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)

Sixty patients from two Radiation Therapy Oncology Group (RTOG) studies with cerebral metastases from malignant melanoma were analyzed to determine the response to whole brain irradiation. General performance status, neurologic function, and specific neurologic symptoms were evaluated for rate and duration of improvement. Also analyzed was the influence of chemotherapy and steroids, although neither was a controlled factor. Results indicate a significant benefit from radiation therapy in terms of symptomatic and neurologic function improvement. Symptomatic improvement was observed in 76%, with 31% completely improved. Of the four most frequent symptoms, complete or partial improvement was observed as follows: headache--27 of 37 patients (73%); motor loss--14 of 23 patients (61%); impaired mentation--13 of 24 patients (62%); and convulsions--10 of 12 patients (83%). Improvement in neurologic function class was observed in 18 of 44 patients (41%). Median survival for Study 1 patients was 10 weeks (range 1-200) and that of Study II patients 14 weeks (range 1-76). These results are comparable to those found in radiation therapy of brain metastases from all other primary tumors.
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PMID:Value of radiation therapy in the management of patients with cerebral metastases from malignant melanoma: Radiation Therapy Oncology Group Brain Metastases Study I and II. 676 93

427 radionuclide brain scans, performed in 1981 at Guy's Hospital Nuclear Medicine Department, were reviewed retrospectively to define clinical circumstances in which the study provided useful information. It was concluded that the radionuclide brain scan was the appropriate first line investigation in patients with known non-cerebral malignancy, in whom the possibility of cerebral metastases exists; and in patients with a low to moderate probability of subdural haematoma. The radionuclide brain scan can provide a valuable alternative to computed tomography studies:--(1) in patients without known underlying disease who develop localising signs; (2) in patients with focal fits; (3) in patients with underlying vascular disease and gradual onset of localising signs; and (4) in patients with suspected inflammatory conditions of the central nervous system. Outside these groups, the radionuclide brain scan rarely provided useful information.
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PMID:Clinical indications for optimal use of the radionuclide brain scan. 685 Feb 24

Smith et al. (1989) have reported a variant of Spitz's nevus with histological atypical features. Despite local lymph node metastases, further metastases were not observed. They proposed the name "malignant Spitz nevus" for this variant. A 2-year-old Japanese girl had a large nodule (27 x 17 mm) surrounded by an indurated erythema over the Achilles tendon. Histologically, it proved to be a melanocytic lesion resembling spindle cell and epithelioid cell nevus (Spitz's nevus) with unusual features; the tumor extended deep into the subcutis, and the mitotic figures deep into the tumor, together with prominent lymphatic vessel invasion by melanocytes. Thus the tumor was aptly termed "malignant Spitz nevus". Flow cytometric analysis of the DNA content revealed a diploid pattern. The child is well 5 years after a wide resection of the tumor. The diploid pattern of the DNA content as well as the good prognosis could support the idea that "malignant Spitz nevus" fits within the spectrum of Spitz's nevus.
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PMID:"Malignant Spitz nevus" in a 2-year-old Japanese child. 756 Apr 41

The clinical features and long-term outcome of seven patients with delayed cerebral radiation necrosis (DCRN) are described. Radiotherapy had been given for pituitary tumour (1), astrocytoma (2), pinealoma (2), craniopharyngioma (1) and parotid carcinoma (1). The mean latency to onset of the first neurological symptoms was 22 months (range 6-40 months), and mean duration of follow-up was 86 months (range 60-126). Three patients died at a mean of 84 months after radiotherapy (range 62-98). A fourth patient probably died from metastatic disease. Three patients remain alive, albeit severely disabled, after 5-10 years. The illness typically ran a stepwise course, with fits and stroke-like episodes occurring against a background of progressive dementia and somnolence. CT and MRI scans showed progressive ventricular dilatation associated with cerebral atrophy and diffuse or focal changes in the white matter. Four patients had had two or more neurosurgical procedures after the radiotherapy. In only one of the seven patients was the diagnosis made at presentation. DCRN produces a distinctive clinical picture, yet remains a poorly recognized complication of cranial irradiation.
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PMID:Delayed cerebral radiation necrosis. 815 88

In this paper I trace the history of the development of the treatment of breast cancer over a 4000-year period. I point out that there have basically been three paradigms within which we have studied and developed treatment for this disease. Clinical trials over the last twenty years as an expression of the scientific method in action, have demonstrated the limited success of the contemporary paradigm with its therapeutic sequelae of breast conserving surgery and adjuvant systemic therapy. At the same time a critical review of the natural history of breast cancer and the results of current treatments suggest logical inconsistencies in the model. I have therefore constructed a novel paradigm which better fits the available information by suggesting that metastases are not only a result of cellular transmission of breast cancer but sub-cellular transmission using the mechanism of in vivo transfection. Although this may sound far fetched, there are a series of remarkable studies in the literature which supports this conceptual revolution. This is surely a fertile field for research and the therapeutic consequences would be obvious. They might suggest that more aggressive adjuvant systemic chemotherapy based on the conventional model is unlikely to achieve any additional benefit, whereas therapy based on anti-viral drugs might produce the next therapeutic advance. It is not the intention of this article to persuade readers that the alternative paradigm is true but merely to open minds to the study of history and scientific philosophy to ensure that we do not repeat the errors of the past.
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PMID:Breast cancer 2000 BC to 2000 AD--time for a paradigm shift? 846 61

We studied 12 histologically malignant salivary tumors that showed complete encapsulation or only limited microscopic invasion. Most cases were histologically characterized by atypical and mitotically active luminal cells forming dilated, angular, variably sized glands in the subcapsular region, varying proportions of nonluminal tumor cells, and a background of central fibrosed hyalinized stroma. The appearance is that of a low-grade carcinoma. Focal higher grade carcinoma was superimposed on this histologic data in three cases. Neither recurrences nor metastases were seen in 11 of 12 patients after surgical resection with a follow-up of 1.2 to 13 yrs (mean, 4.2 years). Ploidy studies were performed on the paraffin-embedded tissue in 11 cases and yielded results for 7 cases. Aneuploid cell populations were found in five tumors; two had normal diploid populations; and the ploidy results are not predictive of tumor behavior. This type of salivary gland tumor fits diagnostically within the category of noninvasive and minimally invasive carcinoma ex pleomorphic adenoma (also referred to as in situ and low-grade malignant mixed tumors), a class that requires additional awareness and precise recognition as it signifies a good prognosis after surgical resection.
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PMID:Noninvasive and minimally invasive carcinoma ex mixed tumor: a clinicopathologic and ploidy study of 12 patients with major salivary tumors of low (or no?) malignant potential. 878 97

A case of early gastric cancer, limited to submucosal layer, which was manifested as cerebral metastasis is presented herein. A 47-year-old man was admitted to Nagaoka Chuo General Hospital with convulsions and a disturbance in consciousness, where a computed tomography (CT) scan revealed a cerebral tumor in the left temporal lobe. The resected tumor was identified as a metastatic adenocarcinoma. Further investigation revealed gastric cancer involving the posterior wall of the cardia. At laparotomy, multiple and small metastases of the liver and a jejunal metastasis were found and a palliative total gastrectomy was performed. The surgical specimen revealed a protruding, poorly differentiated medullary adenocarcinoma, with invasion of the submucosal layer. The patient died 4 months after undergoing the laparotomy. This case report is presented to make clinicians aware of the possibility that early gastric cancers may present as brain metastasis.
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PMID:Early gastric cancer manifested as brain metastasis: report of a case. 908 50

We reported a case of a 76-year-old male who suffered from gait disturbance. His first MR image showed multiple masses in the cerebellum and cerebrum. After 50Gy of whole brain irradiation the masses downsized, but, after 8 months the patient was readmitted because of general convulsions. MRI on his second admission showed an enlargement of the multiple masses and reinforcement of the perifocal edema. One year after the onset, MRI revealed the unusual appearance of multiple obscure-marginated cystic masses, intratumoral hemorrhage, and intraventricular hemorrhage. Soon he died of complications from pneumonia. In the autopsy, a mass 4 x 5 cm in size was found in the right lung and multiple metastatic foci were found in the CNS, small intestine, and lymph nodes. The case was diagnosed as bronchial atypical carcinoid with multiple metastases.
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PMID:[Multiple brain metastasis of bronchial atypical carcinoid: unusual MR imaging, case report]. 930 Apr 50

Eighteen patients with poor risk Ewing's sarcoma (including 11 patients with metastatic disease at presentation) received consolidation therapy of busulphan and melphalan with autologous stem cell rescue. There were nine females. The median age at diagnosis was 14.2 years (range 2.75-30 years). There was one early death due to cytomegalovirus pneumonitis. One patient developed a single generalised convulsion during busulphan therapy. Severe renal toxicity was not encountered. One patient developed veno-occlusive disease of the liver (VOD) which eventually resolved. With a median follow up of 2 years, 13 patients survive including six with initial metastatic disease. We conclude that high-dose busulphan/melphalan is well-tolerated and should be evaluated for efficacy in a larger series of patients with high risk Ewing's sarcoma.
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PMID:High-dose busulphan/melphalan with autologous stem cell rescue in Ewing's sarcoma. 940 24

Twenty-nine nonendocrine pancreatic carcinomas (20 primary tumors and nine metastases) were studied by chromosome banding after short-term culture. Acquired clonal aberrations were found in 25 tumors and a detailed analysis of these revealed extensive cytogenetic intratumor heterogeneity. Apart from six carcinomas with one clone only, 19 tumors displayed from two to 58 clones, bringing the total number of clones to 230. Karyotypically related clones, signifying evolutionary variation, were found in 16 tumors, whereas unrelated clones were present in nine, the latter finding probably reflecting a distinct pathogenetic mechanism. The cytogenetic profile of pancreatic carcinoma was characterized by multiple numerical and structural changes. In total, more than 500 abnormal chromosomes, including rings, markers, homogeneously stained regions, and double minutes, altogether displaying 608 breakpoints, were detected. This complexity and heterogeneity notwithstanding, a nonrandom karyotypic pattern can be discerned in pancreatic cancer. Chromosomes 1, 3, 6, 7, 8, 11, 12, 17, and 19 and bands 1q12, 1q21, 3q11, 6p21, 6q21, 7q11, 7q22, 7q32, 11q13, 13cen, 14cen, 17q11, 17q21, and 19q13 were most frequently involved in structural rearrangements. A total of 19 recurrent unbalanced structural changes were identified, 11 of which were not reported previously: del(1)(q11), del(3)(p11), i(3)(q10), del(4)(q25), del(11)(p13), dup(11)(q13q23), i(12)(p10), der(13;15)(q10;q10), del(18)(q12), del(18)(q21), and i(19)(q10). The main karyotypic imbalances were entire-copy losses of chromosomes 18, Y, and 21, gains of chromosomes 7, 2, and 20, partial or whole-arm losses of 1p, 3p, 6q, 8p, 9p, 15q, 17p, 18q, 19p, and 20p, and partial or whole-arm gains of 1q, 3q, 5p, 6p, 7q, 8q, 11q, 12p, 17q, 19q, and 20q. In general, the karyotypic pattern of pancreatic carcinoma fits the multistep carcinogenesis concept. The observed cytogenetic heterogeneity appears to reflect a multitude of interchangeable but oncogenetically equivalent events, and the nonrandomness of the chromosomal alterations underscores the preferential pathways involved in tumor initiation and progression.
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PMID:Cytogenetic analysis of pancreatic carcinomas: intratumor heterogeneity and nonrandom pattern of chromosome aberrations. 973 11


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