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 case is reported of primary gastric choriocarcinoma occurring in a 73-year-old man, associated with a high serum level of beta hCG. Both primary and lymph node metastases contained exclusively cyto and syncytiotrophoblastic elements. Immunohistochemical localization of chorionic gonadotropin (hCG), placental lactogen (hPL) and pregnancy-specific glycoprotein (SP 1) is described in relation to cytotrophoblastic differentiation. An intramucosal focus of adenocarcinoma supports the hypothesis of the origin of choriocarcinoma from usual gastric cancer.
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PMID:Gastric choriocarcinoma; an immunohistochemical study. 242 92

From Jan. 1973 to Dec. 1984, 60 patients with advanced choriocarcinoma were treated in our hospital. 34 of them were stage IIIB and 26 stage IV. There were 36 patients with lobulated pulmonary metastases and 13 with brain metastases. The 4-drug chemotherapy (methotrexate or fluorouracil, kengsengmycin, vincristine and nitrogen mustard) was used as the main treatment, supplemented by surgery or irradiation. In those with lobulated pulmonary metastatic foci and lesions in the brain, the 4-drug chemotherapy was used before, during or after split course irradiation. Generally, radiation with a total dose of 4,000 rad (2,000 rad/12 D, interval of 4 weeks, 2,000 rad/12 D) was given after 3-4 courses of chemotherapy. The 1, 3 and 5 year survival rates were 85.7%, 78.6% and 79.4%, respectively. Lobulated pulmonary lesions as treated with 4-drug chemotherapy plus split course irradiation gave a 3 year survival rate of 88.0% (22/25). 7 of 8 with brain metastases treated by the same modality gave complete remission. 5 have survived for more than 3 years. In this series, the combination therapy of advanced choriocarcinoma, role of irradiation for this tumor and individualization in treatment are discussed. The authors believe that the 4-drug chemotherapy for advanced choriocarcinoma is superior to the other regiment and, when combined with split course irradiation is very effective in lobulated pulmonary and brain metastases.
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PMID:[Combination therapy of advanced choriocarcinoma--an analysis of 60 patients]. 243 6

A case of choriocarcinoma of the urinary bladder is presented. A 57-year-old man underwent a cystectomy for transitional cell carcinoma, grade II. Choriocarcinoma was found, in addition to the transitional cell carcinoma, in the removed urinary bladder. After the operation, metastases appeared in both lungs, evolving rapidly despite chemotherapy. The patient died five months after admission. Immunohistochemically, staining for human placental lactogen was strongly positive, and both alpha and beta subunits of human chorionic gonadotropin were weakly positive in the primary site of the removed urinary bladder and in the metastatic foci.
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PMID:Primary choriocarcinoma of the urinary bladder. 245 Oct 42

Pregnancy after treatment of choriocarcinoma with cerebral metastases is uncommon. We treated a patient successfully with less-toxic chemotherapeutic agents than those advocated by others together with whole brain irradiation. She subsequently had two uneventful pregnancies.
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PMID:Normal pregnancy after successful treatment of choriocarcinoma with cerebral metastases. A case report. 245 81

We performed a prospective randomized trial of a high-dose chemotherapy regimen v standard cisplatin-based chemotherapy in poor prognosis nonseminomatous germ-cell cancer patients. The high-dose regimen consisting of twice the standard dose of cisplatin (P), along with vinblastine (Ve), bleomycin (B), and the epipodophylotoxin etoposide (VP-16) (V) (PVeBV) was compared to the classic regimen with normal dose cisplatin, vinblastine, and bleomycin (PVeB). Eligibility criteria included large abdominal masses, liver metastases, multiple pulmonary metastases, brain metastases, marked elevations in serum tumor markers (alpha-fetoprotein greater than 1,000 ng/mL or the beta-subunit of human chorionic gonadotropin greater than 10,000 mIU), unfavorable histology (pure choriocarcinoma), or extragonadal germ-cell tumors. Fifty-two consecutive patients with poor prognostic features were randomized to receive either PVeBV or PVeB. The median follow-up is 4 years. Treatment with the high-dose regimen increased the complete remission rate (88% v 67%, P = .14) and was associated with a lower relapse rate (17% v 41%, P = .2). The median survival of patients receiving standard therapy was 30 months, while the median survival for patients receiving the high-dose regimen has not been reached. Actuarial 5-year survival for patients treated with the high-dose regimen is 78%, compared with 48% for patients receiving standard therapy (two-sided Mantel-Cox test = .06). Disease-free survival was also superior for patients randomized to PVeBV (P = .03). Sixty-eight percent of patients (23 of 34) randomized to PVeBV are alive and continuously disease-free, compared with 33% (six of 18) for PVeB (P = .02). The major difference in toxicity between the high-dose regimen and standard therapy was the severity of myelosuppression and the incidence of severe hearing loss. Ninety-one percent of patients treated with PVeBV had a WBC count less than 1,000/microL, compared with 50% of patients receiving PVeB (P less than .05). Hearing aids were recommended for 12 patients who received PVeBV and two who received PVeB. The increased effectiveness of the PVeBV regimen in poor prognosis germ-cell cancer patients may relate to the double-dose cisplatin, the addition of VP-16, or to a synergistic effect of these two drugs.
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PMID:A randomized trial of standard chemotherapy v a high-dose chemotherapy regimen in the treatment of poor prognosis nonseminomatous germ-cell tumors. 245 19

Two cases of metastatic gestational choriocarcinoma to the lungs have been encountered that presented unusual histologic patterns. Both lesions were solitary metastases that followed multiple courses of chemotherapy, and the patients had low serum beta-human chorionic gonadotropin (hCG) levels. Surgical excision appeared to be curative in both cases. Both neoplasms were characterized by a predominance of uniform but highly atypical mononucleate trophoblastic cells. These cells infiltrated pulmonary parenchyma, forming nests of tumor with central dense necrotic debris. Syncytiotrophoblastic cells (STB) were present but showed scant cytoplasm and little vacuolization. Hemorrhage was only focal. Immunohistochemistry revealed that some of the multinucleate STB and occasional mononucleate cells produced hCG, while human placental lactogen was focally produced in the tumors. By electron microscopy the STB were identified but lacked open lacunae lined by microvilli. Most mononucleate cells showed greater maturation evidenced by a more complex cytoplasm than is seen in typical cytotrophoblastic cells (CTB). The results suggest that these tumors are a distinctive subtype of choriocarcinoma composed largely of a form of trophoblastic cell with features intermediate between CTB and STB, yet different from the intermediate trophoblast of the placental site tumor. Identification of this morphologic variant of choriocarcinoma may have clinical utility as additional cases are studied.
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PMID:Metastatic gestational choriocarcinoma. Unusual pathologic variant following therapy. 246 17

Fifty-three patients presenting with non-seminomatous germ cell tumours (NSGCT) of the testis were examined. Particular interest was directed towards the association of several morphological features of the primary tumour with metastatic disease, either at presentation or later in the course of the tumour. It is apparent from this study that the presence of vascular invasion in the primary tumour, high T stage (advanced local disease) and the presence of choriocarcinoma are poor prognostic signs in NSGCT. In such tumours presenting as clinical stage I, surveillance management may not be appropriate because of the high rate of relapse.
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PMID:Prognostic indicators for failure of surveillance management of stage I non-seminomatous germ cell tumours. 253 16

From Jan. 1979 to Nov. 1987, 38 patients with invasive mole and 5 patients of choriocarcinoma were primarily treated with methotrexate and citrovorum factor (MTX-CF) rescue. Thirty-two patients had non-metastatic disease (stage I) and 11 had metastatic disease (stage IIA in 5 cases, stage IIB in 3 cases and stage IIIA in 3 cases). Complete remission was achieved in 28 (87.5%) of 32 patients with non-metastatic disease and in 9 (81.8%) of 11 patients with metastatic disease. Six patients with MTX-CF resistant tumors subsequently achieved complete remission with intravenous infusion of KSM and/or AT 1258. All patients were followed up periodically, 22 of them have been followed up for over 2 years, the longest duration of follow-up being 7 years. Seven of the 14 patients with preserved uterus became pregnant after recovery. All children grew up normally.
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PMID:[Treatment of gestational trophoblastic neoplasms with methotrexate and citrovorum factor rescue: analysis of 43 cases]. 256 Oct 92

A case of extragonadal choriocarcinoma in a 30-yr-old man was diagnosed by fine-needle aspiration (FNA) biopsy with immunoperoxidase studies. FNA diagnosis in this case resulted in prompt treatment of rapidly growing metastases without the need for an invasive diagnostic procedure.
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PMID:Fine-needle aspiration diagnosis of extragonadal choriocarcinoma with immunoperoxidase studies. 265 47

Primary choriocarcinomas of the lung are extremely rare. Like choriocarcinomas elsewhere, they possess rapid growth ability and a high propensity to metastasize. There is minimal information available on the treatment of lung choriocarcinoma. In the case reported herein, neoadjuvant chemotherapy with 5-fluorouracil (5-FU) infusion, etoposide, and cisplatin induced a partial response permitting complete excision of a massive tumor of the right upper lobe involving the chest wall and superior vena cava. The patient relapsed with a metastasis to the brain that was surgically excised. Contralateral lung metastases were soon noted and responded well to systemic chemotherapy; yet the patient died of a new brain metastasis. To our knowledge, this is the first example of a primary choriocarcinoma of the lung treated with intensive multimodality therapy. The latter seems to offer a potential benefit if certain guidelines are followed.
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PMID:Primary choriocarcinoma of the lung: report of a case treated with intensive multimodality therapy and review of the literature. 265 22


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