Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although tumor load has proven to be the most relevant prognostic factor in disseminated germ cell tumors (GCT), methods to determine tumor volume for staging have not been studied so far. In a prospective study, we therefore measured the volume of metastases before and during chemotherapy in 27 patients with disseminated GCT. Abdominal tumor volume was calculated using a General Electric CT scan 8800. Total volume was determined by cumulation of 1 cm slices measured by a cursor. Pulmonary volume was calculated by taking each metastasis as a sphere using V = 0.523 x d3, where V = volume and d = diameter. We used linear regression analysis to determine the dependence of tumor markers on volume. Before chemotherapy, the median tumor volume of all patients was 237 (range 4-2690) cm3. The tumor volume was 1-100 cm3 in 30%, 101-500 cm3 in 41%, and over 500 cm3 in 29% of the patients. NED (no evidence of disease) was achieved in 8/8 patients presenting with a small (1-100 cm3) and 9/10 with a moderate (101-500 cm3) tumor volume. In contrast, only 1/8 with advanced tumor load (greater than 500 cm3) achieved NED. While there was a significant correlation between the initial and the residual tumor volume (P = 0.0024, r = 0.72), there was none between the tumor volume and alpha fetoprotein, beta human chorionic gonadotropin, and lactate dehydrogenase. These results suggest that radiological determination of tumor volume is a reproducible and accurate staging method.
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PMID:[Feasibility and relevance of tumor volumetry for stage classification and assessment of remission of germ cell tumors]. 255 98

Non-seminomatous germ cell tumours (NSGCT) are the most common malignancy from testicular origin in young males. They are characterized by early formation of metastases along retroperitoneal and subsequent mediastinal lymph node stations. Following cisplatin-based induction chemotherapy, residual tumour masses should be removed surgically, although this implies the need for extended procedures. Such an approach can result in cure rates of over 70%. Herein, we report 2 cases of maximally extended surgery for metastatic malignant germ cell tumour of the testis. In both patients, diagnostic work-up revealed a NSGCT with retroperitoneal, mediastinal and cervical lymph node metastases. Multimodal protocols including induction chemotherapy and surgical removal of all primary and secondary tumour masses with curative intent were applied. An 'inverse T' incision in combination with a collar incision was chosen to approach the excessive supra-diaphragmatic tumour spread. This large-scaled surgical access offered an excellent exposure and allowed complete resection of all cervical and thoracic metastases in both patients. Abdominal tumour masses were resected through a standard median laparotomy. These 2 cases illustrate that complete tumour resection is feasible even in stages of NSGCT with generalized lymphatic spread. Metastasectomy should be offered to NSGCT patients despite the necessity of extended surgical approaches.
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PMID:Extended cervico-thoracic metastasectomy for testicular non-seminomatous germ cell tumour masses through an inverse T and combined collar incision. 2492 77

Gastrointestinal stromal tumours are a rare form of intra-abdominal neoplasm derived from mesenchymal tissue, typically presenting with abdominal pain, anaemia or bleeding into the bowel or abdominal cavity. Hypercalcaemia is an unusual complication, having been documented in only seven previous patients, all of whom had advanced metastatic disease. We present a case of treatment-resistant hypercalcaemia in a patient with non-metastatic gastrointestinal stromal tumour, which resolved following excision of the tumour.
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PMID:Refractory hypercalcaemia secondary to localised gastrointestinal stromal tumour. 2965 39