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)

Dermatitis artefacta is a chronic skin lesion produced by self-trauma. Avoidance of further trauma, topical steroids and psychological therapy all play a part in the treatment of such lesions. Unresolved lesions may become large and disfiguring and subject to infection. We report a case of one such lesion in an elderly woman who persistently excoriated a cholecystectomy scar over 40 years. Malignant transformation occurred in a manner analogous to the neoplastic change observed in other types of chronic ulcer (Marjolin's ulcer). The squamous cell carcinoma presented with widespread metastases from which the patient eventually died. Recent literature concerning Marjolin's ulcers is reviewed and it is noted that this is the first reported case of death caused by malignant change in dermatitis artefacta.
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PMID:Malignant change in dermatitis artefacta. 823 14

Advances in vascular radiology techniques for superselective transfemoral arterial infusion prompted us to evaluate the effects of high-dose rapid regional carboplatin infusion for patients with advanced head and neck squamous cell carcinomas. Twenty untreated patients received three infusions of carboplatin (300-350 mg/m2) every 2 weeks with this method. All the infusions were performed without any complication. Treatment was well tolerated, with moderate (Grade 1-3 WHO) local toxicity (stomatitis, dermatitis and alopecia) and minimal (Grade 1-2 WHO) myelosuppression. The total response index (complete response plus partial response) was 94% for primary tumors and 50% for neck metastases. Neoadjuvant chemotherapy employing superselective rapid infusion of high-dose carboplatin is a feasible, relatively nontoxic, effective technique and may have important applications in multimodality therapy of untreated patients with advanced head and neck cancer.
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PMID:[High-dose carboplatin superselective intraarterial chemotherapy in advanced head and neck cancer]. 898 37

The two-stage theory of carcinogenesis attempts to reduce a very complex set of data to simple terms: it defines a carcinogen as "an agent that causes a neoplasm by a two-step process involving initiation and promotion". The theory has achieved the status of a paradigm, and all new experiments carried out by two-stage supporters are designed according to its premises and therefore will eo ipso tend to confirm it. Popper's dictum that any scientific hypothesis should be put to the strongest test, namely, by trying to refute it, has rarely (or never) been observed. The two-stage theory was originally based on standard mouse skin-painting experiments. All the original work is grounded on classic skin carcinogenesis, and only later was it extended to also comprise carcinogenesis in other organs, thereby becoming a general theory. On the basis of the same standard skin painting experiments and in accordance with Popper's dictum, the present review shows how the following generally accepted corollaries of the two-stage theory have been refuted: initiation must come first in time; in previously initiated mouse skin promotion always leads to a synergistic increase in tumor crop, whereas complete carcinogens at subthreshold does (regarded as merely initiating) have only an additive effect; the reverse experiment is innocuous; there is a qualitative difference between the effect of initiators and that of promoters; initiators only initiate at low dose levels, but abruptly become rather complete carcinogens at higher doses, promotion must take place over a long period, and repeated exposure without prolonged intervals is essential; pure initiators exist, for example, urethane for the epidermis; pure promoters exist, e.g., TPA; skin inflammation and persistent hyperplasia are essential parts of promotion; increased levels of the enzyme ODC followed by increasing levels of polyamines are casually involved in promotion; the appearance of many dark epidermal cells is a sign of promotion and the dark cells are stem cells from which tumors arise. Carcinogenesis is a very complicated process characterized not only by disturbances in cell cycle control, cell differentiation and/or maturation, but also by changes in the normal ability of cells to respect organ and tissue boundaries. Infiltrative growth and metastases are the most dangerous properties of cancer, and the two-stage theory does not provide an explanation for these two most serious aspects of the disease.
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PMID:Of mice and men: a critical reappraisal of the two-stage theory of carcinogenesis. 901 91

Cutaneous metastases may be the first clinical manifestation of a visceral carcinoma, its incidence fluctuates between 0.7 and 9% of the carcinomas and normally indicate a dismal prognosis. The most frequent morphologies of cutaneous metastases are metastatic nodules, sclerotic forms that appear as infiltrated and stiff plates, the inflammatory variety that resembles an erysipelatous plate, mammary and extra-mammary Paget's disease that appear as erythematous erosive and crusty plates resembling dermatitis.
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PMID:[Cutaneous metastases. Clinical pathological review]. 933 88

Between January 1993 and December 1996, 21 children with advanced solid tumors were entered in a dose-escalating study of high-dose sequential chemotherapy followed by autologous stem cell transplantation. The diagnoses included neuroblastoma (NB) for 13 patients; Ewing's sarcoma (ES) for six patients and osteosarcoma for two patients. Nine patients received therapy as consolidation for primary metastatic disease, and 12 patients had had previous relapses. Treatment consisted of CY given i.v. at a dose of 7 g/m2 on day 1, followed by G-CSF until myeloid recovery. After 3 weeks of rest, all patients were given thiotepa i.v. on days 22-24. The total dose of thiotepa was 450 mg/m2 in three patients, 600 mg/m2 in six patients, and 750 mg/m2 in 12 patients. Melphalan was given i.v. at a dose of 180 mg/m2 i.v. on day 27 followed by stem cell infusion on day 28. Major toxic reactions included stomatitis, esophagitis, diarrhea and dermatitis. Three patients died of treatment-related complications. Twelve patients have had a relapse. Six patients (five with NB and one with ES) are alive in continuous remission 5-50 months (median 36) after transplantation. The results of this study show that it is feasible to administer high-dose sequential chemotherapy to children with advanced solid tumors.
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PMID:High-dose sequential chemotherapy and autologous stem cell reinfusion in advanced pediatric solid tumors. 946 76

A 13-year-old neutered female domestic shorthaired cat had progressive ventral abdominal alopecia attributed initially to hyperthyroidism. Corrective treatment by unilateral thyroidectomy did not, however, resolve the dermatosis and the alopecia progressed to involve the whole ventral trunk, the lower limbs and the head. Pruritus of the lower limbs was a prominent feature and was associated with the finding of Malassezia on cytology; Malassezia-associated dermatitis was diagnosed. Resolution of pruritus was seen after treatment with oral ketoconazole and a cleansing shampoo to eliminate the yeast, but severe polyphagia, small intestinal diarrhoea and polydipsia developed subsequently and the cat was euthanased. Necropsy revealed an exocrine pancreatic adenocarcinoma with hepatic metastases. The pancreatic, hepatic and dermatological lesions were found to be typical of feline paraneoplastic alopecia (FPA). Malassezia-associated dermatitis can be associated with pruritus in cats with FPA.
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PMID:A case of feline paraneoplastic alopecia with secondary Malassezia-associated dermatitis. 974 76

Angiosarcoma (AS) is a rare, aggressive tumour of endothelial origin occurring in various clinical settings, including idiopathic AS on the head and neck in elderly people, lymphoedema-associated AS, post-irradiation AS, soft-tissue AS, and various others. Despite the widespread use of radiation therapy in the treatment of breast carcinoma, AS developing in the wake of a radiation therapy is extremely infrequent. Although there is little doubt that radiation in therapeutic doses can induce sarcomas, quantification of that risk is complicated by many variables, among them chronic lymphoedema. We describe a 70-year-old woman in generally good health who presented with a 2-year history of a maculo-papular eruption on the skin of her right breast. There was no lymphoedema of the thoracic area. The lesions developed 3 years after she had undergone ipsilateral quadrantectomy for an invasive ductal carcinoma followed by 25 tangent field radiotherapy sessions on the breast. The oncological follow-up did not disclose local recurrence of the tumour or metastases of breast carcinoma. Histopathologic examination of a papule was diagnostic for AS. In addition, signs of chronic radiation dermatitis were found in the biopsy specimens. The patient underwent monthly cycles of chemotherapy with intravenous doxorubicin with partial remission of the affected area after 24 months, followed by the occurrence of liver metastases and exitus 30 months after diagnosis. From the review of the literature, it appears that post-irradiation mammary AS mainly affects women over 60 who have undergone breast-sparing surgery and that it is usually associated with axillary lymphadenectomy. Whereas the role of lymphoedema does not seem relevant to the pathogenesis of this malignancy, the association with chronic radiation dermatitis in our case reinforces the supposed role of radiation in the development of this tumour. Onset of AS should be taken into consideration when treating patients who develop multiple lesions on the skin above the irradiated area, even many years after the therapy.
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PMID:Cutaneous angiosarcoma arising in an irradiated breast. Case report and review of the literature. 1545 28

We performed a clinical trial to assess the feasibility and efficacy of immunotherapy with peptides, tumor lysate or both peptides and tumor lysate-pulsed mature, monocyte-derived dendritic cells (DC) for advanced malignant melanoma patients that are resistant to conventional therapies. Sixteen patients were enrolled in this trial. All patients received DC vaccines i.d. in the proximal thigh, close to the inguinal lymph nodes, one treatment per week or 2 weeks. Several factors such as clinical findings, computed tomography (CT) images, delayed type hypersensitivity (DTH) response, enzyme-linked immunosorbent spot (ELISPOT) assay, and immunohistochemistry in primary, metastatic lesions and the DTH site were evaluated. Clinical results through DC vaccination were as follows: in 11 evaluable cases, three stable disease, six progression of disease and two disease-free from the time of study entry to the completion of one vaccination course. One patient showed reduction of the tumors in the metastases on chest CT during the first and second course of DC vaccination. Ten out of 14 evaluable cases showed positive DTH responses to more than one treatment with melanoma peptides or tumor lysate. Eight out of 13 evaluable cases showed positive immunological responses to more than one treatment with melanoma peptides or tumor lysate in an ELISPOT assay. As for the experiences with toxicity and adverse reactions, autosensitization dermatitis-like eruptions appeared in five cases during DC vaccination. No severe adverse effects were seen in any of the patients. In our study, the clinical efficacy in prolongation of the patients' survival was confirmed. At the same time, cancer immunoediting of the tumor was also found. It will be necessary to improve the tumor-specificity of this therapeutic approach and to analyze the mechanism(s) of tumor escape from immunosurveillance in melanoma.
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PMID:Vaccination of Japanese patients with advanced melanoma with peptide, tumor lysate or both peptide and tumor lysate-pulsed mature, monocyte-derived dendritic cells. 1684 18

The most common metastatic sites from gastric cancer are the liver, intra-abdominal lymph nodes, ovary and peritoneal cavity. Cutaneous metastasis of gastric cancer is rare, and most cutaneous metastases are typically solitary, nodular, have a firm consistency, and are red or hyperpigmented. Thus, cutaneous metastasis is easily distinguished from other skin disease. We report a case of a 60-year-old woman with cutaneous metastasis of gastric cancer, whose facial skin showed painless pruritic eczema, resembling acute dermatitis. She had earlier undergone a total gastrectomy for advanced gastric cancer in our hospital. After 14 months, she developed eczematous facial lesions; the presumptive diagnosis was acute dermatitis. However, skin biopsy unexpectedly revealed cutaneous metastasis of gastric cancer. After 6 months of systemic chemotherapy with capecitabine and cisplatin, the cutaneous metastasis was markedly improved and a clinically complete remission was accomplished.
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PMID:Cutaneous metastasis resembling acute dermatitis in patient with advanced gastric cancer. 1726 31

Neuroendocrine tumor consisting of pancreatic alpha-cells -- glucagonoma -- is a very rare finding (one case per two million people a year). This functionally active, usually malignant tumor has typical clinical manifestations. Glucagonoma syndrome is a disease that has an original clinical picture that includes necrolytic migrating erythema with secondary bullous dermatitis, glucose tolerance disorder or diabetes mellitus, weight loss, anemia, hypoaminoacidemia, venous thrombosis, and alimentary and mental disturbances. By the time diagnosis is made, 60 to 70% of glucagonomas already give metastases, and even small glucagonomas should be considered tumors with unknown malignant potential or malignant tumors. Glucagonomas grow slowly, and patients live long (the survival median is approximately 15 years). The authors describe their own observation.
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PMID:[A case of pancreatic glucagonoma]. 1792 96


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