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)

Lesions that involve the cortex of the tibia are fairly common in radiology practice. However, the number of diseases that involve the tibial cortex is great, and it can be difficult to arrive at a limited differential diagnosis from radiographic findings. Categorization of lesions of the tibia into those that cause cortical destruction and those that cause cortical proliferation can help narrow the broad differential diagnosis. Lesions that cause cortical destruction include nonossifying fibroma, fibrous dysplasia, osteofibrous dysplasia, aneurysmal bone cyst, giant cell tumor, eosinophilic granuloma, Ewing sarcoma, neurofibromatosis, adamantinoma, osteoblastoma, chondromyxoid fibroma, hemangioendothelioma, renal cell metastatic disease, hemangioma, and hemangiopericytoma. Lesions that cause cortical proliferation include osteochondroma, stress fracture, osteoid osteoma, periosteal osteogenic sarcoma, diaphyseal dysplasia, venous stasis, cellulitis, chronic osteomyelitis, osteopathia striatum, and melorheostosis. Conventional radiography along with clinical and pathologic data can aid in diagnosis of the wide variety of disease processes that involve the tibial cortex.
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PMID:Cortical lesions of the tibia: characteristic appearances at conventional radiography. 1253 51

Metastatic hemangiopericytoma to the spine is rare, and operative management of these highly vascularized tumors is challenging. Review of the literature identified only seven previously reported cases. Metastases of hemangiopericytomas to the spine are diagnosed often only after a long delay following resection of the primary tumors. To emphasize the clinical and histopathological features of metastatic hemangiopericytoma to the spine and to review treatment options, a case of a delayed metastatic hemangiopericytoma to the cervicothoracic spine is reported: a 48-year-old woman presented with a large metastatic hemangiopericytoma to the cervicothoracic spine causing left-sided cervicobrachialgias and gait disturbance. Magnetic resonance imaging studies revealed a large left-sided dumbbell-shaped intraspinal and extraspinal tumor from C6 to T2. The patient underwent two-staged total removal of the cervicothoracic mass with posterior stabilization and subsequent radiotherapy. Histopathological findings revealed a malignant hemangiopericytoma which had identical features to the primary cranial meningeal tumor removed 8 years earlier. The radicular symptoms and the gait ataxia disappeared, postoperatively. One year later, however, new metastases were present. Patients with hemangiopericytoma should be controlled regularly for local recurrence and systemic tumor spread. The best available treatment for delayed metastasis to the spinal column is complete tumor removal followed by postoperative radiotherapy.
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PMID:Delayed manifestation of spinal metastasis: a special feature of hemangiopericytoma. 1286 May 7

Yet meningiomas have characteristic neuroimaging features, some other lesions are still confusing with meningiomas. The aim of this study was trying to find the typical (1)H-MRS metabolic factors of histologic subtyped meningiomas, schwannomas, metastases, and other brain tumors for differential diagnosis among them. (1)H-MRS using STEAM (TE/30 ms, TR/2 sec) and PRESS (TE/288 ms, TR/2 sec) sequences were performed on 44 untreated brain tumors. Obtained metabolic patterns from the typical spectra of meningioma, schwannoma, metastasis were compared with each other or other brain tumors to evaluate the usefulness for diagnosis between them. Alanine(Ala) was observed in 15 cases of the 19 meningiomas with a little variation to three histologic subtypes, while minimal lipids were observed in every 19 meningiomas. Elevated glutamate/glutamine(Glx) was detected in 12 cases of the meniningiomas. Increased myo-inositol(mI) was detected in 11 cases of the 13 schwannomas. Dominant lipids signals as well as long-T2 lipids were detected in every metastasis in conjunction with elevated choline (Cho). Enhanced Glx was observed in 4 cases of the 8 metastases without correlation of primary tumor site or types. Hemangiopericytoma showed different spectral patterns from typical meningiomas: only dominant Cho, minimal lipids and absence of Ala or Glx signals. These metabolic patterns in typical tumors may provide a basis for differential diagnosis (average value of chi(2) = 23.33, p < 0.01) between meningiomas and schwannomas as well as metastases. However proton spectral distinction among the different histologic subtypes of meningiomas was not definite.
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PMID:(1)H-MRS metabolic patterns for distinguishing between meningiomas and other brain tumors. 1291 98

We describe two new resected cases of primary pulmonary hemangiopericytoma and the review of cases published in the period 1954-2002. The first patient has a large pulmonary mass of the right apex revealed by scapular pain. The right upper lobectomy with free margins reveals hemangiopericytoma. Pelvic and pulmonary metastases appear two years after surgery, treated by two series of chemotherapy without clinical response. After acute nephrotoxicity controlled by hemodialysis, the patient dies with distant metastases three years and an half after thoracotomy. The second patient develops dry cough and thoracic pain with discovery of a cavitary mass in the right pulmonary field. Fine needle aspiration cytology suggests a mesenchymatous lesion. Three months after extended pneumonectomy, the intrathoracic tumour relapses and regresses partially under chemotherapy. Femoral and brain metastases are irradiated. The patient dies 22 months after thoracotomy. Histology and immunohistochemistry of both tumours closely related to solitary fibrous tumour confirm malignant hemangiopericytoma. Primary pulmonary hemangiopericytoma is rare and may be benign or malignant. Radical resection is the best treatment. Chemotherapy and radiotherapy may improve the prognosis. Compared with lung cancer, the tumour is a slow growing mass, often voluminous, with delayed symptoms, very few lymph node dissemination, rare brain metastasis, more frequent cutaneous or retroperitoneal dissemination, often after long-term and requiring indeed a 10 to 20 years follow-up.
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PMID:[Primary pulmonary hemangiopericytoma: 2 new cases]. 1465 Mar 17

Hemangiopericytoma is a rare vascular tumor featuring the uncontrolled proliferation of pericytes. This tumor tends to develop in subcutaneous tissue and skeletal muscle. The localization of hemangiopericytoma in the orbit is particularly rare. Clinical signs and symptoms are, in order of frequency, proptosis, perception of an intraorbital mass, pain, diplopia, reduction of visus, tumescence, and ecchymoses of the eyelids. Hemangiopericytomas have higher potential of relapse, local invasiveness, and the possibility of producing distant metastases. Surgery must be as radical as possible to avoid incomplete tumor resection and high frequency of relapse together with increased duration of the disease and a higher risk of malignant development. The current report is a study of two cases of hemangiopericytoma in the orbital cavity treated at the Unit of Maxillo-Facial Surgery of the University of "La Sapienza" in Rome. The present data demonstrate that complete en bloc excision of the mass with its capsule is important to avoid the risk of relapse. To this end, an appropriate first surgical treatment should be chosen so as to obtain a wide "surgical light" and complete view of the mass. In the reported cases, the use of a combined anterolateral approach was preferred to attack the tumor from different sides. Indeed, such an approach allows one to obtain optimal exposition of the orbital region and temporal and infratemporal fossae contemporaneously.
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PMID:Surgical treatment of recurrent orbital hemangiopericytoma. 1470 75

Extracranial multiple metastases from meningeal hemangiopericytoma have been reported only rarely. The authors describe the case of a 61-year-old woman, who was previously diagnosed as having primary meningeal hemangiopericytoma with its multiple metastases to the liver, lumbar spine, etc. and who suffered from a sudden attack of hypoglycemia. Considering the history of her present illness, this hypoglycemic shock was most likely brought on by the remarkable metastatic tumors to the liver. Recent literature pertinent to hypoglycemia suggests that insulin-like growth factor-II (IGF-II) produced by tumor is strongly suspected to be involved in the development of hypoglycemia.
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PMID:[Multiple extracranial metastases from a meningeal hemangiopericytoma and severe hypoglycemia: a case report]. 1522 44

Hemangiopericytoma is a rare tumor with uncommon location in the central nervous system. It has only recently been included (WHO classification 1993) in a specific group of CNS tumors and subsequently (WHO classification 1997 and 2000) as a group by itself, while before it was confused with meningeal tumors. We report on a case of a 48-year-old woman affected by this tumor. The neoplasm was located in the posterior fossa. The patient underwent primary surgery in 1990, not followed by any adjuvant therapy because of the histopathological diagnosis of meningioma. After being free from disease for eight years she developed a local recurrence in 1998. Subtotal excision of the tumor, which was finally identified as a hemangiopericytoma, was carried out, followed by adjuvant radiotherapy (64 Gy). After six months multiple metastases were found in the liver and right kidney. A radical metastasectomy was performed, followed by systemic chemotherapy. One year later (2001) the tumor recurred again intracranially and a metastases was detected in the right breast, so the patient again underwent cranial irradiation (40 Gy) and second-line chemotherapy. She died in September 2002, 12 years after the diagnosis. We may conclude that, despite the tumor's natural tendency to recur several times and the ability of intracranial hemangiopericytoma to spread outside the CNS, it is possible to ensure a long survival time.
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PMID:Recurrent intracranial hemangiopericytoma with extracranial and unusual multiple metastases: case report and review of the literature. 1523 97

Primary vascular neoplasms of the spleen constitute the majority of nonhematolymphoid splenic tumors. The benign primary vascular tumors include hemangioma, hamartoma, and lymphangioma, whereas those of variable or uncertain biologic behavior include littoral cell angioma, hemangioendothelioma, and hemangiopericytoma. The primary malignant vascular neoplasm of the spleen is angiosarcoma. Peliosis is a rare lesion of unknown cause that is usually found incidentally in asymptomatic patients but may be associated with hematologic or metastatic disease. Although these vascular neoplasms of the spleen are uncommon, their importance lies in that they must be differentiated from the more common neoplastic disorders of the spleen, such as lymphoma and metastasis. The most common echogenic solid or complex cystic mass in an asymptomatic patient is splenic hemangioma. However, the imaging appearance of splenic hemangiomas may be complex, and differentiation of these lesions from malignant disease may not be possible. The diagnosis of splenic hamartoma may be suggested when findings of increased blood flow on color Doppler images are seen in association with a homogeneous solid echogenic mass. A large subcapsular solitary cystic abnormality discovered incidentally in a child in association with internal septations and tiny mural nodules favors the diagnosis of lymphangioma. Any invasion of the surrounding splenic parenchyma by a splenic lesion should indicate a more aggressive or malignant process. Evaluation of a focal splenic abnormality identified on sonograms should be followed up with computed tomography or magnetic resonance imaging with and without contrast material enhancement. Splenectomy may be required for definitive evaluation of a splenic mass with atypical features.
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PMID:From the archives of the AFIP: primary vascular neoplasms of the spleen: radiologic-pathologic correlation. 1525 34

A 43-year-old housewife suffered from an occipital headache, and brain computed tomography (CT) showed an occipital meningeal tumor. She received a complete tumor excision and the tumor pathology was interpreted as atypical meningioma. Five years later, a subacute left neck pain with radiation to the left arm occurred. A tumor invading the second and third cervical vertebrae with compression on the dural sac was found. Angiography revealed hypervascular tumor staining supplied from the left vertebral artery. CT-guided biopsy was performed and nests of atypical spindle cells accompanied by staghorn vascular pattern were revealed histologically. Immunohistochemical studies showed positive vimentin staining but negative reactions to epithelial membrane antigen, cytokeratin low molecular weight, cytokeratin high molecular weight, CD34 and S-100 protein. Estimation of the Ki-67 proliferative (mitotic) index by using MIB-1 monoclonal antibody was 12%. Later on, a systemic survey revealed lesions in the left lung, liver and kidney. The diagnosis was revised to hemangiopericytoma. Distant metastasis is common in this tumor. However, the delayed multiple metastases without local recurrence were relatively rare. The clinical course in this patient also supported that a high mitotic activity may correlate with a poor prognosis even if the pathology is taken from the metastatic tissue, and that long-term follow-up is mandatory. Detailed immunohistochemical staining is helpful in avoiding misdiagnosis of meningioma.
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PMID:Meningeal hemangiopericytoma with delayed multiple distant metastases. 1564 88

Haemangiopericytoma is a rare, vascular soft tissue tumour originating from the pericytes surrounding capillaries. We report a case of haemangiopericytoma in the sigmoid mesocolon and are aware of only one previously case. A 61-year-old man was referred with a left iliac fossa mass. At operation, a 10-cm diameter mass was found to be arising from the sigmoid mesentery (Fig. 1). The mass did not involve the bowel wall and there was no clinical evidence of metastatic disease. A sigmoid colectomy with primary anastomosis was performed. The patient made an uneventful recovery. Pathological assessment of the specimen revealed a 95 x 70 x 50 mm(3), purple, lobulated mass within the sigmoid mesocolon adjacent to the bowel. Immunohistological analysis (positive CD34, focal factor VIII) was consistent with a diagnosis of a haemangiopericytoma. Complete excision with adequate margins remains the treatment of choice. We therefore suggest that patients be carefully followed for long periods and advised of the risk of long-term relapse.
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PMID:Haemangiopericytoma of the sigmoid mesentery. 1565 26


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