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)

The patient was a 70-year-old male with complaint of macrohematuria at the first visit to our clinic on June 10, 1986. At that time, cystoscopy revealed a thumb sized papillary tumor and a rice sized non papillary tumor, and the biopsy specimen was pathologically diagnosed as undifferentiated carcinoma. But, he refused admission. On January 30, 1987, he came back to our clinic with complaints of dyspnea, general fatigue and weight loss. Moderate lt. gynecomastia was found and the level of serum hCG-beta was detected as high as 101 ng/ml. Excretory urogram and enhanced CT revealed a large mass in the bladder. In the seventeenth day after admission, he died of lung edema and heart failure. The findings of autopsy showed a large light greenish to light brownish tumor of 10 X 10 X 3 cm in the bladder. Distant metastases were observed in internal, common iliac and paraaortic lymph nodes, but without other distant metastasis. In histological and immunohistochemical studies, the final diagnosis is choriocarcinoma of the bladder, containing syncytiotrophoblastic giant cells with hCG-beta granules as an undifferentiated carcinoma. To our knowledge this case is the eighth described in Japan. Herein we report a new case of primary choriocarcinoma of the bladder and make a brief review of the literatures.
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PMID:[Primary choriocarcinoma of the bladder: a case report of autopsy]. 267 66

Vanishing fluid collection (or tumour) in an interlobar fissure associated with congestive cardiac failure is not common. Multiple vanishing tumours are most uncommon and can resemble other multiple opacities, e.g. metastases. The disappearance of these so-called tumours after treatment for cardiac failure provided proof of the diagnosis in the patient reported. This diagnosis is important to consider in order to prevent unnecessary investigation and treatment.
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PMID:Multiple vanishing tumours simulating pulmonary neoplasms. A case report. 272 32

An 80-year-old man who initially presented with a left hemiparesis rapidly developed right-sided heart failure and died. Although an echocardiogram suggested the presence of a tumor, the diagnosis of a primary cardiac lymphoma was made only at autopsy. The tumor involved a leaflet of the tricuspid valve, a finding not previously reported in the literature. In 1977, the Armed Forces Institute of Pathology defined a primary malignant lymphoma of the heart as that involving only the heart and pericardium. Many reports of primary cardiac malignant lymphomas have been published, however, most of which mention the presence of metastases. We have reviewed the world literature to determine the number of actual cases of primary malignant lymphoma of the heart. Only 15 reported cases, including the current case, were found to meet the current criteria.
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PMID:Primary cardiac lymphoma. 273 97

We report on a 62-year-old patient with a metastasising, only poorly differentiated follicular thyroid carcinoma, who was subjected postoperatively to chemotherapy with Aclarubicin. Aclarubicin (Aclaplastin) is a new cytostatic agent, from the group of anthracyclines, with fewer side effects and clearly diminished cardiotoxicity. The patient died suddenly after two treatment cycles with clinical symptoms of cardiac insufficiency; the post-mortem examination, however, revealed that two metastases in the myocardium might have been the cause of death; toxic myocardial damage could be excluded histologically. Upon occurrence of cardial symptoms and signs during therapy with cytostatic agents of thyroid carcinoma with Aclarubicin, whose cardiotoxic side effects are known, the possibility of metastatic spread in the myocardium should, nevertheless, also always be considered in the differential diagnosis.
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PMID:[Metastatic thyroid cancer: sudden death following aclarubicin therapy]. 274 39

We experienced four operative cases of lung carcinoma with intra-atrial extension via the pulmonary vein. In two cases, after assessment of the cardiac involvement, we performed extensive surgery under cardiopulmonary bypass. Their postoperative courses were uneventful, and their performance status was improved. However, seven months later one patient died of widespread metastases, while the other is alive but has recurrence. The other two patients underwent ordinary lobectomy because there were no abnormal findings in the hilar examination. However, the lumen of the resected pulmonary vein was filled with tumor tissue. One patient had massive embolism and died on the second postoperative day. The last case had residual tumor dislodging from the left atrium to the aorta. Though he was discharged without any complication, he developed multiple brain metastases 4 months after operation. We conclude that extensive surgery using cardiopulmonary bypass for lung cancer patients with such intracardiac involvement is effective for improvement of PS and reduces the risk of sudden death due to cardiac failure or emboli. Accurate diagnosis of intracardiac extension in these unusual cases is important.
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PMID:[Four operative cases of lung carcinoma with intra-atrial extension via the pulmonary vein]. 285 68

Secondary tumors of the heart and pericardium are much more common than primary tumors. During a 10-year period (1976-1985), only one instance of a primary tumor (malignant mesothelioma) was identified among 2,649 autopsies of malignant tumors at the National Cancer Center Hospital. In contrast, there were 407 cases in which heart and/or pericardium were secondarily involved with a malignant tumor from other organs. In 78 cases, the secondary tumors were present only in the pericardium, while in 329 cases, the tumors involved the heart itself with or without pericardial involvement. Among the primary tumors, three-quarters were carcinomas of various organs. In addition there were 53 hematologic malignancies, 19 melanomas and 17 sarcomas. In 31 cases, cardiac failure was the direct cause of death. The secondary tumors of the heart were often overlooked clinically because the cardiac dysfunction appeared to be part of the deteriorating general condition. Electrocardiography and echocardiography were often helpful in suggesting the presence of cardiac metastases. Appropriate diagnostic procedures and therapeutic intervention should be considered for the care of patients with advanced malignancy and sudden onset of cardiac failure.
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PMID:The incidence of secondary tumors of the heart and pericardium: a 10-year study. 341 85

Since August 1981, a permanent implantation with iodine-125 seeds has been performed in 41 patients with localized prostatic cancer. The seeds are implanted through a suprapubic incision. This gives the opportunity also to perform a diagnostic dissection of the regional lymph nodes. In five patients, the nodes were positive. In 4 out of these 5 patients bone metastases became manifest within one year. Two patients died of disseminated tumor, the first also had a local recurrence. Two other patients died shortly after treatment because of heart failure, while a third patient also died of heart failure, 2 years after implantation. Out of 31 patients with a follow-up period of 6 months or longer, distant metastases were found in four, in 2 followed by a local recurrence in the prostate. We can conclude that the preliminary results of this technique are encouraging with only three local recurrences in 41 patients. The prognostic value of positive lymph nodes was once again established.
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PMID:Preliminary results with iodine-125 seeds for permanent implantation in patients with localized prostatic cancer. 342 6

Cardiac metastases have been reported increasingly partly because of the longevity of cancer patients, but its antemortem diagnosis is frequently missed. This is due to the nonspecific clinical manifestations or relative lack of characteristic signs which are masked by the underlying disease. This is a report of a 42-year-old man diagnosed as having a metastatic cardiac tumor by echocardiography, six months after operation for squamous cell carcinoma of the gall bladder. Echocardiography revealed abnormal structures in the regions of the posterior and lateral walls of the left ventricle and interventricular septum, suggesting metastatic tumors. The cytological findings of a fine-needle aspiration biopsy specimen were squamous cell carcinoma. The patient died of cardiac failure eight months after the echocardiographic diagnosis. At autopsy, the abnormal structures in the heart were identified as cardiac metastatic tumors from gall bladder cancer. Reports of cardiac metastasis of gall bladder cancer is very rare (0-3%). The myocardial metastasis may have a more serious prognostic importance than the primary neoplasm itself; thus, its definite diagnosis is mandatory.
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PMID:[Metastatic tumor of the heart from gall bladder cancer detected by echocardiography: a case report]. 345 58

Levels of carcinoembryonic antigen(CEA)in the serum and pleural effusion in malignancies (65) and benign (25) of lung were determined. There are 20 cases of adenocarcinoma, 16 undifferentiated carcinoma, 7 squamous cell carcinoma, 4 alveolar carcinoma, 12 unclassified carcinoma, 1 polymorphous adenoma, 1 mesothelioma, 1 thymoma, 1 metastatic cancer from kidney and 2 metastatic breast cancer. In the benign lesions, there are 20 tuberculosis, 2 heart failure, 1 pneumonia, 1 empyema and 1 cirrhosis. The mean of the CEA level in the serum of lung cancer group was 12.63 ng/ml as compared with that of the tuberculosis group, 3.01 ng/ml (P less than 0.01). The level of CEA in pleural fluid in the lung cancer group was 57.30 ng/ml as compared with that of tuberculosis group, 5.55 ng/ml (P less than 0.01). The content of CEA in the serum and pleural fluid in lung cancer group was remarkably different (P less than 0.01). CEA level in the serum of adenocarcinoma is the highest (mean 15.51 ng/ml). If we set 5 ng/ml as the margin of normal CEA level in serum, the positive rate for cancer would be 54.2%. It is suggested that the margin of CEA normal value be set at 10 ng/ml for the pleural fluid. Higher readings may imply cancer.
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PMID:[Carcinoembryonic antigen assay in serum and pleural effusion of pulmonary malignancies and benign lesions]. 358 9

We are reporting a case of malignant pheochromocytoma surgically treated initially for an isolated left pararenal localization, and which recurred several years later accompanied with numerous metastases. Despite of a treatment with Iodine 131 MIBG, the evolution was rapidly fatal with a picture of cardiac failure. This cardiac involvement would be linked to a myocarditis directly secondary to the catecholamines and causing a marked increase of the free fatty acids concentration in the heart tissue. In reference to this case, all the data which may tend to suspect the malignant nature of a pheochromocytoma, present in 10 p. cent of the cases, are successively reviewed. There is no clinical specificity. The presence of a mixed secretion with marked urinary dopamine secretion, would not present, for all authors, the same criteria of specificity. Thoraco-abdominal scan and scintigraphy with iodine 131 MIBG are the two tests permitting to demonstrate, with a great sensitivity and specificity, an extra-adrenal localization, which is the best argument in favor of a malignancy since 30 to 40 p. cent of extra-adrenal pheochromocytomas are malignant, more especially as the metastases are located in areas where there are no embryonic remnants of tissues containing chromaffin cells. This permits to appreciate the difference between a non-malignant multicentric pheochromocytoma and a malignant pheochromocytoma. The ideal treatment of a malignant pheochromocytoma rests on surgery under the condition that there are ony one or two metastases. This procedure is preceded by a sodium nitroprusside preparation and followed with an alpha-blockers treatment. In case of multiple metastases, the therapeutic use of iodine 131 MIBG seems to be a tempting alternative.
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PMID:[Malignant pheochromocytomas. Apropos of a case with multiple metastatic localizations]. 359 57


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