Hungarian Radiology

[Metastasis of the large bowel from gastric signet-ring cell carcinoma - Case report]

TÓTH Géza, LUKOVICS Péter, LÁHM Erika, KOVÁCS Margit

DECEMBER 20, 2004

Hungarian Radiology - 2004;78(06)

[INTRODUCTION - Metastatic tumor of the colon is extremely rare. It could mimic inflammatory bowel disease or ischemic colitis. CASE REPORT - A 59-year-old female underwent gastrectomy because of primary signet-ring cell carcinoma of the stomach in 1999. In November 2003 follow-up CT detected circular and segmental thickening of the wall of the transverse colon with significant targetlike contrast enchancement of the inner layers. Colonoscopy was performed but due to the significant stenosis of the transverse colon, the tumor was not properly examined. Biopsy was taken from the beginning of the stenosis, which did not prove neither specific inflammation or malignancy. Barium enema and virtual colonoscopy was performed. There was mild dilatation of the stenotic part and mucosa seemed to be intact by virtual colonoscopy. Barium enema showed significant stenosis and polypoid alteration of the mucosa in the right part of the colon. There was also an asymmetric bowel wall thickening of the flexura lienalis. Because of subileus the patient was operated on, and an extended right hemicolectomy was made. The histology of the specimen verified secondary signet-ring cell tumor of the colon. CONCLUSION - In case of multiple circular and segmental thickening of the wall of the colon, with striking thickening of the enchancing inner layer with decreased contrast enhancement in the outer layer (target pattern) on the CT, the metastasis of the large bowel should be considered.]

COMMENTS

0 comments

Further articles in this publication

Hungarian Radiology

[We say good bye and stay together]

LOMBAY Béla, HARKÁNYI Zoltán, NÉMETH Éva

Hungarian Radiology

[Digital radiology in Europe - radiology in digital Europe]

BARTA H. Miklós, FORRAI Gábor, PALKÓ András

Hungarian Radiology

[Hungarians on the ECR - ECR 2005 meets Hungary]

MESTER Ádám

Hungarian Radiology

[Meeting of the Hungarian College of Radiologists]

PALKÓ András, FORRAI Gábor

Hungarian Radiology

[CALENDAR OF RADIOLOGICAL EVENTS, 2005]

All articles in the issue

Related contents

Clinical Neuroscience

[Computed tomographic examination of cranial lesions, a paleoradiological approach]

ZÁDORI Péter, BAJZIK Gábor, BÍRÓ Gergely, LELOVICS Zsuzsanna, BALASSA Tímea, BERNERT Zsolt, ÉVINGER Sándor, HAJDU Tamás, MARCSIK Antónia, MOLNÁR Erika, ŐSZ Brigitta, PÁLFI György, WOLFF Katalin, REPA Imre

[Background and purpose - Introducing the multidisciplinary paleoradiology research at the Institute of Diagnostic Imaging and Radiation Oncology of the Kaposvár University, highlighting the cases with potential central nervous system involvement - from the scanning methods to the 3D printing - in order to draw attention to the historical background and clinical aspects of certain pathological conditions. Methods - The authors developed the examination protocols for three different CT scanners. Among the examined archaeological remains cranial lesions were identified in 26 cases, from which 4 cases with potential central nervous system involvement are demonstrated. The scanning parameters and the advantages of secondary image reconstructions (multiplanar reconstruction, maximum intensity projection, three-dimensional volume rendering technique) are presented with the cases. Results - The authors demonstrate a case with destructive skull lesions due to syphilis from the 15th century AD, a condition rarely seen or even unknown nowadays in the modern world. With the CT images of the skull base fracture from the Iron Age, signs of healing could be verified. Using the CT images a non-invasive approach is presented in the case of the craniofacial osteosarcoma in order to visualize the local status and the direct intracranial propagation. Advantages of the 3D VRT reconstructions are shown in the case of unilateral coronal suture synostosis. Conclusion - Paleoradiological CT examinations serve as a non-invasive, non-destructive tool for studying archaeological remains and artifacts. The special applications provided by the imaging modality contribute to the conventional paleopathological investigations. Keywords: paleoradiology, computed tomography, 3D reconstruction, skull lesions, paleopathology]

Hungarian Radiology

[Small bowel perforation due to blunt abdominal trauma in case of an inguinal hernia]

GION Katalin, SÉLEI Ágnes, CSÁSZÁR József, PALKÓ András

[INTRODUCTION - The injury of fixed bowel loops occurs more frequently due abdominal trauma. Authors review the CT signs of bowel injury in conjunction of the presented case. PATIENTS, METHODS - The inguinal hernia of the male patient was present for approximately 30 years prior the abdominal trauma. Due to the trauma the fixed small bowel loop became perforated. CT examination, beside using the conventional methods established the diagnosis of bowel wall perforation and the site of the perforation was localized before surgery. CONCLUSIONS - CT provied additional information compared to X-ray and US in the localization of the lesion due to the blunt abdominal trauma.]

Hungarian Radiology

[Radiologic diagnosis of the diseases of the pediatric gynecology]

LÓRÁND Ágnes, HARKÁNYI Zoltán, LOVAS Györgyi, HÉJJ Ildikó

[The basic examination of the pediatric pelvic organs is the transabdominal ultrasound which provides useful information about the anatomy and the pathological changes and in the vast majority of cases it is sufficient for treatment planning and to establish the diagnosis. Additional examinations are needed in case of complex developmental anomalies, in suspition of tumor, in staging and follow up examinations of tumors. Among the modern imaging methods the use of CT and MRI can be considered. The authors described the most frequent diseases in their practice and gave a brief overview on anatomical and physiological basics which is necessary for the exact interpretation of the examinations.]

Clinical Oncology

[Current strategy in the surgical treatment of abdominal hematogenous metastases]

HARSÁNYI László, BARANYAI Zsolt

[The cornerstone of the therapy of most tumors is still the resecability of the primary tumor: if the cancer can be removed, the chance for recovery will signifi cantly increase. The development of the complex oncologic therapy lead also to the headway of metastasis surgery that used to be a rarity few decades ago. Based on the fi ndings of recent molecular genetic research and multimodular oncologic treatment it was found in more and more tumors that the removal of their metastasis shows benefi t for patients with advanced disease. In order to operate metastatic disease successfully extensive surgical experience and the knowledge of the tumors biologic behavior are required. Thus, the continuous interdisciplinary cooperation and the role of the oncoteam are essential to correct therapeutic decisions. In this review we discuss the possible surgical interventions of abdominal hematogenous metastases of different tumors.]

Lege Artis Medicinae

[CARCINOMATOUS MENINGITIS]

CSERNI Gábor, VÁGÓ Tibor, TÖRÖK Norbert, GAÁL Zoltán, VELKEI Tamás, SERÉNYI Péter, GÖCZŐ Katalin, TUSA Magdolna, KOVÁCS Katalin, SZŰCS Miklós

[INTRODUCTION - Carcinomatous meningitis is a serious complication of advanced stage solid tumours, which may become more common with improved survival. CASE REPORTS - A 53-year-old woman with a recent history of breast cancer (pT2pN2M0) had been treated by mastectomy and adjuvant chemotherapy and radiotherapy. She presented with weakness, diplopia and vertigo raising the possibility of vertebrobasilar ischaemia or an intracranial mass. In another patient, a 62-year-old man with hypertension, a stenotic common bile duct had been diagnosed when examined for abdominal complaints. When he presented with a high blood pressure value accompanied by intensive headache, vomiting and bilateral hearing loss, he was thought to have a hypertensive crisis. The rapidly progressive neurological symptoms and the history of breast cancer and findings suggesting pancreatic head tumour, respectively, led to the clinical diagnosis of carcinomatous meningitis in both cases, despite any evidence on CT scans or a negative MR scan, though of limited value, in the first case. This diagnosis was confirmed by the laboratory and cytological findings of the cerebrospinal fluid, and also by the post mortem examination, since both patients died within a month after the onset of the symptoms. The primary tumour in the second patient proved to be a widely metastasizing diffuse type gastric cancer. CONCLUSION - Carcinomatous meningitis has a varying but characteristic presentation which generally makes it easy to diagnose, but it can sometimes present differential diagnostic problems. What we can learn from these two cases may help in recognizing this complication.]