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

Tumours outside the central nervous system rarely prove to be intracranial glioma metastases. The mechanism of glioma metastasis has been thought to be related to dissemination of tumour cells either at the time of surgery or later through the surgical defect. However, 8 cases have been recorded to date in which metastases have occurred in the absence of surgery. This report details the clinical findings in 2 such patients. One presented with a pharyngeal mass that was found to be a metastasis from an anatomically remote parietal lobe astrocytoma. The other patient presented with a C8 nerve root tumour which was external to the dura. Biopsy revealed an astrocytoma that had metastasized from the roof of the lateral ventricle. Possible mechanisms of pathogenesis are discussed, including that of neural spread.
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PMID:Gliomas presenting outside the central nervous system. 282 1

We present a case of a 17-year-old male with an unbiopsied brainstem glioma who developed drop metastases a few months following completion of hyperfractionated radiation therapy to the primary site. The literature is reviewed with reference to intraspinal metastases from brainstem gliomas.
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PMID:Brainstem glioma with multiple intraspinal metastases during life: case report and review of the literature. 285 13

The interaction of tumour cells with basement membrane components is thought to be important in influencing their invasive and metastatic properties. This paper describes the effect of laminin on the attachment of radiolabelled glioma and B16 murine melanoma cells to tissue culture plastic and type IV collagen. With the exception of the non-metastatic B16 F1 variant, laminin (and fibronectin) stimulated cell attachment to tissue culture plastic. Although laminin stimulated the attachment of the B16 BL6 metastatic variant to type IV collagen, it consistently inhibited the attachment of the glioma cells under the same conditions. Laminin appeared to exert its effect by adsorption to the collagen and was not cytotoxic to the glioma cells. In contrast, fibronectin had very little effect on cell attachment to type IV collagen. One of the most unusual features of glioma is the rarity of metastasis to extraneural sites. However, the effect of laminin observed here may not be the only factor involved in the metastatic inefficiency of this tumour type.
Clin Exp Metastasis
PMID:Effects of laminin on the attachment of glioma cells to type IV collagen. 292 51

It is generally accepted that the metastases of intracranial glioma to extracranial location are rare. In such a case the minimal criteria proposed originally by Weiss should usually be satisfied if a report is to be considered as an acceptable case of metastasizing central nervous system glioma outside the central nervous system. We report a case of glioblastoma multiforme, fulfilling Weiss' criteria, metastasizing the spinal epidural space. The patient was a 32-year-old male, who underwent craniotomy and subtotal removal of a glioblastoma multiforme in the left parietooccipital area. He was additionally treated with irradiation and chemotherapeutic agents. Twelve months after the craniotomy, he was admitted again to our clinic because of sudden onset of severe lumbago, paraplegia and urinary disturbance. Diagnosis of a spinal epidural tumor was made and laminectomy (Th10-L1) was performed. At operation, an epidural mass was found, however no invasion to the spinal cord or dura was noted. Histological diagnosis of the tumor was glioblastoma multiforme. Although he was treated with radiation, pulmonary metastasis was manifested one month later, and the condition of the patient deteriorated. He died 21 months after the first operation and 8 months after the second operation. Even at the terminal stage, his consciousness was clear without any sign for recurrence of intracranial tumor. The general autopsy was done and multiple metastatic lesions of glioblastoma multiforme in paratracheal and paraaortic lymph node, left pleura, both lungs and spinal cord were observed. The present case suggests that the surgical intervention, irradiation, and chemotherapy may contribute to extracranial metastasis of a glioblastoma.
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PMID:[Spinal epidural metastasis of glioblastoma multiforme: a case report]. 298 97

Diffuse astrocytomas of the cerebrum, cerebellum, brain stem, and spinal cord are classified into three groups according to the degree of tumor anaplasia. These groups are the astrocytoma, anaplastic astrocytoma, and glioblastoma multiforme. Juvenile pilocytic astrocytomas have a better prognosis and are clinically and biologically distinct from the diffuse, fibrillary astrocytomas. The prognosis of astrocytomas depends not only on histologic characteristics, but also age of the patient, location of the tumor, and extent of surgical resection. The pattern of invasion into surrounding brain distinguishes gliomas from metastatic carcinomas and sarcomas. Topographic correlations have shown that malignant gliomas may invade the brain for distances of up to several centimeters from the enhancing rim seen on CT scan. However, the junction between glioblastoma and adjacent brain may also be fairly abrupt, with a peripheral margin of less than 1 mm. Recurrent glioblastomas are more widely invasive and often extend into areas that appear normal on CT scan. The optimal site for tumor biopsy corresponds to areas of contrast enhancement. Primitive neuroepithelial tumors are malignant neoplasms with a poor prognosis. They tend to recur locally and metastasize throughout the neuraxis via the CSF. It remains controversial whether these tumors should be classified as a single entity with the potential for differentiation along different cell lines, or whether the categories of neuroblastoma, spongioblastoma, ependymoblastoma, pineoblastoma, and medulloblastoma should be retained as specific entities. The medulloblastoma is the most common of these neoplasms, its clinicopathologic features are well characterized, and the current 5-year survivals of 50 to 60 per cent are better than for other "primitive" neoplasms. Glial fibrillary acidic protein is a specific marker for immature, reactive, and neoplastic astrocytes and ependymal cells. Although the absence of GFAP in a neoplasm does not exclude an astrocytic origin, the presence of GFAP indicates astrocytic or ependymal differentiation. This has important diagnostic applications. The expression of GFAP is used to distinguish astrocytic neoplasms from epithelial or mesenchymal tumors that may on occasion mimic a glioma. The detection of GFAP is also useful in the investigation of tumor histogenesis and differentiation both in vivo and in vitro. Although meningiomas exhibit a wide variety of histologic patterns, most tumors exhibit similar biologic and clinical behavior regardless of the histologic subtype.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Pathologic analysis of primary brain tumors. 300 88

Eleven patients with combined neurological and endocrine complications after external radiotherapy for nasopharyngeal carcinoma are described. Neurologically, memory disturbance, complex partial seizures and hypodense areas in one or both temporal lobes on CT were typical features. Endocrinologically, hypopituitarism was the prominent manifestation. This constellation of clinical features in a patient with previous radiotherapy to the nasopharynx characterises radiation injury to the inferomedial aspects of the temporal lobes and the hypothalamic-pituitary axis. While the parenchymal brain lesions may mimic metastases or glioma on CT, the associated endocrine disturbance would betray the correct diagnosis. The importance of recognising the hypopituitarism which may be clinically asymptomatic and which is amenable to therapy is emphasised, as is the need for a proper fractionation of the radiation dose to minimise the incidence of these disabling complications.
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PMID:Temporal lobe and hypothalamic-pituitary dysfunctions after radiotherapy for nasopharyngeal carcinoma: a distinct clinical syndrome. 322 87

Twenty-six patients with suspected lesions of the spinal cord were studied before and after administration of gadolinium-DTPA to assess whether contrast enhancement was useful in the MR evaluation of intramedullary disease. Nine patients had primary tumors, six had benign syringes, three had multiple sclerosis with cord involvement, three had thrombosed vascular malformations, three had probable intramedullary metastasis, and two were normal. Although all lesions were detected on noncontrast MR scans, gadolinium-DTPA was of great help in their delineation and characterization. Specifically, contrast material may be able (1) to localize tumor nidus and separate it from edema, in cases of hemangioblastomas and metastases; (2) to suggest regions of more active tumors, in cases of glioma, for surgical biopsy or removal; (3) to differentiate benign or reactive processes from neoplastic lesions, such as reactive cyst from tumor cyst or hematoma due to thrombosed malformation from tumor hemorrhage; and (4) possibly to differentiate active from inactive lesions, for example, in multiple sclerosis. Because of these advantages, gadolinium-DTPA probably will often be used routinely when intramedullary lesions are detected on noncontrast MR scans.
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PMID:Intramedullary disease of the spine: diagnosis using gadolinium-DTPA-enhanced MR imaging. 326 73

Tumor-to-tumor metastasis is a rare occurrence. Fewer than 100 cases have been reported, many being metastases from carcinomas to benign intracranial neoplasms, most often meningiomas. A case is presented of carcinoma metastatic to a glioma. The patient, who presented for evaluation of bifrontal headache, was found on computerized tomography to have a partially calcified right frontal mass. Craniotomy revealed an oligodendroglioma containing foci of adenocarcinoma. Further work-up disclosed an infiltrative ductal adenocarcinoma of the breast. It has been suggested that tumors of the central nervous system may provide a fertile substrate or an immunological "haven" for metastases.
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PMID:Metastases of central nervous system neoplasms. Case report. 328 41

A 41 year old male presented with headache, lethargy, and ataxia and found to have a left temporal lobe mass and a leukoerythroblastic peripheral blood smear. The latter prompted an iliac crest bone marrow biopsy on which a diagnosis of metastatic glioma was made and verified by immunohistologic characterization. The patient was treated with cranial irradiation and simultaneous systemic BCNU (bis-dichloroethylnitrosurea) with complete response. This case with diffuse bone marrow involvement demonstrates that a glioblastoma is capable of extracranial metastases without previous intervention. From a review of reported cases of gliomas of extraneural metastasis, it is concluded that untreated gliomas are capable of vascular spread although less frequently than previously manipulated tumors.
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PMID:Intracranial astrocytoma with diffuse bone marrow metastasis: a case report and review of the literature. 329 52

Three patients with malignant gliomas who developed dissemination of tumor at the time of recurrence are presented. All three patients received combination therapy including conventional radiotherapy and interstitial radiation therapy followed by systemic BCNU chemotherapy. A review of the literature on the development of glioma metastases and an analysis of the possible mechanisms of this uncommon growth pattern are presented.
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PMID:Patterns of recurrence in glioma patients after interstitial irradiation and chemotherapy: report of three cases. 336 13


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