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 chordoma metastatic to the skin of the nose is reported. The patient (a 40-year-old man) had undergone excision of a sacral chordoma 16 months previously. In patients whose clinical histories are unknown, cutaneous metastases of chordoma can be confused with mixed tumors of sweat glands. Cytological features, including the presence of physaliphorous cells, and immunohistochemical coexpression of low molecular weight keratins and S-100 protein are helpful features that lead to a correct diagnosis.
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PMID:Cutaneous metastasis of chordoma. 859 77

The aim of our study was to determine the value of magnetic resonance (MR) imaging in the diagnostic workup of pelvic bone tumors. We retrospectively evaluated the MR findings in 60 pelvic bone tumors. Owing to its high contrast resolution and multiplanar imaging capabilities, MR offers a clear depiction of cortical, medullar or soft tissue involvement, intratumoral necrosis, and relationship to neurovascular structures, and may be considered as the modality of choice for the staging of pelvic bone tumors. Since grading of bone tumors reaches a high accuracy on conventional radiography (CR), the value of MR imaging is rather complementary. Although the role of MR imaging in tissue characterization is mostly limited to recognition of tumoral components, accurate tissue characterization if often possible (e.g. in low-grade chondrosarcoma, eosinophilic granuloma, aneurysmal bone cyst, giant cell tumor, and chordoma). MR imaging in osteochondromas, metastases, and fibrous dysplasia remains of limited value since most of these lesions are well recognized on CR and/or CT. CR remains the first choice examination in diagnosis and grading of bone tumors, but MR imaging has significantly improved staging and tissue characterization in bone tumor imaging. The aim of our study is to determine the value of magnetic resonance (MR) imaging in the diagnostic workup of pelvic bone tumors, i.e. in staging, in differentiating benign from malignant tumors (grading), and in further characterization of tumors or tumoral components.
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PMID:Magnetic resonance imaging of pelvic bone tumors. 864 81

Spinal instrumentation currently allows gross-total resection and reconstruction in cases of malignancies at all levels of the spine. The authors analyzed the results in 110 patients who underwent surgery for primary and metastatic spinal tumors over a 5-year period (1989-1993) at a single institution. Major primary sites of tumor included breast (14 cases), chordoma (14 cases), lung (12 cases), kidney (11 cases), sarcoma (13 cases), plasmacytoma (10 cases), and others (36 cases). Prior to surgery, 55 patients (50%) had received prior treatment. Forty-eight patients (44%) were nonambulatory, and severe paraparesis was present in 20 patients. Fifty-three patients (48%) underwent combined anterior-posterior resection and instrumentation. 33 (30%) underwent anterior resection with instrumentation, 18 (16%) underwent anterior or posterior resection alone, and the remaining six patients (5%) underwent posterior resection and instrumentation. Major indications for anterior-posterior resection included three-column involvement, high-grade instability, involvement of contiguous vertebral bodies, and solitary metastases. Postoperatively, 90 patients improved neurologically. The overall median survival was 16 months, with 46% of patients surviving 2 years. Fifty-three patients (48%) suffered postoperative complications. Despite the high incidence of complications, the majority of patients reported improvement in their quality of life at follow-up review. Our findings suggest that half of all patients with spinal malignancies require combined anterior-posterior surgery for adequate tumor removal and stabilization.
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PMID:Indications and results of combined anterior-posterior approaches for spine tumor surgery. 875 30

Primary tumors of the spine are relatively infrequent lesions compared with metastatic disease, multiple myeloma, and lymphoma. However, when a solitary lesion of the spine occurs, these neoplasms represent an important group of entities for diagnostic consideration. A wide variety of benign neoplasms can involve the spine, including osteoid osteoma, osteoblastoma, aneurysmal bone cyst, giant cell tumor, enostosis, and osteochondroma. Common primary nonlymphoproliferative malignant neoplasms of the spine include chordoma, chondrosarcoma, Ewing sarcoma or primitive neuroectodermal tumor, and osteosarcoma. The imaging features of these lesions of the spine are often characteristic. These changes include a small sclerotic focus with irregular thorny margins in the vertebral body (enostosis), a small radiolucent nidus with central calcification in the posterior elements of the vertebral body (osteoid osteoma), a large expansile lesion with multiple fluid-fluid levels (aneurysmal bone cyst), and an aggressive mineralized mass (chondroid or osteoid) with osseous and soft-tissue involvement (chondrosarcoma or osteosarcoma). Radiologists should be aware of the appearance of these unusual neoplasms in order to provide a complete differential diagnosis and to guide clinical colleagues in patient treatment.
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PMID:From the archives of the AFIP. Primary tumors of the spine: radiologic pathologic correlation. 888 95

Synovial metastases are a rare occurrence. Only 28 cases have been reported in the literature, 10 of which were diagnosed by fluid cytologic evaluation. We discuss 2 additional cases in which the diagnosis was made by fine-needle aspiration cytologic investigation. The first case is of a 47-yr-old man with small-cell carcinoma of the lung metastatic to the right knee joint; the second is of a 71-yr-old man with non-Hodgkin's mixed-cell nodular lymphoma also involving the right knee joint. The clinical features of these cases are similar to previously published instances of secondary synovial tumor, namely in regard to sex distribution (14 male and 16 female patients), age range (13-96 yr, mean 59 yr), and histologic types (adenocarcinoma, 13 cases; squamous-cell carcinoma, 4; lymphoma, 3; renal clear-cell carcinoma, 3; unknown origin, 2; rhabdomyosarcoma, 1; melanoma, 1; chordoma, 1; pulmonary clear-cell carcinoma, 1; and Ewing's sarcoma, 1). The condition usually has poor prognosis, with average patient survival of < 5 mo.
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PMID:Synovial metastasis: diagnosis by fine-needle aspiration cytologic investigation. 898 91

Three cases of chondromyxoid fibroma arising in the skull base are reported. The tumors arose in females 34, 65, and 66 (median 55) years of age. Two women presented with headaches, and one with nasal obstruction. Radiographic studies revealed that all three lesions were expansile soft tissue masses centered in the clivus, at least 4 cm in greatest diameter. One lesion involved primarily the clivus, the others extended from the clivus into the sphenoid and ethmoid sinuses. Two of the three cases were initially misdiagnosed as chordoma or chondrosarcoma. The initial treatment was curettage of gross disease in all three cases. One patient also received radiation therapy. One patient had local progression of disease, which was treated with surgery and radiation therapy. All patients are clinically free of disease 11 to 26 months following the most recent treatment. Chondromyxoid fibroma can and should be distinguished from chondrosarcoma and chordoma, two tumors which more commonly arise in the skull base and which have the potential to metastasize.
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PMID:Chondromyxoid fibroma of the skull base: a tumor which may be confused with chordoma and chondrosarcoma. A report of three cases and review of the literature. 915 83

Except for clear cell carcinomas that metastasize to bone, with renal cell carcinoma being the principal representative of that group, clear cell osseous neoplasms are rare. The only distinct nosologic entity in this category that is primary in the bone is the clear cell chondrosarcoma (CCCS). This lesion, which is most often seen in the proximal femur or humerus, affects males more often than females and has a peak incidence during the third and fourth decades of life. Radiologic images of CCCS show a well-circumscribed, often calcified lytic lesion that may expand the bone, but only uncommonly breaches the cortex. Clear cell elements in CCCS are accompanied by "conventional" foci of chondrosarcoma in less than 50% of cases; noncartilaginous "secondary features," including areas of osteogenesis, osteoclast-like giant cells, and zones resembling aneurysmal bone cyst or giant cell tumor of bone, may be apparent as well. CCCS is a relatively indolent malignancy; roughly 25% of patients experience local recurrences of their tumors or suffer metastasis, but tumor-related death is uncommon, particularly when the lesion has been completely resected en bloc. Sporadic examples of other tumors in bone also may be focally or entirely composed of clear cells. These include osteosarcoma, chondroblastoma, chordoma, adamantinoma, Ewing's sarcoma, and primitive neuroectodermal tumor. The last two of these lesions represent the most common primary clear cell bone tumors in children, whereas metastatic renal clear cell sarcoma is the most frequent metastatic pediatric tumor in this category.
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PMID:Clear cell tumors of bone. 938 27

The somatostatin analogue [111In-DTPA-d-Phe1]-octreotide (111In-octreotide) allows scintigraphic visualization of somatostatin receptor-expressing tissue. While it is well known that a large variety of tissues express somatostatin receptors and 111In-octreotide scintigraphy has a clearly defined role in various neuroendocrine diseases, the clinical value of 111In-octreotide scintigraphy in brain tumours is still under clinical investigation. In 124 patients with 141 brain lesions (63 meningiomas, 24 pituitary adenomas, 10 gliomas WHO class I and II, 12 gliomas WHO class III and IV, 11 neurinomas and 2 neurofibromas, 7 metastases and 12 other varieties: three non-Hodgkin B-cell lymphomas, two epidermoids, one abscess, one angioleiomyoma, one chordoma, one haemangiopericytoma, one osteosarcoma, one plasmacytoma and one pseudocyst), 111In-octreotide scintigraphy was performed 4-6 and 24 h after i.v. injection of 110-220 MBq 111In-octreotide. Planar images of the head in four views with a 128x128 matrix and single-photon emission tomographic images (64x64 matrix) were acquired, and lesions were graded according to qualitative tracer uptake. Fifty-nine of the 63 meningiomas showed moderate to intense tracer uptake. Nine of 24 pituitary adenomas were visible; the remaining 15 did not show any tracer uptake. None of the class I and II gliomas with an intact blood-brain barrier were detected whereas 11/12 class III and IV gliomas showed 111In-octreotide uptake. None of the neurinomas or neurofibromas were positive. Five of seven metastases were classified as positive, as were the osteosarcoma, two of three non-Hodgkin B-cell lymphomas, one abscess, one angioleiomyoma, one chordoma and one haemangiopericytoma. The other varieties (one non-Hodgkin B-cell lymphoma, two epidermoids, one plasmacytoma and one pseudocyst) did not show 111In-octreotide uptake. The results demonstrate that a large variety of intracranial lesions express somatostatin receptors and therefore can be visualized by [111In-DTPA-d-Phe1]-octreotide scintigraphy. This technique can be valuable in the differentiation between meningiomas and pituitary adenomas, based on qualitative tracer uptake. [111In-DTPA-d-Phe1]-octreotide scintigraphy allows differentiation between meningiomas and neurinomas or neurofibromas and therefore provides complementary information to computed tomography or magnetic resonance imaging. Furthermore, this technique allows differentiation between scar tissue and recurrent meningiomas postoperatively and can help in non-invasive tumour differentiation of multiple intracranial lesions, which can be of value in defining the most adequate therapeutic strategy.
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PMID:Somatostatin receptor imaging in intracranial tumours. 966 88

We report four new cases of chordoma of "the mobile spine", all at the L2 level. Diagnosis was often delayed due to predominantly nonspecific low back symptoms; however, neurological involvement is more frequent than in chordoma with a sacrococcygeal localization. No pathognomonic images have been described for any imaging modality, and differential diagnosis should include metastases, chondrosarcoma, and giant-cell tumor. Histopathological analysis can be performed on CT-guided puncture biopsy samples, but a high level of suspicion must be present and, if there is any doubt, immunohistochemical studies should be carried out. Despite being the treatment of choice, complete tumor resection by a double-approach spondylectomy is barely feasible at the L2 level.
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PMID:Chordoma of the lumbar L2 vertebra: case report and review of the literature. 968 62

Two cases of sacral chordoma in a 7-year, 9-month-old boy and a 3-year, 4-month-old boy are presented. In addition to the typical histology of conventional chordoma, both tumors showed the less differentiated sarcomatoid appearance of atypical chordoma in the major portion. Immunohistochemically, in both cases neoplastic cells in areas of conventional as well as atypical chordoma were positive for keratins (CAM 5.2, AE1 and AE3), epithelial membrane antigen, vimentin, S-100 protein, carcinoembryonic antigen, and glial fibrillary acidic protein. Both patients underwent resection of the tumor and chemotherapy. In comparison with conventional chordomas in adults, however, these two tumors showed more aggressive clinical course and were less amenable to therapeutic control. The older boy died of multiple metastasis 1 year after initial diagnosis. At the last follow-up, 15 months after initial diagnosis, the younger boy was alive, but with recurrent and metastatic disease of the left parasacral area and chest wall. Our studies of these two cases and the reported cases suggest that sacral chordoma in children has distinctive clinicopathologic features denoting a highly aggressive tumor and that it should be treated as such.
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PMID:Sacral chordoma in early childhood: clinicopathological and immunohistochemical study. 968 66


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