OBJECTIVEThis review discusses the current status and progress in studies on gastric cancer with liver metastasis (GCLM), involving the routes, subtypes, and prognosis of GCLM; the genes and molecules associated with metastasis; the feasibility and value of each imaging modality; and current treatment options.

DATA SOURCESThe data used in this review were mainly from Medline and PubMed published in English from 2005 to August 2010. The search terms were "gastric cancer" and "liver metastasis".

STUDY SELECTIONArticles regarding the characteristics, diagnostic modalities, and various therapeutic options of GCLM were selected.

RESULTSThe prognosis of GCLM is influenced by the clinicopathological characteristics of primary tumors, as well as the presence of liver metastases. Improved understanding of related genes and molecules will lead to the development of methods of early detection and targeted therapies. For the diagnosis of GCLM, each imaging modality has its relative benefits. There remains no consensus regarding therapeutic options.

CONCLUSIONSEarly detection and characterization of liver metastases is crucial for the prognosis of gastric cancer patients. Multidisciplinary team discussions are required to design optimal treatment strategies, which should be based on the clinicopathological characteristics of each patient.

Humans ; Liver Neoplasms ; diagnosis ; drug therapy ; secondary ; surgery ; Stomach Neoplasms ; complications ; diagnosis ; drug therapy ; surgery

Colorectal cancer is one of the most common malignancies in human, and colorectal liver metastasis (CLM) is one of the most common leading causes of death in these patients. In recent years, along with the update of diagnosis and treatment concept and advancement of operative technique, more and more patients with CLM get surgical treatment opportunities and the outcomes are improved. In clinical practice of CLM, depending on evidence-based medicine, standardized diagnosis and treatment is particularly important, which includes diagnosis and treatment by multidisciplinary team, accurate evaluation of the resectability of CLM, standardized surgical resection and essential comprehensive treatment.
Colorectal Neoplasms ; pathology ; Evidence-Based Medicine ; Hepatectomy ; Humans ; Liver Neoplasms ; diagnosis ; secondary ; surgery ; therapy ; Prognosis

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

A 28-year-old female with a pregnant state of 29th gestational week was admitted because of nausea and vomiting. MRI showed a huge hepatocellular carcinoma. At the 36th gestational week, a normal delivery was done. Surgery of hepatocellular carcinoma was done at 20 days after delivery. After 22 months from the operation, pulmonary metastasis was found and resection of lung mass was done. About 3 years after resection, a low attenuating nodule was detected in the left atrial chamber of heart. We report a case of hepatocellular carcinoma with metastatic lesions to lung and heart in a pregnant woman.
Adult ; Carcinoma, Hepatocellular/diagnosis/*secondary/surgery ; Female ; Heart Atria ; Heart Neoplasms/diagnosis/*secondary ; Humans ; Infant, Newborn ; Liver Neoplasms/diagnosis/*pathology/surgery ; Lung Neoplasms/diagnosis/secondary ; Pregnancy ; *Pregnancy Complications, Neoplastic/diagnosis

Adenocarcinoma ; metabolism ; secondary ; surgery ; Carcinoembryonic Antigen ; metabolism ; Carcinoma, Hepatocellular ; metabolism ; secondary ; surgery ; Colectomy ; Colonic Neoplasms ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Humans ; Keratin-18 ; metabolism ; Liver Neoplasms ; metabolism ; secondary ; surgery ; Male ; Middle Aged ; alpha-Fetoproteins ; metabolism

After curative resection of carcinoma of ampulla of Vater, 5-year survival rate has been reported ranging from 40% to 60%. Two major causes of the treatment failure are local recurrence and liver metastasis. Liver metastases are often multiple and are associated with poor prognosis. There have been few reports on long-term survivors after hepatectomy for metastatic liver tumors from carcinoma of ampulla of Vater. We report a 42 year-old female patient with solitary hepatic metastasis from carcinoma of ampulla of Vater, which was successfully treated by hepatectomy 69 months after curative Whipple's operation. Histologic examination of the resected specimen had revealed stage IB moderately-differentiated, intestinal type adenocarcinoma (T2N0M0). Since neither local recurrence or distant metastasis were detected, the patient underwent liver segmentectomy. Histologic study confirmed the presence of metastatic liver tumor from carcinoma of ampulla of Vater. She is doing well without evidence of recurrence at 20 months after hepatectomy.
Adult ; *Ampulla of Vater ; Carcinoma/*diagnosis/secondary/*surgery ; Common Bile Duct Neoplasms/diagnosis/*pathology/surgery ; Female ; *Hepatectomy ; Humans ; Liver Neoplasms/*diagnosis/secondary/*surgery ; Pancreaticoduodenectomy ; Positron-Emission Tomography ; Tomography, X-Ray Computed

No abstract available.
Adenocarcinoma/*secondary/surgery ; Chemotherapy, Adjuvant ; Colectomy ; Glomerulonephritis, Membranoproliferative/diagnosis/*etiology/therapy ; Hepatectomy ; Humans ; Liver Neoplasms/*secondary/surgery ; Male ; Middle Aged ; Paraneoplastic Syndromes/diagnosis/*etiology/therapy ; Renal Dialysis ; Renal Insufficiency/etiology ; Sigmoid Neoplasms/*pathology/surgery ; Treatment Outcome

Basaloid squamous cell carcinoma is a rare and aggressive variant of squamous cell carcinoma, which mostly occurs in the upper aerodigestive tracts. Basaloid squamous cell carcinoma also typically arises in the anal canal, but is extremely rare in the lower gastrointestinal tract. A 70-year-old man presented with loose stool and intermittent hematochezia 2 months ago. Colonoscopy showed an ulceroinfiltrative mass on the rectosigmoid colon from 16 cm to 18 cm above the anal verge. Conventional colonoscope could not pass through the lesion but it was possible with pediatric colonoscope. Abdominal CT scan showed 1.6 cm sized wall thickening with circumferential luminal narrowing in the rectosigmoid colon and multiple ill-defined low density masses in both lobes of the liver. Therefore, colon cancer with liver metastasis was suspected. However, basaloid cells were noted on histologic examination, and they were weakly positive for synaptophysin on immunohistochemical study. After palliative lower anterior resection, histologic examination of the resected specimen revealed basaloid differentiation with keratin pearls, and tumor cells were positively stained with high molecular weighted cytokeratin (34BE12) and CK 5/6. Thus, the patient was finally diagnosed with basaloid squamous cell carcinoma of rectosigmoid colon with distant metastases.
Aged ; Carcinoma, Squamous Cell/*diagnosis/pathology/surgery ; Colonoscopy ; Colorectal Neoplasms/*diagnosis/pathology/surgery ; Humans ; Immunohistochemistry ; Keratins/metabolism ; Liver Neoplasms/radiography/secondary ; Lung Neoplasms/radionuclide imaging/secondary ; Male ; Positron-Emission Tomography ; Synaptophysin/metabolism ; Tomography, X-Ray Computed

OBJECTIVETo investigate the manifestation and diagnostic value of multislice spiral CT (MSCT) and MRI imaging in detection of tumor recurrence after liver transplantation for hepatocellular carcinoma (HCC).

METHODSThe clinical data of 161 consecutive HCC patients who underwent orthotopic liver transplantation were retrospectively reviewed. Twenty-nine HCC patients were classified by pTNM according to the "Pittsburgh criteria". MSCT and MRI findings of tumor recurrence after liver transplantation were evaluated retrospectively in 29 stage II-IVb HCC patients. The recurrence site and relapse interval between liver transplantation and recurrence were analyzed.

RESULTSLung tumor recurrence were found in 21 cases, presented as cotton-like lesions in a diameter of 2 - 3 cm, with a clear margin and homogeneous density. Pleural tumor recurrence was detected in 4 cases. Liver tumor recurrence were found in 9 cases, which can be divided into four subtypes: multinodular in 4 cases, diffuse lesion in 2 cases, huge mass in 2 cases, and uninodular in 1 case. Two cases showed tumor thrombus in the inferior vena cava and portal vein. Lymph node tumor recurrence was found in 9 cases, presented as multiple nodules at hepatic hilum, lesser peritoneal sac, posterior mediastinum, retroperitoneum, or around pancreatic head, and accompanied with merging and necrosis in one case. Bone tumor recurrence were found as osteolytic destruction in 4 cases, and accompanied with adjacent soft-tissue mass in 2 cases. The recurrence sites of the 29 cases were as following: lung (21 cases, 72.4%), liver (9 cases, 31.0%), lymph nodes (9 cases, 31.0%), bone (4 cases, 13.8%) and other sites (3 cases, 10.3%). Lung tumor recurrence was found in all the 10 stage IVb patients with tumor recurrence after liver transplantation, significantly more frequent than that in stage IVa patients (P = 0.023). After liver transplantation, all 25 patients with stage III approximately IVb HCC developed recurrence within one year, but in the 4 cases with stage II HCC at one year later (P = 0.009).

CONCLUSIONThe results of our study show that in hepatocellular carcinoma patients after liver transplantation, the lung and pleura are the most frequent site of recurrence, followed by liver, lymph node and bone as the second and third sites. The Stage IVb hepatocellular carcinoma should be regarded as a contradiction for liver transplantation due to rapid recurrence. Tumor recurrence occurs later in stage II HCC than in stage III approximately IVb patients. MSCT and MRI are of significant importance in diagnosis and formulating operation plan in HCC patients with recurrence after liver transplantation.

Adult ; Carcinoma, Hepatocellular ; diagnosis ; diagnostic imaging ; secondary ; surgery ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; surgery ; Liver Transplantation ; Lung Neoplasms ; diagnosis ; diagnostic imaging ; secondary ; Lymphatic Metastasis ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; diagnosis ; diagnostic imaging ; Neoplastic Cells, Circulating ; Pleural Neoplasms ; diagnosis ; diagnostic imaging ; secondary ; Retrospective Studies ; Tomography, Spiral Computed ; methods

Although the adrenal gland is a common site of metastasis from hepatocellular carcinoma (HCC), adrenal metastases are rarely seen in clinical practice because of its lower metastatic potential compared to the other malignancies. Adrenal metastases usually were detected at the time of diagnosis of primary HCC or simultaneously with intrahepatic recurrence after curative management of HCC. It is very rare that only metastatic HCC is detected without evidence of intrahepatic recurrence. Hereby, we report two cases of adrenal metastasis from HCC without intrahepatic recurrence after hepatic resection.
Adrenal Gland Neoplasms/*diagnosis/radionuclide imaging/secondary ; Aged, 80 and over ; Carcinoma, Hepatocellular/*pathology/surgery ; Humans ; Liver Neoplasms/*pathology/surgery ; Male ; Positron-Emission Tomography ; Tomography, X-Ray Computed