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)

In the transverse rectus abdominis musculocutaneous (TRAM) flap procedure, a portion of the abdominal wall is transposed to the chest as a pedicle or free flap. Patients who have undergone this procedure often subsequently undergo computed tomography (CT) for assessment of metastatic disease or unrelated pathologic conditions. CT scans obtained in patients who had undergone the TRAM flap procedure were reviewed to facilitate recognition of both the normal and abnormal postoperative CT appearances of the TRAM flap. In 28 reconstructed breasts in 21 patients, three general appearances were identified: type 1 (homogeneous fat attenuation) (n = 4), type 2 (fat attenuation with a thin, curvilinear soft-tissue band parallel to the skin surface) (n = 19), and type 3 (thick soft-tissue band parallel to the skin surface) (n = 5). A mass that arose in a type 2 breast 21 months after surgery represented recurrent cancer. A markedly thickened soft-tissue band in another patient represented a dry eschar with inflammation and fat necrosis. The rectus abdominis muscle was partially absent in eight cases and completely absent in 20 cases. Recognition of the normal postoperative appearance of the body wall helps avoid confusion with disease states and allows identification of abnormal conditions such as inflammation, infection, and recurrent breast cancer.
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PMID:Breast reconstruction with TRAM flaps: normal and abnormal appearances at CT. 1055 77

The formation of neoplastic changes in the scar tissue of chronically ulcerating wounds is a well-known process. This condition is most commonly seen after the postburn scars, but it may be seen after many kinds of scars. The term "Marjolin's ulcer" is used to describe this type of carcinoma. Although many different cell types can be seen in these lesions, the most commonly seen is squamous cell carcinoma. Squamous cell carcinomas resulting from the Marjolin's ulcer have a much greater tendency to metastasize than squamous cell carcinomas resulting from the other causes. Confusion continues about the precise pathophysiology of this lesion and the clinical behavior of this neoplasm, and the mortality and morbidity rates are also conflicting. As would be expected, there is a wide variety of suggested treatment protocols for this disease. This article, through case reports and review of the literature, offers criteria for the treatment of the Marjolin's ulcers that arise on the scalp, which is an uncommon site.
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PMID:Marjolin's ulcer of the scalp: report of 5 cases and review of the literature. 1122 88

This study was carried out statistically to evaluate the present situation of carcinoids and related endocrine variants in the uterine cervix. A total of 205 patients who had been reported on in world-wide literature were divided into two groups; one, as a carcinoid group, consisting of 81 patients with carcinoids, 49 typical and 32 atypical, and the others, as an endocrine carcinoma (ECC) group, including 124 patients with other remaining endocrine carcinomas variously expressed up to date. A statistical comparison in multiple factors was attempted between these two groups. A statistically significant difference between them was demonstrated in immunochemistry for chromogranin (p<0.05), serotonin (p<0.01), and CEA (p<0.01), but not regarding average age, clinical manifestations, tumor-size categorization, rates of metastases, sites of metastases, argyrophilia or argent affinity, and postoperative five-year survival rates, though the latter disclosed a statistically significant difference (p<0.05) only between the two groups of typical and atypical carcinoids. The results of analysis in the present study disclosing no statistically significant differences in various aspects between the two groups of carcinoids and the remaining endocrine carcinomas strongly suggest that the considerable extent of confusion produced by various different types of terminology for carcinoids and related endocrine variants should be solved by extensive evaluation and discussion on an international scale, and that diagnostic criteria and simplified classification acceptable for these neoplasms are to be established not only for those of the uterine cervix but also for those of all other organs including the digestive system based on a universally acceptable concept for these neoplasms originating in non-endocrine organs.
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PMID:Gut-endocrinomas (carcinoids and related endocrine variants) of the uterine cervix: an analysis of 205 reported cases. 1171 10

Elective lymph node dissection is selectively performed in patients with clinically localised melanoma. Randomised studies suggest that survival is improved only in a few subgroups of patients, whereas all patients are exposed to the substantial risk of operative morbidity. Sentinel node biopsy enables the early detection of lymph node metastases from melanoma with less morbidity. The technique has been standardised. The sentinel node can be identified in almost 100% of the patients. The tumour status of the node is the most important prognostic factor in patients with clinically localised melanoma. This information is essential for studies of adjuvant systemic treatment. Regrettably, there is confusion about the definition of a sentinel node. In addition, the sensitivity of the sentinel node approach is unclear. Furthermore, it is uncertain whether early lymph node dissection improves regional control and survival. Sentinel node biopsy is not yet the standard of care.
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PMID:[Sentinel node biopsy in melanoma: some critical questions]. 1236 37

We report two patients with leptomeningeal metastases from squamous cell cancer of the skin. In one patient cauda equina metastases appeared 6 years after initial presentation; the tumor from radical neck dissection demonstrated perineural invasion suggesting a possible route for subarachnoid dissemination. The other patient presented 2 years after initial diagnosis with confusion and cranial nerve seven and twelve palsies. Both patients died from complications of leptomeningeal metastases.
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PMID:Leptomeningeal metastases from recurrent squamous cell cancer of the skin. 1289 36

Despite major improvements in the treatment of early-stage breast cancer over the past 15 years, many controversies exist surrounding the optimal adjuvant therapies for these patients. Adjuvant chemotherapy has been demonstrated to reduce recurrence and improve mortality, but questions persist as to what is the optimal regimen and how much adjuvant therapy should be administered. Among the adjuvant chemotherapy issues that remain controversial are the role of the taxanes and the optimal number of adjuvant chemotherapy treatment cycles. In the realm of adjuvant endocrine therapy, the early results of the Anastrozole, Tamoxifen and Combination (ATAC) trial have led to confusion as to how best to treat postmenopausal patients with estrogen receptor-positive, early-stage breast cancer. Clinicians are faced with the decision of choosing between tamoxifen and anastrozole. The enthusiasm for so-called targeted therapies, such as trastuzumab, in patients with metastatic disease, is now being carried over into the adjuvant setting. Multiple clinical trials around the world are evaluating the potential benefit of adding trastuzumab to chemotherapy in patients with HER2-positive, early-stage breast cancer. In the United States, clinicians are faced with many decisions on how to optimally treat patients with early-stage breast cancer. Evidence-based treatment guidelines such as those developed by the National Comprehensive Cancer Network (NCCN) provide a useful algorithm for assisting in making treatment decisions. It is hoped that, in the next few years, the results of ongoing clinical trials now underway will lead to further improvements in the outcome of patients with early-stage breast cancer.
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PMID:Progress in systemic adjuvant therapy of early-stage breast cancer. 1295 80

Carcinoid tumors of the lung are an uncommon group of neoplasms of neuroendocrine origin. Pulmonary carcinoid tumors are typically benign and slow growing. However, more aggressive subtypes may develop early nodal and distant metastases. Although several histologic classification strategies have been proposed to distinguish benign from more aggressive subtypes, the lack of uniformity in terminology has resulted in increased ambiguity and confusion. Because these tumors are generally resistant to chemotherapy, complete surgical resection is the primary form of therapy. Long-term survival for patients with typical carcinoid is excellent but is decreased in those with the atypical subtype. Complete tumor resection with preservation of uninvolved pulmonary parenchyma remains the fundamental goal in the surgical treatment of this unusual clinical entity.
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PMID:Pulmonary carcinoid tumors. 1297 7

A case of a 66-year-old woman with anterior-3(rd) falx metastasis from mammary carcinoma is reported. Radiological and therapeutic aspects are reported. The clinical presentation was headache and confusion together with gait disturbance. MRI showed a frontobasal mass with dural attachment suggestive of meningioma. Surgical resection was decided. Histology confirmed the diagnosis of breast cancer dural metastasis. Dural metastases are not frequent. Two radiological aspects are described: subdural hemorrhage and dural mass. No definitive theory exists about etiopathogenesis. As radiological findings are not specific, we emphasize the importance of suspecting dural metastasis in patients with tumor mass involving dura mater.
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PMID:Dural metastasis mimicking falx meningioma. Case report. 1461 30

The skeleton is the most common organ to be affected by metastatic cancer. Hypercalcemia of malignancy (HM) affects 10 to 20% of patients with advanced cancer. HM causes a series of symptoms, constipation, nausea and vomiting, confusion and/or stupor, polyuria and polydipsia, bone pains, which decrease quality of life. The normalization of calcemia significantly improves all these symptoms. Despite that, HM remains largely underdiagnosed and undertreated. HM is an emergency. Treatment of HM includes rapid rehydration of isotonic saline and i.v. bisphosphonates. Complications from metastatic bone disease include pathological fracture, HM, spinal cord compression, bone marrow infiltration, pain, and reduced mobility. Treatment with bisphosphonates are effective to reduce these complications. They should be started when bone metastases are diagnosed and continue until it is no longer clinically relevant. The most currently used bisphosphonates were clodronate and pamidronate. The increase convenience of a 15 minutes infusion, the greater efficacy and longer duration of response makes zoledronate the standard of care for HM and metastatic bone disease.
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PMID:[Bisphosphonates in malignant hypercalcemia and bone pain]. 1509 27

We report about a 63-year-old male patient who complained of a recent onset of confusion. A mediastinal mass had been detected in his chest X-ray three days before admission to our clinic. Surprisingly, a CT scan of the brain revealed no signs of cerebral masses or oedema. MRI demonstrated bright hyperintens signals in the medial aspect of both temporal lobes. Biopsy by mediastinoscopy showed small cell lung carcinoma (SCLC). No distant metastases were found by staging procedures. Cerebrospinal fluid and serum contained antineuronal antibodies (anti-Hu). The combination of symptoms, MRI findings and paraneoplastic antibodies established the diagnosis of paraneoplastic limbic encephalitis in a patient with SCLC. Chemotherapy combined with immunosuppression by corticosteroids was started immediately. The primary tumour responded to therapy but improvement of cerebral symptoms was unsatisfactory. Severe memory loss and personality changes remained unchanged while there was a slight improvement in confusion and hallucinations.
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PMID:[Paraneoplastic limbic encephalitis in small cell lung carcinoma]. 1516 56


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