Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Radiation therapy plays an important role as an adjunctive treatment modality with surgery and/or chemotherapy in a number of primary and secondary CNS neoplasms, including glioblastoma multiforme, lower grade gliomas, brainstem tumors, medulloblastoma, ependymoma, most pituitary and parapituitary tumors, brain metastases, and epidural spinal cord metastases; it also has an important function in the total management of childhood leukemia. Radiation therapy can also be extremely effective as the primary or sole treatment of pituitary adenomas, craniopharyngioma, and cerebral and epidural metastases. The relative roles of, and indications for, surgery versus irradiation have been discussed. There is clearly a need for more information regarding the natural history relative response of specific tumors to the various therapeutic modalities available, as well as the most effective and safe ways to combine treatments. To this end, it is mandatory that surgeons, radiotherapists, neurologists, pathologists, and internists begin to intercommunicate more freely and objectively. Hopefully, in areas that continue to be controversial, well-designed clinical trials can begin to furnish the necessary answers. This is particularly relevant as all of the disciplines mentioned are developing newer and hopefully more effective diagnostic and therapeutic capabilities.
 ...
PMID:Role of radiation therapy in the management of neoplasms of the central nervous system. 18 Jul 77

A basic and clinical study of radiosurgery using the linear accelerator (Linac) system for unremovable deep-seated brain tumors is reported. A Komai stereotactic ring was used to locate the target coordinates. The patient was laid on the Linac treatment table and held in the head fixation system. Irradiation was given in five positions. The dose profile by film dosimetry and Rando phantom was satisfactory. Seventeen tumors in 14 patients were treated. Clinical or histological diagnoses were nine metastases, one benign and two malignant gliomas, one meningioma, and one craniopharyngioma. Tumor sizes were between 8 and 30 mm. Doses were between 12 and 30 Gy. Computed tomographic evaluation after 3 months of 12 tumors in 11 survivors showed one complete remission, three partial remission, six no change, and two partial deterioration. For progressive tumors, Linac radiosurgery results are excellent.
 ...
PMID:Stereotactic radiosurgery using a linear accelerator. 138 47

Multiplanar capability and superior tissue contrast differentiation render magnetic resonance (MR) imaging the preferred method for examining patients with pituitary axis dysfunction or visual field deficits. In a review of 131 sellar or juxtasellar abnormalities, 76% were common lesions with distinctive features that helped establish their diagnosis: macroadenoma (n = 51), microadenoma (n = 20), meningioma (n = 14), craniopharyngioma (n = 10), and aneurysm (n = 5). On T1-weighted images, microadenomas were usually hypointense relative to normal pituitary gland, and macroadenomas and meningiomas were isointense relative to gray matter. Both microadenomas and meningiomas were more conspicuous immediately after contrast material administration. Craniopharyngiomas were the most heterogeneous of all the sellar lesions due to their cystic and solid components. MR images of aneurysms showed flow void and heterogeneous increased signal intensity in areas of slower turbulent flow. Other characteristics such as extrasellar versus intrasellar location, nature of contrast material enhancement, the presence of cystic components, and clinical findings permitted differentiation among less common lesions, including granulomatous disease, metastases, chiasmatic glioma, arachnoid cyst, hypothalamic glioma, schwannoma, germinoma, epidermoid, Rathke cyst, chordoma, chondrosarcoma, colloid cyst, and hamartoma.
 ...
PMID:MR imaging of the sellar and juxtasellar regions. 194 11

In collaboration with the Institute of Neurosurgery, La Sapienza Rome University, we have treated 214 patients with stereotactic irradiation. The series began in March 1984 and includes 198 cerebral tumours of different histology and 16 AVM. 73% of the patients had been operated on before irradiation. From this first experience the following considerations can be drawn: (a) radiosurgery is not an alternative to neurosurgery except for particular cases; neurosurgery is therefore essential because the smaller the target area the higher the efficiency of stereotactic irradiation; (b) compared to conventional radiotherapy, damage to the brain is minimized as shown by NMR. The follow-up time is too short to allow any definite conclusion. However, positive effects have been observed in malignant gliomas and single metastases. In craniopharyngiomas and pituitary adenomas, tumour growth was arrested or decreased with the disappearance of the tumour in 3 adenomas and 1 craniopharyngioma. With regard to the response of meningiomas to irradiation we have shown that radiosurgery is able to cause a decrease in tumour size as well as reduced contrast enhancement, probably due to vascular changes and fibrosis. In AVM the efficiency of radiosurgery has been further confirmed.
 ...
PMID:Radiosurgery in cerebral tumours and AVM. 305 30

In computed tomography (CT) of the head, some lesions may enhance after intravenous injection of contrast material as semisolid or semicystic lesions resembling a padlock. Thirty-five patients whose scans showed padlock-shaped enhancement patterns were followed up and proved to have the following: 12 gliomas, 9 abscesses, 8 metastases, 3 tuberculomas, 1 craniopharyngioma, 1 meningioma and 1 cystic prolactinoma. The sign is probably caused by excentric cavitation in a solid lesion, or partial-volume averaging of the capsule in an irregularly shaped cystic lesion.
 ...
PMID:The 'padlock sign' in computed tomography of the head. 724 95

The specificity of the computed tomography (CT) diagnosis of intrasellar adenoma has not been studied. We compared the CT findings in intrasellar meningiomas, craniopharyngiomas, aneurysms, and metastases with those of pituitary adenomas. Calcification was a features of intrasellar meningiomas, aneurysms, and craniopharyngioma,s but not a typical feature of adenomas. Low-density regions representing necrosis or cyst were found in most types of intrasellar tumors. Eccentricity, hyperostosis, and bone destruction were useful signs of aneurysm, meningioma, and metastasis, respectively. Since adenoma cannot always be distinguished from another intrasellar mass, angiography to demonstrate tumor angioarchitecture may be needed to characterize some neoplasms or to confirm an intrasellar aneurysm.
 ...
PMID:Differential diagnosis of intrasellar tumors by computed tomography. 730 25

The aim of this retrospective study was to assess the contribution of thallium-201 single-photon emission tomography (SPET) in the detection and differential diagnosis of brain tumours. In 90 patients 201Tl SPET was performed because of clinical or radiological suspicion of tumoral invasion, completed by technetium-99m hexamethylpropylene amine oxime and 99mTc-sestamibi SPET in some patients. For all tumours, diagnosis was based on biopsy or autopsy. Other diagnoses were made only after clinical and radiological follow-up for at least 6 months. Histologically tumours consisted of astrocytoma stage I or II (number of patients, n = 6), astrocytoma stage III (n = 8), glioblastoma multiforme (n = 14) and oligodendroglioma (n = 3), brain metastasis (n = 14), lymphoma (n = 3), meningioma (n = 3), pituitary adenoma (n = 2), pineal tumour (n = 1), colloid cyst (n = 1) and craniopharyngioma (n = 1). False-negative studies included pineal tumour (n = 1), colloid cyst (n = 1), craniopharyngioma (n = 1), astrocytomas stage I or II (n = 6) and stage III (n = 3), oligodendroglioma (n = 2) and metastasis in the brain stem (n = 1). Additional metastases approximately < 1.5 cm were not detected in two patients and 201Tl SPET underestimated tumoral extent in one patient suffering from glioblastoma multiforme (n = 1). A false-positive study was obtained in a patient with skull metastasis (n = 1). All 15 patients who were finally shown to suffer from ischaemic infarction had a normal SPET study 9-28 days after the onset of symptomatology. Of five patients with haemorrhagic infarction, studied within 2 weeks, four were false-positive. Of six patients with intracranial haemorrhage, studied 9-39 days later, one showed focal 201Tl accumulation. Two further false-positive studies consisted of angioma and epidural haematoma. Finally, SPET studies were normal in six patients with definite diagnosis of (reactive) gliosis (n = 3), Binswanger's encephalopathy (n = 1), postinfectious encephalopathy (n = 1) and multiple sclerosis (n = 1). In the patient population presented, sensitivity of 201Tl SPET for supratentorial brain tumours was 71.7% and specificity was 80.9%. Clinical information and control SPET studies in combination with early, 30-min and 3- to 4-h delayed imaging may be expected to improve on these figures. On the other hand it seems that, in addition to tumoral histology, the presence of tumours in the fossa posterior and small volumes contribute to the occurrence of false-negative 201Tl SPET studies.
 ...
PMID:Sensitivity and specificity of thallium-201 single-photon emission tomography in the functional detection and differential diagnosis of brain tumours. 795 48

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.
 ...
PMID:Delayed cerebral radiation necrosis. 815 88

Craniopharyngioma is a rare neoplasm in the rat, and few cases have been described. These lesions are thought to originate from squamous cell remnants of Rathke's pouch, an evagination of primitive stomatodeum. This neoplasm is usually locally invasive, and neither cranial nor extracranial metastases have been described. A spontaneously occurring malignant, metastasizing craniopharyngioma arising from the neurohypophysis was detected in a 2-year-old male albino rat. The infiltrative growth was observed in the wall of the vessels of the circle of Willis, in the perivascular space of Virchow and Robin, in the submeningeal space near the hypothalamus, through the fissura chorioidea, in the medulla oblongata, and along the optic nerve into the periocular region. Metastases were detected in the thalamus and hippocampus. The diagnosis was made on the basis of microscopic, immunocytochemical and ultrastructural findings.
 ...
PMID:Spontaneous malignant craniopharyngioma in an albino rat. 906 81

The current, highly sophisticated, brain imaging techniques and three dimensional (stereotactic) mapping of intracranial targets, combined with recent developments in concentration of radiation therapy (x- or gamma-ray) onto these targets, have allowed obliterative treatment for many intracranial diseases previously the preserve of the neurosurgeon alone. Vascular malformations, acoustic neuroma, complex meningioma, pituitary adenoma and craniopharyngioma all fall into this category, as well as base of skull tumours. There are occasional indications for single (a few) cerebral metastases and possibly a highly selected role in primary malignant brain tumours. The subject of so-called 'radiosurgery' is an important and developing one and is complementary to modern neurosurgery.
 ...
PMID:Stereotactic intracranial radiotherapy/radiosurgery has come of age. 1090 23


1 2 3 Next >>