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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.
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PMID:Role of radiation therapy in the management of neoplasms of the central nervous system. 18 Jul 77

A case is discussed in which the patient presented with a primary extradural sacrococcygeal ependymoma and synchronous pulmonary metastasis. The clinical course has been characterized by recurrent pulmonary metastases. Management has consisted of repeated surgical resections of the pulmonary metastases and the tumor at the primary site; and the use of a wide spectrum of chemotherapeutic agents. Transplantation of this tumor into nude mice initially resulted in rapid growth but there was spontaneous regression in the second transplants. A general discussion of the management of such lesions is presented, and the literature pertaining to this tumor is discussed.
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PMID:Metastasizing extradural ependymoma of the sacrococcygeal region: case report and review of literature. 37 64

The potential of ependymomas to spread throughout the intracranial subarachnoid space is well documented, though the incidence is disputed. This relates in part to the time required for such metastases to produce symptoms. The diagnosis of such spread, however, is important for therapeutic management. This report demonstrates the effectiveness of computerized tomography in diagnosing spread of ependymoma throughout the basal cisterns and cerebral fissures.
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PMID:Subarachnoid spread of ependymoma: diagnosis and evaluation of therapy by computerized tomography. 53 51

Immunoelectrophoresis of extracts of 200 intracranial tumours against rabbit anti-glioblastoma serum gave positive results (= precipitation) in all cases of tumours of neuroectodermal origin such as glioblastoma, astrocytoma, oligodendroglioma, ependymoma, neurinoma, and spongioblastoma. No immunoelectrophoretic precipitation was seen for any of the tumours of mesenchymal origin, for instance meningioma and metastases of cancer. On the basis of these findings, immunoelectrophoresis is considered to be a reliable method for differentiation between tumour tissue of neuroectodermal and non-neuroectodermal origin. Among the 41 posterior fossa tumours some unusual observations were made. Cerebellar angioblastoma (Lindau tumour) showed an atypically located precipitation line, which for the present is interpreted as an immunological reaction to vascular wall tissue. Furthermore, among the group of so-called medulloblastomas, two subgroups were distinguished on the basis of three parameters. The first of these subgroups comprises tumours whose immunoelectrophoretic pattern resembles that of gliomas, which are histologically characterized by neuroectodermal structures and which occur in younger children (5--10 years). The tumours of the second subgroup, which do not show this neuroectodermal immunoelectrophoretic pattern, have a sarcomatous character histologically, and occur in patients aged between 10 and 50 years. The view that medulloblastoma comprises a number of different types of tumour seems to be confirmed by this finding.
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PMID:Immunoelectrophoresis in the diagnosis of neuroectodermal and mesodermal intracranial tumours, especially those of the posterior fossa. 57 8

The course of 36 patients with medulloblastoma and ependymoma was evaluated prospectively by clinical examination, radionuclide (RN) studies and computed tomography (CT). Seventeen of the 36 patients (47%) had tumor recurrence. Twelve (41%) of the 29 patients with medulloblastoma had recurrent tumors of which 7 of 12 (58%) were at the primary site and 2 of 12 (17%) were within the ventricles while 10 of 12 (83%) were in the subarachnoid space. Five of the 7 patients with ependymoma had recurrent tumors. In 4 of the 5 patients tumor recurred at the primary site while subarachnoid seeding occurred in 2 of 5 patients (40%) and intraventricular metastases were found in 4 of 5 patients (80%). Progressive ventricular enlargement often accompanied subarachnoid seeding, presumably secondary to obstruction of cerebrospinal fluid (CSF) flow in the subarachnoid pathways. CT and RN scans were frequently complementary in detecting tumor recurrence.
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PMID:Computed tomography in the follow-up of medulloblastomas and ependymomas. 66 26

The results of histological and ultrastructural investigations of a tumour of the type of myxopapillary ependymoma growing initially extradurally in the end-part of the vertebral canal are reported. The patient has been observed for 13 years. During the disease several recurrences and distant metastases outside the central nervous system were observed. Histological examinations were carried out of the primary tumour and recurrences or metastases and always an evident papillary structure of tissue was found with characteristic "oedematous" stroma. In submicroscopic investigations attention was called to the stroma and to the ultrastructure of neoplastic cells. Slit-like spaces with numerous microvilli protruding into their lumen were observed between the neoplastic cells lying pallisade-like on the surface of papillae. These slits seemed on cross-sections to be minute tubular structures. This submicroscopic feature was not paid attention to in two previous papers discussing the ultrastructure of myxopapillary ependymoma.
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PMID:[Ultrastructure of ependymoma myxopapillare]. 67 24

A case is described in which a metastatic ependymoma of the cauda equina recurred after prolonged remission. Similarities to five previously reported cases are discussed, with emphasis on the mode of metastasis. Factors most closely associated with distant metastases include early onset, numerous local operations, long survival, and massive local recurrence at the time of distant metastases.
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PMID:A metastasizing ependymoma of the cauda equina. Case report. 90 42

The case of an eight-year old male with a pineal tumor is reported, in which metastases occurred to extraneural organs. The pineal tumor consisted of portions of benign teratoma, malignant ependymoma and embryonal carcinoma. Only the embryonal carcinoma metastasized. The intracanial and spinal subarachnoid space alos was invaded by disseminated embryonal carcinoma. There have been seven other similar cases reported. All patients were males from five to 34 years of age.
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PMID:Extraneural metastasis of pineal tumor. 111 Nov 47

1954 to 1989, 33 patients with intracranial ependymomas had primary treatment in our hospital with surgery and postoperative radiotherapy. Five- and ten-year survival rates were 48% and 34% in 25 patients with a high-grade ependymoma and for low-grade ependymomas was maintained at 78% for both the five- and ten-year follow-up period. Cumulative frequency of local or intracranial recurrence was 70% (high-grade) and 20% (low-grade). Despite the fact, that only three of 25 patients with high-grade ependymomas had spinal irradiation with 19.5 to 30 Gy, there was only a single patient with clinical signs of spinal metastases simultaneously with an intracranial recurrence. Twelve out of 13 living patients without signs of tumor have been classified according to the neurological performance: Performance was good or very good in five patients, satisfying in three with an independent life, fair in two patients working in a sheltered office and dependent on some assistance and poor in two patients. Published results are discussed and compared with the own observations and our current treatment policy is given.
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PMID:Long-term follow-up in 39 patients with an ependymoma after surgery and irradiation. 141 24

Ependymomas, glial neoplasms usually arising in the posterior fossa or spinal cord, rarely metastasize outside the central nervous system. We have reviewed all 81 ependymomas evaluated at MSKCC between 1956-1989. Five (6.2%) had extraneural metastases (ENM). The primary tumor was in spinal cord in 3 patients and the cerebral hemisphere in 2. Two tumors were histologically anaplastic; 3 were histologically benign. The 5 patients were 3, 3, 3.5, 16 and 37 years old. Time from initial diagnosis to development of ENM was 0, 15, 35, 40, and 288 months. At the time of ENM the primary tumor was progressing in 4/5 patients. Prior therapy had included resection plus radiation therapy (RT) (1), RT plus chemotherapy (1), resection plus RT plus chemotherapy (2). One patient had not received prior therapy because ENM were present at diagnosis. The sites of ENM included lung and thoracic lymph nodes (2), pleura and peritoneum (2), and liver (1). Both patients with peritoneal ENM had had ventriculoperitoneal shunts. ENM did not correlate with histologic grade, age, or degree of surgical resection. When patients with ependymoma develop signs or symptoms of systemic disease such as abdominal pain, cough, or adenopathy, ENM should be considered.
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PMID:Extraneural metastases in ependymoma. 143 36


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