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 26-year-old woman was operated on for a bulky tumor in the sacral region; she died of massive local tumor recurrence and pulmonary metastases 3 months later. Most of the original tumor showed a highly cellular spindle-cell sarcoma compatible with a fibrosarcoma of a high grade of malignancy. In a few small areas of the tumor, a chordoma-like pattern surrounded by growth of spindle-cell sarcoma was found. The spindle-cell component exhibited vimentin positivity in all tumor cells, but many cells were also cytokeratin-positive. The chordoma-like areas showed cytokeratin in all tumor cells. The chordoma-like areas, but not the spindle-cell areas also were positive for epithelial membrane antigen and S-100 protein. This case indicates that the sarcomatous change associated with chordoma may contain keratins as a sign of epithelial differentiation, and may thus represent sarcomatous transformation of chordoma cells, rather than a coincidental soft-tissue sarcoma or collision tumor.
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PMID:Chordoma with a massive spindle-cell sarcomatous transformation. A light- and electron-microscopic and immunohistological study. 244 Mar 25

Twenty-five patients with gross residual chordoma after partial excision or biopsy were treated by radical radiotherapy at Royal Marsden Hospital between 1952 and 1981. The median duration of freedom from local progression following radiotherapy was 32 months. Twenty-four of the 25 patients (96%) had stabilization or reduction in symptoms. All 19 patients in whom pain was a major symptom had relief. The overall actuarial 5- and 10-year survival rates were 44% and 17%, respectively. The corresponding progression--free survival rates were 33% and 20%. Permanent cure was unusual with any radiotherapy dose, but doses higher than 55 Gy or a TDF of 90 were associated with a statistically significant improvement in duration of local control. Seven of 17 (41%) patients who received greater than 55 Gy had freedom from local progression for 5 or more years compared with only 1 of 8 patients receiving less than 50 Gy. Subtotal excision prior to radiotherapy did not appear to improve median survival or probability of long-term local control. Distant metastases were seen in 16% of the patients, derived entirely from sacrococcygeal lesions, but only half of these caused significant morbidity or death. Local control is obviously the overwhelming problem. High dose, generous volume radiotherapy is advocated.
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PMID:Radiotherapy for chordoma. 245 5

The cytologic, cytochemical, immunocytochemical and ultrastructural findings on the aspirated material are presented for the case of a 57-year-old man with sacrococcygeal chordoma diagnosed by fine needle aspiration biopsy. Cytologically, two types of cellular elements were differentiated: medium-sized cells with few cytoplasmic vacuoles and classic physaliferous cells. Both types showed marked cytoplasmic positivity for keratin and S-100 protein; the absence of nuclear positivity in the physaliferous cells was notable. Ultrastructural study demonstrated the existence of true intracytoplasmic vacuoles and frequent rough endoplasmic reticulum-mitochondria complexes. The cytologic differential diagnosis with chondrosarcoma, myxoid liposarcoma, ependymoma and metastases of mucosecretory carcinomas is reviewed.
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PMID:Cytologic, cytochemical, immunocytochemical and ultrastructural diagnosis of a sacrococcygeal chordoma in a fine needle aspiration biopsy specimen. 264 45

Forty histologically confirmed primary and secondary cerebral tumours are described. These contained fifteen primary tumours, five adenomas of the hypophysis, four hamartomas or lipomas and craniopharyngiomas, three meningiomas and three vascular malformations. One malignant lymphoma, one chordoma and eight cerebral metastases were also included. In our series, the accuracy of CT and MR were the same, particularly since most patients coming for MR had abnormal CT findings. MR was superior in demonstrating vascular malformations and sometimes in the differential diagnosis of tumour versus infarct. MR is also more accurate in demonstrating the extent of a tumour and of infiltration, since it is possible to obtain images in several planes. Disadvantages of MR are related to the characterisation of primary brain tumours, since the signals from these tumours failed to show characteristic differences. Calcification cannot be recognised. In sixteen out of 36 patients, MR proved superior, whereas CT was superior in five. Tumour-related oedema was present in 18 cases and demonstrated by MR in seventeen. CT failed to differentiate tumour from oedema on one patient.
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PMID:[Nuclear spin tomography in brain tumors. Evaluation of 40 confirmed cases]. 299 87

Investigations in proton beam therapy of cancer patients have been initiated at the Cyclotron Laboratory, Harvard University, Cambridge, USA, since 1974 using a proton beam with the energy of 160 MeV for fractionated irradiation of uveal melanoma (899 cases), chordoma and chondrosarcoma of the base of the skull (96), sarcoma of the soft tissues and bones (79), prostatic cancer, head and neck tumors, etc. (altogether 1331 patients had been irradiated by June, 1986). To stop a beam in the target computer-assisted three-dimensional design and heterogeneity calculations were performed; computed compensatory boles were produced. Proton beam therapy is used alone or in combination with proton beam irradiation, routine radiotherapy. Areas of particular interest are ocular melanoma, chordoma and chondrosarcoma of the base of the skull, paraspinal sarcomas. Investigations in the field of proton beam therapy of malignant meningioma, metastases to the paraaortic lymph nodes hold promise.
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PMID:[Fractionated proton radiotherapy]. 304 Nov 70

Chordomas are bone tumors of the axial skeleton. They arise from notochordal remnants. In children these tumors are extremely rare and are predominantly located in the skull base. The authors report on a clivus chordoma in a 9 7/12-year-old girl. It presented as a nasopharyngeal mass with destruction of the clivus and paralyses of the ninth, tenth, and eleventh cranial nerves on the right side. After incomplete resection by a transoral transclival route, high-dose radiotherapy was added. This treatment was effective as demonstrated by follow-up CAT scans. A short review of the current literature is given. The local recurrence rate is extremely high, and distant metastases may occur. Complete resection is rarely possible, and combined management with postoperative radiotherapy is propagated. Permanent cure is rare, and at the present time, chemotherapy appears to be of no value in the primary treatment of chordomas.
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PMID:Clivus chordoma in a 9-year-old child: case report and review of the literature. 315 25

Twelve cases of the chordoma, including 4 cases with metastases, have been examined by light and electron microscopy for a comparison with 5 cases of the human notochord. Observed similarities in the histological and ultrastructural characteristics of the chordoma with those of the notochord suggested the histogenetic origin of the chordoma from the remnant of notochord. A "diffuse pattern" that was seen in the histological appearance of 4 cases of the chordoma, including 2 cases with metastases, was not observed in the notochord and was considered to indicate the malignant nature of such chordoma. Electron microscopy of the physaliphorous cells characteristic of the chordoma demonstrated intracytoplasmic large vacuoles containing glycogen.
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PMID:[Morphological characteristics, especially the malignant features, of chordoma in comparison with the notochord]. 317 14

The authors report on two cases of sacrococcygeal chordoma, with complications involving visceral organ metastases and distal bony metastases. Chordomas are malignant tumors which develop in adult subjects which originate from remnants of the embryonic notochord. Sacrococcygeal localization is found in 50% of the 1,300 cases reported in the medical literature, which represents 20% of sacrococcygeal tumors observed. The difficulty and the delay in diagnosing these tumors should decrease by routine CAT scan examination. Diagnostic certainty is based on histological examination, often suggestive of the diagnosis (physaliphore-like cells), possibly combined with ultrastructure and immunohistological study. The clinical course involves local recurrences, but there is a real risk of metastatic development, notably in the case of sacrococcygeal chordomas, with their incidence estimated at 17.5% of cases. Sometimes developing in later stages of their course, histological findings are similar to those of the initial lesion. Organs which are frequently the sites of metastases are the lung (48% of cases) and bone (26%), then the lymphatic organs, the liver, and subcutaneous tissue... Therapeutic management is unsatisfactory, with ideally, complete surgical excision of the initial tumor of its size permits and hence early diagnosis of this condition is a prerequisite for good results.
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PMID:[Metastatic chordoma. General review apropos of 2 cases]. 331 68

The Bone Tumor Registry of Westphalia contains data on 7,400 tumors and tumor-like lesions of bone, 135 primary spinal tumors, 187 metastases, 98 plasmacytomas, 4 extranodal manifestations of Hodgkin and non-Hodgkin lymphomas of the vertebral column. The most frequent type of primary tumor is the chordoma (35 cases), followed by osteoblastoma (16 cases), eosinophil granuloma (16), and hemangioma (12 cases). Most of the metastases derive from carcinoma of the breast, bronchial carcinoma, or prostate carcinoma. The present review concentrates on differential diagnosis by means of histological examination, with particular reference to immunohistological methods. In addition, the necessity for complementary assessment of the X-ray findings and histology is emphasized. In particular, the current status of knowledge on the prognosis of primary spinal tumors is presented. In our experience, the preparation of nondecalcified plastic sections has proved especially valuable for diagnostic procedures using punch biopsy specimens.
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PMID:[Pathology of spinal tumors]. 332 Aug 58

One case of chordoma is described. A review of literature shows that this condition is rare. This malignant tumor grows slowly. The symptoms owing to the surrounding structures compression appear insidiously. Standard radiography, tomography, echography and computed tomography are an aid to diagnosis confirmed by biopsy. Surgical removal of the tumor is the primary modality of treatment. Surgical resection is carried out using a combined abdominal and trans-sacral approach. Complete tumoral resection is limited by preservation of sacral stability and urinary and fecal continence. Many patients are referred for radiation therapy after subtotal resection. Local recurrence is frequent. Metastasis is rare. 90 per cent of patients are dead in ten years.
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PMID:[Sacral chordoma, a rare tumor]. 352 70


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