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)

Detection of serum and cellular AFP and hCG has made a significant contribution in understanding and management of testicular cancer. It is essential to remember the following events in utilizing these markers: (1) Histologic diagnosis of seminoma, but AFP is elevated. There is usually an element of choriocarcinoma. (2) Histologic diagnosis of seminoma and highly elevated hCG greater than 100 ng/ml has usually an element of choriocarcinoma. (3) Histologic diagnosis of choriocarcinoma with an elevated serum AFP. There is usually an element of embryonal carcinoma. (4) Pathologic stage I nonseminomatous testicular cancer with elevated serum markers is either stage II or stage III. (5) In a recent study of 23 patients undergoing resection of residual nonseminomatous testicular cancer after intensive chemotherapy, 21 had either teratoma in primary tumor or bulky metastatic disease. The markers were normalized after chemotherapy and prior to resection. (6) Although normalization of these markers after chemotherapy indicates effective therapeutic response, one should look of residual tumor utilizing radiologic investigations.
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PMID:Current status of tumor markers in testicular cancer. A practical review. 138 31

Choriocarcinoma of the nonmolar placenta is presumptively a rare entity and is usually associated with widespread maternal metastases at the time of diagnosis. Nonmetastatic disease goes unrecognized and undiagnosed because placental carcinoma can be limited to a few villi, and grossly evident disease is often misinterpreted as a placental infarct. The optimal treatment for patients with choriocarcinoma of the placenta is not known but aggressive combination chemotherapy is suggested for patients with metastatic disease. Historically, the prognosis for both mother and infant has been poor.
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PMID:Choriocarcinoma in a term placenta with maternal metastases. 150 30

Hydatidiform moles are classified as partial or complete by histologic criteria (Am J Obstet Gynecol 131:665-671, 1978 and Am J Obstet Gynecol 132:20-27, 1978). While persistent gestational trophoblastic tumors follow both types, there remains controversy as to whether the malignant extreme of gestational trophoblastic tumors, choriocarcinoma, can follow a partial hydatidiform mole (Am J Obstet Gynecol 127:167-170, 1977 and Arch Gynecol 234:161-166, 1984). In this instance, a 37-year-old woman presented with a partial hydatidiform mole that persisted and was treated with one course of chemotherapy. She attained a remission for 10 months, when a routine follow-up examination revealed an asymptomatic rise in serum beta-human chorionic gonadotropin from baseline to 14,600 mIU/mL. Dilatation and curettage revealed abundant avillous cytotrophoblast and syncytiotrophoblast with marked atypia, diagnostic of choriocarcinoma. Flow cytometry of paraffin blocks of both specimens showed the partial hydatidiform mole to be triploid and the choriocarcinoma diploid. The patient had no evidence of metastatic disease and was successfully treated with multiple-agent chemotherapy.
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PMID:Choriocarcinoma following a partial hydatidiform mole: a case report. 156 50

This is a report on a 33 year old patient with a metastatic gestational choriocarcinoma. The patient was hospitalized with the picture of a spontaneous left kidney rupture and nephrectomy was performed. Under primary mono-dose methotrexate chemotherapy, the patient showed rapidly progressive metastases in both lungs, liver, right kidney and soft tissue. With the use of multiple-chemotherapy, according to the EMA-CO scheme, we observed complete remission. To date, there has been no indication of any tumour recurrence.
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PMID:[Treatment of primary therapy refractory choriocarcinoma using the EMA-CO protocol]. 160 19

Choriocarcinoma is a malignant germ cell tumor that usually arises from a previous gestation, but may also arise from germ cells anywhere along their known migratory pathway during fetal development. Gestational choriocarcinoma is highly sensitive to chemotherapy. This malignancy is known to undergo spontaneous regression of the primary tumor, which, in the face of metastases, may obscure the primary tumor site. The authors report the case of a patient with choriocarcinoma who was seen with pulmonary metastases and a single large lesion in the kidney 5 years posthysterectomy. The problems in resolving the primary site and the importance of a tissue diagnosis before nephrectomy are discussed.
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PMID:Choriocarcinoma of the kidney. 161 47

The object of this enquiry was to group together a series of patients with a mediastinal germ cell tumour who were diagnosed and treated between 1983-1990 to specify their clinical characters and their prognostic factors and to evaluate the current therapeutic strategies. Out of a total of 87 cases that were analysed 23 had seminomas and 64 malignant dysembryomas. Amongst the 23 patients suffering from seminomas, 8 had first been treated by surgery, 13 by chemotherapy and 2 by radiotherapy. At the end of treatment 22 made a complete response and 4 patients relapsed after 4-13 months following a complete response. 3 patients had metastases at the outset and were alive and in complete response at 1,4 and 7 years respectively. The survival level at 2 years for seminomas was 84%. Of 64 patients suffering from a malignant dysembryoma, 19 were first treated with surgery (10 by complete resection) followed by chemotherapy in 17 cases. At the end of treatment 12 patients were in complete remission. Only one of these patients had a subsequent relapse. 45 patients were first treated by chemotherapy (10 complete responses, 26 partial responses) then secondary surgery was performed in 22 cases, allowing a complete remission in 21. Seven malignant dysembryomas relapsed after an initial complete remission. The patients treated for pure choriocarcinoma were 7 in number: 6 of these received primary chemotherapy. One patient underwent a secondary resection and was living at 26 months. The other 5 died rapidly. The 2 year survival for malignant dysembryomas was 52%. The median survival was 28 months. There was a significant difference in surviyal between dysembryomas in complete remission and those in partial remission.
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PMID:[Primary malignant germinal tumors of the mediastinum. Results from a national retrospective survey]. 161 94

From 1948 to 1985, a total of 630 cases of choriocarcinoma and invasive mole were treated in our hospital. The methods of treatment varied in different periods of time. In the third period (1972-1985), 5 Fu and/or KSM were the main therapeutic agents used in the treatment of 110 cases of choriocarcinoma and 99 cases of invasive mole. Metastases were observed in more than 90% of cases of choriocarcinoma and nearly 1/4 belonged to stage IV. The mortality of choriocarcinoma decreased from 84.3% to 32.7% after treatment and that of invasive mole from 32.4% to 8.1%. 43 of 80 patients treated with chemotherapy alone conceived after recovery, resulting in a total of 50 pregnancies including 31 term deliveries by 28 women. All the children are normal and healthy, the eldest being 11 years old now.
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PMID:Treatment of malignant trophoblastic tumors. An analysis of 209 cases. 165 28

A clinicopathological and immunohistochemical study of a fatal case of placental site trophoblastic tumor (PSTT) is presented. PSTT is a rare variant of trophoblastic disease. Histologically the tumor is characterized by a monomorphic cell population, derived from the extravillous intermediate trophoblast. The tumor cells contain human placental lactogen (HPL) as the predominant marker, while human chorionic gonadotropin (HCG) is present only locally. PSTT has a malignant potential. In the case presented the tumor finally developed the biphasic pattern of choriocarcinoma. The clinical and pathological features of the malignant PSTT are reviewed. Establishing the diagnosis and predicting the biologic behavior of PSTT may be difficult. If metastases occur the prognosis is poor regardless of therapeutic intervention.
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PMID:Malignant placental site trophoblastic tumor. A case report and a review of the literature. 165 95

From 1962 through 1989, 5063 patients were referred to the John I. Brewer Trophoblastic Disease Center of the Northwestern University Medical School. Among these were 564 patients treated with chemotherapy for gestational trophoblastic tumors (choriocarcinoma and invasive mole). The overall cure rate was 94%, 100% for 323 patients without evidence of metastases and 85% for 241 patients with metastatic disease. Four factors were determined to significantly influence treatment response: (1) clinicopathologic diagnosis of choriocarcinoma, (2) metastases to sites other than the lung or vagina, (3) number of metastases, and (4) previous failed chemotherapy.
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PMID:Study and treatment of gestational trophoblastic diseases at the John I. Brewer Trophoblastic Disease Center, 1962-1990. 166 98

Major advances have been achieved during the past 40 years in the epidemiology, etiology, pathology, endocrinology, immunology, diagnosis, and treatment of molar pregnancy (MP) and gestational trophoblastic neoplasia (GTN). MP is now recognized as composing two distinct entities--complete and partial, with distinct histopathology, genetics, and clinical presentations. Proper management is dependent on a thorough understanding of each type. Early diagnosis and effective treatment of patients with GTN has resulted in 100 percent cure rates in non-metastatic disease and in the majority of patients with metastases. In most instances, resistant disease leading to death results from delayed diagnosis and overwhelming tumor burden. Moreover, in most instances successful treatment can be accomplished with preservation of fertility and normal pregnancy outcome anticipated. A rare variant of choriocarcinoma called placental site trophoblastic tumor (PSTT) has been described, which, although curable by surgery when localized, is usually fatal when disseminated. It is anticipated that during the decade of the nineties the scientific work in progress will lead to earlier diagnosis and improved survival in resistant cases.
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PMID:Gestational trophoblastic neoplasia in the 1990s. 166 40


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