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 patient with postoperative intracranial seeding from a malignant spinal-cord astrocytoma is presented. This case is compared with 17 previously cited cases of intracranial dissemination from spinal-cord astrocytoma. Factors associated with tumor dissemination include histological malignancy, proximity of the tumor to cerebrospinal fluid (CSF) pathways, and surgical manipulation. Hydrocephalus with infiltration of the basal cisterns also appears to be a consistent feature in these patients. Cytological studies of the CSF in this and previous cases were noted to be misleading, whereas intravenous contrast-enhanced cranial computerized tomography was invaluable for diagnosis of tumor dissemination in each case. Prophylactic irradiation of the entire neuraxis may limit intracranial metastases from malignant astrocytomas of the spinal cord.
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PMID:Intracranial metastases from malignant spinal-cord astrocytoma. Case report. 303 Dec 41

Prompted by several unsatisfactory outcomes, we reviewed the records of 59 patients with cerebellar metastases (26 solitary) with respect to clinical presentation, diagnosis, and natural history. Eighty-seven percent of patients initially complained of headache, gait disturbance, and/or dizziness. At time of diagnosis, 92% of patients with solitary cerebellar metastases and 74% of the overall series complained of headache and/or difficulty walking. In three of four cases, magnetic resonance imaging (MRI) was superior to x-ray computed tomography (CT) in detecting the cerebellar lesions. Several patients acutely deteriorated during evaluation or at the initiation of radiation therapy. We conclude that a cancer patient presenting with headache and gait difficulty with or without nausea/vomiting and dizziness should promptly undergo head CT scanning, and that MRI is useful even if CT is negative. In addition, we recommend that patients with documented cerebellar metastases receive high-dose glucocorticoid therapy for 48 to 72 hours before beginning radiation therapy. The presence of symptomatic hydrocephalus or failure to respond to glucocorticoids initially are particularly ominous features that may be best managed by early neurosurgical consultation before beginning radiation therapy.
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PMID:Cerebellar metastases: diagnostic and management considerations. 303 34

Seven patients with central nervous system neoplasia and leptomeningeal metastases, proved either at initial diagnosis or on follow-up with contrast material-enhanced computed tomography (CT), were evaluated with magnetic resonance (MR) imaging. In two patients, diffuse sulcal enhancement on CT scans was inapparent on T1- or T2-weighted MR images. Likewise, in four patients diffuse cisternal enhancement on CT scans was not identifiable with MR. Nodular or focal cisternal masses were identified with both CT and MR imaging in three patients; in two, however, MR imaging provided less information. Ependymal and subependymal metastases identified with CT (two patients) were indistinguishable on MR images from periventricular abnormalities of radiation therapy and/or hydrocephalus. These findings suggest that leptomeningeal metastasis may be so subtle or inapparent as to be overlooked with MR imaging alone. Thus, CT and MR imaging should be considered complementary techniques for initial diagnosis and follow-up of tumors with a propensity for leptomeningeal metastasis.
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PMID:Leptomeningeal metastasis: MR imaging. 356 25

A common cause of malfunctioning ventricular shunts is the occlusion of either tip by a variety of normal or reactive tissues and foreign substances. A six-year-old girl with communicating hydrocephalus and a meningomyelocele, a 48-year-old man with an ependymoma and an 11-year-old boy with a pineal germinoma had multinucleated histiocytic giant cells and ependymal cells in cerebrospinal fluid obtained from their ventricular shunts. These cellular changes were interpreted as the cytologic counterpart of the foreign-body inflammatory reactions often seen histologically on occluded shunt tips. Numerous clusters of benign choroid plexus epithelium were found in an ascitic fluid from a six-year-old girl with an optic nerve glioma and a ventriculoperitoneal shunt. Such embolism of normal tissues must be distinguished from metastases from intracranial neoplasms.
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PMID:The cytopathology of reactions to ventricular shunts. 389 Apr 42

The case of a 7-year-old girl with a cerebellar glioblastoma and extraneural metastases has been presented. The dura mater was left open at the time of tumor resection. Postoperative hydrocephalus caused prolonged bulging of the incision. We believe that an open dura mater facilitates continuous exposure of extrameningeal tissue to glioma cells that are capable of invading local lymphatics and extracerebral veins, enhancing the probability of widespread dissemination. We suggest that every effort should be made to close the posterior fossa dura mater after resection of a malignant tumor.
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PMID:Extraneural metastasis of cerebellar glioblastoma multiforme. 628 98

In a series of 26 consecutive autopsy cases of intracranial tumors of neuroectodermal origin, tumor seeding on the ventricular surface and in the subarachnoid space was studied. Five cases of glioblastoma multiforme, six of malignant astrocytoma, six of medulloblastoma, one mixed glioblastoma-fibrosarcoma, one unclassified glioma, and one ependymoma showed ventricular and/or subarachnoid seeding of tumor. The incidence of tumor seeding in our series (76.9%) is much higher than in other series. This discrepancy is probably due to the inclusion of a large number of very small tumor metastases that may have been overlooked in other series. In all cases where metastases were observed the primary tumor extended into the cerebrospinal fluid (CSF). Tumor seeding via the cerebrospinal pathway was more frequently associated with malignant tumors. The distribution of tumor metastases correlated with CSF flow and with the site of focal ependymal defects, which were present in normal brains but occurred more frequently and widely in hydrocephalus.
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PMID:Ventricular and subarachnoid seeding of intracranial tumors of neuroectodermal origin--a study of 26 consecutive autopsy cases with reference to focal ependymal defect. 630 22

Sixty-four (57.6%) of 111 cancer patients with cerebrospinal fluid cytology positive for malignant cells had cranial computed tomographic (CT) scans within 2 weeks before or after a lumbar puncture. Twenty-two (34.3%) of the 64 had abnormal CT findings indicative of leptomeningeal metastasis: (1) sulcal-cisternal enhancement, (2) ependymal-subependymal enhancement, (3) widened irregular tentorial enhancement, or (4) communicating hydrocephalus. Thirteen (59.6%) of these 22 patients had associated parenchymal metastases. Recognition of leptomeningeal disease may alter the management of patients with parenchymal metastases. Communicating hydrocephalus in cancer patients should be considered to be related to leptomeningeal metastasis until proven otherwise.
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PMID:Cranial computed tomographic abnormalities in leptomeningeal metastasis. 633 46

Lesions from the SC region of children examined histologically at the RAHC were: 1. Malformations almost always associated with spina bifida aperta or occulta: 183 myelomeningocele (MM), 32 meningocele (M), 35 lipoMM and lipoma, 19 dermoid cyst, six occult meningocele, two Pacinian hamartoma, one short filum, four hindgut cysts or sinuses, two tailgut cysts, and two epithelial heterotopia. 2. Neoplasms, usually without spina bifida: 56 teratomas (11 malignant), five ependymomas (two purely subcutaneous), and 14 miscellaneous primary malignancies, (most neuroblastoma and rhabdomyosarcoma). Distinction between MM with glial tissue and M without glial tissue is important as M had a much better prognosis, less than a third developing hydrocephalus, and 77% walking unaided. Of those with glial tissue, the eight without Arnold-Chiari malformation were myelocystocele associated with cloacal exstrophy (six), caudal regression syndrome (one), and microcephaly (one). Postsacral glial tissue without paraplegia may occur with a subcutaneous vestige of filum terminale, or with herniation of the nonfunctioning half of a diplomyelia. Of postsacral "lipomas" and dermoids, 70% had an intraspinal connection through an occult spina bifida. This posterior vertebral defect is easily overlooked as the arches normally may not ossify until after 6 years. Therefore, the pathologist receiving a postsacral specimen may wish to alert the clinician to the high incidence of late effects from an occult intraspinal component or tethering of the spinal cord. Transsacral hindgut herniations and cysts probably result from ectoendodermal adhesions. Presacral multicystic malformations with mixed squamous and mucus cell lining are probably tailgut remnants or anorectal duplications, and may be mistaken for dermoid or teratoma. In SC teratoma in infants, contrary to some reports on ovarian teratoma in adults, immature tissues do not indicate a worse prognosis. Malignancy is virtually confined to teratomas including a carcinomatous or "yolk sac" component. It is more common in predominantly presacral examples and rare before the age of 4 months. SC ependymoma differs from ependymoma elsewhere in that it may be primary outside the craniospinal cavity (presacral or postsacral), may have a myxopapillary pattern special to the region, and although low-grade and slow growing, is more likely to metastasize beyond the central nervous system. Postsacral examples arise from vestiges of the filum terminale which are normal in the subcutis there. Combinations of all these lesions occur with vertebral defects and with each other.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Sacrococcygeal developmental abnormalities and tumors in children. 636 33

Abnormal computed tomographic enhancement in the basal cisterns and cortical sulci was observed in 21 of 42 patients after subarachnoid hemorrhage. The appearance is similar to that described in granulomatous infection and metastatic disease. The enhancement was associated with an increased incidence of hydrocephalus, but it did not correlate with clinical grade, arterial spasm, location of bleed, or temporal relation to bleed. Presumably, abnormal cisternal enhancement is due initially to increased vascular permeability and later to increased vascularity associated with arachnoiditis.
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PMID:Cisternal enhancement after subarachnoid hemorrhage. 679 80

A young man developed a tumor in the pineal region that grew along ventricular surfaces and caused obstructive hydrocephalus. Cytologic examination of cerebrospinal fluid demonstrated malignant cells consistent with germinoma. Following a ventriculoperitoneal shunt and radiotherapy, the tumor and the hydrocephalus regressed. Three years later, an intraperitoneal tumor appeared that was diagnosed by transcutaneous biopsy specimen as a germinoma. The abdominal germinoma also regressed after radiotherapy. While extracranial metastases of intracranial germinomas via shunts are probably rare, their occurrence, as exemplified by this case, argues for including protective filters in the shunts.
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PMID:Metastasis of intracranial germinoma through a ventriculoperitoneal shunt. 727 27


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