Liver is the most common metastatic site of gastrointestinal stromal tumor(GIST). The recurrence rate is high even after hepatectomy. Although tyrosine kinase inhibitors (TKI) makes the resection feasible for some of the liver metastasis of GIST and significantly increase the overall survival, surgery still can not be substituted. Therefore, it is worth investigating and exploring the most appropriate treatment for the GIST with liver metastasis.
Gastrointestinal Stromal Tumors ; pathology ; therapy ; Humans ; Liver Neoplasms ; secondary ; therapy

OBJECTIVETo study the clinical characteristics and MR imaging features of intracranial metastasis from malignant tumors.

METHODS1271 patients who had history of primary tumor and suspected of cranial metastasis had MRI on Philips Gyroscan T5-NT MR scanner. The sequences included pre-contrast T(1)WI, FLAIR, and postcontrast transversal, sagittal, and coronal T(1)WI. All of the clinical data and MRI features of the patients were recorded and analyzed.

RESULTSOf 547 patients with intracranial metastasis, 393 came from lung cancer (71.9%), 10% of 547 patients were found to have the presenting symptoms of cranial metastasis. 526 had parenchymal cerebral metastasis, and 21 only meningeal metastasis. Of these 526 patients found to have brain metastasis, 164 had single metastasis (31.2%), and 362 multiple (68.8%). Most of the cerebral metastatic lesions showed uniform or ring enhancement after intravenous injection of contrast medium, dura-arachnoid metastasis showed continuous and thick-curve enhancement at the cerebral convex, but not extending to the sulcus, while pia-dura metastasis displayed as thin and linear or nodular enhancement extending to the adjacent sulci.

CONCLUSIONThe most common primary lesion with metastasis to the brain were lung cancers, followed by breast and gastrointestinal cancers. By using gadolinium-DTPA enhanced MR imaging, many single and small cerebral metastasis could be found earlier.

Adult ; Aged ; Brain Neoplasms ; diagnosis ; secondary ; Breast Neoplasms ; pathology ; Female ; Gastrointestinal Neoplasms ; pathology ; Humans ; Lung Neoplasms ; pathology ; Magnetic Resonance Imaging ; Male ; Meningeal Neoplasms ; diagnosis ; secondary ; Middle Aged

Duodenal choriocarcinoma, either primary or metastatic, is very rare. Early diagnosis and prompt initiation of chemotherapy improve the prognosis of this neoplasm. We herein present, together with the referred literatures, a case of a 47-year-old female patient who visited to our hospital with upper intestinal bleeding. She was diagnosed as duodenal choriocarcinoma by operation. Brain metastasis was found soon after the operation and combination chemotherapy was done.
Brain Neoplasms/*secondary ; Choriocarcinoma/*diagnosis/secondary ; Duodenal Neoplasms/*diagnosis/pathology ; Female ; Gastrointestinal Hemorrhage/*diagnosis ; Humans ; Middle Aged

No abstract available.
Aged ; Female ; Gastrointestinal Neoplasms/*diagnosis/pathology/*secondary ; Humans ; Liver Neoplasms/*diagnosis/radiography/*secondary ; Melanoma/*pathology ; Skin Neoplasms/*pathology ; Tomography, X-Ray Computed

No abstract available.
Adenocarcinoma/*diagnosis/pathology/*secondary ; Female ; Gastrointestinal Hemorrhage ; Humans ; Jejunal Neoplasms/pathology/*secondary ; Lung Neoplasms/*diagnosis/pathology ; Middle Aged ; Tomography, X-Ray Computed

BACKGROUND/AIMS: Metastasis to the stomach is rare. The aim of this study was to describe and analyze the clinical outcomes of cancers that metastasized to the stomach. METHODS: We reviewed the clinicopathological aspects of patients with gastric metastases from solid organ tumors. Thirty-seven cases were identified, and we evaluated the histology, initial presentation, imaging findings, lesion locations, treatment courses, and overall patient survival. RESULTS: Endoscopic findings indicated that solitary lesions presented more frequently than multiple lesions and submucosal tumor-like tumors were the most common appearance. Malignant melanoma was the tumor that most frequently metastasized to the stomach. Twelve patients received treatments after the diagnosis of gastric metastasis. The median survival period from the diagnosis of gastric metastasis was 3.0 months (interquartile range, 1.0 to 11.0 months). Patients with solitary lesions and patients who received any treatments survived longer after the diagnosis of metastatic cancer than patients with multiple lesions and patients who did not any receive any treatments. CONCLUSIONS: Proper treatment with careful consideration of the primary tumor characteristics can increase the survival period in patients with tumors that metastasize to the stomach, especially in cases with solitary metastatic lesions in endoscopic findings.
*Endoscopy, Gastrointestinal ; Female ; Gastric Mucosa/*pathology ; Humans ; Male ; Melanoma/*pathology ; Middle Aged ; Stomach Neoplasms/mortality/*secondary/therapy ; Survival Analysis

Peritoneal metastases (PM) are the common endpoint for patients with advanced gastrointestinal cancers. PM from these cancers are often managed in a similar fashion to other sites of systemic metastases, but the following must be taken into consideration. (a) PM do not respond to systemic chemotherapy in the same fashion as liver and lung metastases. (b) PM cause local problems, resulting in disruption of chemotherapy. (c) Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) actually work for PM. (d) PM are not easily detected on imaging modalities. There has been mounting evidence of the effectiveness of CRS-HIPEC at prolonging survival in selected patients with colorectal and gastric PM, but there remains a reluctance to explore this treatment modality. This is likely because of the perceived morbidity and mortality. An effective management strategy employing CRS-HIPEC for selected patients with gastrointestinal PM can only be achieved if a concerted effort is made to understand this disease and address the concerns regarding this treatment.
Colorectal Neoplasms ; pathology ; Combined Modality Therapy ; Cytoreduction Surgical Procedures ; Gastrointestinal Neoplasms ; pathology ; Humans ; Hyperthermia, Induced ; Intestinal Neoplasms ; pathology ; Peritoneal Neoplasms ; secondary ; therapy ; Peritoneum ; Standard of Care

Hepatocellular carcinoma (HCC) rarely invades the gastrointestinal (GI) tract. It occurs in 0.7% to 2% of clinical HCC cases. Moreover, gastric invasion with GI hemorrhage via peritoneal seeding is very rare. We report the case of 67-year-old woman who had a history of HCC rupture and was admitted due to left upper quadrant abdominal pain. The patient was diagnosed with three omental metastatic masses and underwent hepatic segmentectomy and omental tumorectomy. Two months later, the patient had massive melena, and an esophagogastroduodenoscopy showed very large ulcerated friable mass on the gastric body. The histology was consistent with the diagnosis of metastatic HCC. The patient died from persistent GI hemorrhage 93 days after the admission. This case illustrates the very rare event of peritoneal seeding of a ruptured HCC causing direct invasion of the stomach, followed by GI hemorrhage.
Aged ; Carcinoma, Hepatocellular/*diagnosis/radiography/secondary ; Female ; Gastrointestinal Hemorrhage/*diagnosis/etiology/radiography ; Gastroscopy ; Humans ; Liver Neoplasms/*diagnosis/pathology/radiography ; *Neoplasm Seeding ; Peritoneal Neoplasms/*diagnosis/radiography/secondary ; Stomach Neoplasms/*diagnosis/radiography/secondary ; Tomography, X-Ray Computed

OBJECTIVETo summarive the experience in diagnosis and treatment of primary small intestinal neoplasm.

METHODSThe data of 305 patients with pathologically confirmed primary small intestinal tumor collected from 6 hospitals around the Songhua River during the past 33 years were analyzed retrospectively.

RESULTSThere were 42 benign and 263 malignant tumors in this series with a ratio of 1: 6.26. The 263 malignant tumors in this series consisted of 135 adenocarcinomas, 57 malignant stromal tumors, 37 malignant lymphomas, 20 carcinoids, and etc. Chronic occult bleeding, gradual of body weight loss and mild abdominal pain (three obscurities) were the common clinical features and alerting massage of intestinal tumor. Correct preoperative diagnostic rate was only 57.0% (174/305) due to difficulty in early diagnosis, which was 67.2% (92/137) in the duodenal tumors, and 51.9% (82/168) in the jejunoileal tumors. All of the 42 benign tumors were resected completely. For the 263 patients with malignant tumors, radical dissection was performed in 153, palliative resection in 34, and gut by-pass or biopsy in 76. The median survival of the patients who underwent radical resection of their malignant tumors was 92 months, which was significantly higher than that of the other groups.

CONCLUSIONEarly diagnosis of primary small intestinal tumors is difficult and with a preoperative misdiagnosis rate of 43.0%. Total intestinal barium swallowing, endoscopy and superior mesenteric arteriography are three critical examinations for diagnosis and location. Early surgical resection is crucial in improving the prognosis. The primary small intestinal tumor should be resected as early as possible if no distant metastasis is detected.

Adenocarcinoma ; diagnosis ; secondary ; surgery ; Adenoma ; diagnosis ; pathology ; surgery ; Adult ; Aged ; Aged, 80 and over ; Carcinoid Tumor ; diagnosis ; secondary ; surgery ; Diagnostic Errors ; Digestive System Surgical Procedures ; methods ; Duodenal Neoplasms ; diagnosis ; pathology ; surgery ; Female ; Gastrointestinal Stromal Tumors ; diagnosis ; secondary ; surgery ; Humans ; Ileal Neoplasms ; diagnosis ; pathology ; surgery ; Jejunal Neoplasms ; diagnosis ; pathology ; surgery ; Liver Neoplasms ; secondary ; surgery ; Lymphatic Metastasis ; Lymphoma ; diagnosis ; pathology ; surgery ; Male ; Middle Aged ; Young Adult

Targeted therapy is the first line treatment for patients with recurrent/metastatic gastrointestinal stromal tumors(GIST). Sunitinib is effective for patients who have failed imatinib, specially with c-kit exon 9 gene mutation. Tyrosine kinase inhibitors combined with partial hepatectomy may increase the overall survival of GIST patients with liver metastasis. Selective patients with recurrent or metastatic GIST can benefit from surgical resection. Regorafenib and pazopanib can provide a significant improvement in progression-free survival in patients after failure of standard treatment.
Benzamides ; Disease-Free Survival ; Gastrointestinal Neoplasms ; pathology ; therapy ; Gastrointestinal Stromal Tumors ; secondary ; therapy ; Hepatectomy ; Humans ; Imatinib Mesylate ; Indoles ; Liver Neoplasms ; secondary ; therapy ; Phenylurea Compounds ; Piperazines ; Pyridines ; Pyrimidines ; Pyrroles ; Recurrence ; Sulfonamides