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)

More than 80% of malignant gliomas have been reported to recur locally after conventional chemoradiation therapy. This regional pattern of recurrence has encouraged the introduction of new treatments for local tumors. Since 1987 interstitial brachytherapy using Iridium-192 seeds has been carried out in our department for malignant brain tumors. The present study was designed to evaluate the patterns of recurrence following interstitial brachytherapy and to assess how this recurrence differs from that observed in patients treated by conventional means. Ten patients who satisfied the following criteria were selected among 41 patients treated with brachytherapy. The criteria were; 1) histologically diagnosed to be malignant glioma (astrocytoma grade III or glioblastoma), 2) followed up with MRI every month after the brachytherapy, 3) follow-up period was more than 6 months, and 4) the time of recurrence was confirmed. The patients were classified into 3 groups according to the patterns of tumor recurrence as follows; 1. Local recurrence group: The tumor recurred near the pretreatment tumor site. 2. Necrotomy group: Reoperation was performed because of neurological deterioration and radiographic evidence of increasing mass effect with surrounding edema. Neurological symptoms were unchanged or improving during the 6 months after the reoperation. 3. CSF seeding group: Primary tumor was well controlled, but seeding via cerebrospinal fluid was recognized on MRI. Local recurrence occurred in three patients, necrotomy was carried out in three patients, and CSF metastases were defined by both MRI and clinical symptoms in four patients. Median radiation does was 33 Gy in the local recurrence group, 57.6 Gy in the necrotomy group, and 43.2Gy in the CSF seeding group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Patterns of recurrence in malignant gliomas after brachytherapy]. 816 95

A 41-year-old man was referred to this hospital after being diagnosed as suffering from malignant astrocytoma. In spite of two operations and subsequent chemoradiation therapy, the patient died 20 months after the onset of disease. At autopsy, the authors found skin invasion of tumor at left temporal region, softening of the brain and subarachnoid hemorrhage at the base of the brain. Yellowish-white bulging lesions were found at the bottom of left lung, diaphragm and parietal pleura. Histologically, primary lesion showed features of anaplastic malignant astrocytoma. Subarachnoid dissemination was noted at the base of the brain and in the spinal canal. Invasion into the vessels were observed both at the primary site and at the base of the brain. Glial fibrillary acidic protein positive spindle-shaped tumor cells proliferation was seen in the metastatic lesions. This case was diagnosed as malignant astrocytoma with remote extracranial metastases.
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PMID:Malignant astrocytoma with extracranial metastases: a case report. 822 Jul 93

The aim of this prospective study was to characterize intracranial tumors on the basis of the degree of blood-brain-barrier (BBB) disruption and tumor blood flow (TBF). We studied 28 patients with brain tumors by MRI. BBB disruption was demonstrated by a pathological increase of signal intensity in T1-weighted spin-echo images (1.5 T, TR = 600 ms, TE = 10 ms, alpha = 90 degrees) after intravenous gadolinium-DTPA injection. TBF flow was assessed by an MRI-method based on the signal intensity decrease in T2-weighted gradient-echo images (TR = 25 ms, TE = 20 ms, alpha = 10 degrees) immediately after gadolinium-DTPA bolus injection. Typical constellations include intake BBB and low TBF in low-grade intraaxial tumors (astrocytoma I/II), disrupted BBB and heterogeneous TBF in high-grade intraaxial tumors (glioblastomas and metastases), and disrupted BBB and high TBF in extraaxial tumors (meningeomas). This study demonstrates the quasi-simultaneous assessment of the blood-brain-barrier and tumor blood flow. The results support the concept that additional uncorrelated information is obtained from the assessment of regional cerebral blood flow that may be helpful for the differential diagnosis of brain tumors.
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PMID:[Magnetic resonance tomographic characterization of intracranial tumors by evaluating the blood-brain barrier and regional cerebral circulation]. 824 Dec 97

Using a combination of polymerase chain reaction and single-strand conformation polymorphism techniques (PCR-SSCP) we have analyzed 78 brain tumor samples (70 primary and 8 metastatic) for the presence of mutations in the conserved regions of the Tp53 (tumor p53) gene. We have found that only two groups, gliomas (exclusively in astrocytomas) and metastases, displayed Tp53 mutations. Three of eight (37.5%) metastases showed a mutant Tp53 allele accompanied by loss of the normal one. In contrast, the frequency of Tp53 mutations in the primary brain tumors examined was lower (5.7%). Although we have examined different types of primary brain tumors, Tp53 mutations were exclusively observed in both, low and high-grade astrocytomas (four of 24). The Tp53 mutations detected in astrocytic tumors appear to be correlated with the malignancy grade. The low-grade astrocytomas were heterozygous for the mutation, whereas the high-grade astrocytomas had affected the two Tp53 alleles, suggesting a two-steps model for inactivation of the p53 gene in astrocytomas. Thus, single p53 mutation seems to occur in initial stages of astrocytoma tumorigenesis; the later lost of the remaining wild-type allele appears associated with the progression towards a more malignant stage.
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PMID:Timing of p53 mutations during astrocytoma tumorigenesis. 826 22

A 43-year-old man died from the complications of astrocytoma metastasis. He first noticed symptoms of a lumbar disc prolapse in 1979. In 1987 a pilocytic astrocytoma (grade I) of the spinal cauda was removed. In 1989 a tumor recidivation at the same site was partially removed. Histology showed a grade II astrocytoma. Two months later the patient developed symptoms of increased intracerebral pressure. CSF cytology showed polymorphic giant tumor cells with hyperchromatic nuclei and a glioblastoma of the cerebral ventricles was diagnosed. The patient died from cardiovascular complications. The post-mortem investigation revealed an astrocytoma of the conus medullaris with an anaplastic ventral area (grade IV). This area was inaccessible to the biopsy. It is believed that tumor metastases from anaplastic parts spread along the spinal cord and brainstem and finally invaded the brain and cerebral ventricles.
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PMID:Ascending central nervous spreading of a spinal astrocytoma. 859 75

Image cytometry (ICM) is used in surgical pathology to quantify nuclear DNA content, nuclear and cytoplasmic immunostain. DNA aneuploidy is shown to be an independent negative prognostic factor in malignant melanoma, small cell carcinoma of the lung, esophageal, ovarian, endometrial, prostatic, urinary bladder, and papillary thyroid carcinoma. On bladder washings, DNA ploidy by ICM is used as an aid in diagnosis and management of recurrent transitional cell carcinoma of the bladder. Quantitation of nuclear immunostain for proliferation markers by ICM has clinical significance in prognosis and management of solid tumors of bladder, breast and ovary, astrocytoma, lymphoma, and malignant melanoma. Angiogenesis, measured by microvessel density is a predictor of prognosis in breast carcinoma and an independent predictor of metastasis for breast carcinoma, malignant melanoma, non-small cell lung carcinoma, and prostate carcinoma. Quantitated by ICM, angiogenesis is predictive of the presence or subsequent development of regional lymph node metastases in head and neck squamous carcinomas. Future prospects for ICM in pathology include the standardization of ICM techniques; extended clinical use of DNA ploidy for diagnosis, prognosis and as a help with therapeutic decisions; development of neural networks and quantification of fluorescence in situ hybridization to distinguish benign from malignant lesions of low malignant potential, and three-dimensional reconstruction of morphology from two-dimensional sections measured for prognostic parameters.
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PMID:Image cytometric analysis in pathology. 862 Nov 87

The expression levels of nm23-H1 have been reported to correlate with the metastatic potential of some tumours. We have treated a child with a rare case of astrocytoma with diffuse osteoblastic metastases. We therefore decided to examine the expression of the nm23 gene product in 24 gliomas in order to clarify the association of its expression with the clinical features of the disease. A polyclonal antibody against a GST/nm23-H1 fusion protein was raised in rabbits. Twenty-four specimens, including 5 recurrent gliomas and one extraneural metastasis, were obtained from 19 patients treated surgically between 1990 and 1993 in our hospital. Immunohistochemical staining was performed on paraffin sections using an avidin-biotinyl peroxidase complex method. Of the 24 astrocytic neoplasms, 3 (12.5%) specimens from one patient with diffuse bony metastases stained intensely with nm23-H1. Two specimens obtained from glioblastoma multiforme patients stained weakly. The other 19 specimens were negative for nm23-H1 expression. Little or no nm23 expression was observed in adjacent nontumourous cerebral tissues. The results suggest that high levels of nm23 expression might correlate with extraneural metastatic potential in astrocytic neoplasms.
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PMID:Immunohistochemical analysis of the nm23 gene product (NDP kinase) expression in astrocytic neoplasms. 873 95

A 46-year-old man presented with low dorsal pain and paresthesia. Computed tomography showed an osteolytic lesion involving most of the vertebral body and the left pedicle of the 12th thoracic vertebra (T12). Contrast-enhanced magnetic resonance imaging (MRI) of the spine showed an enhancing soft-tissue mass that involved the T11 and T12 vertebral bodies, as well as that of the first lumbar vertebra; the mass caused cord compression. Another lesion was identified at T9. The findings of percutaneous needle aspiration biopsy of the lesion were consistent with metastatic astrocytoma, a diagnosis confirmed at surgery. MRI of the brain showed an asymptomatic lesion of the left temporal lobe; histologic confirmation of malignant astrocytoma was obtained by stereotactic biopsy. This report shows that metastatic bone disease secondary to malignant astrocytoma may manifest itself before the primary lesion becomes symptomatic. This presentation of astrocytoma was unusual because there were no symptoms of the intracranial tumour and because metastatic disease to the bones is less common than to the chest and the lymph nodes.
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PMID:Spinal metastases as a first presentation of malignant astrocytoma. 885 73

Over the last several decades in Europe and 15 years in North America, numerous centers have used stereotactic high-activity brachytherapy for patients with malignant brain tumors. A number of nonrandomized series have contributed information regarding the efficacy compared to historical controls for patients with de novo and recurrent malignant gliomas and metastases. Two randomized studies for patients with de novo malignant astrocytoma and glioblastoma are nearing completion. Based on the author's personal experience with 115 patients and the reported literature, we conclude that brachytherapy is appropriate for a minority of patients with malignant brain tumors, that reoperation is frequently required, and complications of therapy can be significant. However, a proportion of highly selected patients benefit significantly from this therapy.
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PMID:Stereotactic high-activity brachytherapy for malignant intra-axial brain tumors. Status report as of March, 1995. 891 48

High grade astrocytomas remain incurable even though these tumors often appear localized on modern imaging studies, rarely metastasize to systemic sites, and can be aggressively treated with surgery and radiation therapy. Recent data suggest that the dissemination of astrocytoma cells along white matter tracts to distant regions of the brain may be responsible for the poor survival of these patients and the limited impact of local therapies. Movement of astrocytoma cells along these white matter tracts can be active or passive in nature. To study the potential for tumor dissemination by bulk flow of interstitial fluid resulting from peritumoral edema. 20 microL of tritiated inulin, Evans Blue, and rat albumin were injected stereotactically into the right frontal lobe and the left temporal lobe at the gray-white matter junction in Sprague-Dawley rats. Six hours later, the rats were sacrificed and the brains were removed, frozen and prepared for quantitative autoradiography and histologic analysis. Interstitial flow rates were calculated from the autoradiographs, and flow pathways were determined from the movement of Evans Blue, inulin and histologic data. In each animal injected in the frontal lobe, Evans Blue and inulin were primarily confined to large ipsilateral white matter tracts and extended from the frontal injection site to the occipital lobe. The average interstitial fluid flow rate in the association fibers of the external capsule was 0.86 mm/hr. In contrast, the animals receiving temporal lobe injections had Evans Blue and inulin confined to the temporal lobe. The average interstitial fluid flow rate in the white matter tracts of the temporal lobe was 0.61 mm/hr. The rapid and preferential flow of interstitial fluid along white matter tracts and the differences in the clearance of extracellular fluid observed between the frontal and temporal lobes may have important clinical implications. These data suggest that aggressive treatment of peritumoral edema, expansion of radiotherapy ports, and consideration of the location of the tumor in treatment planning may improve therapeutic outcomes for some patients. An improved understanding of the mechanisms of tumor dissemination is crucial to designing more effective therapeutic approaches for patients with this devastating malignancy.
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PMID:Interstitial fluid flow along white matter tracts: a potentially important mechanism for the dissemination of primary brain tumors. 904 80


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