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)

Hemangiopericytoma is a rare vascular tumor featuring the uncontrolled proliferation of pericytes. This tumor tends to develop in subcutaneous tissue and skeletal muscle. The localization of hemangiopericytoma in the orbit is particularly rare. Clinical signs and symptoms are, in order of frequency, proptosis, perception of an intraorbital mass, pain, diplopia, reduction of visus, tumescence, and ecchymoses of the eyelids. Hemangiopericytomas have higher potential of relapse, local invasiveness, and the possibility of producing distant metastases. Surgery must be as radical as possible to avoid incomplete tumor resection and high frequency of relapse together with increased duration of the disease and a higher risk of malignant development. The current report is a study of two cases of hemangiopericytoma in the orbital cavity treated at the Unit of Maxillo-Facial Surgery of the University of "La Sapienza" in Rome. The present data demonstrate that complete en bloc excision of the mass with its capsule is important to avoid the risk of relapse. To this end, an appropriate first surgical treatment should be chosen so as to obtain a wide "surgical light" and complete view of the mass. In the reported cases, the use of a combined anterolateral approach was preferred to attack the tumor from different sides. Indeed, such an approach allows one to obtain optimal exposition of the orbital region and temporal and infratemporal fossae contemporaneously.
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PMID:Surgical treatment of recurrent orbital hemangiopericytoma. 1470 75

In our hospital, 24 patients who underwent surgery for breast cancer during 1980 to 2001 were diagnosed with metastasis to the eye. Metastasis to the choroid was found most frequently, making the choroid the most common site of metastasis. A few patients had metastasis to the orbit. Decreased visual acuity and tunnel vision were frequently found in patients who had metastasis to the choroid, and ocular floaters and blurred vision were also found in a few patients. Patients with metastasis to the orbit showed diplopia caused by ocular dyskinesia and eyelid swelling. The mean postoperative period until the diagnosis with metastasis to the eye was 3 years and 2 months, with most cases diagnosed between 20 and 40 months postoperatively, a relatively long period. We performed radiotherapy in 21 of the 24 patients, and more than half of the patients showed improvement. The mean survival period after diagnosis with metastasis to the eye was 10 months, and some of them already had recurrence to other organs such as the bones or lungs. Examination with consideration of metastasis to the eyes is required to improve the quality of life of cancer patients,.
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PMID:Clinical study on the metastasis to the eyes from breast cancer. 1476 63

Paraneoplastic neurologic syndromes are disorders of the nervous system function caused by cancer but not due to metastatic disease, vascular or metabolic deficits, infections, nutritive deficiency, nor side effects of antineoplastic drugs or irradiation. Immunologic factors probably play the crucial role in the pathogenesis of paraneoplastic neurologic syndromes, but nonimmunologic mechanisms that include metabolic abnormalities and competition for substrate are also involved. Paraneoplastic cerebellar degeneration most commonly occurs in the setting of gynecologic cancers, but it accompanies the small-cell lung cancer too. Other tumors are infrequently associated with cerebellar degeneration. Several paraneoplastic antibodies have been identified in patients with paraneoplastic cerebellar degeneration. Their association with particular cancers may help identify an occult lesion. Anti-Yo antibodies are directed against Purkinje cell antigens and occur in patients with cerebellar degeneration who have breast cancer or gynecologic tumors. A target antigen of anti-Yo antibody is CDR2 protein that is normally expressed only in the brain and testis. Patients with paraneoplastic cerebellar degeneration present with dizziness, nausea and vomiting followed by gait instability, diplopia, gait and appendicular ataxia, dysarthria and dysphagia. Therapeutic options include tumor excision, chemotherapy and/or irradiation, and adjuvant therapy with glucocorticoids, immunoglobulins and plasmapheresis. The role of plasmapheresis in the treatment of paraneoplastic cerebellar degeneration is still uncertain. Reports of its efficacy are anecdotal. We present patient with paraneoplastic cerebellar degeneration with positive anti-Yo antibodies and tumor of the ovaries whose neurologic status significantly improved after four daily plasmaphereses, which was accompanied by a fourfold decrease in the anti-Yo antibodies titer. Further investigations are needed to define a protocol for plasmapheresis in the treatment of patients with paraneoplastic syndromes.
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PMID:[Importance of plasmapheresis in the treatment of paraneoplastic cerebellar degeneration]. 1512 96

Metastatic cancer must be considered as a possibility for intrasellar masses. Newer treatment modalities, such as gamma knife radiosurgery needs to be explored for these lesions. Three cases of intrasellar metastatic lesions were retrospectively reviewed. Presenting complaints, radiographic studies, operative procedure, and histopathological confirmation were recorded for each patient. All had an unknown primary malignancy prior to the presentation with the intrasellar lesion detected by magnetic resonance imaging (MRI). Presenting symptoms were diplopia with extraocular movement deficits in all patients. Transsphenoidal resection or biopsy was performed. Histopathological analysis revealed small cell carcinoma in two patients and plasmacytoma in one. All patients received postoperative radiation and/or chemotherapy. Survival following initial presentation was 2 months and 6 months for two of the patients; the third patient is alive at 2-month follow-up.
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PMID:Metastatic lesions involving the sella: report of three cases and review of the literature. 1547 29

It is relatively unusual that initial symptoms of renal cell cancer begin with the metastatic involvement of other sites. Intracranial metastases especially in the paranasal sinuses may be unusual not only to surgeons but also to physicians. In this report, we present a case where a metastasis was first manifest as a sphenoid sinus secondary with ocular and visual disturbances prior to the demonstration of the primary tumor site. It turned out to be a case of diplopia masquerading as a metastatic renal cell cancer.
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PMID:Diplopia - an unusual primary manifestation of metastatic renal cell carcinoma. 1553 54

A 75-year-old woman had gradually progressive binocular diplopia and 2 months later had breast cancer diagnosed. Examination showed bilateral external ophthalmoplegia with lid retraction and lag and no pupillary abnormalities. Orbital magnetic resonance imaging showed enlargement and enhancement of all extraocular muscles bilaterally. A right orbital biopsy was consistent with metastatic breast carcinoma. Positron emission tomography, bone scan, and computed tomography of the chest, abdomen, and pelvis failed to disclose other evidence of breast cancer metastases. It is unusual to encounter metastatic breast cancer affecting every extraocular muscle before the diagnosis of the primary carcinoma.
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PMID:Multiple bilateral extraocular muscle metastases as the initial manifestation of breast cancer. 1575 32

Cavernous sinus syndrome (CSS) may be caused by a wide range of pathological process among we include metastatic disease. A case of a woman whose breast neoplasm was initially expressed by a CSS is discussed in this article. We describe a 64-year-old woman with several weeks progressive course of pain and numbness in her left-side facies and occasional diplopia. Neurological examination showed left ptosis, limitation of elevation of left eye and abducens nerve palsy as well as hypoesthesia in the frontal and maxillary regions of her left-side facies. Brain magnetic resonance imaging (MRI) scan revealed the presence of a mass in the orbit and left cavernous sinus. General examination disclosed a sclerotic and retractile lesion in her left breast which involved the nipple suggesting breast carcinoma metastases. The patient underwent a breast fine-needle aspiration biopsy which established the presence of an infiltrating breast carcinoma. This case shows the importance role of the general physical examination to determine the etiology of the CSS. It is necessary and fundamental to perform it on each patient not only to orientate further investigations but also to avoid more invasive diagnostic procedures.
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PMID:[Cavernous sinus syndrome: an initial expression of a breast carcinoma]. 1581 52

A 47-year-old man had nasopharyngeal carcinoma (NPC). He received radiotherapy 10 years ago and was cancer-free after the treatment. However, diplopia occurred 1 year ago and became more progressive recently. An FDG-PET scan was performed to rule out the possibility of recurrence. No abnormal FDG uptake was demonstrated in the head and neck. However, an irregular area of increased FDG uptake was noted in the right lower lung. The plain chest x-ray showed barium retention in the same area, which might have resulted from aspiration of barium during gastrointestinal barium examination 2 years ago. A follow-up chest x-ray showed no apparent change and there was no evidence of metastases in the lung 6 months later.
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PMID:FDG-PET findings in barium aspiration. 1582 4

A 62-year-old woman presented with diplopia caused by bilateral sixth cranial nerve palsies. Two weeks later, she had bulbar weakness and ataxia. Brain magnetic resonance imaging showed non-specific abnormalities and spinal fluid was acellular but contained an elevated protein and oligoclonal bands. A paraneoplastic screen showed anti-Hu antibodies. Her clinical condition improved with immunoglobulin and systemic corticosteroid treatment. Breast cancer was diagnosed 21 months later by mammography but there were no metastases detected. Four and half years after the onset of her diplopia, she died of diffuse metastatic breast cancer. This is the first reported case of anti-Hu paraneoplastic brain stem encephalitis presenting with sixth cranial nerve palsies.
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PMID:Anti-hu paraneoplastic syndrome presenting as bilateral sixth cranial nerve palsies. 1593 31

Prostatic carcinoma accounts for only 3.6% of orbital metastases encountered in clinical practice. We report the clinical presentation and response to treatment of a patient with metastatic prostatic carcinoma to the sella turcica. A 73-year-old man presented with a three-months history of progressive right proptosis associated with increasing diplopia in down-gaze and slightly decreased visual acuity. Gadolinium-MRI scans of the head revealed a left osteoblastic intrasellar mass, displacing the pituitary gland. Laboratory testing revealed a serum PSA level of 22 ng/ml. Transrectal ultrasound-guided biopsy revealed prostatic adenocarcinoma (Gleason score 4+3) in both lobes of the prostate. A bone scan was performed showing that the patient had multiple secondary bony lesions. Total androgen blockade was initiated. Moreover, he was referred for radiotherapy of this metastatic lesion to the sella turcica. The visual complaints regressed dramatically within the first month of the treatment. A follow-up MRI scan at 6 months showed almost complete involution of the orbital metastatic process. However the disease subsequently progressed and the patient died 22 months after diagnosis.
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PMID:Orbital metastasis as a first indication of prostate cancer: a case report. 1614 73


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