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)

Patients with cranial nerve palsies and roentgenographic evidence of sphenoid sinus destruction present diagnostic problems. Although the presence of local primary neoplasms may be considered first, metastatic disease from distant sites also should be considered. We report on eight patients with metastatic tumors to the sphenoid sinus seen at the Mayo Clinic from 1950 through 1976. Primary sites of the lesions included the breast, thyroid gland, lung, kidney, and prostate (two patients). Metastatic myeloma was seen in two patients. Symptoms resulted from involvement of the structures adjacent to the sphenoid sinus and in all patients included diplopia or decreased visual acuity. In four patients, these ocular symptoms were the first sign of disease, after which a complete general examination disclosed the occult primary sites.
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PMID:Metastatic tumors to the sphenoid sinus. 45 57

A 47-year-old white man in apparent good health had diplopia and swelling of the right upper eyelid. Ocular examination showed proptosis of the right eye, together with a large, pulsatile, collapsible mass simulating a vascular neoplasm and involving the right temple as well as the right upper outer quadrant of the orbit. Biopsy of the orbital tumor disclosed a clear-cell carcinoma compatible with a renal primary tumor; subsequent laboratory examination revealed the offending tumor in the left kidney. Renal carcinomas may metastasize to the globe or to the orbit before the primary tumor is recognized. Pulsatile exophthalmos acquired in middle life associated with significant bone destruction represents a constellation of findings most consistent with a metastatic tumor, probably renal carcinoma, caused by the exceedingly rich vascularization of these metastatic deposits.
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PMID:Pulsating metastatic tumor of the orbit. 67 3

A 61-year-old man presented with macroscopic haematuria. Infiltrating transitional cell carcinoma of the urinary bladder was diagnosed after transurethral resection, and he was treated first with three doses of cisplatinum (100 mg/m2 at three week intervals) and then by radical cystectomy. Eleven months later he complained of progressive diplopia, which was found on computed tomography to be caused by a retro-orbital metastatic mass. There was no evidence of a space occupying lesion in the brain or of other metastases. The patient died four weeks later and permission for necropsy was refused. Despite the fact that carcinoma of the urinary bladder rarely metastasis in this way, urologists should be aware that it can happen.
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PMID:Metastasising carcinoma of the urinary bladder presenting as a retro-orbital mass. Case report. 204 79

The authors reviewed the clinical and histopathologic records of 38 patients with metastatic orbital tumors. Diplopia, ocular motility limitation, and mass effect with displacement, proptosis, or palpable mass were common signs and symptoms. Enophthalmos occurred in 25% of cases. The authors found that the clinical presentations could be broken down into four generalized syndromes of presentation: infiltrative (20 cases, 53%); mass (14 cases, 37%); inflammatory (2 cases, 5%); and functional (1 case, 3%). An infiltrative pattern of presentation may be a clue to the metastatic nature of the orbital tumor. There may be no history of systemic cancer; in 25% of the patients in this series, the orbital tumor was the initial manifestation of systemic disease. Although the prognosis is poor for patients with metastatic cancer (average survival in this series, 10.2 months), modern treatment methods continue to improve and long-term palliation is often possible. The ophthalmologist plays a vital role in the diagnosis, histologic evaluation, and referral of these patients.
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PMID:Clinical characteristics of metastatic orbital tumors. 234 7

We report five cases of discrete solid tumor metastasis to extraocular muscles. Computed tomography confirmed that orbital involvement in all cases was confined to the extraocular muscles; there was no tumor in the bony orbit or in the adjacent paranasal sinuses or intracranial space. In two of our five cases, ophthalmic signs were the first evidence of metastatic disease; in the three other cases, there was a known history of cancer prior to orbital involvement. Pain, diplopia, and proptosis were the most common presenting manifestations. Neuroimaging demonstrated bilateral focal, nodular enlargement of multiple extraocular muscles in three cases. Diffuse enlargement of a single muscle occurred in the two other cases, inclusive of the tendinous insertion in one instance. Fine-needle aspiration biopsy provided a diagnosis of undifferentiated malignancy in all four cases in which it was performed.
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PMID:Discrete metastasis of solid tumors to extraocular muscles. 240 28

The clinicopathologic features and the results of diagnostic studies were reviewed in five patients with primary orbital liposarcoma. The major clinical complaints were diplopia and proptosis; visual function was typically well maintained. In three cases, computed tomographic (CT) scans displayed lesions with a central fat density rimmed by a variably radiodense pseudocapsule, leading to the erroneous clinical impression that the lesions were cystic in character. Ultrasonography ruled out a truly cystic tumor by demonstrating internal acoustic interfaces. Magnetic resonance imaging (MRI) in one case showed hyperintense signals in T-1-weighted images, suggesting the presence of fat within the lesional tissue. In the other two cases, CT scans showed reticulated densities accentuating the septa of the orbital fat in the absence of clear-cut circumscription. A potentially useful feature pointing to a neoplasm was bowing of an involved extraocular muscle, which is usually straightened and splinted in either Graves' disease or inflammatory pseudotumor. Histopathologically, two lesions were well-differentiated liposarcomas and three were myxoid liposarcomas, all featuring univacuolar signet ring lipoblasts. Scattered bizarre hyperchromatic mesenchymal cells without prominent lipidization were present in the lesions. None of the patients has experienced regional or distant metastases with follow-ups from onset of 1 to 7 years (mean, 5.2 years); three required orbital exenteration after local recurrence; and two who refused exenteration received only orbital radiotherapy.
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PMID:Primary liposarcoma of the orbit. Problems in the diagnosis and management of five cases. 270 36

Clinical, echographic, radiological (CT, NMR), and histopathological findings in a 57-year-old male patient who presented with proptosis of the left eye and diplopia caused by a histologically proven metastasis of a clinically silent small-cell carcinoma of the lung. Echographic problems of the differential diagnosis of orbital metastases are discussed.
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PMID:[Echographic findings in metastization in an extraocular muscle]. 282 18

A patient with rapidly progressive metastatic gastric carcinoma developed diplopia and diminished adduction of the right eye. The right medial rectus muscle belly was enlarged, as shown by computed tomography. This case is unusual, because gastric carcinoma comprises only 1% of orbital metastases and less than 5% of all orbital metastases localize to extraocular muscle.
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PMID:Acquired divergent strabismus: presumed metastatic gastric carcinoma to the medial rectus muscle. 291 14

Four patients with histologically confirmed parasellar metastases are reported. The main symptoms and signs were persistent right facial pain followed by diplopia (patient 1), headache and minimal right abducens palsy (patient 2), acute, total left ophthalmoplegia (patient 3), and acute, total bilateral ophthalmoplegia (patient 4). Positive radiologic evidence was present only in patient 1: there was bony erosion of the petrous apex and computed tomography scan showed an enhanced parasellar mass. This patient underwent partial surgical removal of the tumor. Patient 3 was treated with irradiation. All patients died within 14 weeks of the onset of the initial symptoms and all were autopsied. Their primary lesions were hepatoma, stomach cancer, lung cancer, and mesenteric liposarcoma.
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PMID:Parasellar metastases: four autopsied cases. 298 Nov 20

Adenoid cystic carcinoma of the nasopharynx is a rare disease with 34 previously reported cases in the literature. We report three additional cases with clinical presentation, treatment, and outcome. The presenting symptoms were facial pain in one case, middle ear effusion and epistaxis in another, and diplopia in the third. Radiotherapy was administered with relief of symptoms in all three cases. However, two patients with long-term follow-up developed local recurrence as well as distant metastases. The literature review showed that patients with this disease present with symptoms and signs such as insidious onset of facial pain, epistaxis, diplopia, and hearing loss. The final outcome, despite vigorous treatment, was dismal.
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PMID:Adenoid cystic carcinoma of the nasopharynx. Case reports and literature review. 299 Mar 13


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