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

A patient with papillary--follicular carcinoma of the thyroid, with metastases to the lungs, skeleton, and brain was treated 5 weeks after thyroidectomy with 135 mCi of 131I. Although preliminary studies with 1 mCi had not shown any iodine uptake by the brain metastasis, this lesion showed intense concentration at the time of the larger therapeutic dose. Four days later, acute hemorrhage of the tumor occurred, requiring surgical removal. Although 131I therapy would seem an unlikely cause of acute necrosis and hemorrhage in these lesions, the association of therapeutic radioiodine and hemorrhage is interesting. Since recent reports suggest that brain metastasis may be somewhat more common than previously suspected, we suggest that brain imaging be included in the workup prior to radioiodine therapy of patients with advanced metastatic disease or neurologic symptoms.
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PMID:Sudden hemorrhage in metastatic thyroid carcinoma of the brain during treatment with iodine-131. 0 32

A preliminary report on a histologic malignancy grading of vulvar carcinoma is presented. A retrospective histologic study of 40 vulvar carcinoma cases stage I and II (TNM-system) with a minimum five-year follow-up was carried out and correlated to the course of the disease. Morphologic criteria characterizing the tumor cell population, as well as the tumor-host relationship, were examined and scored. The scores obtained could be divided into three groups that correlated well with the clinical outcome. The low-score group had no metastases or recurrence, whereas 82% of the high-score group had both metastases and fatalities. Depth of invasion was found to have a strong correlation to clinical outcome. A more accurate morphologic malignancy grading of such carcinomas could lead to a more individual and often less radical treatment plan.
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PMID:Histologic malignancy grading in invasive squamous cell carcinoma of the vulva. 3 84

The article presents a case of a young pregnant woman with vaginal carcinoma who had been exposed to diethylstilbestrol (DES) in utero. Surgical excision of the lesion was attempted but failed. Interstitial irradiation was then applied and proved successful. The patient's infant, as well as two subsequent children, were delivered by cesarean section after normal pregnancies. There was no evidence of metastatic disease or recurrence in 11 1/2 years following the initial diagnosis. Since 1965, a rising incidence of vaginal adenocarcinoma in women who were exposed to (DES) in utero has been reported. These women should be examined regularly after menarche for prompt evaluation and treatment of precancerous lesions such as adenosis, cervical erosion or transverse ridges. Since most of these patients are young, a conservative treatment is recommended. Extensive surgery and pelvic irradiation is indicated, however, in the cases of widespread disease.
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PMID:Vaginal adenocarcinoma in a gravida with prenatal DES exposure. 3 86

Twenty-seven small cell carcinomas of the lung and three tumors of the large intestine with combined adenocarcinomatous and small cell and/or anaplastic carcinoid-type histologic features were studied by light and electron microscopy. It was shown that the small cells have morphologic characteristics of APUD cells. Also presented are the histologic features of a carcinoma of the lung with large cell undifferentiated carcinoma, adenocarcinoma, squamous cell carcinoma, and giant cell carcinoma areas in the primary site and in several metastatic foci. Two of the renal metastases showed small cell carcinoma. The combined tumors and the numerous other similar neoplasms described in the literature and reviewed here suggest an endodermal origin for digestive and respiratory tract APUD cells based on the hypothesis that cancer is a clonal proliferation, and mucous and squamous cell differentiation is an endodermal rather than neural crest characteristic. The ultrastructural features of tumors of cells of known neural crest origin, including a medullary carcinoma of the thyroid, three carotid body tumors, a pheochromocytoma, and two cutaneous melanomas were compared with those of other APUD cell tumors including small cell carcinomas of the lung, two bronchial carcinoids, a carcinoid of the appendix, and a carcinoid of the kidney. Cells of the latter group sometimes possessed cytoplasmic tonofibrils, round compact masses of cytoplasmic microfilaments, and ductal lumina. These features were lacking in the former group and may signify a different embryologic origin. The histologic, histopathologic, and embryologic evidence regarding the origin of digestive and respiratory tract APUD cells is reviewed, showing that the former are, and the latter probably are, of endodermal and not neuroectodermal origin.
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PMID:The endodermal origin of digestive and respiratory tract APUD cells. Histopathologic evidence and a review of the literature. 3 40

We have reviewed our experience in a multidisciplined breast cancer clinic where we have utilized hormonal, ablative, and chemotherapetuci modalities. Our experience seesm to be similar to that of other groups in that oophorectomy treatment produces approximately a 61 per cent response (regression and arrest) rate, androgen therapy produces a 47 per cent response (regression and arrest) rate estrogen therapy produces a 40 per cent response (regression and arrest) rate, and ablative treatment produces approximately a 50 per cent response (regression and arrest) rate. Adrenalectomy and hypophysectomy showed similar response rates. Until it can be shown that hypophysectomy clearly offers enhanced benefits, this will not be utilized by our group except in those patients who cannot tolerate abdominal surgery (that is, patients with poor pulmonary reserve). Of interest is the high response rate (65 per cent) to ablative treatment in patients in whom disease exacerbates on additive hormonal treatment, with an increased duration of response and survival. Survival is increased in patients who are rebound responders after estrogen withdrawal. We expect to report data with future follow-up of this group of patients. New protocols will be instituted after review of the data in the hope of increasing clinical benefit and survival in this group of patients. Carcinoma of the breast accounts for almost 90,000 new cases of cancer a year, with metastases eventually developing in at least half of these patients. All physicians must be aware of the many complex problems associated with this disease and, hopefully, arrive at a logical approach for its control. We believe this can be achieved with a multidisciplined group approach as established at the Lahey Clinic Foundation.
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PMID:A multidisciplined approach for the treatment of metastatic carcinoma of the breast. 4 45

The potential value of indium-labelled bleomycin as a diagnostic scanning agent has been investigated in patients with a variety of malignant neoplasms involving the thorax, abdomen or pelvis. Sixty-five patients were scanned on 72 occasions, the optimum time to perform the examination being 72 hours after the intravenous injection of 2 mCi 111-In chelated to 2 mg bleomycin. Tumour uptake was visualized in 53 out of 62 scans in which tumour was present, but the extent of tumour was underestimated in seven cases, and over-estimated in five others. The latter were mostly due to uptake in infective lesions. These results indicate that the situations in which indium bleomycin is most likely to provide clinically relevant information are the distinction between recurrent tumour and post-radiotherapy changes in the thorax and pelvis, the diagnosis of recurrent carcinoma within the pelvis, and the distinction between bony metastases from carcinoma of the prostate and Paget's disease. Further clinical trials are necessary to assess these situations.
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PMID:111-In-labelled bleomycin; clinical experience as a diagnostic agent in tumours of the thorax and abdomen. 4 96

A three-stage study of 177 patients in Puerto Rico who had esophageal carcinoma is presented. Those surviving five or more years over a twenty-one-year period were located. Next, the experience at the San Juan City Hospital from 1968 to 1973 was examined. The information obtained from those two groups led to the last stage, a prospective study in which treatment was based on objective staging of the extent of the disease. Only 27% of these patients are really potentially curable upon admission to the hospital, and they should have aggressive therapy. Adequate palliation can be obtained with radiotherapy and chemotherapy in the remainder. The findings that nearly half of the five-year survivors had metastases or tumor extension and that some patients survived for prolonged periods without treatment emphasize the need for individualized treatment and research in tumor immunology.
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PMID:Esophageal carcinoma. The value of staging in long-term survival. 4 79

Fifty-five patients treated for cervical carcinoma developed bony metastases between January 1, 1961 and December 31, 1973. Roentgenograms were diagnostic in all but 2 of the patients. In 15 patients, a combination of radioactive scans and roentgenograms was used to establish the diagnosis. The most common mechanism of bony involvement from carcinoma of the cervix was extension of the neoplasm from para-aortic nodes, with involvement of the adjacent vertebral bodies. The earliest metastases were discovered at the time of the primary diagnosis. Thirteen years was the longest interval from the primary diagnosis until the discovery of bony metastases. Sixty-nine percent of the patients were diagnosed within 30 months. Ninety-six percent of the patients died within 18 months. Seventy-six percent of the patients received some form of therapy for their metastases. Thirty-six of these patients were treated with radiation therapy. Four of these patients received complete relief of symptoms, 24 some relief, and 8 patients received no relief.
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PMID:Bony metastases from carcinoma of cervix. Occurrence, diagnosis, and treatment. 5 Aug 73

Forty-eight patients with advanced squamous-cell lung cancer were treated with radical radiotherapy. Thereafter twenty-five received B.C.G. regularly and twenty-three did not. Differences in survival during the first year of observation and absence of peripheral metastases were significantly in favour of the patients treated with B.C.G. There was no response to B.C.G. in patients receiving palliative radiotherapy or cyclophosphamide nor in those with undifferentiated carcinoma.
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PMID:A 5-year controlled study of B.C.G. and radiotherapy inoperable lung cancer. 5 47

Fourteen cases of yolk sac carcinoma, 10 occurring in gonadal, and four in extragonadal sites, seen at the Indiana University Hospitals from 1949 to 1974, were analyzed with respect to pathologic features, laboratory findings, and clinical course. Their histologic appearance was similar regardless of the site of origin. Two basic histologic types were observed--the more common endodermal sinus pattern and the rare polyvesicular vitelline form. The prognosis is unfavorable, but three of our cases exhibited objective responses to chemotherapy. In our small series, the better prognosis of testicular yolk sac carcinomas in children found by some authors was not evident. Four of the 6 patients with yolk sac carcinoma in which serum alpha-fetoprotein determinations were performed showed positive results. Three of these cases had residual or metastatic disease clinically. The demonstration of alpha-fetoprotein in the serum of patients with yolk sac carcinoma lends further support to the yolk sac origin of these tumors and could also prove to be of prognostic value by indicating the presence of residual or recurrent disease.
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PMID:Gonadal and extragonadal yolk sac carcinomas: a clinicopathologic study of 14 cases. 5 18


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