vitamin-b-12 and Polyps

A 73-year-old white man was referred to a cancer genetics clinic for evaluation of a approximately 20-year history of mixed upper and lower gastrointestinal polyposis, including hyperplastic, inflammatory and adenomatous polyps, colonic ganglioneuromas, and associated diffuse, esophageal glycogenic acanthosis. Two synchronous gastric carcinomas had been identified before referral and the patient had undergone a total gastrectomy, omentectomy and cholecystectomy. Multiple hyperplastic polyps and small, sessile polyps were also observed in the gastrectomy specimen.. History and physical examination, upper and lower gastrointestinal endoscopy and biopsy, genetic testing, molecular pathology investigations (immunohistochemistry), thyroid ultrasonography, fine-needle aspiration of a thyroid nodule.. Cowden's syndrome.. Genetic counseling, thyroidectomy, vitamin B(12) supplementation, continued endoscopic surveillance and genetic testing of at-risk family members.

Topics: Aged; Biopsy, Needle; Carcinoma; Endoscopy, Gastrointestinal; Gastrointestinal Diseases; Genetic Counseling; Genetic Techniques; Hamartoma Syndrome, Multiple; Humans; Immunohistochemistry; Male; Polyps; Stomach Neoplasms; Thyroid Gland; Thyroidectomy; Ultrasonography; Vitamin B 12

A 54-year-old man was admitted to hospital with dyspnoea, giddiness, lack of appetite and burning sensation in the tongue for 3 years. Gastritis was known from his history. Clinical examination showed jaundice, glossitis, systolic murmur and pallhypesthesia of both legs.. Blood and bone marrow investigations revealed pernicious anaemia. At gastroscopy, fundal gastritis was diagnosed and two small polyps of the fundus were removed. Histologically, one of the two polyps turned out to be a gastric carcinoid type 1 (according to [16]). Additional investigations (x-ray, ultrasound of the abdomen, somatostatin-receptor scintigraphy) did not find any metastases.. With the diagnosis of a pernicious anaemia the patient was treated with vitamin B12. The original symptoms and the anaemia disappeared. Additional therapy of the gastric carcinoid was not necessary. One year after beginning of the treatment, no signs of the gastric carcinoid were found.. In gastric polyps of patients with pernicious anemia neoplastic transformations will often be found. That is why polypectomy should always be done. The best therapy of the gastric carcinoids type 1, which are the most frequently gastric carcinoids, is endoscopic tumour removal. Surgery is the treatment of choice only for gastric carcinoids type 2 to 4. Concerning quality of life and costs, endoscopic treatment is better for patients with gastric carcinoids type 1 than conventional surgical therapy.

Topics: Anemia, Pernicious; Carcinoid Tumor; Diagnosis, Differential; Follow-Up Studies; Gastritis; Gastroscopy; Humans; Male; Middle Aged; Polyps; Stomach; Stomach Neoplasms; Time Factors; Vitamin B 12

The Authors report the case of a 83 year old woman with large cystic polyps of the stomach. Gastric cystic polyps are polypoid lesions which may develop following functional disorders such as increased mucosal stimulation by gastrin, or excessive retention of gastric secretions. The incidence of these polyps is variable, depending on their being underestimated since they are not always macroscopically visible. The case here reported is very interesting not only for the number of lesions (over 50), but also for their size (5-25 mm in diameter).

Topics: Aged; Aged, 80 and over; Anemia, Iron-Deficiency; Female; Folic Acid; Gastrointestinal Agents; Gastroscopy; Hematinics; Humans; Polyps; Stomach Neoplasms; Ursodeoxycholic Acid; Vitamin B 12

Vitamin B12 absorption was studied in 34 patients, 10 months to 6 years after construction of a continent ileostomy. Normal Schilling test values (greater than 10 percent) were obtained in 21 of the cases after a single determination. Repeated tests showed a normal B12 absorption in 8 of the 13 patients who had revealed a Schilling test value below 10 percent at the first determination. In the remaining 5 patients, repeated Schilling tests showed borderline values (5-10 percent) in 4 cases and a low value (mean 4.5 percent) in one case. One of the patients with borderline values had previously undergone resection of 80 cm of the terminal ileum. When vitamin B12-intrinsic factor complex was instilled directly into the reservoir in 3 patients, it was found that the vitamin was absorbed by the mucous membrane of the reservoir. The construction of a continent ileostomy reservoir thus does not appear to expose the patient to an increased risk of developing vitamin B12 malabsorption.

Topics: Adolescent; Adult; Colitis, Ulcerative; Crohn Disease; Female; Follow-Up Studies; Hemoglobins; Humans; Ileostomy; Ileum; Intestinal Absorption; Intestinal Mucosa; Iron; Male; Middle Aged; Polyps; Schilling Test; Vitamin B 12

Topics: Adult; Aged; Anemia, Pernicious; Female; Gastric Mucosa; Gastroscopy; Humans; Male; Middle Aged; Neoplasm Regression, Spontaneous; Photography; Polyps; Radiography; Stomach; Stomach Neoplasms; Time Factors; Vitamin B 12

Topics: Adult; Chronic Disease; Crohn Disease; Diagnosis, Differential; Gastric Juice; Gastritis; Humans; Ileum; Intestinal Mucosa; Male; Middle Aged; Polyps; Stomach; Stomach Diseases; Stomach Neoplasms; Vitamin B 12

Topics: Aged; Female; Follow-Up Studies; Humans; Male; Middle Aged; Polyps; Postoperative Complications; Stomach Neoplasms; Vitamin B 12

Topics: Atrophy; Duodenal Ulcer; Gastritis; Gastritis, Atrophic; Humans; Intrinsic Factor; Polyps; Stomach Diseases; Stomach Neoplasms; Stomach Ulcer; Vitamin B 12