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)

The patient was a 70-year-old male with complaint of macrohematuria at the first visit to our clinic on June 10, 1986. At that time, cystoscopy revealed a thumb sized papillary tumor and a rice sized non papillary tumor, and the biopsy specimen was pathologically diagnosed as undifferentiated carcinoma. But, he refused admission. On January 30, 1987, he came back to our clinic with complaints of dyspnea, general fatigue and weight loss. Moderate lt. gynecomastia was found and the level of serum hCG-beta was detected as high as 101 ng/ml. Excretory urogram and enhanced CT revealed a large mass in the bladder. In the seventeenth day after admission, he died of lung edema and heart failure. The findings of autopsy showed a large light greenish to light brownish tumor of 10 X 10 X 3 cm in the bladder. Distant metastases were observed in internal, common iliac and paraaortic lymph nodes, but without other distant metastasis. In histological and immunohistochemical studies, the final diagnosis is choriocarcinoma of the bladder, containing syncytiotrophoblastic giant cells with hCG-beta granules as an undifferentiated carcinoma. To our knowledge this case is the eighth described in Japan. Herein we report a new case of primary choriocarcinoma of the bladder and make a brief review of the literatures.
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PMID:[Primary choriocarcinoma of the bladder: a case report of autopsy]. 267 66

A 66-year-old man with a primary gastric choriocarcinoma is presented. The pre-operative diagnosis of the gastric barium examination and an endoscopy was an unusual gastric carcinoma in the antrum. At laparotomy, an abscess in the lesser sac that had developed by a tumoral penetrance was found. Thus a total gastrectomy and a lymphadenectomy with a reconstruction was performed. The resected specimen was found to be a Borrmann 1 type tumor, and a histological examination showed it to be a choriocarcinoma with a syncytiotrophoblast, that was immunostained by human chorionic gonadotropin (HCG). The physical findings however, disclosed no tumor in the testis. The serum HCG was found to be 1,380 IU/l on the 7th postoperative day, then a pulmonary metastases appeared and progressed, and the patient died on the 22nd postoperative day.
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PMID:[A case of primary gastric choriocarcinoma]. 268 80

The development of metastases represents the lethal event in the clinical course of most neoplastic diseases. The complex mechanism responsible for the spread of cancer are governed by interactions between tumour cells and the host tissues. Choriocarcinoma cells and cultured blood vessels were used to study the interaction between tumour and endothelial cells. Seeding of tumour cells onto blood vessel wall caused retraction of endothelial cells leading to the exposure of underlying tissue. Subsequently, the tumour cells penetrated the sub-endothelial connective tissue and the internal elastic lamina.
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PMID:In vitro studies on the invasion of blood vessel wall by choriocarcinoma cells. 270 42

We present a case of pure testicle choriocarcinoma in a 13-year-old male. Its first clinical manifestation consisted in a pattern of acute dyspnea caused by multiple pulmonary metastases. Alphafetoprotein investigation in serum and tissue proved negative. We carry out an immunohistochemical study of the case and discuss its histogenesis current classification and prognostic significance.
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PMID:[Pure testicular choriocarcinoma]. 272 38

A case of a ruptured metastatic aneurysm of choriocarcinoma is reported. The fourteen other cases of the literature are summarized. The pathological significance of this rare presentation of metastatic disease is discussed. The treatment of choice is defined as excision followed by chemotherapy and whole brain irradiation. The prognosis remains poor.
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PMID:A ruptured cerebral aneurysm from choriocarcinomatous origin--a case report and a review. 274 37

Choriocarcinoma is the rarest testicular germ cell tumor, occurring in less than 1% of cases. Gastrointestinal bleeding is not uncommon in cases of testicular choriocarcinoma and reflects metastatic disease. Typically, the patient presents with marked upper or lower gastrointestinal tract bleeding. A young adult male with metastatic testicular choriocarcinoma presented as a near-syncopal episode, with a hematocrit of 22% and hemoccult-positive stool. Endoscopy revealed a solitary bleeding lesion along the greater curvature of the stomach. His presentation suggested chronic, rather than acute, gastrointestinal blood loss. This case may represent the first case of testicular choriocarcinoma in which chronic gastrointestinal blood loss was the presenting manifestation of metastatic disease.
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PMID:Testicular choriocarcinoma. An unusual presentation as occult gastrointestinal blood loss. 278 29

In 121 proven cases of intracranial metastases, lung cancer was as high as 48 per cent. Multiple lesions were noted (67.8%) in almost every type of organ source. Brain parenchyma (80.3%), predominantly supratentorium was the major site of metastases. The minority was observed in leptomeninge, cranial bone and subgaleal tissue. Subarachnoid seeding tumors along CSF pathways spread mainly from pineal neoplasms; a few cases from lung and choriocarcinoma. Extensive brain edema occurred in metastases from almost every type of primary organ source. Calcification exhibited 5.8 per cent and their origins were lung and breast. Bleeding tumors were noted in 10.7 per cent mainly from choriocarcinoma, a few from lung and GI. Hyperdense tumors occurred in 86.8 per cent on noncontrast scans. Almost all tumors (95.2%) showed contrast enhancement, predominantly ring-shaped lesions. Their organ sources were GI, lung and breast. A few patterns of enhancement were homogeneous and heterogeneous. Non-enhanced lesion were noted in 4.8 per cent mainly due to the high density of calcium and blood inside the tumors. Apart from seeding, calcified and bleeding tumors, the CT findings were not specific for various types of metastases.
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PMID:CT findings of brain metastases. 279 20

With recent progress in chemotherapy, the prognosis of patients with trophoblastic neoplasia has greatly improved, but the remission rate of patients with choriocarcinoma remains unfavorable. The Committee for Trophoblastic Disease of the Japan Society of Obstetrics and Gynecology reported the results of hospital registration at 77 institutions throughout Japan in 1987. In this report, the survival rates of patients treated during the 7 years from 1974 to 1980 were described as follows. The 5-year survival rate has approached 100% for patients with invasive mole, while the rate for patients with choriocarcinoma is now approaching 80%. As far as choriocarcinoma is concerned, the survival rate depends on the presence of metastases. The 5-years survival rate for patients without metastases has approached 100%, while that for patients with metastases is barely 60%. Patients with poor-prognosis choriocarcinoma present difficult and challenging problems for the clinician. These patients are best treated on the basis of the prognostic scoring system proposed by Bagshawe. The higher the score, the greater the risk of drug resistance developing during traditional therapy. To date, our experience with the MECA regimen would indicate that it is most effective for patients with high-risk trophoblastic neoplasia. We now also recommend that all high-risk patients should receive at least four additional courses of the regimen after a negative hCG titer has been obtained. After complete remission has been achieved, further follow up should be repeated every month for at least three years.
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PMID:[Chemotherapy of high-risk trophoblastic neoplasia]. 282 Mar 10

Fifty-three (9.8%) of 539 patients with gestational trophoblastic tumors (invasive mole or choriocarcinoma) referred to the John I. Brewer Trophoblastic Disease Center, Northwestern University Medical School, from 1962 to 1986 died. They all had histologically documented choriocarcinoma. The time from the pregnancy event to treatment and the pretreatment human chorionic gonadotropin level were both significantly greater in the 53 patients who died as compared to the 486 who were cured. Seventy percent of fatal cases developed in association with term or preterm pregnancies, abortions or ectopic pregnancies rather than hydatidiform moles. Fifty-one percent of patients who died had brain, liver and/or peritoneal metastases at diagnosis. Ninety-six percent of patients had a Bagshawe score of greater than or equal to 8 (high-risk group): the average score was 13. The most common causes of death were hemorrhage from one or more metastatic sites (42%) and pulmonary insufficiency (31%). Factors primarily responsible for the treatment failures in these patients were: (1) presence of extensive choriocarcinoma at the time of diagnosis, (2) lack of appropriately aggressive initial treatment in high-risk patients, and (3) failure of presently used treatment protocols to control advanced disease. Secondary chemotherapy and radiotherapy to sites other than the brain failed to improve survival. Adjuvant surgical procedures, especially hysterectomy and thoracotomy, may be useful for excising localized, chemotherapy-resistant tumors.
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PMID:Causes of treatment failure in gestational trophoblastic disease. 282 22

The course of 51 patients with high-risk metastatic gestational trophoblastic tumor was reviewed. The clinical characteristics and therapy of patients who died were compared to patients who attained remission to identify parameters that are associated with treatment failure. The presence of liver, brain, or intestinal metastases and the failure of prior chemotherapy were found to portend a poor prognosis (P less than 0.001, P less than 0.05). Other high-risk factors such as markedly elevated HCG levels, time interval greater than 4 months from the antecedent pregnancy to treatment, and post-term choriocarcinoma were not independently associated with treatment failure. The mean prognostic score and the mean number of high-risk factors for patients who died were 13 and 3, as compared to 7 and 2, respectively, for patients who achieved remission (P less than 0.001, P less than 0.001). Alternative intensive chemotherapy regimens need to be developed to improve remission rates in patients with liver, brain, or intestinal metastases, failed prior chemotherapy, or a high prognostic score.
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PMID:Analysis of treatment failure in high-risk metastatic gestational trophoblastic disease. 282 99


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