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

Carcinosarcoma of the adult kidney is a very rare tumour and there are only a few well documented cases in the literature. In this report such a tumour is described from a 50-year-old white male, which progressed very rapidly with widespread metastases. Histologically, the tumour consisted of renal cell carcinoma and fibrosarcomatous components. The interesting features in this case were that both the carcinomatous and sarcomatous elements of the tumour exhibited metastases separately to various organs.
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PMID:Carcinosarcoma of the adult kidney. 88 83

The percentage of patients with renal cell carcinoma who also have identifiable metastases when first seen is increasing. In the past metastases were considered justification for excluding nephrectomy in the management of the patient. However, numerous opportunities for therapy which are abetted by removal of the primary tumor are presented. It is concluded, depending on several variables, that the advantages of nephrectomy usually justify the procedure.
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PMID:Nephrectomy for renal cell carcinoma with metastases. 88 58

The primary symptoms and signs, indicating urography, in 369 patients with renal carcinoma have been reviewed. Gross haematuria was noted in 33%, signs of malignancy in 20% and in 13% metastases were first diagnosed. In 15% the renal tumor was an incidental finding at urography performed because of prostatism, cystopyelitis, hypertension and prostatic carcinoma. It is concluded that every urography must have such a high quality as to be able to evaluate the entire urinary system in all patients, as a renal carcinoma may be found at urography in any patient above the age of 30 years.
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PMID:How is renal carcinoma detected? 89 23

With a uniform pathohistological technique of investigation the frequency of histological verified lymph node metastases in tumor nephrectomy depends on the surgical approach. Lymph node metastases were seen twice (6%) in 33 cases of lumbar nephrectomy, 22 times (17%) in 132 cases of abdomino-paracolic operations without systematic lymphadenectomy, 11 times (37%) in 30 abdomino-transplical nephrectomies with systematic lymphadenectomy. Primarily, one can expect lymph node metastases in case of infiltration of capsula adiposa, macroscopic invasion of veins, histologic grade 3 of malignancy, and/or if the tumor exceeds a size of 10 cm. Metastases are also possible in not enlarged and macroscopic normal lymph nodes. Without systematic dissection of the regional abdominal lymph nodes unknown regional lymph node metastases are likely to remain. Therefore, the treatment of choice in renal cell cancer is abdominal transplical nephrectomy with systematic lymphadenomectomy.
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PMID:[Regional lymph node metastases in renal cell cancer. Morphologic findings and clinical consequences (authors transl)]. 89 37

A 71-year-old woman had massive pulmonary metastases from a right hypernephroma, as shown by a chest roentgenogram. Nine days after nephrectomy, there was no roentgenographic evidence of such metastases. This represents the most rapid regression of clear-cell pulmonary metastases ever reported. Metastases reappeared six months postoperatively and the patient died of widespread metastatic disease 18 months after nephrectomy. The unpredictable behavior of metastatic hypernephroma is discussed.
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PMID:Regression of metastatic hypernephroma. 90 44

Twenty patients with metastatic renal cell carcinoma and nine patients with minimal residual disease (MRD) but at high risk for recurrence following nephrectomy received weekly four milligram intradermal injections of purified RNA extracted from lymphoid organs of sheep immunized with human renal cell carcinoma. Eighty-six consecutive UCLA patients with metastatic renal cell carcinoma served as retrospective controls. Survival between subpopulations in each group matched by computer according to extent and location of metastases, age, sex, and interval between nephrectomy and occurrence of metastases were compared by Life Table Analysis. Survival was significantly greater in RNA-treated patients (P < .05) who had multiple metastases limited to the lungs when compared with matched controls. RNA therapy did not influence survival of patients with metastases to other sites (bone, brain, liver, lymph nodes, or skin) or multiple organ involvement. All nine MRD patients treated with RNA remained free of recurrence for a mean observation period of 18 months, range ten to 34 months. No significant toxicity was observed. Changes in skin test responses were related primarily to tumor burden. Increased lymphocyte mediated cytotoxicity in RNA recipients was associated with a somewhat improved survival period. Changes in absolute lymphocyte counts had no correlation with clinical course, and complement fixing antibody generally decreased after excision of tumor, was absent in patients with progression, and was present in low levels in patients with a favorable clinical response. RNA therapy may be of value in selected patients with metastatic renal cell carcinoma, and as an adjunct to definitive surgery.
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PMID:Immune RNA therapy for renal cell carcinoma: survival and immunologic monitoring. 90 90

Herein we review 48 acceptable cases of idiopathic regression of metastases from renal cell carcinoma culled from the literature and present 3 additional cases. The data are analyzed and the issue of organ specificity in coping with metastases is discussed.
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PMID:Idiopathic regression of metastases from renal cell carcinoma. 91 44

Mediastinal and hilar renal cell carcinoma metastases are reported in 9 patients, representing an incidence rate of 8 per cent in the series. This observation indicated an ominous prognosis since the mean survival of these patients was only 1.4 months after the discovery of the neoplasm. It is postulated that this poor prognosis is attributable to the size of the primary lesion, with direct extension into retroperitoneal structures and perhaps to an associated exhaustion of immunologic defense mechanisms of the patients. Dissemination from the involved retroperitoneal lymphatics to the thoracic duct and then in retrograde fashion via the bronchomediastinal and paratracheal trunks is advocated as the pathway for this tumor dissemination.
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PMID:Renal cell carcinoma presenting with metastases to pulmonary hilar nodes. 91 45

Four cases of vaginal metastases of renal carcinoma are reported. This is an incidence of 1.3% in 313 operated patients (from 1/1/70 to 12/31/76). A surgical treatment of primary renal carcinoma and vaginal metastasis seems to be reasonable in there cases. Since in accordance with the literature metastatic involvement of vagina and vulva seems not to be a very rare finding, the diagnostic in renal carcinoma should imply a gynecologic examination. Although in carcinoma of the left kidney metastatic spreading into the external female genitalia most probably occurs by a retrograde venous pathway (left ovarian vein), the way of dissemination in carcinoma of the right side is unclear.
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PMID:[Vaginal metastasis of renal carcinoma (author's transl)]. 92 4

In 76 patients with space occupying lesions of the kidneys CT scans were performed. Size, shape and localisation of the kidneys could well be demonstrated by this method. Space occupying lesions were clearly seen, and solid tumors could be differentiated from cysts. However differential diagnosis between either primary renal cell carcinoma and metastases or between malignant and benign mass lesions was not possible. There was no problem in the diagnosis of hydronephrosis where as a differentiation between inflammatory changes and solid masses proved to be difficult. CT scanning seems to be usefull in the diagnosis of renal space occupying lesions. As a non invavise method it should be performed previous to renal angiography, which thereby becomes unnecessary in many cases.
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PMID:[CT diagnosis and differential diagnosis of renal spaca occupying lesions (author's transl)]. 92 54


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