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 authors report the case of a 2-year-old boy with a recurrent and locally metastasizing, spindle cell, vascular tumor with histiocytoid cells involving the skin, subcutaneous tissue, and muscle of the right forearm, the right distal radius and ulna, and multiple lymph nodes of the right axilla. Diagnoses of hemangioma, hemangiopericytoma, angiomatosis, spindle cell hemangioendothelioma, and malignant hemangioendothelioma were made on successive excision specimens. The soft tissue of the right arm became diffusely enlarged, and a severe syndrome developed that was similar to that described by Kasabach and Merritt. The limb was amputated above the elbow, the axillary lymph nodes were cleared, and a total dose of 6,000 centigrays axillary radiation was given. After operation, the Kasabach-Merritt syndrome resolved. Despite the lymph node metastases and multiple tissues involved, the patient has remained well 6 years after surgery. Although the tumor exhibited some of the histologic features of a spindle cell hemangioendothelioma, the low-grade aggressive behavior resembled that of an epithelioid hemangioendothelioma. The reported case cannot be classified into any of the recognized categories or subdivisions of vascular tumors.
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PMID:Locally metastasizing vascular tumor. Spindle cell, epithelioid, or unclassified hemangioendothelioma? 195 Nov 88

A case of a lymphangiosarcoma (LAS) in a chronic postmastectomy lymphedematous arm in a 67 y.o; women is reported. The LAS was found 8 years after a radical left mastectomy for cancer and 7 years after the development of a lymphedema in the left arm. Because of a rapid spread of the disease no surgical treatment was done. The patient died 14 months after the diagnosis. Lymphangiosarcoma is a rare neoplasia that usually arise in chronic lymphedematous limbs mostly in post-mastectomy lymphedema of the arms. Chronic lymphedema is an important neoplastic stimuli decreasing the local immunity, as well leading to lymphoproliferative and degenerative changes of collagenous and fat tissues. Usually it appears as a multicentric lesion like bluish nodules, sclerotic plaques, bullous lesions. Lungs, pleura and thoracic wall are the most common sites of metastatic disease. The DD should be done with Kaposi sarcoma, hemangioma, hemangiopericytoma. The prognosis is always poor and after treatment the mean survival time is 18 months. The best treatment that gives a temporary result is the ablative surgery. Therefore because of unsuccessful therapeutic procedures a particular care should be paid to avoid postmastectomy lymphedema leaving, when possible, a reasonable lymphatic drainage of the arm.
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PMID:[Lymphangiosarcoma with postmastectomy edema of the arm]. 203 81

We retrospectively studied the value of MR imaging at 1.5 T in distinguishing hepatic hemangiomas (n = 15) from metastases (n = 15) by using (1) lesion/liver signal-intensity ratios, (2) contrast/noise ratios, and (3) T2 relaxation time on long TR/TE spin-echo (SE) sequences. Lesion/liver margin sharpness, lesion shape, and overall lesion morphologic pattern were evaluated also. Univariate logistic regression analysis of the quantitative data showed that T2 was the only statistically significant (p less than .02) variable for distinguishing a hemangioma from a metastasis. A receiver-operator-characteristic plot of T2 produced an area of 0.80 (+/- 0.08). T2 values for these lesions still overlapped with those for metastases. Morphologically, hemangiomas were sharply marginated (80%), rounded or oval (93%), homogeneous, hyperintense lesions (73%), whereas metastases were poorly marginated (66%) and inhomogenous (67%) lesions. The marked, hyperintense appearance was present in 27% of metastases. Retrospective, multivariate logistic regression analysis of T2 and the presence of hyperintense morphology did not improve results based on T2 alone. Morphologic criteria are helpful in differentiation, as some metastases have a prolonged T2 and are not homogenous, hyperintense lesions. In cases where T2 or morphology are equivocal, other diagnostic tests may help confirm the MR findings. We currently use a T2 of greater than 88 msec and the presence of hyperintense morphology to diagnose hemangiomas. Despite both quantitative and qualitative analysis, data for these hemangiomas and metastases still overlap.
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PMID:Hepatic hemangiomas vs metastases: MR differentiation at 1.5 T. 211 64

We studied the feasibility of using MR imaging at 0.6 T to differentiate small hepatic hemangiomas from small metastases on the basis of quantitative criteria. Ninety-two liver masses up to 5 cm in diameter, including 51 proved hemangiomas (mean, 1.9 +/- 1.1 cm) and 41 proved metastases (mean, 1.9 +/- 1.2 cm) were analyzed. Lesions were divided into three groups on the basis of size (less than or equal to 1 cm, greater than 1- less than or equal to 2 cm, greater than 2- less than or equal to 5 cm). The ability to distinguish hemangiomas from metastases was examined by using differences in lesion/liver signal-intensity ratio (SIR) and contrast-to-noise ratio (CNR) on T2-weighted images (SE 2350/180). Receiver-operating-characteristic analysis for all lesions grouped together showed that differentiation based on SIR was superior to that based on CNR (p less than .05). The mean SIR of hemangioma and the difference between mean SIRs of hemangioma and metastasis decreased with lesion size (greater than 2- less than or equal to 5 cm: 6.11 +/- 2.61 vs 2.30 +/- 1.22; greater than 1- less than or equal to 2 cm: 4.47 +/- 1.56 vs 2.40 +/- 0.73; less than or equal to 1 cm: 3.59 +/- 0.92 vs 2.01 +/- 0.52). However, in each size group, the difference between the mean SIR of hemangioma and metastasis was statistically significant (p less than .0001). These observations suggest that MR imaging is useful in differentiating small hepatic hemangiomas from small metastases and suggest the need for establishing size-specific quantitative criteria for tissue characterization.
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PMID:Differentiation between small hepatic hemangiomas and metastases on MR images: importance of size-specific quantitative criteria. 211 65

With the increasing availability of curative surgical techniques for primary and secondary hepatic neoplasms, the tasks for clinical imaging of patients suspected of having liver cancer have become more exacting. Detection of tumor, differential diagnosis of individual nodules, and mapping the anatomic extensions of malignant disease are now required routinely. Related and unrelated liver substrate abnormalities such as cavernous hemangioma and focal fatty deposits are often discovered in these patients and must be differentiated from metastatic deposits. Moreover, modern imaging methods frequently display tiny nodules (less than 1 cm) that often prove difficult to adequately characterize (micrometastases vs other kinds of lesions). The most sensitive imaging techniques are CT after arterial portography and intraoperative sonography, but because of their invasiveness, these are reserved exclusively for cancer staging. For primary screening, MR imaging is increasingly preferred over CT because of its superiority in discriminating hemangiomas and cysts from metastases without the need for iodinated contrast material.
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PMID:Liver tumor imaging: current concepts. 184 88

With a retrospective analysis of images from 39 patients with histologically proven liver tumours we tried to determine the best MRT-parameter for detection of cavernous hemangioma (n = 19) and its differentiation from malignoma (metastases n = 17, HCC n = 5). The best differentiation was achieved with the contrast-to-noise ratio between lesion and liver in multi-echo-images with TR/TE = 2,000/210 ms and a definite limit with an accuracy of 84% for hemangioma and 91% for malignoma. The respective intensity ratios (lesion/liver) were 95% and 77%. T2-relation times and the T1- and T2-ratios were also calculated. In contrary to the literature we think that these parameters are not sufficiently discriminating.
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PMID:[Differential diagnosis by MRT of cavernous hemangiomas and malignant tumors of the liver--advantages of the multi-echo technic]. 216 Jun 68

The feasibility of dynamic sequential magnetic resonance (MR) imaging of focal hepatic lesions using Gd-diethylenetriamine pentaacetic acid (DTPA) was evaluated in this study. Three patients with hepatocellular carcinoma, 12 patients with metastases, and 7 patients with hemangiomas were studied with pre- and postcontrast multislice spin echo (SE) images using a repetition time of 500 ms and an echo time of 15 ms. The dynamic distribution phase of Gd-DTPA (0.1 mmol/kg) was investigated by using a sequential, transverse partial flip imaging sequence [fast low angle shot (FLASH)] before and after intravenous administration of Gd-DTPA. The lesion-liver contrast-to-noise ratio showed a great variability in patients with metastases and was significantly improved following administration of Gd-DTPA in patients with hemangiomas, two patients with hepatocellular carcinoma, and eight patients with metastases both on FLASH and SE images. Hemangiomas appeared darker than liver parenchyma on precontrast SE and FLASH images, increasingly enhanced over 5 min postinjection (pi) on FLASH images, and were still greatly enhanced at 10 min pi on SE images. During the dynamic sequential image acquisition the contrast enhancement of hemangiomas was significantly different from the enhancement observed in malignant lesions. The results of this study indicate the clinical potential of dynamic sequential imaging for the MR assessment of focal hepatic lesions.
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PMID:Dynamic sequential MR imaging of focal liver lesions: initial experience in 22 patients at 1.5 T. 216 38

Clinical aspects of twelve patients with benign mesenchymal lung tumours including four so-called sclerosing haemangiomas were studied. The age of the patients varied from 17 to 62 years (mean 40 years). Seven patients were female and five were male. The benign tumour was enucleated in five cases and excised by segmentectomy in one case. Three tumours were removed by lobectomy, and one by bilobectomy including bronchial resection and bronchoplasty. Two tumours (an endobronchial leiomyoma and fibroma) were removed by bronchial resection. Two patients who had previous hysterectomy for uterine leiomyomas had intraparenchymal pulmonary leiomyomas with histologically benign appearance. Although these tumours might represent metastases from uterine tumours, the follow-up of 5 and 8 years did not reveal clinically malignant features. None of the patients in this series showed tumour recurrences. Our results confirm earlier observations suggesting that the so-called sclerosing haemangioma is actually an epithelial, not a mesenchymal tumour.
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PMID:Benign mesenchymal tumours of the lung including sclerosing haemangiomas. 216 37

Small cell lung cancer is an aggressive neoplasm; metastases are detected in two-thirds of patients at diagnosis with use of conventional staging, which includes bilateral bone marrow biopsy, bone scintigraphy, and computed tomography (CT) of the head and abdomen. In 25 patients, small cell lung cancer was staged prospectively with both conventional staging and a magnetic resonance (MR) imaging protocol that included 1.5-T MR imaging of the pelvis, abdomen, spine, and brain. According to conventional staging, 14 patients had extensive disease and 11 patients had limited disease; according to staging with MR, 19 patients had extensive disease and six had limited disease. All metastatic disease sites seen with conventional staging were identified on MR images. MR images showed additional metastatic involvement in bone (four patients) and liver (three patients) not detected at conventional staging. A low-attenuation hepatic lesion on a CT scan was identified as a hemangioma on MR images. These preliminary data suggest that small cell lung cancer may be accurately staged with use of a single MR imaging study.
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PMID:Small cell lung cancer: staging with MR imaging. 217 44

In a retrospective study the findings of dynamic CT investigations in 185 patients with histologically confirmed hepatic masses were analysed and related to 47 criteria which have been described in the literature. The criteria with the highest value for making a specific diagnosis have been defined for seven different lesions (abscess, adenoma, FNH, haemangioma, adenocarcinoma metastases, metastases from other tumours, HCC). We found agreement with the literature in the following: the target phenomenon for abscesses, central scarring for FNH, spreading enhancement for haemangiomas and irregularity of the liver contour in the absence of subcapsular tumours for HCC. By combining a number of criteria it was possible to suggest the type of lesion retrospectively. The predictive value was found to range from 73% to 100%, a definite diagnosis was possible in only 64%.
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PMID:[A frequency analysis and evaluation of the criteria for dynamic CT and a test of the CT diagnosis of space-occupying lesions of the liver]. 217 14


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