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)

A 45-year-old woman presented with an extremely rare metastatic fibrosarcoma of the brain manifesting as persistent headache. She had undergone surgery for a fibrosarcoma of the soft tissue of the thigh 2 months earlier. She had a history of previous surgery and radiotherapy for this tumor. She was somnolent with papilledema and left hemiparesis. Magnetic resonance imaging of the brain revealed a right frontal lesion with mass effect and heterogeneous enhancement. Computed tomography and scintigraphy showed multiple metastatic lesions of the lung. Right frontal craniotomy was performed for gross total removal of the yellowish-white tumor. Histological examination showed signs of epithelioid transformation based on positive staining for epithelial membrane antigen compared to the primary tumor. Postoperatively the patient was alert and the left hemiparesis improved. She refused radiotherapy or chemotherapy. Follow-up computed tomography showed multiple intracranial metastases. She died 5 months after the surgery.
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PMID:Metastatic fibrosarcoma of the brain: transformation from conventional to epithelioid form--case report. 1560 Feb 87

A 58-year-old female with gastric cancer presented with left chronic subdural hematoma (CSH) without history of head injury. Magnetic resonance imaging revealed left CSH with atypical findings such as abnormal dural enhancement and swelling of the left cerebral hemisphere. One month after gastrectomy, motor aphasia and right hemiparesis developed. Irrigation of the left CSH was performed. The hematoma was abnormally mucinous and became solid immediately after irrigation. Histological examination showed that adenocarcinoma cells had metastasized to the dura mater and the outer membrane of the hematoma. The preoperative cerebral blood flow (CBF) in the affected cerebral hemisphere, measured by single photon emission computed tomography using N-isopropyl-p-[123I]iodoamphetamine, was much higher than that in the opposite hemisphere, whereas the postoperative CBF was almost equal in both hemispheres. Subdural hematomas secondary to dural metastases of extraneuronal malignancies are rare, and are usually the chronic type. Measurement of the pre- and postoperative CBF in the present patient with CSH following dural metastasis of the malignant tumor showed that preoperative hyperemia in the affected hemisphere may result from dilation of the cerebral vessels caused by the effects of the CSH.
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PMID:Chronic subdural hematoma following dural metastasis of gastric cancer: measurement of pre- and postoperative cerebral blood flow with N-isopropyl-p-[123I]iodoamphetamine--case report. 1568 96

The paper analyzes the use of a Leibinger Stryker stereotactic frame system (Germany) for surgical interventions for deeply located cerebral masses. Twenty three patients were operated on, by applying this system. Twenty five supratentorial masses were removed; of them 12 masses were paraventricularly located, including 5 masses being present close to the subcortical nuclei and internal capsule or immediately in them. In 9 patients, the foci were located subcortically in the projection of the sensorimotor region and motor zone of speech. Four masses were positioned in the substantia alba of the hemispheres. The patients having foci measuring not greater than 30-35 mm in diameter were selected for the study. Most cases were metastatic medullary lesions (11 single cases, 2 cases with multiple metastases, 3 cavernous angiomas, 2 arteriovenous malformations, 5 glial tumors). An algorithm for the stereotactic planning of approaches to masses of various localization and a procedure for there removal are presented in the paper. All the patients showed satisfactory postoperative results. Only did 4 patients with metastases being adjacent to the motor zone of the cortex and with a significant perifocal edema in the postoperative period display a recess of preoperative contralateral hemiparesis that regressed due to therapy. There were no other surgical complications. The method has proved to be effective against minor tumors (not more than 30 mm); whose access trajectory is over a length of more than 40-50 mm and against metastatic processes with a significant perifocal edema. This stereotactic system that considers the individual anatomic features of the patients' brain altered due to a pathological process provides convenience and precision when the deeply located brain masses are removed, by minimizing surgical trauma.
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PMID:[Stereotactic technique in the surgical treatment of deeply located cerebral masses]. 1591 64

We report a case of an elderly man who presented with hemiparesis and plain CT scan findings highly suggestive of an extradural hematoma as the underlying cause. This patient was later found to have dural metastases secondary to bronchogenic carcinoma. Dural metastases are rare, usually presenting as dural mass, but may also present as chronic subdural or extradural hematoma on non contrast CT scan, leading to an erroneous diagnosis in the unsuspecting.
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PMID:Dural metastases presenting as an extradural hematoma: a rare presentation. 1630 75

Three male patients aged 82, 56 and 60 years presented with cognitive impairment and hemiparesis, weakness of the tongue and facial muscles, and pain and weakness of the left arm, respectively. They were found to have carcinoma of the prostate with cerebral, skull and cervical spine metastases. They were treated with hormonal therapy and local radiotherapy for bone metastases. The first patient died within 2 weeks, the second after 1.5 year, and the third was still alive after 6 years. The diagnostic work-up in men with unexplained neurological symptoms should probably include a rectal exam and assessment of prostate-specific antigen.
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PMID:[Neurological symptoms as the first sign of prostate carcinoma]. 1667 9

Radiosurgical treatment of brain tumors is sometimes considered to be free from significant acute complications or adverse effects. A rare case of fatal intratumoral hemorrhage immediately after gamma knife radiosurgery (GKR) for brain metastasis is reported. A 46-year-old woman with lung cancer complicated by systemic dissemination experienced an acute episode of headache, speech disturbances, and right-side hemiparesis. She had no history of arterial hypertension or coagulation disorders. CT and MRI disclosed multiple brain metastases. The largest tumor, which was located in the left frontal lobe and caused a significant mass effect, was removed microsurgically without any complications. GKR for nine residual metastases was done on the fourth postoperative day. The marginal dose, which corresponded to the 50% prescription isodose line, constituted 20 Gy. No complications were noticed during frame fixation, treatment itself, or frame removal. Fifteen minutes after the end of the GKR session the patient acutely fell into a deep coma. Urgent CT disclosed a massive hemorrhage in the left cerebellar hemisphere in the vicinity of the radiosurgically treated lesion. The patient died 4 days later and autopsy confirmed the presence of intratumoral hemorrhage. In conclusion, GKR for metastatic brain tumors should not be considered as a risk-free procedure and, while extremely rare, even fatal complications can occur after treatment.
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PMID:Fatal intratumoral hemorrhage immediately after gamma knife radiosurgery for brain metastases: case report. 1704 40

A 49-year-old man presented with palpitation and shortness of breath. He was seen to have a massive pleural and pericardial effusion on radiography and echocardiography. Computed tomography (CT) scanning showed that cardiac tumors arose from the right atrium with epicardial and endocardial extension. Pathology examination of samples at pericardiotomy revealed them to be angiosarcoma. Two days after the surgery, he developed left hemiparesis. CT scans showed a large cerebral hemorrhage on the right temporal lobe with midline shift by brain metastases. He died 37 days after the surgery. At autopsy, he had metastases in the brain, multiple bones, and soft tissues but no lung or left-side heart involvement. Primary cardiac angiosarcoma is rare, and mostly arises from the right side of the heart. Common metastatic sites are the lungs and liver. There are only a few reports of brain metastases. In conclusion, this is a rare report of cardiac angiosarcoma presenting with pericardial tamponade. There were rapid brain and multiple bone metastases but no lung or left-side heart lesions.
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PMID:Primary cardiac angiosarcoma: presenting with cardiac tamponade followed by cerebral hemorrhage with brain metastases. 1723 55

Uterine cervix carcinoma usually spread by local extension and through the lymphatics to the retroperitoneal lymph nodes. Brain metastases are extremely rare in the course, are usually seen late and have poor prognosis. We report a 49-year-old woman with squamous cell carcinoma of the cervix who developed right parieto-occipital lobe metastasis after three years of treatment of the primary disease. The presenting symptoms of the metastatic disease were hemiparesis, headache, and vomiting. Her hemiparesis improved after surgical excision of the metastasis. Treatment in these cases is mainly palliative but may offer symptomatic relief and improvement in the quality of life.
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PMID:Intracranial metastases from carcinoma of the cervix. 1745 90

A 78-year-old man with liver cirrhosis was found to have multiple hepatocellular carcinomas (HCCs) and underwent 3 sessions of transcatheter arterial chemoembolization. Fourteen months after diagnosis, the patient presented with left hemiparesis. Contrast-enhanced magnetic resonance imaging showed multiple metastases with ring-shaped enhancement in the cerebrum and cerebellum. There were no metastases to other organs. The metastatic lesions almost completely disappeared after whole-brain radiotherapy with a total dose of 50 Gy. Neurologic symptoms decreased, and the patient's quality of life improved. The patient underwent 2 more sessions of transcatheter arterial chemoembolization. Twelve months after the diagnosis of brain metastasis, the patient remains alive. The present case indicates that radiotherapy can improve quality of life and prolong survival in some patients with brain metastases from HCCs.
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PMID:Radiotherapy for multiple brain metastases from hepatocellular carcinomas. 1772 13

We report a case of toxoplasmic encephalitis (TE) in a young woman without prior history of human immunodeficiency virus (HIV) infection. She was referred to our clinic with a diagnosis of multiple metastases following cerebral magnetic resonance imaging (MRI) revealing multiple ring-enhanced mass lesions. She had suffered from headaches for four weeks and there had been new onset of confusion and left hemiparesis. Soon after hospitalization, her neurological status rapidly deteriorated and she was operated for decompression. Pathology examination revealed TE and her blood samples were found to be HIV positive. We conclude that TE should be considered in the differential diagnosis of multiple lesions in sexually active individuals including cases without a prior history of HIV infection.
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PMID:HIV related toxoplasmic encephalitis mimicking multiple metastasis: case report. 1793 9


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