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)

A 27-year-old woman with Peutz-Jeghers syndrome since age 11 years was hospitalized with a sudden onset of weakness of the right extremity, an expressive aphasia, and a three-month history of back pain. Liver and whole-body scintigrams demonstrated multiple metastatic disease; the brain scintigraphic study was compatible with infarction of the left hemisphere. Postmoretem examination two weeks after these studies showed extensive metastases in bone, liver, brain, lung, and left ovary. The source of the metastases was a malignant change from Peutz-Jeghers polyps.
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PMID:Extensive metastases in Peutz-Jeghers syndrome. 65 Aug 7

A 50-year-old man, transferred from another hospital, was admitted because of adult onset seizures. Nine months earlier, he had undergone an esophagogastrectomy; the lesion was confirmed to be a carcinoid tumor. Laboratory tests, chest x-rays, and electrocardiogram were normal. A second liver and spleen scan was performed. A computed tomographic scan revealed a well-circumscribed homogeneous enhancement of a lesion in the left frontal superficial area. On the 10th day, the patient underwent a left frontal parietal craniotomy. Postoperatively, he manifested no residual neurological deficits and was discharged on the 6th postoperative day. A week later, he was readmitted for treatment of aphasia and right hemiparesis; he was treated and discharged. The patient survived 16 more months. The occurrence of central nervous system metastasis from carcinoid tumor is rare. This tumor resembled, in many respects, a parasagittal meningioma. Radiological findings on the computed tomographic scan were typical of these tumors. This patient was diagnosed as having metastatic disease just 9 months after the diagnosis of the primary tumor and 13 months from the onset of any symptoms. This is a short period of time compared with that reported in other cases.
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PMID:Malignant carcinoid tumor metastatic to the dura mater simulating a meningioma. 192 16

We have treated 14-patients with metastatic tumors located in eloquent cortical areas by a stereotactic-guided keyhole craniotomy and total microsurgical excision utilizing the Pelorus stereotactic device. Patients ranged in ages from 26 to 82 years with a median age of 59 years. There were 9 women and 5 men. Ten patients presented with hemiparesis and 4 with aphasia. Primary tumor location was lung in 7, colon in 2, melanoma in 2, and breast, renal, and bone in 1 case each. Gross total resection was accomplished in all cases, with postoperative imaging confirmation of complete removal. Single metastatic tumors were removed in 12 cases, and multiple lesions in 2 cases. Twelve patients had postoperative whole brain irradiation (30 Gy/10 fractions); 2 patients had previously received whole brain irradiation, yet demonstrated tumor growth. Complete resolution of neurologic deficits was accomplished in 8 patients, 3 had improved and 2 were unchanged. One patient had resolution of preoperative deficit but developed hemiparesis secondary to a hemorrhagic infarction contralateral to the operative site. Nonneurologic morbidity includes deep venous thrombosis in 3 patients, and pneumonia in 1. Thirty-day perioperative mortality is zero, and to date no patient had died of intracranial disease. We believe that with the assistance of stereotactic localization, metastases in vital regions of the cortex can be removed with very low neurologic morbidity, and with a high proportion of patients having improvement in their level of neurologic function. The morbidity in this series compares favorably with that of stereotactic radiation series reported in the literature with local disease control and resolution of neurologic deficits that equals or exceeds stereotactic radiation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Stereotactic resection of brain metastases in eloquent brain. 762 49

From 1980 to 1992 we followed 12 patients with cardiac myxomas for an average of 4.4 years (8 months-11 years). Presenting symptoms were neurological in four patients (hemiparesis, aphasia, visual field deficits, progressive dementia or vertigo), progressive dyspnoea in six, pulmonary embolism in one, and peripheral arterial or renal emboli in three. The diagnosis was suspected clinically in 11 patients. It was confirmed by echocardiography in ten and by thoracic CT in one. All these patients had cardiac surgery. One diagnosis was made at autopsy; the patient died unexpectedly during surgery for emboli to the leg arteries. At follow-up, two additional patients had died, one from myocardial infarction and one from rhabdomyosarcoma. Only one of the nine surviving patients had recurrent symptoms after cardiac surgery. His dementia continued to progress. The patients without new symptoms after cardiac surgery had normal MRI of the brain or residual ischaemic lesions. MRI of the patient with progressive dementia showed multiple cerebral lesions with a bright centre and a dark rim on T1- and T2-weighted spin-echo images. On CT there were many calcified lesions. CT, MR angiography and contrast angiography revealed multiple fusiform aneurysms. The rare occurrence of progressive neurological symptoms after myxoma resection with multiple cerebral lesions and aneurysms should suggest myxoma metastases to the brain.
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PMID:Cardiac myxomas: a long term study. 856 32

Primary small cell carcinoma of the esophagus is a rare and aggressive disease. We report on our experience with two patients having a small cell cancer of the esophagus, being treated with photodynamic therapy combined with irradiation and induction-chemotherapy as well as a review of literature. Both patients were admitted with severe dysphagia, weight loss and a Karnovsky performance status of 90. Diagnostic work-up revealed tumor-stenosis in the proximal third in one and in the distal third in the other case. Clinical staging showed T4N2M0 and T3N2M0, pure small cell carcinoma. Due to dysphagia and lymph node enlargement, local and systemic therapy were considered as first-line treatment. Restaging after three cycles of induction-chemotherapy revealed partial response in both cases. Esophagectomy as a second-line treatment was considered. However, in the preoperative period, one patient developed motorical aphasia. The CT-scan of the brain showed multiple brain metastases. External beam irradiation and further chemotherapy was initiated. The patient died 12 months after admission. The other patient revealed anatomical inoperability at the staging laparoscopy. External beam irradiation and a second session of PDT was performed. The patient is still alive, 12 months after his first admission. The biological behavior of this aggressive disease and metastases in about 50% of patients at admission, as well as significant dysphagia makes combined systemic and local treatment necessary. Nevertheless, after reviewing the literature, esophagectomy and adjuvant chemotherapy may have an advantage pertaining to survival time when anatomical and functional operability is given.
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PMID:Local and systemic treatment in small cell carcinoma of the esophagus. 1060 16

Intracranial metastases from malignant fibrous histiocytoma (MFH) are rare, particularly with associated hemorrhage. This article reports one case and presents a review of the literature on this topic. A 55-year-old man presented with acute drowsiness, aphasia and right homonymous hemianopsia and hemiparesis. The first CT scan showed a left occipitoparietal hematoma and the second one, nodular, contrast-enhanced lesions. He had been previously operated on soft tissues MFH. Lung metastases developed subsequently. A craniotomy was performed with evacuation of the hematoma and total gross resection of the mass lesions. Microscopic examination disclosed a metastasis from a MFH. Neoangiogenesis, stimulated by angiogenic growth factors, seems to take part in this vascular, stroke-like event. Due to longer survivals of patients harboring systemic sarcomas, these tumors should be considered in the differential diagnosis of intracranial neoplasms, whether hemorrhagic or not. In particular, history of a previous soft tissue or heart tumor associated with lung metastasis should evoke the possibility of MFH metastasis.
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PMID:Brain metastases of a malignant fibrous histiocytoma presenting as an acute cerebral hemorrhage. 1132 99

A 47-year-old man, who presented with dyspnoea, gynaecomasty, and aphasia due to an extensively metastasized malignancy, was transferred to the hospital for chemotherapy as a matter of urgency. Because of his severe clinical symptoms, the widespread presence of metastases on radiological examination, and a striking increase in serum human chorionic gonadotrophin (HCG), the patient was treated with bleomycin, etoposide, and cisplatin (BEP) for a suspected metastasized germ-cell tumour. Definitive histology, however, revealed not a germ-cell tumour, but instead a large-cell undifferentiated HCG-producing carcinoma of uncertain primary origin. Using this patient's history, ectopic HCG production by malignancies is described in more detail.
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PMID:[A patient with very high serum level of human chorionic gonadotrophin; the diagnosis is not always a germ-cell tumour]. 1843 68

A 67-year-old right-handed woman presented with a case of hemangiopericytoma in the lateral ventricle manifesting as digit number memory disturbance, sensory aphasia, and right quadrantanopsia. Magnetic resonance imaging demonstrated a 6-cm homogeneously enhanced mass in the trigone of the left lateral ventricle. The tumor was totally removed via the left inferior temporal gyrus. The histological findings were consistent with hemangiopericytoma. Differential diagnosis of hemangiopericytoma from meningioma and solitary fibrous tumors is very important because the clinical behavior of hemangiopericytoma is very aggressive, including local recurrence or distant metastases in the central nervous system and periphery. Histological confirmation is required to make a definitive diagnosis. The present patient did not receive radiation therapy, but developed no local recurrence or metastases. Complete surgical resection and awareness of hemangiopericytoma in the lateral ventricle are very important for good clinical outcome.
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PMID:Hemangiopericytoma in the trigone of the lateral ventricle. 2161 66

Glioblastoma multiforme is the most common primary malignant brain tumor in adults. It's characterized by a high malignancy and rapid, frequent tendency to local recurrence. Distant metastases disseminated in the brain compared to the primary lesion and outside the central nervous system are rarely reported in the literature. The case which is being presented is of a 53 year old man operated in 2008 because of Glioblastoma multiforme IV WHO in the left periventricular parietal region, in which the main symptoms were the Gerstmann syndrome, mixed aphasia and memory disturbance. The patient was operated totally followed by adjuvant radiotherapy and chemotherapy. Two years later epileptic seizures and aphasia were intensified. Due to this adverse symptoms MRI was ordered, which revealed a tumor in the left periventricular temporal region in different location compared to the primary lesion. The patient was operated by temporal lobectomy. Histopathological diagnosis was Glioblastoma multiforme IV WHO. According to the literature we analyzed the natural GBM tumor features and factors responsible for possibility to appear of the same type of tumor in another location of the brain.
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PMID:Intracerebral metastasis of glioblastoma multiforme. Case report and literature review. 2259 93

Cervical cancers spread locally through the angiolymphatic apparatus and very rarely metastasize to the brain. The intracranial metastasis is a late event and a sign of poor prognosis. We present two cases of uterine cervical carcinomas with brain metastasis presenting with severe headaches in one case and hemiparesis and aphasia in the other one. Palliative craniotomy and debulking of the tumor was performed in both patients.
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PMID:Cerebral metastasis of cervical cancer, report of two cases and review of the literature. 2297 69


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