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Modulation of matrilysin levels in colon carcinoma cell lines affects tumorigenicity in vivo.

The expression of the metalloproteinase matrilysin in the human colon carcinoma cell lines SW480 and SW620 correlates with the ability of the SW620 cells to invade an artificial basement membrane in vitro and metastasize to the liver following injection into the cecum of nude mice in vivo. Transfection of either wild-type or activated forms of matrilysin into the SW480 cells, which do not express endogenous matrilysin, did not reproducibly increase in vitro invasion but increased the tumorigenicity of the cells when injected into the cecum of nude mice. Antisense reduction of matrilysin levels decreased the tumorigenicity of the SW620 cells and subsequent metastasis to the liver. These results suggest that matrilysin gene expression by colon adenocarcinoma cells is not sufficient for tumor invasion and metastasis but contributes to the tumorigenicity and progression of colorectal tumors.

Abdominal Neoplasms↗

Graded compression sonography of abdominal neoplasms mimicking acute appendicitis.

Over a 3-year period nine patients (mean age of 43 years) with acute abdominal pain and unsuspected abdominal neoplasms were referred for graded compression sonography to rule out appendicitis. Six of the nine patients had right lower quadrant neoplasms involving the cecum, terminal ileum, iliacus muscle, or iliac lymph nodes. However, in three patients neoplasm was noted outside the right iliac fossa involving the liver, right kidney, and upper abdominal mesentery. This study underscores the fact that in patients without sonographic evidence of acute appendicitis, a survey of the upper abdomen and right flank should routinely be performed in addition to scanning the right iliac fossa and pelvis. In patients more than 50 years of age neoplasm must also be kept in mind in the differential diagnosis of appendicitis.

Abdominal Neoplasms↗

Perforation due to metastatic tumors of the ileocecal region.

We reviewed our department's medical records between April 1986 and April 1994 to identify patients who showed acute abdominal symptoms requiring surgical treatment due to metastatic tumors of the small intestine. In group A, seven patients (30%) were treated for acute peritonitis, and all were found to have an intestinal perforation due to hematogenous metastases (group A). In group B, 16 patients (70%) were treated for an intestinal obstruction, and all were found to have disseminated tumors of the small intestine (group B). In group A all tumors were isolated and located exclusively in the ileocecal region, whereas all tumors in group B showed peritoneal dissemination, with no predominant anatomic localization. In general, the intestinal tumors in group A originated from cancers of the upper aerodigestive tract, whereas those in group B originated from advanced cancers in the abdominal cavity. The tumors were significantly smaller and the period between the onset of symptoms from the original malignancy and the onset of abdominal symptoms (perforation or obstruction) was significantly shorter in group A. In conclusion, intestinal metastases located in the ileocecal region have unique clinicopathologic features and so should be recognized as a distinct disease entity. Therefore when patients with a known upper aerodigestive malignancy exhibit acute abdominal symptoms, intestinal metastasis to the ileocecal region, necrotic changes, and perforation should be considered in the differential diagnosis.

Abdominal Neoplasms↗

[Two cases of surgically treated triple cancer].

Two cases of surgically treated triple cancer are reported. Case 1: Three tumors, one in the lung, one in the stomach, and one in the colon of a 74-year-old man were diagnosed preoperatively. First a subtotal gastrectomy and transverse colectomy were performed and, second 27 days later, a lobectomy of the lower left lung. Pathologically, each tumor proved to be a primary sion. Case 2: A 70-year-old woman, treated surgically for left breast cancer 5 years ago, was found to have anemia. Gastric endoscopy showed a cancer in the antrum. A subtotal gastrectomy was performed. Intraoperatively another tumor in the cecum was found and a right hemicolectomy was also performed. Pathologically each tumor was a primary lesion.

Adenocarcinoma↗

Villous adenoma of the vermiform appendix with cecal intussusception: a case report and review of literature.

Villous adenoma of the appendix is an uncommon neoplasm. Intussusception of the appendix is a rare pathological entity. We report here an intussusception of the appendix, the lead point being a villous adenoma, presenting in a 62-year-old male whose initial complaint was a progressive enlargement of a right inguinal hernia. The endoscopic, surgical, and pathologic data are presented. A review of the literature of this uncommon entity is also presented.

Adenoma, Villous↗

Carcinoma of large bowel in the young.

The incidence of large-bowel carcinoma in young people seems to be increasing. Twenty-one cases occurring between the ages of 13 and 25 are reviewed. Most cases were found to be in an advanced state of the disease. High grade malignant growths were found to be twice as common in the young as in adults. The mode of presentation is no different from that in adults and a plea is made for improving results of treatment by earlier diagnosis, which can be established by an increased awareness of the disease in children and young adults.

Adenocarcinoma↗

Transhepatic percutaneous cholangiography.

Transhepatic percutaneous cholangiography continues to be a significant tool in the diagnosis of jaundice. It allows direct, easily achieved graphic delineation of the biliary system. Although specific diagnosis may not be possible, the site and extent of obstruction and the differentiation from intrahepatic parenchymal disease may be determined with a high degree of success.

Adenocarcinoma↗