Study of gastric malignant neoplasms in the surgical gastroenterology unit in the Main Alexandria University Hospital

The present work included data of 42 patients with gastric malignant neoplasms that were admitted to the gastroenterology surgical unit of the main Alexandria university hospital in the period from September 2002 through December 2004 [28 months]. The highest incidence was in the age group above 50 years [61.9%]. The male to female ratio was 1.5:1. the commonest symptom was loss of weight in 23 patients [54.76%]. The main site affected was the pyloric antrum in 22patients [52.38%]. Other sites were the body [67%], cardia [14.29%], and fundus [9.52%]. Three tumors were diffuse [7.14%]. Adenocareinoma was present in 32 patients [76, 19%]; 14 patients had a poorly differentiated tumor, Il patients [34.38%] had moderately differentiated tumor, and in 7 patients [21.88%] the tumor was well-differentiated. Other microscopic types included mucoid carcinoma [11.9%], Non-Hodgkin's lymphoma [7.14%], signet ring carcinoma [2.38%] and squamous cell carcinoma [2.38%]. The diagnostic procedure included upper GIT endoscopy with biopsy taking that was diagnostic in 100% of the study group. Barium meal was done for 34 patients and was diagnostic in 29 [[85.29%]. Conventional Ultrasonography was carried out for 32 patients and was diagnostic in 18 [56.25%]. CT was done for all patients and was of diagnostic value in 92.86% [39 patients]. The major lines of treatment were gastreetomy either total or subtotal [80.95%], while palliative resection was done in three patients [7.14%]. Palliative feeding jejunostomy was done in 2 patients [4.76%]. and there was no surgical interference in one advanced ease only [2.38%]

Profile of carcinoma of the maxillary antrum

This is a retrospective study evaluating carcinoma [Ca] of the maxillary sinus. Medical records of 55 patients with histologically proven diagnosis of maxillary Ca who were treated between years 1995-2001 were examined. Tumors were restaged according to AJC Classification 1997. Most of the patients were treated surgically followed by radiotherapy. 90% of the tumors were in stages III, IV and cervical nodal metastases were present in 25% of the cases at the time of initial presentation

Correlation of CT and operative staging in cancer head of the pancreas

In a current series of 150 patients with obstructive jaundice studied by abdominal CT, there were only 30 cases with operatively proved pancreatic carcinoma. A correct CT diagnosis was made in 24 cases [80%] while 6 patients [20%] were incorrectly diagnosed. The primary CT finding of pancreatic carcinoma was a tumour mass with associated bile and or pancreatic duct dilatation. The mass was located in the head in 28 cases [93%] and involved most of the gland in 2 cases [7%]. On CT, the mass was demonstrated as a central hypodense zone in 18 cases representing the hypovascular scirrhous tumour surrounded by normal parenchyma or inflammatory tissue caused by obstructive pancreatitis. In 6 cases, the mass was heterogenous in density. The common bile duct was dilated in all of our cases. A dilated pancreatic duct was seen in 12 cases, Tumour obstruction of the main pancreatic duct causing rupture of lateral side branch ducts resulted in the formation of post obstructive pseudo-cysts in 2 cases. Knowledge of this finding is important to avoid the mis-diagnosis of a tumour as pancreatitis with pseudocysts. The secondary findings of local tumour extension or metastatic diasease help to differentiate malignant masses from benign ones and aid in tumour staging and resectability. One or more of the ancillary findings were seen in 22 out of 24 correctly diagnosed cases. CT diagnosed resectable tumours in 2 cases. During operation however one case only was resectable