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)

Worldwide, hepatocellular carcinoma (HCC) is one of the most common and deadly solid cancers. At least one million new patients are diagnosed annually with this cancer. Incidence in non-Western countries is related to infections of hepatitis B virus and dietary ingestion of aflatoxins, whereas in Western countries alcohol-related cirrhosis and chronic hepatitis C virus infection are leading causes of HCC. In the United States, approximately 155,000 new cases of cancer of the liver and bile duct occur annually, with the majority being colorectal metastases.
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PMID:Radiofrequency ablation of primary and metastatic liver tumors. 1238 70

We report a patient with hepatocellular carcinoma (HCC) with intraperitoneal lymph node metastases in whom UFT (uracil + tegafur) was markedly effective. The patient was a 70-year-old woman with chronic hepatitis C, who developed HCC mainly infiltrating the medial segment of the liver. Arterial infusion chemotherapy and embolization were performed, and radiofrequency ablation was also conducted. Despite these interventions, the serum alpha-fetoprotein level continued to increase, and reached a level as high as 208,000 ng/ml by the second month of treatment. Abdominal computed tomography (CT) revealed no recurrence in the liver, but multiple metastases to intraperitoneal lymph nodes were identified. UFT-E treatment was initiated at the dose of 400 mg/day. A subsequent abdominal CT revealed complete disappearance of the intraperitoneal lymph node metastases 2 months after the start of UFT treatment. The serum alpha-fetoprotein level returned to normal 4 months after the start of UFT treatment. We consider that the patient described here is a good example to illustrate the remarkable effectiveness of UFT in the treatment of metastatic HCC.
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PMID:[A patient with hepatocellular carcinoma with intraperitonial lymph node metastases in whom oral UFT treatment was markedly effective]. 1246

Combined hepatocellular and cholangiocellular carcinomas are rare. Moreover, double cancer cases of hepatocellular carcinoma and cholangiocellular carcinoma are very rare. This report describes a patient with double cancer. A correct clinical diagnosis was made with successful resection, and cutaneous metastases occurred near the exit site of an abdominal drain after the resection of the tumor. The patient, a 66-year-old man with chronic hepatitis C, was admitted to our hospital because he was suspected of having primary liver cancer. Two liver masses in the anteroinferior segment were detected by using angiography, computed tomography during angiography, and computed tomography during arterioportography. These clinical findings indicated that the tumor in the right lobe was hepatocellular carcinoma. A resection of the S5 subsegmentectomy was performed. One mass was diagnosed histologically as hepatocellular carcinoma, and the other mass was diagnosed as cholangiocellular carcinoma. One year after the operation, the patient palpated a hard subcutaneous nodule 4.0 cm in diameter in the right lower abdominal wall. A subcutaneous tumor was excised, and a histological examination revealed moderately differentiated hepatocellular carcinoma. The patient is currently doing well without further recurrence of hepatocellular carcinoma or cholangiocellular carcinoma, 18 months after subsegmentectomy and six months after excision of the subcutaneous tumor.
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PMID:Resected case of a double cancer, a hepatocellular carcinoma and a cholangiocellular carcinoma, and their spread to the skin. 1274 21

Hepatocellular carcinoma (HCC) has a tendency for fatal spontaneous rupture leading to massive hemorrhage. The majority of such ruptures of HCC occur in the liver, while a few previous studies showed that such HCC rupture developed at metastatic sites including the lung, pleura, spleen, and peritoneum. We here report a case of hepatitis C virus-related HCC with spontaneous rupture of a peripancreatic lymph node with HCC metastases. A 61-year-old Japanese man died of hepatic failure after therapy for cirrhosis and HCC for 6 years. At autopsy, the liver showed diffuse multinodular HCC in both lobes. Metastases were found in lumbar vertebral bones and abdominal lymph nodes of the hepatic hilar, peripancreatic and perigastric regions. One lymph node (4 cm in diameter) around the pancreatic head was found ruptured, and blood coagula (100 g) was present around the ruptured node. Pure blood of 2000 ml was noted in the peritoneal cavity. Cirrhosis was not recognized. Histologically, the liver tumors and metastases in the lumbar vertebral bones and abdominal lymph nodes were poorly-differentiated HCC of Edmondson's grade III. The ruptured lymph node was almost replaced by poorly-differentiated HCC, and the ruptured site showed hemorrhage, breakdown of the capsule, and ischemic changes. Non-tumorous liver showed chronic hepatitis C. The immediate cause of death was suggested to be circulatory insufficiency due to rupture of the lymph node and/or hepatic failure. The present case showed that abdominal lymph nodes with HCC metastases may rupture and cause severe hemorrhage in the peritoneal cavity, leading to death.
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PMID:Spontaneous rupture of peripancreatic lymph node with hepatocellular carcinoma metastasis: report of an autopsy case with massive peritoneal bleeding. 1278 8

Brain metastases from hepatocarcinoma are exceptional and only a few cases have been reported in the literature, mainly from Far-Eastern countries. Clinical diagnosis in asymptomatic patients with preserved liver function is difficult and usually late. In some cases, cerebral metastasis is the initial manifestation of HCC and patients may develop intracerebral hemorrage and have a stroke-like presentation. We report on the first Italian case of cerebral metastases from multifocal hepatocellular carcinoma in an asymptomatic HbsAg negative patient with unknown HCV related chronic hepatitis and no evidence of liver cirrhosis. For many years he had a mild liver enzyme elevation and the presence of multiple misinterpreted hypoechogenic hepatic lesions. The hepatic tumor spread to the lungs and the brain and the patient developed two major episodes of intracranial hemorrage. He had two nodular lesions in the brain and alpha-fetoprotein levels were more than 10,000 ng/ml. He died from neurologic causes, without major signs of liver failure.
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PMID:Intracranial hemorrage due to brain metastases in an Italian HCV patient with hepatocellular carcinoma. 1505 9

In March 1999, a 54-year-old man with chronic hepatitis C was referred to our hospital because of ruptured hepatocellular carcinoma (HCC) located in Couinaud's segments 4 and 8. He underwent central bisegmentectomy of the liver with partial resection of the diaphragm. After the first surgery, extrahepatic metastases were found on different occasions in the abdominal wall, thoracic cavity, and greater omentum and were all surgically resected. In February 2001, the serum protein induced by vitamin K absence or antagonist-II (PIVKA-II) level increased markedly to 19,000 mAU/l. Magnetic resonance imaging showed a massive right subphrenic tumor with invasion to the right diaphragm and posterior segment of the liver. The patient underwent en bloc resection of the tumor, diaphragm, posterior segment of the liver, and right lower pulmonary lobe. After the surgery, the PIVKA-II level rapidly decreased, and it has remained within the normal range to date. Two years after the last surgery, the patient is doing well without any extrahepatic recurrence, although small intrahepatic recurrences have been completely treated by radiofrequency ablation and transcatheter arterial chemoembolization. Ruptured HCC often exacerbates the risk of peritoneal dissemination and is usually difficult to completely resect. This is an extremely rare case of a patient who successfully underwent five repeated resections for extrahepatic recurrences after hepatectomy for ruptured HCC.
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PMID:Repeated resection for extrahepatic recurrences after hepatectomy for ruptured hepatocellular carcinoma. 1512 81

The patient was a 73-year-old male who was identified with an increase of serum PIVKA-II during a treatment for chronic hepatitis B. Hepatocellular carcinoma (HCC) of 60 mm in diameter with satellite nodules was diagnosed in segment 8 of the liver. In addition, portal vein tumor thrombosis (PVTT) of the right branch (Vp3) and metastases to bilateral lung and right adrenal gland were recognized. He received serial treatments with transcatheter arterial chemoembolization (TACE), radiation therapy and hepatic arterial chemotherapy with reservoir for primary liver tumor and PVTT. Soon after the treatments, PVTT was reduced in size and the serum level of PIVKA-II was decreased to 57 mAU/ml. After three months, the level of PIVKA-II had increased again and the size of the right adrenal metastasis grew to 50 mm in diameter. He received TACE to the right adrenal metastasis and percutaneous transhepatic portal chemoembolization to prevent further growth of PVTT. In spite of several treatments, the therapeutic effect was insufficient. Therefore, we performed right adrenalectomy and radio-frequency ablation of HCC in the liver S8. After the surgery, he received two times of TACE and the viable tumor had disappeared on CT and MRI. Prognosis of HCC with PVTT and distant metastasis is very poor. The two-year survival rate is less than 10%. However, it is possible to improve the prognosis of advanced HCC by multidisciplinary treatment with surgical intervention, local chemotherapy and radiation therapy.
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PMID:[Multidisciplinary treatment for advanced hepatocellular carcinoma with portal vein tumor thrombosis and adrenal/lung metastases]. 1555 60

Acute liver failure is a clinical condition associated with high mortality despite recent technological advances. Supportive devices such as the Molecular Adsorbents Recirculating System (MARS) provide therapeutic strategies to add time to find an organ for orthotopic liver transplantation or to allow the native liver to recover sufficiently to make transplantation unnecessary. In this series of cases, we discuss our initial experiences with three patients with acute liver failure. One patient had high bilirubin levels caused by Epstein-Barr virus infection and responded well after three MARS sessions. In a second patient, MARS therapy was used to treat acute-on-chronic liver failure caused by chronic hepatitis B virus infection that had not been treated previously; because of severe hemodynamic compromise, only one MARS session was performed. The third patient had an initial diagnosis of acute liver failure and cryptogenic hepatitis, and was treated with five MARS sessions as a supportive measure until the definitive diagnosis (metastatic disease) was performed. In all patients, MARS therapy was well tolerated and induced only mild hypokalemia. In conclusion, although MARS therapy was an effective strategy for these cases of liver failure and greatly improved the biochemical variables, its impact on the mortality rate has not yet been determined.
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PMID:Acute liver failure and the Molecular Adsorbents Recirculating System: early experience in a tertiary care hospital in Mexico City. 1565 60

A 63-year-old man, with atypical pulmonary mycobacteriosis and also with hepatic dysfunction due to chronic hepatitis C, underwent wedge resection of the right lower lobe for non-small cell lung cancer. On the 9th postoperative day, the patient developed acute tetraplegia and then respiratory failure. Neither computed tomography (CT) nor magnetic resonance imaging (MRI) of brain and cervical vertebrae showed any cancer metastases. The neurological symptoms were those of Guillain-Barre syndrome. Therefore, we speculate that the cause of the neuromyopathy might be autoimmune antibodies from lung cancer. Steroid pulse therapy and plasma exchange treatment were effective and the patient's symptoms disappeared in a month. We reported the extremely rare case of a lung cancer patient with acute tetraplegia in the early postoperative period.
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PMID:[Tetraplegia and respiratory failure due to carcinomatous neuropathy in the early postoperative period of a lung cancer patient: report of a case]. 1595 26

Primary liver lymphoma is a very rare disease and is frequently overlooked as a possible diagnosis. We report the case of an asymptomatic middle-aged man with chronic hepatitis C who developed primary liver lymphoma (PLL). A large solitary tumor in the left lobe of the liver was incidentally detected on routine ultrasound examination. Imaging studies showed mixed iso- and hypoechogenicity with hypoechoic rim, hypodense in the pre-contrast phase and thick wall enhancement in the post-contrast phase on computed tomographic study, hypointensity on T1WI, and hyperintensity of the central portion and slightly higher intensity in the peripheral wall on T2WI. These pictures were different from focal nodular hyperplasia, hepatocellular carcinoma, cholangiocarcinoma or metastases. Atypical hepatectomy was performed and the pathology of the hepatic tumor revealed non-Hodgkin's lymphoma. Systemic staging revealed no evidence of nodal or bone marrow involvement, so PLL was diagnosed. There was no tumor recurrence more than 4 years after operation and chemotherapy. PLL should be included in the differential diagnosis of solitary hepatic tumor in patients who are hepatitis C virus-positive, and who have atypical imaging and no known malignancy or elevated tumor marker levels.
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PMID:Primary liver lymphoma in a patient with chronic hepatitis C. 1652 Aug 42


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