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)

We examined the signal intensity on diffusion-weighted imaging and the apparent diffusion coefficients (ADC) relative to normal cerebellum of the solid portions of 10 cerebellar haemangioblastomas and 12 other cerebellar tumours: three metastases, three medulloblastomas, three malignant lymphomas, an atypical teratoid rhabdoid tumour, an ependymoma and a subependymoma. The tumours were confirmed histopathologically except for one metastasis with pathological diagnosis of the primary lesion. In nine of the haemangioblatomas, the solid and contrast-enhancing portions gave low signal on DWI, but this was not seen in the other tumours. The ADC was increased in haemangioblastomas. These findings may indicate rich vascular spaces of the haemangioblastomas. DWI may be useful for distinguishing haemangioblastomas from other enhancing cerebellar tumours.
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PMID:Diffusion-weighted MRI of haemangioblastomas and other cerebellar tumours. 1268 3

Ependymomas are uncommon neoplasms of the central nervous system (CNS), and as a consequence, few randomized, clinical trials have been performed, thereby limiting treatment guidelines. A review of the literature would permit the following conclusions regarding treatment. The best management of newly diagnosed ependymoma entails a complete resection corroborated by postoperative contrast-enhanced magnetic resonance imaging (MRI). If an incomplete resection is documented, a second attempt at gross total resection should be considered, given the prognostic significance of complete resection. Small volume residual disease is best managed with involved-field radiotherapy unless postoperative staging (cerebrospinal fluid cytology, neuraxis MRI) documents metastatic disease, which is best managed by craniospinal irradiation. The role of chemotherapy is uncertain and in general would be reserved for patients having previously failed surgery and radiotherapy. Disease-free survival following recurrence is unusual (<15% at 5 years) and suggests intensification of initial adjuvant treatment may best prevent relapse.
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PMID:Ependymomas. 1269 23

The March COM. A 41-year-old woman presented in 1997 with diffuse abdominal pain, meteorism and intermittent diarrhea. Imaging studies revealed a focal rounded lesion in the liver. Although there was no history of progesterone or estrogen therapy, the radiographic appearance was considered to be suggestive of adenoma. The lesion was monitored by ultrasound until October 2000 when a resection was performed because of the presumed risk of a malignant transformation. H&E stained sections revealed an ectopic ependymoma that was strongly positive for GFAP. The surrounding hepatic tissue was negative for GFAP. An extensive search for a CNS manifestation or any other extraspinal localization was unrevealing. We believe we have encountered the first case of an ectopic ependymoma presenting as a solitary hepatic lesion in the absence of CNS disease. Ependymomas generally arise in the CNS in relation to the ventricular system. Extraneural metastasis from ependymomas may occasionally occur even years after detection and treatment of the primary lesion and have been the subject of several reports. In contrast, there are only anecdotal reports of primary extraneural "ectopic" ependymomas. So far those rare cases have only been found in close vicinity to the neural axis, eg, in the sacrococcygeal region, the posterior mediastinum or the ovaries and are there thought to originate from embryonic remnant cells around the neural tube. Distant metastases of ependymomas invading or arising within the extraneural lumbosacral soft tissue may occur in this situation. Here, we report what appears to be the first case of a primary ectopic ependymoma originating in the liver, with no signs of CNS or other systemic involvement.
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PMID:March 2003: a 41 -year-old female with a solitary lesion in the liver. 1294 33

The authors describe a 9-year-old boy with a large spinal cord ependymoma whose apparent drop metastases on imaging studies were later demonstrated to be schwannomas. This finding led to the discovery of small bilateral acoustic neuromas and an intracranial meningioma, establishing the diagnosis of neurofibromatosis 2. The presence of additional radiographic abnormalities in a patient with a spinal cord tumor should prompt careful consideration of the diagnosis of neurofibromatosis 2, as early identification of this disorder may significantly affect patient management.
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PMID:Spinal cord schwannomas mimicking drop metastases in a patient with intramedullary ependymoma and neurofibromatosis 2. 1470 16

A 45-year-old man presented with progressive deterioration of vision. Visual acuity test revealed no light perception in both eyes. The fundoscopic examination demonstrated pale optic discs, consistent with secondary optic atrophy. Preoperative neuroimaging studies revealed a well-defined contrast-enhancing mass, 3 cm in diameter, at the left parietal region. Its radiologic appearances simulated those of cerebral metastases. A totally removed lesion was verified pathologically as an anaplastic clear cell ependymoma, which is rare in this location. A brief review of clinical features and neuroimaging of supratentorial lobar ependymoma is also included.
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PMID:Supratentorial lobar anaplastic ependymoma resembling cerebral metastasis: a case report. 1552 Dec 41

Most of the space demands in the cerebellopontine angle lie extra-axially. Important structures run within the cisterns of the cerebellopontine angle, such as the trigeminal, facial and vestibulocochlear nerves as well as the anterior inferior and posterior inferior cerebellar arteries and the veins which lead to the petrosal sinus. The most common space demands are caused by acoustic neuromas, meningeomas, vascular ectasia and aneurysms. Less common are epidermoid and other schwannomas as well as metastases, paragangliomas and arachnoidal cysts. Intra-axial tumours in the area of the cerebellopontine angle include the medulloblastoma, astrocytoma and the ependymoma, which occurs predominantly in children, in addition to the uncommon choroid plexus papilloma. Nearby, there are also space demands around the petrous bone, such as cholesterol granuloma, malignant otitis media, paraganglioma and metastases. For differential diagnosis, an understanding of the space requirements of the tumours in the cerebellopontine angle is needed in addition to knowledge of the anatomical structures.
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PMID:[Differential diagnosis of space demands in the cerebellopontine angle]. 1552 82

Extraspinal ependymomas are rare. The majority occur in the sacrococcygeal region. The subcutaneous variety accounts for approximately two thirds of cases, which are commonly misdiagnosed as a pilonidal cyst or sinus. Treatment is complete surgical resection. The role of coccygectomy is controversial. Adjuvant radiotherapy is of benefit to those with an incompletely excised tumour. Up to 20% metastasise, chiefly to the inguinal lymph glands, but pulmonary metastases are also reported. Palliative chemotherapy has not been shown to be of any benefit. Long term follow-up is important as metastases can occur up to 20 years after initial presentation. We report a 37-year-old woman with a subcutaneous sacrococcygeal ependymoma with iliac lymph nodal metastasis at presentation.
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PMID:Case report: primary subcutaneous sacrococcygeal ependymoma: a case report and review of the literature. 1663 28

A 9-year-old boy was admitted with a circumscript subcutaneous tumor of the sacral region. Serum alpha-fetoprotein was not elevated. The lesion was excised en bloc including the top of the coccygis. Histology revealed a myxopapillary ependymoma without bony involvement. Metastases were excluded. Extraspinal myxopapillary ependymoma is a rare tumor of the sacrococcygeal region with a potential risk to develop metastases and for local relapse. Long-term follow-up is recommended.
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PMID:[Sacrococcygeal extraspinal myxopapillary ependymoma]. 1681 8

Cerebrospinal metastases of benign choroid plexus papillomas (CPPs) are extremely rare. We report a case of 32-year-old woman who presented with a 6-month history of vertigo and intermittent headache. Plain CT scan of the cranium revealed a partly calcified tumor filling the fourth ventricle and its right recess. Cranial MRI showed an inhomogeneously contrast-enhancing tumor and leptomeningeal enhancement encasing the brain stem. Complete resection of the tumor was carried out, and seedings to the floor of the fourth ventricle and cervico-medullary junction were found during the operation. While intraoperative frozen section suggested pathology of papillary ependymoma or CPP, to our surprise, final histological examination revealed a benign choroid plexus papilloma. One month after the first operation, a metastatic nodule was found in the spinal subarachnoidal space at the level of T8-9. Two months after the first operation, on follow-up MRI of the cranium, the leptomeningeal enhancement encasing the brain stem had resolved spontaneously. This special case helps increase our understanding of benign CPPs and expands our differential diagnostic consideration of lesions with similar manifestations.
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PMID:Metastasis of a histologically benign choroid plexus papilloma: case report and review of the literature. 1738 33

Ependymoma are rare glial neoplasm, it rarely metastasize outside the central nervous system. We present a case of anaplastic ependymoma with extraneural metastases with review of literature. A ten-year-old male child presented with anaplastic ependymoma of choroid plexus and treated with craniospinal radiotherapy in 1998. He had intracranial recurrence in 2004, confirmed by biopsy. He was given adjuvant chemotherapy in form of PCV. At 10 months after completion of chemotherapy, he developed extracranial scalp metastasis and so was treated with palliative local radiation therapy to the scalp metastasis and systemic chemotherapy with oral Etoposide. Scalp metastasis completely disappeared and ataxia improved. After five cycles of chemotherapy, the patient had progression of disease in form of scalp and cervical lymph node metastasis confirmed by fine needle aspiration cytology, biopsy and immunohistochemistry. He was given salvage chemotherapy (carboplatin + ifosfamide + etoposide) at 3-weekly. He had partial response and was still on chemotherapy till May 2007.
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PMID:Extraneural metastases in anaplastic ependymoma. 1799 33


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