ABSTRACT
Colorectal cancers rarely present with bone metastases. Regular postoperative monitoring after resection by conventional imaging techniques and carcinoembryonic antigen levels aids physicians in identifying such tumor recurrences. However, some recurrences might elude detection by bone scan, computed tomography, and magnetic resonance imaging, and newer tests such as immunoscintigraphy using radioimmune-tagged monoclonal antibodies may be more diagnostic. Here we report a case, presenting with delayed recurrence at a rare bony site, in which application of immunoscintigraphy helped in the definitive detection of the tumor recurrence.
Subject(s)
Adenocarcinoma/diagnostic imaging , Adenocarcinoma/secondary , Bone Neoplasms/diagnostic imaging , Bone Neoplasms/secondary , Sigmoid Neoplasms/pathology , Sternum , Fatal Outcome , Female , Humans , Middle Aged , Radioimmunodetection , Sternum/diagnostic imagingABSTRACT
We report a gastric duplication in a 23-year-old man. The case is unique because the stomach is the rarest location for enteric duplication, the duplication almost never occurs in adults, and the duplication consisted exclusively of pancreatic tissue. This extreme example illustrates the close embryologic and anatomic association between stomach and pancreas. A case is made for the use of the general term of foregut duplication to avoid confusing nomenclature.
Subject(s)
Stomach/abnormalities , Adult , Humans , MaleABSTRACT
A case of congenital duodenal stenosis is reported complicated by recurrent pancreatitis. The diagnosis was not initially entertained because of the pancreatitis. The radiographic appearance on gastrointestinal series was unusual for pancreatitis. The finding of an anomalous celiac axis on arteriography suggested the possibility of other congenital anomalies. The diagnosis of congenital duodenal stenosis was confirmed at laparotomy. The obstruction was relieved with a duodenojejunostomy. Two year follow-up reveals the patient to be asymptomatic without recurrence of pancreatitis. This is the first endoscopic report of this lesion and the presence of the duodenal cervix sign should suggest the diagnosis of congenital duodenal stenosis.
Subject(s)
Duodenal Obstruction/congenital , Pancreatitis/complications , Adult , Age Factors , Celiac Artery/abnormalities , Child , Duodenal Obstruction/complications , Duodenal Obstruction/surgery , Duodenum/diagnostic imaging , Duodenum/surgery , Humans , Jejunum/surgery , Male , Pancreatitis/diagnostic imaging , RadiographyABSTRACT
Significant hepatotoxicity due to allopurinol seems to be rare. Only 6 such cases have been recorded in the literature. The clinical and histopathologic findings of allopurinol-induced liver injury are variable in the previously reported cases. Described herein is another patient with allopurinol hepatotoxicity. Of interest is the similar histopathology between the present case and the two previously reported cases of allopurinol-induced granulomatous hepatitis; thus this is the third such recorded case. Allopurinol should be suspected when liver abnormalities occur following use of this drug.
Subject(s)
Allopurinol/adverse effects , Chemical and Drug Induced Liver Injury/etiology , Adult , Allopurinol/therapeutic use , Arthritis/drug therapy , Biopsy , Chemical and Drug Induced Liver Injury/pathology , Gout/drug therapy , Humans , Liver/pathology , Liver Function Tests , MaleABSTRACT
Five cases of pancreatic pseudocyst are presented with unusual manifestations. Clinical features of each entity are discussed to enable one to diagnose the rare manifestations and complications of pancreatic pseudocyst. Reasonable understanding of such cases enables accurate diagnostic work-up for confirmation and early surgical intervention.
Subject(s)
Pancreatic Cyst/diagnosis , Adult , Ascites/etiology , Cholestasis/etiology , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Pancreatic Cyst/complications , Pancreatic Cyst/surgery , Rupture, SpontaneousABSTRACT
A 76-year-old man presented with hypoglycemic coma associated with metastatic liver disease. Serum immunoreactive insulin excluded insulinoma as a cause of hypoglycemia. Negative glucose responses to glucagon and epinephrine testing indicated failure of compensatory glycogenolysis. The patient's increased glucose requirements of 500 g per 24 hr were reduced to normal only after shrinkage of the liver tumor bulk was accomplished with chemotherapy. Hepatic hypoglycemia is discussed and the literature is reviewed.
Subject(s)
Hypoglycemia/etiology , Liver Neoplasms/complications , Aged , Cyclophosphamide/therapeutic use , Fluorouracil/therapeutic use , Humans , Liver Neoplasms/drug therapy , Male , Neoplasm Metastasis , Prostatic Neoplasms/pathologyABSTRACT
10 cases of pancreatic ascites are presented. Ascitic fluid lipase is complementary to the determination of ascitic amylase in the diagnosis of pancreatic ascites and may be a more reliable diagnostic indicator of pancreatic ascites on a random ascitic fluid sample. Conservative management, consisting of abdominal paracentesis with or without diurectics, proved to be the treatment of choice in 3 of our patients who failed to reveal an associated pseudocyst.
Subject(s)
Ascites/diagnosis , Ascitic Fluid/enzymology , Lipase/analysis , Pancreatitis/diagnosis , Adenocarcinoma/diagnosis , Adult , Aged , Alcohol Drinking , Ascites/etiology , Female , Humans , Male , Middle Aged , Pancreatic Neoplasms/diagnosis , Pancreatitis/complicationsABSTRACT
The extremely unusual patient reported here had malignant histiocytosis with extensive gastrointestinal involvement. The presenting symptoms were those of a gastrointestinal disorder and barium studies of the upper gastrointestinal tract revealed an infiltrative process of the entire small bowel. A biopsy of the small bowel demonstrated abnormal malignant cells and the diagnosis of malignant histiocytosis was considered and confirmed at postmortem. Strongyloidiasis, which was also found in this patient, may represent a hyperinfestation phenomenon due to altered host-parasite balance.
