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(105). Retinal metastasis revealing of a gastric adenocarcinome (one case)
Helicobacter pylori and cancer / Arab Journal of Gastroenterology 10 (2009) AB45–AB52
showed positive staining for chromogranin-A (CgA) and synaptophysin by immunohistochemistry. Abdominal computerized tomography (CT) and endosonography were all normal.A conservative treatment was proposed but the patient refused. She preferred surgical resection. Discussion and conclusion: Gastric carcinoid tumors type ‘‘A’’ are usually latent and developed from enterochromaffine-like cells. The physiopathological mechanism studies are in favour of the predominant part of hypergastrinemia following achlorhydria. The frequent occurrence of gastric carcinoid tumours in patients with long-standing pernicious anemia suggests that surveillance gastroscopy and biopsies of the fundus might be indicated. Endoscopic resection is recommended for non invasive small tumor. Total gastrectomy is permitted only in case with diffuse injury.
AB47
inflammation; A draining trans-parietal biopsy echo driven: adénocarcinome invasive of metastatic origin; while the tumoral markers in this particular case the ACE, the CA15-3, the CA19-9 and the CA125 were normal. The echographies cervical, mammary bilateral and abdomino-pelvienne were also normal. It is the sogastroduodénale fiberscopy that discovered a digging stomach ulcer which the biopsy revealed a well differentiated gastric adénocarcinome hurting and infiltrating with images of vascular emboles; thus we ended in retinal and lung metastases from a gastric adénocarcinome. The retinal metastases present 4.5% of the eye metastases and are generally associated with a neoplastic pathology advanced with multiple metastases Whose forecast is bad. The average survival after the diagnosis of a retinal metastasis is of 13 months. The radiotherapy extern partner in the chemotherapy stays the treatment of choice.
doi:10.1016/j.ajg.2009.07.127 doi:10.1016/j.ajg.2009.07.129
(104) An exceptional association celiac diseases and multiple gastric carcinoma M. Soufi, M.K. Lahlou, O. benzekri, J. Mdaghri, S. Benamer, E. Mohammadine, A. Essadel, A. Settaf, A. Taghy, B. Chad Surgery B department, Rabat, Morocco
The association between coeliac disease (CD) and neoplasms has been long established, but few data are available about the risk factors. The aim of this work is to report an exceptional association (celiac disease and gastric adenocarcinoma) in young women in 16 years old revealed by a hematemesis, diagnosed by the endoscopic exam, and treated by total gastic resection. The originality of this observation is that the gastric carcinoma is multiple and classed T1 N0M0. Coeliac patients have an increased risk of developing cancer in relation to the age of diagnosis of CD. This risk results higher for malignancies of the gastro-intestinal sites. The gastric carcinoma is an exceptional case. An accurate screening for tumors should be performed in patients diagnosed with CD in adulthood and in advancing age. doi:10.1016/j.ajg.2009.07.128
(105) Retinal metastasis revealing of a gastric adenocarcinome (one case) H. Sammoud a, W. Ahmadi a, H. Dekaoui b, N. Benchakroun b, M. Sahraoui b, A. Ben Idder b a Service de gastro-entérologie, CHU Ibn Rochd, Casa, Morocco b Service d’oncologie, CHU Ibn Rochd, Casa, Morocco
The gastric tumours present 4% of the intraocular metastatic tumours. However, the intraocular metastases remain rare and arise at 5–30% of the patients presenting a systematic malignant affection. We report the observation of an old patient of 48 years without particular pathological histories, which presented for tree months a decline of the visual acuteness of the right eye associated with a persistent dry cough in a context of anorexia and loss of weight and to whom the clinical examination was normal. The bottom of eye showed a detachment of the retina bulleux of secondary aspect and on the angiogramme, an aspect of metastatic tumour. In search of the primitive neoplasm we realized: a cerebral scanner: normal; a thoracic scanner: image in released balloon of both lungs; a bronchoscopy with biopsies: not specific chronic
(106) Surgical treatment of locally advanced gastric cancer H.O. El Malk a,b, O. Mouaquit a, M. Chenna a, B. Serji a, R. Mohsine a, L. Ifrine a, A. Belkouchi a a Clinique Chirurgicale ‘‘A’’, Hôpital Ibn Sina, Rabat, Morocco b Centre de Recherche en Epidémiologie Clinique et Essais Thérapeutiques, Faculté de Médecine et de Pharmacie de Rabat, Morocco
Introduction: Locally advanced Gastric cancer prognostic is still dark and redoubtable. five-years overall Survival rate, all stages confound, is 16%. The aim of the study is to discuss surgical management of locally advanced gastric tumour. Methods: This retrospective concerns 18 patients with locally advanced gastric cancer managed in our department from January 2000 to July 2006. Patients with metastatic tumours or peritoneal carcinosis were excluded. Result: Half patients were men with an average age of 59 years old. Clinical features were dominated by epigastric pain, weight loss and digestive bleeding The most invaded organs were pancreas in half patients, mesocolon (33%) and transverse colon (27%). All patients were operated. We decided surgical abstention in 10 patients, subtotal gastrectomy with transverse mesocolon flange resection in 3 patients; total gastrectomy associated to a transverse colectomy in one patient, subtotal gastrectomy associated to a total colectomy and splenectomy in other patient and in 3 left patients a gastric derivation. Post-operative outcomes were simple for all of them. Conclusion: Without an efficient adjuvant therapy for locally advanced gastric tumours pT4, only a curative extended resection should be performed. However, the bad general state of those patients can not allow this resection. doi:10.1016/j.ajg.2009.07.130
(107) Surgical management adenocarcinoma
of
gastroesophageal
junction
Am Souadka, B. Zakri, O.H. El malki, R. Mohsine, L. Ifrine, A. Belkouchi Surgical department A, Ibn Sina hospital, Rabat, Morocco
Introduction: Adenocarcinoma of the gastroesophageal junction (GEJ) remains a neoplasia of great interest in view of the remarkable increase of incidence observed during the last decades. Its mean cause remains the chronic evolution of a non treated esoph-
showed positive staining for chromogranin-A (CgA) and synaptophysin by immunohistochemistry. Abdominal computerized tomography (CT) and endosonography were all normal.A conservative treatment was proposed but the patient refused. She preferred surgical resection. Discussion and conclusion: Gastric carcinoid tumors type ‘‘A’’ are usually latent and developed from enterochromaffine-like cells. The physiopathological mechanism studies are in favour of the predominant part of hypergastrinemia following achlorhydria. The frequent occurrence of gastric carcinoid tumours in patients with long-standing pernicious anemia suggests that surveillance gastroscopy and biopsies of the fundus might be indicated. Endoscopic resection is recommended for non invasive small tumor. Total gastrectomy is permitted only in case with diffuse injury.
AB47
inflammation; A draining trans-parietal biopsy echo driven: adénocarcinome invasive of metastatic origin; while the tumoral markers in this particular case the ACE, the CA15-3, the CA19-9 and the CA125 were normal. The echographies cervical, mammary bilateral and abdomino-pelvienne were also normal. It is the sogastroduodénale fiberscopy that discovered a digging stomach ulcer which the biopsy revealed a well differentiated gastric adénocarcinome hurting and infiltrating with images of vascular emboles; thus we ended in retinal and lung metastases from a gastric adénocarcinome. The retinal metastases present 4.5% of the eye metastases and are generally associated with a neoplastic pathology advanced with multiple metastases Whose forecast is bad. The average survival after the diagnosis of a retinal metastasis is of 13 months. The radiotherapy extern partner in the chemotherapy stays the treatment of choice.
doi:10.1016/j.ajg.2009.07.127 doi:10.1016/j.ajg.2009.07.129
(104) An exceptional association celiac diseases and multiple gastric carcinoma M. Soufi, M.K. Lahlou, O. benzekri, J. Mdaghri, S. Benamer, E. Mohammadine, A. Essadel, A. Settaf, A. Taghy, B. Chad Surgery B department, Rabat, Morocco
The association between coeliac disease (CD) and neoplasms has been long established, but few data are available about the risk factors. The aim of this work is to report an exceptional association (celiac disease and gastric adenocarcinoma) in young women in 16 years old revealed by a hematemesis, diagnosed by the endoscopic exam, and treated by total gastic resection. The originality of this observation is that the gastric carcinoma is multiple and classed T1 N0M0. Coeliac patients have an increased risk of developing cancer in relation to the age of diagnosis of CD. This risk results higher for malignancies of the gastro-intestinal sites. The gastric carcinoma is an exceptional case. An accurate screening for tumors should be performed in patients diagnosed with CD in adulthood and in advancing age. doi:10.1016/j.ajg.2009.07.128
(105) Retinal metastasis revealing of a gastric adenocarcinome (one case) H. Sammoud a, W. Ahmadi a, H. Dekaoui b, N. Benchakroun b, M. Sahraoui b, A. Ben Idder b a Service de gastro-entérologie, CHU Ibn Rochd, Casa, Morocco b Service d’oncologie, CHU Ibn Rochd, Casa, Morocco
The gastric tumours present 4% of the intraocular metastatic tumours. However, the intraocular metastases remain rare and arise at 5–30% of the patients presenting a systematic malignant affection. We report the observation of an old patient of 48 years without particular pathological histories, which presented for tree months a decline of the visual acuteness of the right eye associated with a persistent dry cough in a context of anorexia and loss of weight and to whom the clinical examination was normal. The bottom of eye showed a detachment of the retina bulleux of secondary aspect and on the angiogramme, an aspect of metastatic tumour. In search of the primitive neoplasm we realized: a cerebral scanner: normal; a thoracic scanner: image in released balloon of both lungs; a bronchoscopy with biopsies: not specific chronic
(106) Surgical treatment of locally advanced gastric cancer H.O. El Malk a,b, O. Mouaquit a, M. Chenna a, B. Serji a, R. Mohsine a, L. Ifrine a, A. Belkouchi a a Clinique Chirurgicale ‘‘A’’, Hôpital Ibn Sina, Rabat, Morocco b Centre de Recherche en Epidémiologie Clinique et Essais Thérapeutiques, Faculté de Médecine et de Pharmacie de Rabat, Morocco
Introduction: Locally advanced Gastric cancer prognostic is still dark and redoubtable. five-years overall Survival rate, all stages confound, is 16%. The aim of the study is to discuss surgical management of locally advanced gastric tumour. Methods: This retrospective concerns 18 patients with locally advanced gastric cancer managed in our department from January 2000 to July 2006. Patients with metastatic tumours or peritoneal carcinosis were excluded. Result: Half patients were men with an average age of 59 years old. Clinical features were dominated by epigastric pain, weight loss and digestive bleeding The most invaded organs were pancreas in half patients, mesocolon (33%) and transverse colon (27%). All patients were operated. We decided surgical abstention in 10 patients, subtotal gastrectomy with transverse mesocolon flange resection in 3 patients; total gastrectomy associated to a transverse colectomy in one patient, subtotal gastrectomy associated to a total colectomy and splenectomy in other patient and in 3 left patients a gastric derivation. Post-operative outcomes were simple for all of them. Conclusion: Without an efficient adjuvant therapy for locally advanced gastric tumours pT4, only a curative extended resection should be performed. However, the bad general state of those patients can not allow this resection. doi:10.1016/j.ajg.2009.07.130
(107) Surgical management adenocarcinoma
of
gastroesophageal
junction
Am Souadka, B. Zakri, O.H. El malki, R. Mohsine, L. Ifrine, A. Belkouchi Surgical department A, Ibn Sina hospital, Rabat, Morocco
Introduction: Adenocarcinoma of the gastroesophageal junction (GEJ) remains a neoplasia of great interest in view of the remarkable increase of incidence observed during the last decades. Its mean cause remains the chronic evolution of a non treated esoph-