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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-nine cases of single cerebral metastases from renal carcinoma were the object of a retrospective and prospective study covering a period of 15 years (1975-1988). The best diagnostic means were NMR imaging with paramagnetic contrast medium and CAT scans after intravenous injection of a double dose of contrast medium. All patients underwent total surgical removal of the cerebral lesion. Radiotherapy was useful but had less influence on further reproduction than in metastases from tumors of other sites. The median survival was 28.1 months in patients who received radiotherapy and 23 months in the others. No significant difference in survival was found between the group of patients with unknown primary tumors and the other group with diagnosed primary neoplastic disease.
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PMID:Single brain metastases from kidney tumors. Clinico-pathologic considerations on a series of 29 cases. 129 35

A case of paraplegia occurring after a spinal anaesthetic is reported. The 79-year-old man was admitted for a fractured neck of femur. Twenty years previously, he had had pharyngeal surgery and a tracheostomy. He had also undergone a prostatectomy for prostate cancer, and had been on oestrogen therapy for two years. He complained of dyspnoea at rest and his chest film showed diffuse pulmonary opacities. In order to avoid possible intubation and respiratory complications, spinal anaesthesia was performed without any problems in the L4 space. After the surgery, the patient recovered all his motor and sensory functions in the lower limbs. On the second postoperative day, he suffered from a motor paralysis of the right leg, which spread to the left leg on the fourth day. NMR imaging showed several vertebral metastases, together with anterior and lateral epidural invasion responsible for cord compression. Treatment with tetracosactide was begun, but the patient died six weeks later in his home, not having recovered any neurological function at all in his lower limbs. In fact, it was only after the procedure that the anaesthetist was informed that, at the time the prostate cancer had been diagnosed, vertebral body metastases, of which the patient had not been informed, were already present. The part played by the spinal anaesthetic in the occurrence of the paraplegia is not clear. It is reminded that such a technique should be used with extreme care in patients having a neoplasm with a very often high incidence of vertebral metastases.
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PMID:[Paraplegia after spinal anesthesia]. 150 98

Metastases in the central nervous system (C.N.S.) from urological tumors can be spinal or craniocerebral. The experience of 30 patients with spinal and craniocerebral metastases from urological tumors admitted to Neurosurgical Clinic of the University of Milan, is reported. They were 7.5% of the all number of metastases admitted at the Neurosurgical Department, during the same period. The brain metastases constitute 10% of brain metastases diagnosed in this period. Only patients with solitary (to CT scan and NMR) metastasis, and with a general prognosis that allow to an adequate and useful period of survival, are submitted to surgical treatment. 23 patients (76.6%) are surgical treated. The mean survival from the discovery of the C.N.S. metastases was 9 months (9.4 months among surgically treated patients and 7.8 months among those were not operated). Surgical mortality was 13%. Out of patients with survival until 5 months, patients submitted to surgical treatment showed a better quality of life. Our results allow us to affirm that in selected patients surgical removal of solitary metastases, could improve the quality of survival, but is not able to prolong substantially the period of survival.
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PMID:[Neurosurgical aspects of urologic metastases]. 157 May 26

A group of 42 adult patients with supratentorial brain tumors were studied with computed tomography (CT or/and NMR) and brain-stem evoked potentials (BAEPs). 12 patients had meningiomas and 30 had malignant tumors (gliomas and metastases). The latencies of wave V and of the interpeak latency I-III, III-V and I-V were evaluated both on the lesion side and the opposite side. In meningiomas mean latencies did not show significant differences from normal, while mean latencies in malignant tumors were significantly prolonged, except for the I-III interpeak latency. The results of this study demonstrate that BAEPs may be altered by supratentorial brain tumors. This examination appears to be useful in the monitoring of these lesions after treatment.
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PMID:Brain-stem auditory evoked potentials in supratentorial brain tumors. 162 47

The usefulness of proton NMR spectroscopy of human blood plasma for cancer research has been extensively studied in recent years. Two main starting points have been offered by Fossel et al. (N. Engl. J. Med. 315, 1369 (1986)) and Mountford et al. (FEBS Lett. 203, 164 (1986)). In this work the experimental proton NMR spectra of blood plasma were analyzed with the aid of the multivariate lineshape fitting method. An appropriate model structure, in terms of the various lipoprotein (VLDL, LDL, and HDL) signals, for the methylene region was used. Neonates, healthy adults, and adults with nonmalignant and malignant tumors were studied. The linewidth of the methylene region was found to be linearly dependent on the relative concentrations of the lipoproteins. The correlation coefficient was -0.89 (P less than 0.001) for VLDL and 0.88 (P less than 0.001) for HDL. A correlation between VLDL concentration and age, 0.76 (P less than 0.001), was also established. VLDL was modeled using two components. The half-linewidth of the lower field component was slightly elevated for the adults with large metastases. This might be in association with the fucose-containing proteolipid complex detected earlier in cancer cells or in sera of cancer patients. Some signals of this complex may fall in the same region of the spectra. The spectra for the neonates were indicated to be totally different from the adults. This and other related questions were explained by means of the model parameters and the relative concentrations of the lipoproteins VLDL, LDL, and HDL. The presented technique can be used as a rapid research tool for figuring out the relative concentrations of the lipoproteins in blood plasma and explaining the reasons behind the changes in the spectra.
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PMID:Proton nuclear magnetic resonance lineshape studies on human blood plasma lipids from newborn infants, healthy adults, and adults with tumors. 162 71

Surgical-pathological categorising of endometrial carcinoma makes it possible to treat this cancer in a more differentiated way. In clinical stage I, 6% of the adnexes, 10% of the pelvic lymph nodes and 5% of the paraaortic lymph nodes are affected. There is a direct correlation between depth of invasion and pelvic and paraaortic lymph node metastases. The new surgical-pathological categorising of endometrial carcinoma requires extensive surgery. Lymphadenectomy, which is necessary for categorisation means over-treatment for 2 thirds of all cases. Today, low-risk endometrial cancers can be distinguished from high risk ones by vaginal sonography as well as NMR permits the detection of invasion preoperatively and curettage to determine the unfavorable subtypes (seropapillary, clear-cell), hormonal receptors and ploidy. In low-risk cases, hysterectomy (with adnexes) and careful revision of the abdomen is sufficient. No further adjuvant therapy is necessary. In high-risk cases, an extended pelvic and, in the case of metastases, an para-aortic lymphadenectomy is imperative. Percutaneous X-ray therapy is not necessary in low-risk cases postoperatively. In high-risk cases, its effectiveness is not established and is probably not superior to the operative removal of metastases. Radiation of the vaginal cuff is necessary and successful in high-risk cases. In low-risk cases, side-effects are minimal. Adjuvant therapy with gestagens in low-risk cases is not indicated, because of their side-effects and does not reduce recurrence rate. Recurrent and metastasizing endometrial carcinomas respond to gestagens in about 15% of cases. Response is receptor dependent. High dose is not more effective. Endometrial carcinoma responds to chemotherapy. Most effective is adriamycin with a response rate of 35%. Combination therapies did not show greater effect in randomized studies. Recurrence free interval is only 6 to 8 months, however. An adjuvant chemotherapy is only indicated in the case of a serous carcinoma.
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PMID:[Therapy of endometrial cancer]. 176 Nov 67

The complexities of diagnosing melanoma metastases are discussed. More accuracy can be attained with the aid of USG, CT, NMR and scintiscans of the liver. The LDH test appears to be the most effective in cases of metastases developing in the liver. A case of melanoma metastases in the gallbladder is analyzed.
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PMID:[Metastasizing melanoma]. 258 69

In patients undergoing radiotherapy (RT) for malignant neoplasies of the head and neck the availability of a diagnostic method permitting frequent, easy checkups of the latero-cervical lymph nodes would be extremely useful. This is especially so because clinical examination is often hindered by the post-actinic fibrosis of the tissues. Among the methods presently available for this purpose (CAT, NMR, lymphoscintigraphy, xerography, ultrasound) echotomography appears to be the most indicated as it is least invasive, can easily be repeated and is not difficult to perform. The refining of ultrasound techniques would, as reported in the literature, make it possible today to evaluate the effects of RT on latero-cervical metastases both during and some time after treatment. The authors, therefore evaluated the advantages and limitations of the method examining 33 patients undergoing RT for latero-cervical metastases due to head and neck carcinoma. Each patient underwent ultrasound examination prior to, during and at the end of the RT treatment cycle. Once treatment had been terminated 18 underwent latero-cervical neck dissection. Upon termination of the radiation treatment three distinct types of ultrasound behaviour were identified: complete response; partial response; minimal or negligible response. For those patients undergoing surgery this response was compared to lymph node chain histology while, for the others, it was compared to the ultrasound findings of subsequent examinations. The results obtained appear to indicate that a systematic scheduling of ultrasound checkups offers a reliable evaluation of how metastatic adenopathies respond to RT. At times such response can only be completed several months after treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Role fo ultrasound in the study of latero-cervical metastases]. 265 70

More than 7 years after the diagnosis and treatment of breast cancer (T1N1aM0), multiple nodular foci were observed in the liver of a 40-year-old woman at ultrasonographic examination. The lesions were confirmed by CT scan, but CT-guided liver biopsy revealed only non-specific alterations. At subsequent peritoneoscopic examination, bluish-brown foci were indeed visible on the liver surface, but guided liver biopsies again failed to corroborate the suspected metastases. Instead, histology showed mild portal fibrosis, moderate steatosis and siderosis of hepatocytes, as before. Only the intense red fluorescence of part of the biopsy material under Wood's light suggested the diagnosis of chronic hepatic porphyria or porphyria cutanea tarda, here presumably as a consequence of prolonged alcohol consumption. Subsequent porphyrin studies in urine, faeces and plasma yielded the typical constellation of latent porphyria cutanea tarda (chronic hepatic porphyria type C). The activity of erythrocyte uroporphyrinogen decarboxylase was normal, which argued against a genetic predisposition. After 1 year of strict alcohol abstinence and low-dose chloroquine treatment the "nodular foci" in the liver were no longer visible on ultrasonogram and CT scan; only proton-weighted NMR imaging (SE 1500/30) still showed ill-defined areas of higher signal intensity. The renal excretion of porphyrins had decreased considerably. The levels are now consistent with the diagnosis of subclinical chronic hepatic porphyria type A. Modern non-invasive imaging techniques are tremendously useful, but they have their pitfalls. Focal liver lesions may present serious diagnostic problems, especially when they are found in a patient with a history of carcinoma at an extrahepatic primary site. A rare example is described.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Multiple nodular foci in the liver associated with chronic hepatic porphyria after previous treatment of breast cancer. 266 32

To evaluate the diagnostic value of preoperative staging of bladder cancer and cancer of the prostate, CT and NMR scans of 45 histologically defined tumors of the bladder and the scans of 24 patients with radical prostatectomy were compared. Lack of extravesical spread was imaged correctly by NMR in all cases of urothelial cancer (pT1-pT3a). CT diagnosis failed in 39%. False-negative results were obtained in 2 of 5 invading tumors (pT3b) by NMR and in 3 of 5 by CT. Extraglandular spread of cancer of the prostate was diagnosed with an accuracy rate of 79% by NMR and of 46% by CT. The diagnostic value for detection of pelvic lymph node metastases had a low-sensitivity rate of 26% in NMR and of 22% in CT.
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PMID:[The clinical value of preoperative staging of bladder and prostatic cancers with nuclear magnetic resonance and computerized tomography]. 271 95


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