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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Metastasis to the eye represents by far the most common form of intraocular and orbital cancer. This form of malignant disease may present with a variety of signs and symptoms including pain, vision loss, visual field defect, and proptosis. This varied clinical presentation is described, and available treatment modalities are discussed.
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PMID:Ocular metastatic disease. 819 52

Cancer-related problems are seen frequently by the emergency physician. More difficult presentations are seen with premonitory symptoms, paraneoplastic syndromes, and nonspecific lesions. Dermatologic paraneoplastic syndromes are numerous, nonspecific, and consist of hamartomatous growths, texture changes, new hair growth, or changes in skin color. Alteration of skin color may be of practically any color, localized or diffuse, and of sudden or indolent onset. Hormone production by tumors may lead to acne, hirsutism, gynecomastia, or a cushingoid appearance. Pruritus may herald the onset of leukemia or lymphoma and be intolerable, as with erythroderma. All suspicious presentations require thorough investigation for underlying disease. Metastasis to skin is not common and implies a poor prognosis if seen. Most metastases are seen on the head and neck, anterior chest wall, and abdomen. Basal cell and squamous cell carcinomas commonly occur in sun-exposed areas. Basal cell is locally destructive, whereas squamous cell occasionally metastasizes to local lymph nodes. Malignant melanoma is the leading fatal illness originating in skin, with a dramatic rise in incidence. It is classically described as asymmetric with irregular borders, is elevated, and shows color variegation; however, melanoma may present atypically, particularly in non-whites. Kaposi's sarcoma lesions are well-demarcated, symmetric, smooth nodules that appear purplish-brown, particularly if below the knee (owing to venous stasis). The closely interrelated structures of the eye and orbit are easily disturbed, leading to the presenting symptoms of visual disturbances, exophthalmos, pain, and ocular motility disorders. Primary tumors are not unusual and may include retinoblastoma, rhabdomyosarcoma, and melanoma. Equally common are metastatic lesions, most commonly lung and breast carcinoma. An estimation of the malignancy of bony lesions can be made by assessing the zone of transition, periosteal reaction, and bone destruction. A malignant lesion will more likely have a broad zone of transition, irregular periosteal reaction, and moth-eaten or permeative destruction of trabeculae. Metastatic bone lesions primarily occur in sites of persistent red marrow: skull, ribs, vertebrae, pelvis, and proximal humerus and femur. Bony lesions can be blastic or lytic in nature. Solitary pulmonary nodules that have not grown for 2 years can be assumed to be benign. Calcification seen on plain films are a strong (but not absolute) indication of benignancy. Lesions that are greater than 3 to 4 cm in diameter, have irregular contours, are cavitated with thick walls, have multiple peripheral nodules, and have lack of calcification are more likely malignant.
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PMID:Visual diagnosis of hematologic and oncologic diseases. 849 Nov 9

Squamous cell carcinoma of the canine nasal cavity and frontal sinus was diagnosed in eight cases between May 1988 and April 1994. The most common presenting complaints were nasal discharge, including epistaxis; sneezing; and facial deformity or exophthalmos. Metastasis was not identified in any case, but bone lysis and invasion into tissues outside the nasal cavity were noted in five cases. Computed tomograms were performed in five cases and were more useful than radiographs in determining the extent of neoplastic involvement. Euthanasia was performed within one week of diagnosis in three cases at the owner's request; one case died at home within one month; and the remaining four cases were euthanized within eight months due to progressive clinical signs. The mean survival time in these eight cases was three months, with a range of zero weeks to eight months.
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PMID:Squamous cell carcinoma of the canine nasal cavity and frontal sinus: eight cases. 868 Sep 15

Although solitary fibrous tumors are well-recognized tumors, they have only recently been described in the orbit. Although histopathological awareness of the lesion has been heightened recently because of the discovery of CD-34 immunoreactivity in solitary fibrous tumors, including orbital lesions, it remains unrecognized clinically as a cause of unilateral proptosis. Clinical awareness of the lesion is important, because benign and malignant forms of the tumor occur. The malignant forms pursue an aggressive course manifested by local invasion, recurrent growth, or metastases. The benign lesions are histologically banal and are cured by surgical excision. This case report describes unilateral proptosis caused by an orbital solitary fibrous tumor, which occurred in a 43-year-old woman. The tumor had a benign histomorphology and clinical course, with surgical excision being curative. In reviewing the literature on orbital solitary fibrous tumors, clinical awareness of the tumor as a cause of unilateral proptosis is emphasized.
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PMID:An unusual cause of proptosis: orbital solitary fibrous tumor: case report. 872 32

Ethmoid sinus adenocarcinoma with orbital invasion is distinctly uncommon. This case presented with epiphora, whereas proptosis and decreased ocular motility were later signs. Treatment was delayed for 4 months, while misdiagnoses like dacryocystitis and thyroid eye disease were entertained. Even an incisional biopsy was not sufficient for a conclusive diagnosis and adenomatous differentiation was only present in a small proportion of tissue available after an excisional attempt. The aggressive behaviour including this patient's death of metastatic disease, underlines the importance of considering secondary invasion from a sino-nasal malignancy in uncharacteristic orbital disease.
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PMID:Orbital presentation of ethmoid sinus adenocarcinoma. 875 Nov 29

Osteosarcoma is the most common primary malignant tumour of bone and it usually metastasises to the lung. In the nasal cavity metastatic disease is extremely rare. We describe a case of osteosarcoma presenting with recurrent epistaxis, and proptosis due to secondaries in the nasal cavity. To our knowledge such a case has not been reported previously in the available English literature.
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PMID:Metastatic osteosarcoma of the ethmoid: an unusual cause of recurrent epistaxis and proptosis. 875 46

A retrospective oncological study was performed in 25 woodworkers, in whom an adenocarcinoma of the ethmoid sinuses was discovered between March 1985 and December 1993. All patients were males with a mean age of 57 years, and a mean duration of wood dust exposure of 24 years. Signs of nasal obstruction, drainage, and discomfort were present in all cases. Ophthalmological findings were a poor prognosis indicator. It was possible to precisely evaluate treatment and outcome in 23 cases. The majority of tumors were classified as T3 or T4 (72%), with extension beyond the ethmoid sinuses; all were in contact with the roof of the ethmoidal sinuses. Extension was predominantly into the orbital and intracranial cavities as compared with extension posteriorly or into the maxillary sinuses. Treatment was identical in the 25 patients: a) combined surgery including a paranasal and a neurosurgical approach, b) postoperative radiotherapy. Results were expressed in terms of morbidity related to surgery and the oncologic outcome. Operative morbidity and mortality were substantially reduced with reconstruction of the roof of the ethmoidal sinuses. Meticulous excision, in addition to postoperative radiotherapy, resulted in a decreased rate of local recurrence (26%). On the other hand, metastasis were encountered more frequently (30%). Radiotherapy was insufficient when macroscopic excision was incomplete. Chemotherapy was used as palliative treatment in the event of a recurrence and/or metastases. Survival rate was 68% at 3 years, and 48% at 5 years. Most complications and recurrences arose within the first two years. Exophthalmos, intracranial extension, incompleteremoval, and extensive class T4 tumors were associated with a poor prognosis. Optimal therapy for malignant tumors of the ethmoid sinuses requires combined transfacial and neurosurgical approaches that allow precise assessment of tumor extension and adequate excision, yielding an improved oncologic outcome. Followed by radiotherapy, this association can result in a remission. Patient prognosis depends essentially on management of the initial lesion.
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PMID:[Adenocarcinoma of the ethmoid sinus in woodworkers. Retrospective study of 25 cases]. 929 54

Two cases of rare metastases from renal cell carcinoma are reported. The first case was in a 44-year-old man presenting with left exophthalmos. Radiological examination revealed left renal tumor with metastases to paraaortic lymph nodes, left orbit, bone and lungs. Radical nephrectomy was performed. Pathological diagnosis was renal cell carcinoma, pT3aN2M1. The patient died of widespread pulmonary metastasis 5 months postoperatively. The second case was in a 59-year-old man with a complaint of tongue tumor. Histopathology of the enucleated tumor was suggestive of metastatic renal cell carcinoma. Computed tomographic scan revealed left renal tumor with regional lymph node metastasis. No other metastasis was found. Radical nephrectomy confirmed the pathological diagnosis of renal cell carcinoma, pT3bN1M1. He has been treated with interferon-alpha and has been free of recurrence for 10 months postoperatively.
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PMID:[Two cases of renal cell carcinoma detected by metastasis to another organ]. 936 44

We report a 49-year-old woman with Marfan syndrome who underwent total thyroidectomy for follicular carcinoma. The patient was given 100 mCi of radioactive iodine (131I) followed by levothyroxine (LT4) 0.2 mg/day after surgery. The subsequent five total body scans were negative and thyroglobulin (TG) measurements ranged between undetectable levels to 12 ng/mL. Nine years after thyroidectomy the patient developed bilateral exophthalmos with markedly positive thyroid-stimulating immunoglobulins (TSI), indicating the presence of Graves' disease. TG levels increased and concurrently pulmonary metastases that did not concentrate radioiodine at tracer doses, were diagnosed. Due to these metastatic lesions, the patient received a therapeutic dose of 150 mCi of 131I 1 month after LT4 withdrawal, and a total body scan was made 10 days later. Slight uptake of 131I was found in the right side of the neck, whereas predominant uptake occurred in the right lung base. We suggest that the elevated TSI played a role in the growth of metastases.
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PMID:Development of Graves' disease nine years after total thyroidectomy due to follicular carcinoma of the thyroid. 945 37

Clinical symptoms in patients with primary orbital lymphosarcoma, generalized lymphosarcoma involving the orbital tissues, and metastatic tumors of the orbit of another origin are analyzed. The orbital process has bee studied in 158 patients. The most frequent symptoms were ptosis and exophthalmos. Decreased visual acuity, pain, sensation of swelling in the orbit caused by rapid tumor growth were characteristic of metastases to the tumor and orbital lymphosarcoma in total system's involvement. In case of an isolated involvement of the orbit, lymphosarcoma ran a more swift course than metastases to the orbit and orbital lymphomas in systemic involvement which ran an aggressive course. These data cannot serve as differential diagnostic signs. The decisive information is provided by morphological examination of a biopsy specimen.
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PMID:[The characteristics of the clinical picture of lymphosarcoma and of a metastatic tumor of the orbit of another origin]. 1058 15


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