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)

In a 20 year period seven cases of craniocervical chordoma were seen and treated. Since it is not possible to completely resect these lesions, the aim of treatment has been to debulk the tumor as much as feasible and employ postoperative irridation. Palliation is the most that can be hoped for, and minimal success in delaying the natural history of the tumor has been achieved. Surgery for relief of symptoms secondary to bulky recurrence is indicated for palliation, as is a repeat course of x-ray therapy. Isolated cases of long-term useful survival have followed doses in the range of 10,000 rads or more [19,20]. This therapy is usually given in smaller increments of an initial dose when there is evidence of recurrent tumor or pain [2]. However, whenever the dosage to the spinal cord or the base of the brain exceeds 4,000 rads, there is a concern about possible permanent radiation damage. These patients are difficult to care for late in the course of their disease when multiple cranial nerve paralysis, long tract signs, and intractable pain become progressively severe. Chordomas usually remain localized; however, about 10% metastasize distally. One case is presented of a large retropharyngeal mass with destruction of the second cervical vertebra that recurred locally in 3 months despite usual treatment; distal bony metastases were found 3 years after initial treatment. The histology of the lesion, its recurrence, and distal bony metastases were essentially indistinguishable from the other lesions that remained localized. Short periods of palliation from severe local pain and exquisite tenderness have been achieved by local resection of the involved bones.
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PMID:Craniocervical chordomas. 11 69

104 patients with various cancer, excluding malignant lymphoma and leukemia, underwent bone marrow biopsy using a Jamshidi needle, regular type. In 100 patients an adequate pice of bone marrow was obtained. In 24 patients metastases were detected in the bone marrow. Metastases were found in 10 of 38 (26.3%) patients with breast cancer, in 5 of 17 (29.4%) patients with lung cancer, in 5 of 10 (50%) patients with cancer of the prostate, in 1 patient with rhabdomyosarcoma, 1 with chordoma and in 2 of 14 patients who underwent biopsy in search of unknown cancer. 71% of the patients with positive findings in the bone marrow had clinical signs of bone involvement, 80% had positive X-ray film and 78.9% had positive skeletal isotope survey. Hemogram, serum alkaline phosphatase, serum calcium level and sedimentation rate were of no value in predicting whether the marrow was involved or not. No complications were documented following biopsy. The use of the Jamshidi bone marrow biopsy needle for staging and early detection of metastases in a select group cancer patients is suggested.
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PMID:Bone marrow biopsy in patients with malignant neoplasms other than lymphomas or leukemia. 11 9

Thirty cases of chordoma were reviewed with respect to the incidence of distant metastases. Follow-up information was obtained in 27 (90%), and the incidence of metastases was approximately 30%. The sites of the metastasizing primary tumors were predominantly sacral and vertebral. The sites of the metastases were predominantly skin and bone, although metastases were found in the lungs and lymph nodes. In two of the three patients with dermal metastases, the metastases were present prior to the diagnosis of the primary lesions. All three dermal metastases were initially diagnosed as mixed tumors of the skin, and all three patients had at least four such lesions of the skin. Accurate prediction of which chordomas will eventually metastasize is difficult. Clinically, local aggressiveness and radiotherapy were positively correlated with this ability; histologically, more anaplastic chordomas were more likely to metastasize.
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PMID:Chordoma. A clinicopathologic study of metastasis. 38 31

Chordomas can be categorized into those of clival, cervical and sacrococcygeal origin. The clival chordomas are primarily discussed in this report. In defining pathological anatomy or histology, a differentiation of benign from malignant chordomas by histological means alone is impossible. A preoperative diagnosis is only possible if tumor grows into the nasopharynx and allows a tissue biopsy to be taken. These tumors are clinically malignant though strict anatomic criteria for malignancy such as nuclear polymorphia or atypia, mitoses and metastases are rarely observed. The therapeutic results of operation and radiation are compared. Each alone fails because of the high recurrence rate of the tumor so that their combination is preferred. Although the prognosis of this disease is poor, one of our patients who was treated with radiation and surgery had a survival time of 14 years.
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PMID:[Chordoma - a review and report of two cases (author's transl)]. 42 97

A group of 79 patients with soft tissue sarcomas and 46 with primary malignant bone tumors underwent lymphangiography as part of the initial diagnostic workup. In the group of soft tissue sarcomas, the overall incidence of metastases was 22 of 79 (28%). According to the site of origin, the highest incidence was found in tumors originating from the buttocks (57%), followed by those from the inferior limbs (31%). Considering the histology, the incidence ranges from 50% in anaplastic sarcoma, to 43% in rhabdomyosarcoma, to 23% for liposarcoma and fibrosarcoma. The incidence of lymphographically proven metastases in bone tumors was 8 to 46 (17%), with 1 out of 4 in reticulum cell sarcoma, 1/1 in chordoma, and 22% in Ewing's sarcoma. A radiographic/histologic correlation on the lymph nodes was obtained in 19/79 (24%) soft tissue sarcomas and in 4/46 (9%) bone tumors. In the 12 radiographically negative and 11 radiographically positive cases, this correlation was always correct. The results of this study suggest a larger use of lymphography in these tumors.
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PMID:Lymphographic evaluation in bone and soft tissue sarcomas. 89 95

Chordoma is a recurring malignancy which does not play by the rules. A five-year survival or even a survival of ten years or longer without evidence of tumor cannot assure the surgeon that the malignant growth has been laid to rest. Recurring local episodes as well as metastases may continue to yield to surgery, irradiation, and other forms of treatment for an astonishing length of time. Thus, situations that may be cause for despair in other malignancies are often a challenge for renewed vigorous treatment in chordoma.
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PMID:Chordoma: an analysis of twenty cases treated over a twenty-year span. 117 55

A review of 222 patients with sacrococcygeal chordoma from the English language literature since the first American case in 1913 reveals that men are affected twice as frequently as are women after age 40, but not before. A history of prior trauma can be found in about 20 percent of patients, but no clear etiologic relation can be proved. The evidence for a congenital origin from displaced notochordal tissue is equally inconclusive. Metastasis occurs in only about 10 percent of patients, but recurrence of the primary lesion is almost universal. Of 67 patients followed, 11 survived 10 years or longer after diagnosis of chordoma. Resection of the tumor rarely is complete. Preservation of sacral stability and of sacral nerve pathways to the rectum and the bladder limit the extent of permissable surgery. Repeated local excision of the tumor recurring after initial excision and irradiation remains the treatment of choice.
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PMID:Sacrococcygeal chordoma: Report of a case and review of the literature. 118 99

During the period 1953-1971, 20 cases of chordoma were reported to the Finnish Cancer Registry. Twelve of the patients were males. The mean annual (crude) incidence of chordoma in Finland was 0.30/10(6) in males, and 0.18/10(6) in females. Fifteen of the tumours were sacral, three vertebral, and two cranial. Local recurrences were common, and distant metastases were observed in 60 per cent of the cases; this exceeds the proportion usually mentioned in the literature. The commonest treatment was surgery combined with postoperative high-dose irradiation. The relative 5-year survival rate was 35 per cent, and the 10-year rate 18 per cent.
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PMID:Chordoma in Finland. 126 92

Chordomas are slow-growing malignant tumors that arise from fetal notochord cells. They are commonly found at the cranial or caudal ends of the spinal cord, but can be seen infrequently in other areas of the cord. Thoracic chordomas can present as either a posterior mediastinal mass or with cord compression symptoms. The tumors present most frequently in the 4th to 5th decade of life. It is extremely rare to see thoracic chordoma in a child. The treatment of choice for chordomas is surgery. The tumors should be totally excised when possible. If the tumor is large or invasive, debulking is indicated. Adjuvant therapy is controversial. Chordomas are very resistant to radiotherapy but there have been several reports of increased survival with high-dose radiotherapy (7,500 rad). Chemotherapy is unproven in the treatment of chordomas. Chordomas tend to recur locally quite frequently and occasionally with distant metastases. Survival ranges from 10% to 30% at 5 years.
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PMID:Chordoma presenting as a posterior mediastinal mass in a pediatric patient. 146 56

Two cases of saccrococcygeal chordoma that were diagnosed on the basis of smear preparations are presented. Only one case showed typical physaliferous cells. In both cases the final diagnosis was greatly facilitated by applying peroxidase-antiperoxidase immunocytochemistry techniques to the cytologic specimens. Chordomas coexpress epithelial markers, such as intermediate filaments of the cytokeratin type, epithelial antigens (such as tissue polypeptide and epithelial membrane antigen), intermediate filaments of the vimentin type and S-100 protein. This antigenic spectrum may greatly facilitate the differential diagnosis of chordoma from filum terminale ependymoma, chondroma and chondrosarcoma, metastases of clear cell-type carcinomas and schwannomas, and neurofibromas, even when the only specimens available are from aspiration cytology.
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PMID:Value of immunocytochemistry in aspiration cytology of sacrococcygeal chordoma. A report of two cases. 154 18


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