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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The distribution of regional lymph node metastases in carcinoma of the left side of the colon, rectum, and anus can be well shown by routine CT of the abdomen and pelvis. Recognition of the location of nodes in the mesocolic, left colic, and IMA nodal groups can help in developing a systematic approach to the detection of nodal metastasis. This can be especially important in preoperative planning for cases in which resection may be curative. In addition, an understanding of the distribution of nodal metastasis will make it possible to recognize early recurrent nodal disease, particularly with an increase in associated increase in levels of carcinoembryonic antigen, and to predict certain clinical sequences such as hydronephrosis of the left kidney associated with left colic nodal metastases.
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PMID:Regional lymph node metastases in carcinoma of the left side of the colon and rectum: CT demonstration. 152 37

From January 1974 to December 1989, 16 patients with locally recurrent rectal adenocarcinoma and hydronephrosis underwent exploratory celiotomy with curative intent. There were eight males and eight females. The median age was 61 years. Primary rectal adenocarcinomas were treated with abdominoperineal resection in 12 patients and low anterior resection in 4 patients. Four patients underwent adjuvant radiotherapy, one patient adjuvant chemotherapy, and one patient combination therapy. The median disease-free interval between resection of the primary tumor and recurrence was 18 months. Hydronephrosis was unilateral in seven patients (44%), and bilateral in nine patients (56%). Preoperative evaluation indicated that all 16 patients had local pelvic-perineal recurrence or pelvic recurrence alone. Resection was not possible in any of these 16 patients for the following reasons: 5 patients (31%) had pelvic sidewall involvement and carcinomatosis; 3 patients (19%) pelvic sidewall involvement alone; 2 patients (13%) pelvic sidewall involvement and sacral fixation; and 2 patients (13%) had sacral fixation alone. In the remaining four patients, there was pelvic sidewall involvement by tumor and/or synchronous hepatic metastases, carcinomatosis, or sacral fixation. The median survival after exploratory celiotomy was 8 months in the 16 patients who died of their disease. Unilateral and bilateral hydronephrosis appears to be a contraindication for potentially curative surgical resection in recurrent rectal adenocarcinoma.
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PMID:Surgery for recurrent rectal adenocarcinoma in the presence of hydronephrosis. 162 1

Renal pelvic carcinoma was induced in mice by giving N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN). Initially, differences in renal pelvic carcinogenesis by BBN were examined in three male mouse strains: NON/Shi, which demonstrate spontaneous hydronephrosis with incidences of 10-30%, and DS/Shi and B6C3F1, which do not exhibit hydronephrosis. When mice of these strains were given 0.05% BBN in the drinking water for 12 weeks followed by water without BBN for 8 weeks, renal pelvic carcinoma morphologically similar to human carcinomas developed in 8 of 23 NON/Shi mice (35%). Metastasis to the lung was found in one of them (13%). B6C3F1 and DS/Shi mice had no pelvic tumors, but the response to urinary bladder carcinogenesis in NON/Shi mice was nearly equal to that in DS/Shi and B6C3F1 mice. These results suggest that renal pelvic carcinogenesis is related to the presence of stagnant urine containing carcinogen in the renal pelvis. In a second experiment, we examined renal pelvic carcinogenesis in NON/Shi mice given BBN for 4 weeks followed by water without BBN for 32 weeks. The incidence of renal pelvic carcinoma (28%) was similar to that in the first experiment, but the incidence of metastasis was markedly elevated to 60%. These results indicate that BBN treatment can induce renal pelvic carcinoma which often metastasizes to the lung in NON/Shi mice.
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PMID:Renal pelvic carcinoma which shows metastatic potential to distant organs, induced by N-butyl-N-(4-hydroxybutyl)nitrosamine in NON/Shi mice. 177 60

Endorectal ultrasound examination is a valuable method for detection and monitoring of pelvic diseases. The authors record their clinical experience in endorectal ultrasonography with Bruel & Kjaer ultrasound scanner. One hundred patients with diseases of the pelvic organs were examined, mainly before and after operation of ano-rectal cancer. There were 59 patients with rectal cancer, 8 patients with relapse after rectal resection, 3 patients with anal cancer, 2 patients with insufficiency of the anastomoses after rectal resection with formation of pelvic abscesses, 2 patients with metastases of bladder cancer, 2 patients with rectal cancer invading the prostate gland, 1 patient with vaginal cancer invading the rectum, 1 patient with rectal cancer invading the bladder and both ureters leading to bilateral hydronephrosis and 2 patients with extrauterine pregnancy. Another group of 20 patients was examined for detecting early postoperative recurrences. EU is an obligatory method of diagnosis of rectal cancer. It is part of the complex approach to the choice of operative method and helps to make short- and long-term prognosis after the operation. The method is also essential for the diagnosis of inflammatory processes in the pelvis and in-lying organs.
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PMID:[Endorectal ultrasonography]. 184 84

To determine the frequency and distribution of extrahepatic and extraskeletal metastases in patients with breast carcinoma, the abdominal CT scans of 260 consecutive patients were systematically evaluated. Extrahepatic and extraskeletal metastases were demonstrated in 26 patients (10%). Confirmation of findings was made by biopsy, autopsy, or by demonstration of progression or regression of disease. Twelve patients (4.6%) demonstrated metastases to the stomach, eleven of whom presented with a linitis plastica pattern. Retroperitoneal and/or mesenteric adenopathy was noted in 10 patients (3.8%), of whom three demonstrated associated hydronephrosis and one demonstrated associated biliary obstruction. Ascites was seen in 14 (5.4%) and peritoneal carcinomatosis in 7 (2.6%). Genitourinary involvement included metastases to the kidney (one case), ureter (one), and uterus (one). Direct invasion of the diaphragm by adjacent pleural metastases (two cases) as well as a soft tissue metastasis (one case) was also demonstrated. Metastases to the ovaries, adrenals, or pancreas could not be identified. Although lesions to the liver and skeleton account for the largest group of metastases from breast carcinoma seen in the abdomen, one should be aware of the potential for other locations of metastatic disease.
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PMID:Distribution of metastases in breast carcinoma: CT evaluation of the abdomen. 193 43

Self-expanding metallic stents were inserted into the ureters of two female patients (29 and 46 years old) with malignant ureteric stenosis, in the first patient caused by metastases of a malignant melanoma, in the second by retroperitoneal lymph-node metastases from a colon carcinoma. In the first patient the stent was introduced antegrade into the left ureter via a nephrostomy after balloon dilatation of the stenotic segment. She was subsequently without symptoms, but six weeks later the ureter got kinked just above the bladder due to continued tumour growth against the stent. After insertion of a silicon splint she had no further symptoms referrable to the kidneys until she died two months later. In the other patient in whom both ureters were obstructed they could not be catheterized percutaneously. Stents were, therefore, introduced transurethrally after previous balloon dilatation of the stenoses. Obstruction occurred in the right ureter three days after the procedure due to mucosal oedema, but it was controlled by anti-inflammatory drugs. Hydronephrosis developed again six months later, caused by circumscribed incrustations in parts of the the stent not covered by mucosa. Silicon splints were placed bilaterally and the patient has so far been free of symptoms for two months.
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PMID:[Self-expanding metallic stents in malignant ureteral stenosis]. 201 64

For patients with prostate cancer, diagnostic imaging can play three roles: screening, staging, and monitoring. Bayesian analysis dictates that if the prior probability of cancer is relatively low or if the consequences of a false-positive result are unacceptable, the test must be optimally specific. If the prior probability of cancer is high or if the consequences of missing it are unacceptable, the test must be optimally sensitive. For screening, the consequences of a miss are slight, and the consequences of labeling an insignificant cancer significant are serious. Thus, a very specific test is required. No current imaging modality fulfills this criterion. For staging, the prior probability of significant disease is relatively high, and the consequences of a miss serious, so a very sensitive test is required. Transrectal sonography, plus biopsy under sonographic control, fulfills this criterion for local disease, as does a bone scan for bone metastases. For monitoring, the prior probability is high, and the consequences of a miss serious, so a very sensitive test is needed. The bone scan is sensitive for bone metastases. Although CT is not sensitive for detecting lymph node metastases, it has practical clinical advantages over other imaging modalities for monitoring purposes in that it can detect disease in multiple structures at once. It is the only test that can monitor prostate size, the size of the lymph nodes, and whether hydronephrosis or liver metastases are present all in the scope of one examination.
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PMID:The role of imaging in prostate cancer. 202 8

Of 1192 patients treated for breast cancer, four had extrahepatic gastro-intestinal metastases as first clinical manifestation of the tumour dissemination. One woman presented with gastric metastases mimicking a linitis plastica. Another had metastases localized to the rectum also mimicking a linitis plastica. Two women had peritoneal and retroperitoneal metastases that caused, in one case, a right hydronephrosis. Histology of the four primary tumours showed invasive lobular carcinoma (ILC) mixed with invasive ductal carcinoma in two. However, ILC exclusively was found at the site of the gastro-intestinal metastases involving the serosal layer (two cases) and extending to the submucosa (one case) or to the mucosal stroma (one case). Thus, when a women with previous history of invasive lobular breast cancer experiences gastro-intestinal symptoms, particular attention should be paid to the large and deep biopsy of lesions to ascertain the histological type and whether oestrogen or progesterone receptors differ from those of the primary breast lesion. Since survival is extremely variable (one woman is alive 7 years after the discovery of gastro-intestinal metastases), treatment including surgery, hormonal manipulation and chemotherapy with the expectation of a cure is often justifiable, particularly if no other extensive metastases are present.
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PMID:Gastro-intestinal metastases as first clinical manifestation of the dissemination of a breast cancer. 215 8

A case of primary carcinoma in situ of the ureter in a 77-year-old man is reported. The patient had been to another hospital with right flank pain and macroscopic hematuria. Ultrasound sonogram showed right hydronephrosis. An excretory urogram showed right hydronephrosis and stenosis of right ureter. He was referred to our hospital for further evaluation and treatment. Retrograde pyelogram demonstrated a right ureteral stricture at the level of S1-2, but no space occupying lesion was detected in the ureter. Cytology of voided urine was negative for malignant cells and no other abnormal findings were present. Probe laparotomy was performed under the preoperative diagnosis of ureteral stricture. During the operation, frozen section examination of the stenotic ureter showed carcinoma in situ and so we performed right total nephroureterectomy with a bladder cuff. Pathologic diagnosis was primary carcinoma in situ of the right ureter. The patient has been doing well for six months postoperatively with no evidence of recurrent or metastatic disease.
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PMID:[Primary carcinoma in situ of the ureter: a case report]. 228 13

Among 753 autopsy prostatic cancer cases with a metastasis, 476 (63%) had a lymph node metastasis, whereas 277 (37%) did not. Two different lymph node metastatic patterns were observed: Type 1, combined metastasis involving the pelvic and paraaortic lymph nodes; and Type 2, metastasis to the paraaortic lymph nodes, but not to the pelvic lymph nodes. Type 1 metastasis cases showed a significantly more frequent metastasis to the bladder and rectum, and a less frequent metastasis to the lungs and liver. Hydronephrosis occurred more frequently (P less than 0.01) in the Type 1. Furthermore, in the Type 1 cases the lymph node metastasis appeared to be continuously invasive, but in the Type 2 cases, metastasis appeared to be the skip type or some metastases may have spread via the vertebral vein bypass route and may have been associated with a hematogenous metastasis.
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PMID:Two different lymph node metastatic patterns of a prostatic cancer. 231 63


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