Presentation
This case study discusses the presentation, diagnosis, and complications of ECD. Case: A 65 year-old female presented with new onset, transient neurologic symptoms of ataxia, headaches, right sided weakness, and dysarthria. [journals.lww.com]
It can present as a small submucosal nodule with arterial enhancement (image) and sometimes they lead to intussusception. GIST Typical GIST in the ileum presenting as an exophytic tumor. [radiologyassistant.nl]
Presenting signs include diarrhea, rectal bleeding, intussusception, anemia, prolapse, and failure to thrive. [emedicine.medscape.com]
Patients may present with anorexia and weight loss (95%) as well as abdominal pain that is vague and insidious in nature. [radiopaedia.org]
Entire Body System
- Weight Loss
"If you're losing weight and not dieting, that's something to pay attention to," she explains. Be aware that the weight loss may be gradual. [prevention.com]
Unintentional weight loss: While many cancers can cause weight loss due to the increased demands of the growing tumor, weight loss is particularly common in stomach cancer. [buoyhealth.com]
The most common symptoms include: Pain or discomfort in the abdomen Nausea and vomiting Loss of appetite Fatigue or weakness Bleeding (vomiting blood or passing blood in stools) Weight loss Early satiety (cannot eat a complete meal because of a “full [gi.org]
Possible signs of small intestine cancer include Abdominal pain Weight loss for no reason Blood in the stool A lump in the abdomen Imaging tests that create pictures of the small intestine and the area around it can help diagnose intestinal cancer and [medlineplus.gov]
Some common symptoms of cancer that develops in the small intestines include: Abdominal pain Unexplained weight loss Weakness or fatigue (sometimes a result of anemia) Bloody or tarry stools (from bleeding tumors) A noticeable lump in the abdomen Small [cancercenter.com]
- Anemia
Presenting signs include diarrhea, rectal bleeding, intussusception, anemia, prolapse, and failure to thrive. [emedicine.medscape.com]
A slowly bleeding tumor may lead to anemia. Digested blood may cause the stool to become black or tarry. An obstruction—when the flow of food is completely blocked—may cause intense pain, nausea and vomiting and typically requires immediate surgery. [cancercenter.com]
Pernicious anemia 12. h/o partial gastric resection 13. [slideshare.net]
Click here to view Figure 5: (a–d) A male patient aged 59 Ys presented by abdominal pain and anemia. [tdj.eg.net]
- Inflammation
Cancer-related inflammation. Nature 2008;454:436-44. DOI PubMed 2. Macarthur M, Hold GL, El-Omar EM. Inflammation and Cancer II. Role of chronic inflammation and cytokine gene polymorphisms in the pathogenesis of gastrointestinal malignancy. [jcmtjournal.com]
Review Article Interleukin-6 and its receptor, key players in hepatobiliary inflammation and cancer Christopher Johnson, Yuyan Han, Nathan Hughart, Jennifer McCarra, Gianfranco Alpini, Fanyin Meng Cells of origin and cancer stem cells in cholangiocarcinoma [tgc.amegroups.com]
This can sometimes be caused by inflammation and healing and may go away once inflammation stops or the body has healed. [news-medical.net]
This clonal disorder, marked by recurrent BRAFV600E mutations in over 68% of patients, presents as uncontrolled inflammation of multiple organ systems. [journals.lww.com]
Your risk of getting it is also higher if you Have had a Helicobacter pylori infection Have had stomach inflammation Are a man Eat lots of salted, smoked, or pickled foods Smoke cigarettes Have a family history of stomach cancer It is hard to diagnose [medlineplus.gov]
- Fatigue
Symptoms such as abdominal pain, nausea, and fatigue overlap with many other conditions and diseases. If you’re experiencing any of these or other abnormal symptoms, you should talk with your doctor. [healthline.com]
Some common symptoms of cancer that develops in the small intestines include: Abdominal pain Unexplained weight loss Weakness or fatigue (sometimes a result of anemia) Bloody or tarry stools (from bleeding tumors) A noticeable lump in the abdomen Small [cancercenter.com]
One or more of the following symptoms may indicate carcinoid syndrome: facial flushing diarrhea abdominal pain (caused by blockage of the intestines) shortness of breath or wheezing fatigue rapid heartbeat weight gain or loss heart valve damage Patients [mskcc.org]
GISTs can be asymptomatic or present with various non-specific signs, depending on the location and size of tumor, such as loss of appetite, anemia, weight loss, fatigue, abdominal discomfort or fullness, nausea, vomiting, as well as an abdominal mass [orpha.net]
- Surgical Procedure
Comprehensive treatment options Cancer treatment is changing rapidly, and SCCA offers the latest and best treatments, including chemotherapy regimens that are easier to tolerate and surgical procedures that are less invasive. [seattlecca.org]
This minimally invasive surgical procedure is used to examine the stomach wall, nearby lymph nodes, and remove samples when necessary. During a laparoscopy, instruments are delivered to the surgery site through thin tubes inserted into the abdomen. [innerbody.com]
Surgical procedures should be performed by a surgeon with experience in thyroid surgery in children and with the management of medullary thyroid cancer. [cancer.net]
Subtotal gastrectomy: A part of the stomach is surgically removed. Total gastrectomy: The whole stomach is surgically removed. Abdominal surgeries are significant procedures and may require prolonged recovery time. [medicalnewstoday.com]
Gastrointestinal
- Abdominal Pain
Peutz-Jeghers syndrome is diagnosed on the basis of family history, pigmented spots, and cramping abdominal pain. [emedicine.medscape.com]
However, some patients may experience symptoms such as facial flushing, diarrhea, abdominal pain, asthma, a rash, and dark-colored stools (which indicate intestinal bleeding). [mskcc.org]
This can also result in severe abdominal pain. Emergency surgery might be needed in these situations. [cancer.org]
Possible signs of small intestine cancer include Abdominal pain Weight loss for no reason Blood in the stool A lump in the abdomen Imaging tests that create pictures of the small intestine and the area around it can help diagnose intestinal cancer and [medlineplus.gov]
Figure 2f Patients with intramural tumors can be asymptomatic or can present with an abdominal mass or pain. [pubs.rsna.org]
- Loss of Appetite
GISTs can be asymptomatic or present with various non-specific signs, depending on the location and size of tumor, such as loss of appetite, anemia, weight loss, fatigue, abdominal discomfort or fullness, nausea, vomiting, as well as an abdominal mass [orpha.net]
Nausea and vomiting Difficulty swallowing Heartburn Loss of appetite Weight loss Feeling tired Bloating Vomiting blood (in advanced stages) Cleveland Clinic News & More Cleveland Clinic News & More [my.clevelandclinic.org]
Some are more obvious, such as: losing weight without trying to feeling or being sick having problems swallowing (dysphagia) a lump at the top of your tummy Others might be harder to spot, such as: heartburn or acid reflux loss of appetite symptoms of [nhs.uk]
Other possible symptoms of GISTs Other symptoms of GISTs can include: Abdominal (belly) pain A mass or swelling in the abdomen Nausea and vomiting Feeling full after eating only a small amount of food Loss of appetite Weight loss Problems swallowing [cancer.org]
Stomach cancer unexplained weight loss or loss of appetite difficulty swallowing indigestion – e.g. pain or burning sensation in the abdomen (heartburn), frequent burping, reflux persistent nausea and/or vomiting with no apparent cause a sense of fullness [cancervic.org.au]
- Melena
She then presented with melena, was found to have a clean-based antral ulceration on EGD, and was treated conservatively. Several months later a PET scan revealed a new subepithelial duodenal mass with FDG avidity. Patient underwent an EUS with FNA. [journals.lww.com]
[…] mutation of c-kit 25% are clinically malignant Clinical features 2 - 3% of gastric malignancies Usually older adults, median age 60 - 65 years; 1% occur in children Male = female incidence Symptoms: abdominal pain, gastric outlet obstruction, mass effect, melena [pathologyoutlines.com]
Massive hematemesis or melena is uncommon, but secondary anemia may follow occult blood loss. Occasionally, the first symptoms are caused by metastasis (eg, jaundice, ascites, fractures). [msdmanuals.com]
Patients with gastric glomus tumors can be asymptomatic, or they can present with epigastric discomfort, hematemesis, or melena. Surgical resection is usually curative. [pubs.rsna.org]
- Hematemesis
Patients experiencing upper GIB may present with hematemesis, dark stools, nausea, abdominal pain, syncope, and hematochezia if the bleeding is brisk enough. [cancertherapyadvisor.com]
Massive hematemesis or melena is uncommon, but secondary anemia may follow occult blood loss. Occasionally, the first symptoms are caused by metastasis (eg, jaundice, ascites, fractures). [msdmanuals.com]
The symptoms associated with gastrointestinal bleeding were defined as hematemesis, melena, and/or progression of anemia due to upper gastrointestinal lesions. [pancreas.imedpub.com]
Patients with gastric glomus tumors can be asymptomatic, or they can present with epigastric discomfort, hematemesis, or melena. Surgical resection is usually curative. [pubs.rsna.org]
- Abdominal Mass
GISTs can be asymptomatic or present with various non-specific signs, depending on the location and size of tumor, such as loss of appetite, anemia, weight loss, fatigue, abdominal discomfort or fullness, nausea, vomiting, as well as an abdominal mass [orpha.net]
They may present as an abdominal mass, abdominal pain or, rarely, with jaundice, as in this case. Timely resection on diagnosis provides long-term survival. Conflict of interest: none declared. [academic.oup.com]
Symptoms of abdominal mass and bowel obstruction. They may also present as an incidental finding during investigation for other diseases. [patient.info]
Where the disease is advanced, the doctor’s examination may reveal: Abdominal mass/es; Enlarged lymph nodes (lymphadenopathy) Bowel obstruction; Fluid in the abdomen (ascites); Enlarged liver (hepatomegaly); and/or Lower extremity fluid accumulation [myvmc.com]
[…] computed tomography (CT) scan is of critical value in detection of an intra-abdominal mass. [touchoncology.com]
Skin
- Erythema
Rongioletti F., Fausti V., Parodi A.: erythema gyratum repens is not an obligate paraneoplastic disease: a systematic review of the literature and personal experience. J Eur Acad Dermatol Venereol 2014, 28, 112-115. [termedia.pl]
Necrolytic migratory erythema is probably the most characteristic clinical feature of the glucagonoma syndrome. This skin lesion may precede the diagnosis by at least 5 years [12]. [cancernetwork.com]
Mild adverse events occurred in 1.4% of individuals, including nausea, vomiting, transient hypotension without shock, injection site erythema, diffuse rash and mild epigastric pain [ 3 ]. [omicsonline.org]
Neurologic
- Irritability
There are three types of adenocarcinoma: Noncardia (Distal) Stomach Cancer This type of stomach cancer may be related to long periods of inflammation and irritation in the lower part of the stomach. [mskcc.org]
Three Types of Stomach Cancer (Adenocarcinoma) Noncardia (Distal) Stomach Cancer This type of stomach cancer may develop from long periods of inflammation and irritation in the lower portion of the stomach. [nostomachforcancer.org]
Less common causes of irritation can also increase the chance of developing esophageal cancer. [gi.org]
Esophageal irritation due to alendronate sodium tablets: possible mechanisms. Digestive diseases and sciences. 1998;43(9):1998–2002. Epub 1998/09/30. pmid:9753265. View Article PubMed/NCBI Google Scholar 34. [journals.plos.org]
- Headache
Case: A 65 year-old female presented with new onset, transient neurologic symptoms of ataxia, headaches, right sided weakness, and dysarthria. [journals.lww.com]
Large pituitary tumours may cause problems with vision or headaches. [yourhormones.info]
Resulting symptoms may include headaches and visual problems, such as blurred vision. In addition to a prolactinoma, other tumors affecting the pituitary gland may occur. [rarediseases.org]
Workup
[…] and Staging Surgical Treatment Neoadjuvant Treatment Chemoradiation Chemotherapy for Palliation Summary and Further Reading Chapter 4 - Gastric Cancer Epidemiology and Clinical Presentation Diagnostic Workup, Staging and Surgery for Localised Disease [oncologypro.esmo.org]
The following tests are generally ordered in the workup of patients who present with nonspecific abdominal symptoms; abdominal pain; or complications such as hemorrhage, obstruction, or perforation: Complete blood cell count Coagulation profile Serum [emedicine.medscape.com]
Currently, there are no guidelines that recommend an initial endoscopic workup for evaluation of an underlying GI malignancy in dermatomyositis patients. [wjgnet.com]
Mucins (MUCs) appear to have limited utility in the workup of carcinomas of the digestive system. CK7 and CK20. The differential expression patterns of CK7 and CK20 are routinely used in the workup for adenocarcinomas of unknown primary. [archivesofpathology.org]
Therefore the first step in management is usually extensive imaging and other workup such as endoscopies and biopsies. [buoyhealth.com]
Microbiology
- Helicobacter Pylori
What role does Helicobacter Pylori play in gastric cancer? Gastroenterology 1997; 113 (6 Suppl): S 56-60. Editt S, Stolte M. The significance of Helicobacter Pylori in relation to gastric cancer and lymphoma. [ams.ac.ir]
Diagnosis of Helicobacter pylori Infection and Serum Pepsinogen (PG) Levels Fasting serum samples were taken. Helicobacter pylori infection was diagnosed by enzyme immunoassay (EIA) for anti-H. pylori immunoglobulin G (IgG). [hindawi.com]
SHP-2 tyrosine phosphatase as an intracellular target of Helicobacter pylori CagA protein. Science 2002;295:683-6. DOI PubMed 42. [jcmtjournal.com]
Etiology of stomach cancer is multifactorial, but Helicobacter pylori plays a significant role. Symptoms include early satiety, obstruction, and bleeding but tend to occur late in the disease. [msdmanuals.com]
Malfertheiner P, Megraud F, O'Morain CA, Atherton J, Axon AT, Bazzoli F, Gensini GF, Gisbert JP, Graham DY, Rokkas T, El-Omar EM, Kuipers EJ, European Helicobacter Study Group Management of Helicobacter pylori infection – the Maastricht IV/Florence Consensus [ncbi.nlm.nih.gov]
Gastroscopy
- Gastric Lesion
However, those with a Japanese viewpoint diagnosed suspected or definite carcinoma in 77–94% of the gastric lesions, in 45–75% of the colorectal lesions, and in 81–100% of the oesophageal lesions. [gut.bmj.com]
Six patients had both gastric and duodenal lesions. Eight patients had only gastric polyps, and four had duodenal polyps only. [link.springer.com]
The three esophageal and two gastric lesions were successfully removed by endoscopic submucosal dissection, while the two colorectal lesions and the lesion in the external ear canal were surgically resected. [bmccancer.biomedcentral.com]
For mucosal gastric lesions, endoscopy may be indicated. Concurrent imaging with CT and 18-fluorodeoxyglucose positron emission tomography (FDG-PET) may aid in the interpretation of CT findings, particularly where there is peritoneal disease. [journals.lww.com]
Prognostic analysis of gastric gastrointestinal stromal tumor with synchronous gastric cancer. World J Surg Onocl. 2014;12:25. View Article Google Scholar Hedenbro JL, Ekelund M, Wetterberg P. Endoscopic diagnosis of submucosal gastric lesions. [wjso.biomedcentral.com]
Treatment
Adjuvant Treatment Treatment of Unresectable Patients Palliative Treatment Second-Line Treatment Summary and Further Reading Chapter 8 - Hereditary Colorectal Cancer Syndromes Classification and Identification Non-Polyposis CRC Syndromes: Lynch Syndrome [oncologypro.esmo.org]
[…] by the treating physician - Failed prior treatment with imatinib mesylate, defined as either progression of disease or significant toxicity during treatment with imatinib mesylate that precluded further treatment - Male or Female, 18 years or older - [pfizer.com]
In addition to providing an expert approach to standard treatments, the Gastrointestinal Cancers Program offers innovative treatment options, including clinical trials for the treatment of advanced and metastatic pancreatic cancer and cutting-edge surgical [ynhh.org]
Early diagnosis and treatment of early gastrointestinal neoplasm gets very good prognosis. Features Endoscopic submucosal dissection, ESD ESD is a promising advance for treatment of early gastrointestinal neoplasm in recent 10 years. [imsc.vghtpe.gov.tw]
[…] as access to the most advanced treatments possible. [muhealth.org]
Prognosis
Prognosis is better with protruding tumors than with spreading tumors because protruding tumors become symptomatic earlier. [msdmanuals.com]
Treatment and prognosis It is an aggressive tumor with a 5-year survival rate of less than 20%. Prognosis is correlated to the stage of the tumor at presentation. [radiopaedia.org]
The prognosis of gastrointestinal high-grade MiNENs largely depends on stage and type of neoplastic components, but in general, it seems to be similar to that of pure NECs suggesting that the NEC component is pivotal in determining the prognosis [3, 7 [hindawi.com]
Etiology
[…] histology blood blood supply cerebrospinal fluid chemical synthesis chemically induced chemistry classification complications congenital cytology diagnosis diagnostic imaging diet therapy drug therapy economics embryology enzymology epidemiology ethnology etiology [ncbi.nlm.nih.gov]
[…] blood CF cerebrospinal fluid CI chemically induced CH chemistry CL classification CO complications CN congenital DI diagnosis DG diagnostic imaging DH diet therapy DT drug therapy EC economics EM embryology EN enzymology EP epidemiology EH ethnology ET etiology [decs.bvs.br]
Etiology of stomach cancer is multifactorial, but Helicobacter pylori plays a significant role. Symptoms include early satiety, obstruction, and bleeding but tend to occur late in the disease. [msdmanuals.com]
Only 500 cases have been described in the literature with longstanding uncertainty about etiology and classification. [journals.lww.com]
The Journal also offers basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. [link.springer.com]
Epidemiology
The second section covers essential developments exploring epidemiological factors implicated in GI cancer, disease prevention, the new opportunities that promise to advance our understanding, molecular subtyping, and tailored treatment of these diseases [oncologypro.esmo.org]
[…] analysis anatomy and histology blood blood supply cerebrospinal fluid chemical synthesis chemically induced chemistry classification complications congenital cytology diagnosis diagnostic imaging diet therapy drug therapy economics embryology enzymology epidemiology [ncbi.nlm.nih.gov]
English: BS blood supply BL blood CF cerebrospinal fluid CI chemically induced CH chemistry CL classification CO complications CN congenital DI diagnosis DG diagnostic imaging DH diet therapy DT drug therapy EC economics EM embryology EN enzymology EP epidemiology [decs.bvs.br]
Matthew Quinn, Sharon DeMorrow Review Article Interleukin-6 and its receptor, key players in hepatobiliary inflammation and cancer Christopher Johnson, Yuyan Han, Nathan Hughart, Jennifer McCarra, Gianfranco Alpini, Fanyin Meng Cholangiocarcinoma: Epidemiology [tgc.amegroups.com]
Pathophysiology
Reticulocyte test and serum ferritin level test help to differentiate pathophysiological origin of anaemia. [ncbi.nlm.nih.gov]
Looking for Zebras in Metastatic Colorectal Cancer January 4, 2019 Although colorectal cancer is one of the most commonly diagnosed cancers in the United States,1 and researchers’ understanding of the biology and pathophysiology of CRC has grown, its [ruesch.georgetown.edu]
In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. https://www.clinicalkey.com. Accessed March 23, 2016. Gastric cancer. [mayoclinic.org]
Outline the pathophysiologic development of colorectal cancer. [slideshare.net]
Pathophysiology Benign small-bowel tumors may be found throughout the duodenum, jejunum, and ileum (in order of increasing frequency). Tumors may be single, multiple, or widespread (ie, as part of a polyposis syndrome). [emedicine.medscape.com]
Prevention
Share on Pinterest Aspirin could prevent digestive cancers, especially in the elderly, suggests new research. [medicalnewstoday.com]
All chapters follow a consistent template including the following features: - An opening bottom-line/key points section - Classification, pathogenesis and prevention of disease - Evidence-based diagnosis, including relevant algorithms, laboratory and [books.google.com]
Cancer prevention is an action taken to lower the chance of getting cancer. While there is no guarantee that you will not develop cancer, there are steps you can take to protect yourself. [compassoncology.com]
Colorectal Cancer Preventable. Treatable. Beatable. Each year nearly 137,000 people are diagnosed with colorectal cancer, often referred to as colon cancer, in the U.S. and over 50,000 people die from it annually. [asge.org]
[…] therapy economics embryology enzymology epidemiology ethnology etiology genetics history immunology legislation and jurisprudence metabolism microbiology mortality nursing organization and administration parasitology pathology physiology physiopathology prevention [ncbi.nlm.nih.gov]