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 treacherous and deceptive nature of pheochromocytoma makes it crucial to detect and treat it promptly; otherwise it will almost certainly be fatal from cardiovascular complications or metastases. Hypertension occurring in patients with pheochromocytomas is sustained in about 50% and paroxysmal in the remainder; however, many patients remain normotensive. Hypertension attacks may be precipitated by physical activity, postural changes, anxiety, certain foods or wine, some drugs, operative procedures, etc. Cardinal manifestations are paroxysmal hypertension, headache, palpitations +/- tachycardia, inappropriate sweating; anxiety, tremulousness, pallor (rarely flushing), chest and abdominal pains; nausea and vomiting often occur. Hypercatecholaminemia manifestations are more common and pronounced when paroxysmal hypertension occurs, but persons with familial pheochromocytoma may be asymptomatic. Protean manifestations of pheochromocytoma may simulate many conditions, some of which may have elevated plasma and urine catecholamines and their metabolites. Baro-reflex failure, postural tachycardia syndrome, sleep apnea, carcinoid, renal failure, and pseudopheochromocytoma may be diagnostic challenges. The history, physical examination, biochemical testing (after eliminating interfering drugs, when possible) for plasma and urinary metanephrines can usually establish or exclude presence of pheochromocytomas. Occasionally a clonidine suppression test is needed to differentiate neurogenic from pheochromocytic hypertension. Manifestations suggesting hypercatecholaminemia without hypertension are highly atypical of pheochromocytoma. Pheochromocytoma may present as panic attacks, pre-eclampsia, cardiomyopathy, infection with fever and leucocytosis, diabetes, migraine, shock, Cushing's syndrome, multiple organ failure with lactic acidosis, neurological manifestations, transitory electrocardiogram abnormalities, constipation, intestinal obstruction, visual impairment, convulsions, etc. The key to diagnosis is always to think of pheochromocytoma in the differential diagnosis of hypertension.
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PMID:The protean manifestations of pheochromocytoma. 1924 99

We report a case of a brain metastasis of thyroid papillary carcinoma. A 50-year-old man suffered generalized convulsion. MRI showed a mixed intensity mass with a perifocal low intensity rim in T2WI, mimicking cavernous angioma. The patient underwent craniotomy and total removal of the mass. The resected specimen revealed thyroid papillary carcinoma. Further examination showed a mass in his thyroid gland. Other distant metastases were not revealed. This is a case of a solitary brain metastasis of thyroid papillary carcinoma and the patient's initial symptom was caused by brain metastasis. Such cases are extremely rare. The mass was presurgically diagnosed as a cavernous angioma but was actually a case of brain metastasis. If we had not performed mass removal, we would not have been able to diagnose it as brain metastasis from thyroid papillary carcinoma and would have not taken appropriate steps toward further examinations and treatment. We must manage carefully a mass resembling cavemous angioma in MRI in consideration of the possibility of its being another diseases such as a metastatic tumor.
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PMID:[Solitary brain metastasis of thyroid papillary carcinoma mimicking a cavernous angioma by MRI]. 1943 95

Papillary renal cell carcinomas (PRCCs) tend to metastasize to lymph nodes, while metastasis to the brain is extremely rare. We report the case of a man who had a brain metastasis of PRCC type 2. He was brought to our hospital due to the sudden onset of convulsions. Diagnostic imaging studies showed a metastatic brain tumor in the left parietal lobe, and a primary renal tumor in the right kidney, with paraaortal lymph node metastases. An excision of brain tumor was performed. The brain tumor had a papillary structure with eosinophilic cytoplasm. Five weeks later nephrectomy was carried out. Histological analysis of the nephrectomy specimen revealed the same papillary structure, which was compatible with PRCC type 2.
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PMID:Brain metastasis of a papillary renal cell carcinoma, identified as type 2. 1959 23

Cancer treatment has revolutionized from a "one size fits all" approach to a more individualized approach with the advancement of medicine and molecular biology. Several predictive and prognostic factors have been studied and applied to clinical practice to assist clinicians in cancer management. In breast cancer therapeutics, the appearance of biomarkers such as expressions of hormone receptor and human epidermal growth factor (HER) receptors has modified treatment strategies from chemotherapy to molecular-targeted therapy including endocrine therapy and anti-HER therapy. With better understanding of the molecular level of tumorigenesis, cancer pathogenesis and metastases, several novel biomarkers such as cyclo-oxygennase-2 enzyme and tyrosine kinases have been discovered and new anti-cancer agents have been introduced into the currently available treatments. The change has also modified pre-operative treatment for locally advanced and early breast cancers. The neo-adjuvant treatment indeed provides an excellent platform for translational research which is a widely used research method in clinical research. The study of gene and protein expressions from tissue and blood samples collected before, during and after neo-adjuvant treatment provides a lot of keys to decipher the signaling pathways and discover novel biomarkers which are essential for development of new drugs and prediction of the clinical outcome of therapy. The addition of gene expression profiling to conventional predictive factors will give more prognostic information to clinicians for better management of the disease.
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PMID:Gene expression profiles as an additional tool to conventional predictive factors to assist in management of early endocrine responsive breast cancer. 2037 25

The optimal approach to and the role of surgery in stage IIIA-N2 (ipsilateral lymph node metastases) non-small-cell lung cancer (NSCLC) remains a challenge for many clinical oncologists. Much of the question relates to the choice between a generalized or personalized approach. We should realize that a generalized approach--'chemoradiotherapy fits all'--as advocated by some based on Phase III trials--is not optimal for these patients, just as 'any platinum doublet fits all' is no longer the best choice in stage IV NSCLC. While chemoradiotherapy may be the choice for patients with bulky or multilevel N2-disease, for others surgery will be an important part of the multimodality treatment. To make this distinction, 'personalization factors' should be considered: complete resectability, downstaging of mediastinal nodes and favorable clinical and pathological response of the primary tumor. A personalized approach making the appropriate choice based on multidisciplinary assessment of stage, resectability and cardiopulmonary fitness is in the interest of each of our individual stage IIIA-N2 patients.
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PMID:Generalized or personalized treatment for stage IIIA-N2 non-small-cell lung cancer? 2049 93

Many difficult-to-treat solid cancer tumours and metastases have high-glucose uptake, usually under hypoxic conditions. Hypoxic tumours suppress the immune system and are insensitive to traditional chemoradiotherapies. The only therapy usually available is surgical resection. However, with widespread metastases, surgery often becomes unviable. Surgery in itself can also result in metastasis. The need for investigating adjuvant treatments is obvious. Here we investigate whether the high-glucose uptake of hypoxic tumours could lead to such a treatment. Before any treatment can be hypothesised, it is crucial to understand how this glycolytic cancer phenotype fits in with the normal body's blood glucose cycle. The brain creates the healthy body's largest demand for blood glucose (BG) and ensures a very high level of control on in vivo supply. It is hypothesised that, through somatic evolution, high-glycolytic cancer cells opportunistically tap into this very stable energy environment. It is shown that therapies which target the glycolytic cancers' high BG needs cannot be developed without addressing the brain's energy needs. Based on this knowledge, and to initiate thinking on potential BG therapies, a first attempt is made at hypotheses for potential control of the in vivo brain demand as well as the available in vivo BG. The aim is to adversely affect primary as well as metastatic tumours without damaging brain and innocent bystander cells.
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PMID:High-glycolytic cancers and their interplay with the body's glucose demand and supply cycle. 2095 Sep 42

We report a case of a 48-year-old man with a history of violent coughing fits and general fatigue underwent urgent surgery for cardiac tamponade, and who was later diagnosed with metastatic intracardiac squamous cell carcinoma of the esophagus. After admittance to Munakata Suikokai General Hospital, Fukuoka, Japan, echocardiography showed extensive pleural and pericardial effusion and a mass, 4 by 2 cm, with a solid echo pattern in the right ventricular cavity. The working diagnosis was primary malignant cardiac tumor of unknown origin with multiple metastases. To prevent sudden death due to obliteration of the outflow tract of the right ventricle, we performed urgent surgery for cardiac tamponade. Histological examination of the resected tumor revealed squamous cell carcinoma. Fiberoptic esophagoscopy showed hypertrophy of the esophageal wall and a submucosal tumor extending throughout the esophagus. Microscopic examination of the esophagus biopsy specimen showed moderately differentiated squamous cell carcinoma, the histology of which was similar to that of the resected tumor and cytology of pericardial effusion. The patient recovered and was able to return home for a few days; however, he was readmitted, and despite maximal supportive therapy, he died one month after the operation.
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PMID:Intracardiac metastasis of esophageal squamous cell carcinoma -report of a case-. 2159 14

A 30-year-old female presented with an episode of generalized tonic-clonic convulsions. The imaging revealed multiple hemorrhagic lesions in the brain. There was no significant past history except for a cardiac surgery two years ago, for a benign atrial myxoma. The diagnosis of probable metastases was thought of and a thorough workup was planned, to determine the primary. Surprisingly, no primary lesion was detected, and therefore, as a histological diagnosis was required, she underwent navigation-guided excisional biopsy of one of the lesions. The histopathology proved that it was a myxomatous lesion. Thus, a rare diagnosis of atrial myxoma presenting as hemorrhagic metastases of the brain was formed. Atrial myxoma is a benign tumor of the heart. It can embolize distally and can present with known embolic/ischemic manifestations. However, presentation as hemorrhagic mass lesions, involving multiple areas of the brain, after many years of complete surgical excision, is quite rare and is rarely considered as a differential diagnosis. Hence, such a possibility should be kept in mind and careful primary cardiac intervention, with preventive measures to minimize the chances of distal embolization should be undertaken. As only few such cases have been reported worldwide, no treatment protocol has been devised at present, and a close follow-up of these patients is warranted.
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PMID:A rare diagnosis of multiple hemorrhagic metastases in brain. 2194 Oct 60

Melanoma has a high propensity to metastasize to the brain, and this is often responsible for treatment failure in patients with advanced disease. Melanoma patients with brain metastases are usually excluded from clinical trials because of their expected survival of approximately 5 months. A growing body of evidence suggests that ipilimumab, a human monoclonal antibody that blocks cytotoxic T-lymphocyte antigen-4, has activity against melanoma brain metastases. We conducted a retrospective analysis of data from a phase II study of ipilimumab in advanced melanoma patients. Twelve of 115 patients randomized in the parent trial had stable brain metastases at baseline, as identified by an Independent Review Committee, and were evaluated for efficacy. Two of the 12 patients achieved a partial response and three had stable disease. Both patients with a partial response and one with stable disease were alive at the last follow-up, with survival time of more than 4 years. The median overall survival of the 12 patients was 14 months (range: 2.7-56.4+). An additional four patients with stable brain metastases at baseline were identified by a secondary Independent Review Committee reviewer, and were evaluated for safety. Central nervous system-related adverse events of grade 3-4, specifically cerebral edema and convulsion/seizure, occurred in two of 16 patients. Although the present study is limited by the fact that it is a retrospective analysis of a small number of patients, the results provide further evidence for the safety and efficacy of ipilimumab in melanoma patients with stable brain metastases.
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PMID:Safety and clinical activity of ipilimumab in melanoma patients with brain metastases: retrospective analysis of data from a phase 2 trial. 2205 8

The tumour suppressor gene hypermethylated in cancer 1 (HIC1) is a transcriptional repressor, which functionally cooperates with p53. Loss of HIC1 function is associated with the development of various tumor entities. The aim of this study was to elucidate the relevance of CpG island (CGI) methylation of HIC1 in renal cell carcinoma (RCC). DNA methylation of HIC1 was analysed in a total of 98 tumor and 70 tumor adjacent normal specimens. After conducting bisulfite conversion, relative methylation levels were quantitated using pyrosequencing. Relative methylation values were compared for paired tumor and normal specimen and for correlation with clinico-pathologic and follow-up data of patients. Tumor-specific hypermethylation could not be detected for the subregion of the HIC1 - CGI analyzed in this study. Comparing the level of methylation in tumors to clinicopathological data solely, patients without lymph node metastases demonstrated a higher level of methylation compared to patients with lymph node metastases (p=0.030). Patients recurrence-free survival (p=0.0074) both in univariate as well as bivariate cox regression analysis. This study identifies HIC1 hypermethylation in tumors as an independent predictor of reduced recurrence-free survival, which fits into our current understanding of hypermethylated HIC1 being a marker for poor prognosis. Therefore, HIC1 - CGI methylation could be a candidate marker to improve individualized therapy and risk stratification.
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PMID:Prognostic and diagnostic relevance of hypermethylated in cancer 1 (HIC1) CpG island methylation in renal cell carcinoma. 2232 10


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