Imaging; Humans; Paraganglioma, Extra-Adrenal; Pheochromocytoma; Preoperative Care; Prognosis
PubMed: 21862435
DOI: 10.1016/j.jviscsurg.2011.07.003 -
The British Journal of Radiology Oct 2021To investigate trends observed in a decade of published research on multimodality PET(/CT)+MR imaging in abdominal oncology, and to explore how these trends are... (Review)
Review
OBJECTIVES
To investigate trends observed in a decade of published research on multimodality PET(/CT)+MR imaging in abdominal oncology, and to explore how these trends are reflected by the use of multimodality imaging performed at our institution.
METHODS
First, we performed a literature search (2009-2018) including all papers published on the multimodality combination of PET(/CT) and MRI in abdominal oncology. Retrieved papers were categorized according to a structured labelling system, including study design and outcome, cancer and lesion type under investigation and PET-tracer type. Results were analysed using descriptive statistics and evolutions over time were plotted graphically. Second, we performed a descriptive analysis of the numbers of MRI, PET/CT and multimodality PET/CT+MRI combinations (performed within ≤14 days interval) performed during a similar time span at our institution.
RESULTS
Published research papers involving multimodality PET(/CT)+MRI combinations showed an impressive increase in numbers, both for retrospective combinations of PET/CT and MRI, as well as hybrid PET/MRI. Main areas of research included new PET-tracers, visual PET(/CT)+MRI assessment for staging, and (semi-)quantitative analysis of PET-parameters compared to or combined with MRI-parameters as predictive biomarkers. In line with literature, we also observed a vast increase in numbers of multimodality PET/CT+MRI imaging in our institutional data.
CONCLUSIONS
The tremendous increase in published literature on multimodality imaging, reflected by our institutional data, shows the continuously growing interest in comprehensive multivariable imaging evaluations to guide oncological practice.
ADVANCES IN KNOWLEDGE
The role of multimodality imaging in oncology is rapidly evolving. This paper summarizes the main applications and recent developments in multimodality imaging, with a specific focus on the combination of PET+MRI in abdominal oncology.
Topics: Abdominal Neoplasms; Contrast Media; Humans; Magnetic Resonance Imaging; Medical Oncology; Multimodal Imaging; Neoplasm Staging; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals
PubMed: 34387508
DOI: 10.1259/bjr.20201351 -
BMJ Case Reports Jun 2020There are less than 150 cases of non-functioning retroperitoneal abdominal schwannoma (NRS) reported. Hormonal assay is crucial in confirming the diagnosis of NRS, as...
There are less than 150 cases of non-functioning retroperitoneal abdominal schwannoma (NRS) reported. Hormonal assay is crucial in confirming the diagnosis of NRS, as manipulation of a functional retroperitoneal paraganglioma will instigate an abrupt liberation of catecholamines, resulting in devastating consequences. We report the case of 42-year-old woman who presented with headache, night sweats and abdominal discomfort. Cross-sectional imaging demonstrated a retroperitoneal mass adherent to the aorta and inferior vena cava but biochemical testing of blood and urine was negative for metanephrines and normetanephrines. She underwent successful tumour resection via laparotomy, as location increased the complexity and risk of laparoscopic resection.
Topics: Abdominal Neoplasms; Adult; Female; Humans; Neurilemmoma; Retroperitoneal Neoplasms
PubMed: 32554461
DOI: 10.1136/bcr-2019-233371 -
Journal of B.U.ON. : Official Journal... 2018Gastrointestinal stromal tumors (GISTs) are the most frequent neoplasms of mesenchymal origin affecting the gastrointestinal tract. GISTs quite frequently co-exist with... (Review)
Review
PURPOSE
Gastrointestinal stromal tumors (GISTs) are the most frequent neoplasms of mesenchymal origin affecting the gastrointestinal tract. GISTs quite frequently co-exist with other primary tumors in up to 33% of the cases. Such occurrence has been mainly described in the literature in the form of case reports and rarely of case series which hasn't been sufficient to prove if there is any association between these two entities.
METHODS
We conducted a review of the current literature regarding the synchronous occurrence of GISTs and other intra-abdominal malignancies. An electronic search of the literature was undertaken using MEDLINE (database provider PubMed). A primary selection of relevant studies was based on the title and abstract, whereas a secondary selection was performed according to the full text of publications.
RESULTS
Ten retrospective case series were considered and overall 1108 GISTs patients were included. Synchronous intra-abdominal malignancies were found in 18% of all GISTs patients studied. The mean age was 70,5 years, affecting more the male gender (65%). The mean size of the concurrent GISTs were 18mm while the most common GIST-associated malignancy were gastric adenocarcinomas.
CONCLUSION
The synchronous occurrence of GISTs and other intra-abdominal primary tumors is more common that it has been considered and while it is not yet clear if there is a causal association for the concomitant occurrence of GIST with other malignancies a closer surveillance of GIST patients is needed due to their proved increased prevalence of a second primary tumor especially during the first year after diagnosis.
Topics: Abdominal Neoplasms; Gastrointestinal Neoplasms; Gastrointestinal Stromal Tumors; Humans; Neoplasms, Multiple Primary; Prognosis
PubMed: 30610779
DOI: No ID Found -
Revista Espanola de Enfermedades... Sep 2018We report the case of a 67-year-old male with epigastric pain and weight loss during the last nine months. Physical examination revealed a hard palpable mass in the...
We report the case of a 67-year-old male with epigastric pain and weight loss during the last nine months. Physical examination revealed a hard palpable mass in the epi-mesogastrium. An abdominal ultrasound identified a large, heterogeneous and hypovascular mass, which compressed the left hepatic lobe and the pancreas.
Topics: Abdominal Neoplasms; Aged; Duodenal Neoplasms; Endosonography; Humans; Liposarcoma; Male; Tomography, X-Ray Computed
PubMed: 30032632
DOI: 10.17235/reed.2018.5176/2017 -
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 and Applied... Jul 2014With advances in modern imaging techniques, portal vein thrombosis (PVT) is being increasingly diagnosed. It has a wide ranging clinical spectrum from being an... (Review)
Review
With advances in modern imaging techniques, portal vein thrombosis (PVT) is being increasingly diagnosed. It has a wide ranging clinical spectrum from being an asymptomatic state to a potentially life-threatening situation. It is not unusual to find it as an incidental finding in the abdominal imagings done for other reasons. It is commonly associated with cirrhosis and abdominal malignancies and also has a strong association with prothrombotic disorders. It is often difficult for the clinicians to decide whether PVT is acute or chronic. This poses great challenges to its management strategies that include anticoagulants, thrombolysis, and surgical options. Timely diagnosis and appropriate management have great bearings on its outcomes of morbidity and mortality. In this clinician-oriented review, we have provided a concise review of clinical aspects of PVT and discussed various management strategies while addressing the common questions that come to a physician's mind dealing with such a patient.
Topics: Abdominal Neoplasms; Humans; Liver Cirrhosis; Portal Vein; Venous Thrombosis
PubMed: 23364162
DOI: 10.1177/1076029612473515 -
Medicina 2023Desmoplastic small round cell tumor is a rare and very aggressive neoplasm that belongs to the family of "small round blue cell tumors". It has a higher incidence in...
Desmoplastic small round cell tumor is a rare and very aggressive neoplasm that belongs to the family of "small round blue cell tumors". It has a higher incidence in males in the second decade of life. It is due to translocation t(11;22) (p13;q12). It can be located both in the abdomen and in the retroperitoneum and is characterized by nonspecific symptoms. The treatment is very varied and the one that guarantees the total cure of the patient has not yet been detected. The objective of this study is to expose a clinical case of desmoplastic tumor as an rare abdominal disease and its imaging expression.
Topics: Male; Humans; Abdominal Neoplasms; Sarcoma; Translocation, Genetic
PubMed: 37582135
DOI: No ID Found -
The New England Journal of Medicine Mar 2019
Topics: Abdominal Neoplasms; Aged; Female; Humans; Neoplasm Metastasis; Ovarian Neoplasms; Tomography, X-Ray Computed; Umbilicus
PubMed: 30865800
DOI: 10.1056/NEJMicm1809024 -
The British Journal of General Practice... May 2022Quantifying cancer risk in primary care patients with abdominal pain informs diagnostic strategies. (Observational Study)
Observational Study
BACKGROUND
Quantifying cancer risk in primary care patients with abdominal pain informs diagnostic strategies.
AIM
To quantify oesophagogastric, colorectal, liver, pancreatic, ovarian, uterine, kidney, and bladder cancer risks associated with newly reported abdominal pain with or without other symptoms, signs, or abnormal blood tests (that is, features) indicative of possible cancer.
DESIGN AND SETTING
This was an observational prospective cohort study using Clinical Practice Research Datalink records with English cancer registry linkage.
METHOD
The authors studied 125 793 patients aged ≥40 years with newly reported abdominal pain in primary care between 1 January 2009 and 31 December 2013. The 1-year cumulative incidence of cancer, and the composite 1-year cumulative incidence of cancers with shared additional features, stratified by age and sex are reported.
RESULTS
With abdominal pain, overall risk was greater in men and increased with age, reaching 3.4% (95% confidence interval [CI] = 3.0 to 3.7, predominantly colorectal cancer 1.9%, 95% CI = 1.6 to 2.1) in men ≥70 years, compared with their expected incidence of 0.88% (95% CI = 0.87 to 0.89). Additional features increased cancer risk; for example, for men, colorectal or pancreatic cancer risk with abdominal pain plus diarrhoea at 60-69 years of age was 3.1% (95% CI = 1.9 to 4.9) predominantly colorectal cancer (2.2%, 95% CI = 1.2 to 3.8).
CONCLUSION
Abdominal pain increases intra-abdominal cancer risk nearly fourfold in men aged ≥70 years, exceeding the 3% threshold warranting investigation. This threshold is surpassed for the >60 years age group only with additional features. These results will help direct appropriate referral and testing strategies for patients based on their demographic profile and reporting features. The authors suggest non-invasive strategies first, such as faecal immunochemical testing, with safety-netting in a shared decision-making framework.
Topics: Abdominal Neoplasms; Abdominal Pain; Aged; Colorectal Neoplasms; Female; Humans; Male; Middle Aged; Primary Health Care; Prospective Studies
PubMed: 35379605
DOI: 10.3399/BJGP.2021.0552