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

Clinical and radiographical data are presented for a case of suspected pathological fracture of the right ulna in a 66-yr-old women mastectomised two years previously. Multiple skeletal lesions were noted, often morphologically different from those usually observed in metastasis of breast cancer, with a fibrous and cystic appearance reminiscent of von Recklinhausen's disease. However, indisputable serohumoral data, the histological picture on biopsy, and repair of bone as a result of immuno-antiblastic management showed that true metastases were involved. The radiographical picture and the response to therapy make it clear that atypical bone pictures must be carefully watched, since metastasis from breast cancer may be responsible for special morphological and structural features requiring close differential investigation.
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PMID:[A case of atypical bone metastasis from breast carcinoma]. 65 89

Sixteen hundred and seventy-seven melanoma patients were treated at Duke University Medical Center from 1956 to 1976. Osseous metastases were more common than previously reported and occurred in 116 patients (6.9 per cent), most often in the axial skeleton. Diagnosis was made by roentgenogram, bone scan, or both in the symptomatic patient. Seventy-five patients sustained pathological fractures, most of which were successfully treated conservatively. Nine of the ten patients with neurological symptoms were improved by laminectomy. The grave prognosis for melanoma patients with osseous metastases (mean survival, 3.6 months) led to conservatism even for an impending pathological fracture. Unstable pathological fractures of long bones were treated by internal fixation and irradiation.
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PMID:Skeletal metastases of melanoma. 68 83

Eight pathologic fractures of benign and 52 of malignant origin are reported. Open reduction and rigid internal fixation should be performed to give the patient the use of his affected limb as soon as this can be accomplished. Treatment consists of internal fixation in lesions of the shaft and prosthetic replacement in the case of lesions near joints. Only very rarely a primary amputation must be performed. Malignant fractures are most frequently caused by metastases from breast cancers. The treatment will at least make nursing easier, and three-quarters of these patients can be mobilized. The combination of surgical treatment and radiotherapy is discussed. In spite of this approach the average time of survival of 14 months is short because a pathological fracture due to a malignant tumor is a late symptom of the disease.
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PMID:[Treatment of pathologic fractures]. 95 7

Of approximately 1,999 cases of osteogenic sarcomas at the Mayo Clinic, 25 were diagnosed as telangiectatic osteogenic sarcomas. Of the 25 patients involved, 16 were males and 9 were females, and their ages ranged from 6 to 49 years. Six patients had had pathologic fracture. The lesions were typically located centrally and usually in the distal femur or proximal humerus and roentgenographically were large and purely lytic with destruction of cortex. Grossly, the lesions were cystic and contained clotted blood. Histologically, cystic spaces that contained blood were lined with anaplastic spindle cells and benign giant cells; sometimes, there were so few malignant cells that diagnosis was difficult. Usually, fine, lacelike osteoid was present. Of the 25 patients, 23 have died of metastatic disease, and another has developed pulmonary metastasis 11 months after amputation. Only one patient has survived for more than five years; however, he has developed pneumothorax. Data from this series suggest that the outlook in telangiectatic osteogenic sarcoma is more bleak than in conventional osteosarcoma.
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PMID:Telangiectatic osteogenic sarcoma. 106 3

Improved survival rates of cancer patients have led to an increase in the incidence of metastatic disease of the bone. Normal load and minimal trauma may result in pathological fractures. The malignant diseases most commonly diagnosed were breast cancer, bronchial carcinoma and hypernephroma. The majority of the patients treated were female. The average interval observed between diagnosis of primary malignant disease and occurrence of the pathological fracture was 2.8 years. The purpose of the surgical procedure is to achieve immediate and lasting stability and ultimately to increase and restore the quality of life. Immediate postoperative mobilization and early functional treatment are an indispensable part of the management of pathologic fractures. If possible extensive bone destructions involving the risk of fracture should be stabilized prophylactically. Specific techniques of composite osteosyntheses of fractures in metastatic disease of the bone are presented.
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PMID:[Diagnosis and therapy of metastasis-induced pathologic fractures]. 138 16

This report describes the cytologic, radiologic and histologic findings in a 76-year-old male who presented with a pathologic fracture of the first metacarpal bone as the result of metastatic transitional cell carcinoma. The primary neoplasm was sited in the right renal pelvis. Metastases were also detected in the liver and confirmed cytologically. Problems encountered with the cytologic diagnosis are explained by correlation with the histologic findings. The case also illustrates the importance of clinicopathologic correlation when interpreting fine needle aspiration biopsies.
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PMID:Transitional cell carcinoma of the renal pelvis metastatic to the metacarpal. A case report correlating cytologic and histologic findings. 144 34

Bone metastases in breast cancer are common and frequently lead to serious skeletal related morbid complications. Metastases develop in areas of metabolically active trabecular bone. It is presumed that breast cancer cells undergo the same stepwise process for metastases development as demonstrated in other tumor types. The specific factor or factors responsible for the osteotropism of breast cancer have not been identified. The morbid events associated with skeletal metastases, such as pathologic fracture, and spinal cord compression, may be assessed objectively by a variety of techniques including skeletal radiography, radionuclide scanning, computed tomographic scanning and magnetic resonance imaging. Biochemical parameters or markers of skeletal metastases are not sensitive enough to detect clinically occult disease. Therapeutic interventions for bone metastases include local and systemic therapies. Surgery and radiation therapy are most frequently used for relief of pain or impending fracture, or when bone fracture or neurologic compromise has already developed. Systemic treatment of bone metastases appears to be as effective as systemic treatment of other metastatic sites. Both hormone and chemotherapy may provide significant palliation. Clinical research suggests that the adjunctive use of bisphosphonates may significantly reduce the incidence of skeletal-related morbid events associated with osteolytic bone disease. Future research efforts directed at determining the osteotrophic factors responsible for bone metastases in breast cancer, the pathophysiology of the bone remodeling process in metastatic disease and the prophylactic use of bisphosphonates may lead to significant clinical benefit for those in whom bone metastases from breast cancer develop.
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PMID:Bone metastasis in breast cancer. 145 Apr 38

The article deals with the results of operations applied in the system of complex treatment of 83 patients (86 operations) with metastases of malignant tumours in the skeletal bones. Fourteen patient had carcinoma of the lung, 23--carcinoma of the breast, 28--carcinoma of the kidney, 8--carcinoma of the thyroid gland, and 10 patients had other malignant tumors. Operative interventions in the form of resection of the articular end or total removal of a tubular bone with endoprosthesis in affection of a long tubular bone and its pathological fracture or the threat of such fracture were substantiated. In the presence of special indications, osteosynthesis of the pathological fracture or amputation (exarticulation) of the limb may be undertaken. Laminectomy is indicated in metastatic lesion of the spine with the development of neurological disorders. Four (5%) patients died in the postoperative period. Average survival in the group of patients was 35 months, in the separate groups it was as follows: lung carcinoma metastases--9 months, kidney carcinoma metastases--31 months, thyroid carcinoma metastases--37 months, breast carcinoma metastases--40 months, metastases of other forms of malignant tumors--30 months. Longest survival--7.5 years. Average value of life quality according to Karnovsky was 30% before operation and 67% after it.
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PMID:[A surgical method in the complex treatment of metastatic bone tumors]. 146 75

Malignant fibrous histiocytoma (MFH) was found in the femur of a 28-year-old man who had suffered from chronic osteomyelitis. The patient had undergone surgery for a valgus knee deformity and the procedure was complicated by chronic osteomyelitis which lasted for 12 years. Four months after the onset of painful symptoms related to the occurrence of MFH, gross bone destruction with pathologic fracture and pulmonary metastases were present. The patient died 4 months later. Histopathological and immunohistochemical examinations indicated the diagnosis of MFH.
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PMID:Malignant fibrous histiocytoma in the course of chronic osteomyelitis. 166 83

Twelve dogs with appendicular osteosarcoma were treated with 24-40 Gy of cobalt 60 radiation and two doses of intraarterial cisplatin. Improvement in limb function occurred in four dogs, and three dogs, which had only mild initial lameness, had no worsening of their lameness post-treatment. In nine dogs in which local control was evaluable, eight had local failure, with the median (95% CI) duration of local control being 5.9 (4.6, 6.7) months. Two dogs had metastatic disease before therapy, and an additional nine dogs had metastatic disease at a median time of 6.4 months. Pathologic fracture was present in four dogs; two fractures occurred before treatment and two were documented at the time of tumor recurrence. Median (95% CI) survival time for all 12 dogs was 4.9 (3.4, 6.8) months. Excluding the two dogs with preexisting metastatic disease, median survival time was 6.7 months. Three dogs survived longer than 1 year. This mode of therapy was well tolerated and may be considered an alternative to amputation or limb-sparing surgical procedures in selected dogs with appendicular osteosarcoma.
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PMID:Treatment of canine appendicular osteosarcoma using cobalt 60 radiation and intraarterial cisplatin. 177 23


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