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 recurred and metastasized hemangiopericytoma of menigeal origin caused a terminal hypoglycemia syndrome in a 40 year old man. The disease had been observed over a period of 10 years. The total weight of the tumour metastases was 1800 g. Electron microscopical examination of the tumour cells revealed, in particular, a markedly developed ergastoplasm, prominent Golgi complexes surrounded by many microvesicles, round to ovoid electron dense bodies and fine fibrillar structures. Furthermore, large deposits of basement membrane-resembling material were found in the pericapillary and intercellular spaces. On the basis of the structural characteristics which indicate distinct synthesizing capacity of the cells, an excessive glucose consumption by the tumour is suggested to be an important factor in the pathogenesis of tumour hypoglycemia. The question whether the ultrastructure of the tumour also exhibits secretory processes, which may be related to the release of a presumed inhibitor of hepatic gluconeogenesis and/or glycogenolysis, remains open. Typical granules as in polypeptide hormon secreting cells were not observed. The possibility that the demonstrated electron dense membrane limited bodies represent atypical secretory granules is discussed.
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PMID:Ultrastructure of hemangiopericytoma associated with paraneoplastic hypoglycemia. 13 25

Thirty cases of islet cell carcinoma of the pancreas diagnosed at Memorial Hospital were studied. There were 17 male and 13 female patients. The average age was 44 years. Most of the tumors were located in the body or tail of pancreas; in 25 instances, the primary tumor was larger than 6 cm. Epigastric pain, hypoglycemia, and jaundice were frequent primary clinical presentations. No morphological differences were found between functioning and nonfunctioning tumors. Size of tumor, local tissue infiltration, and vascular invasion were helpful; but they were not absolute parameters aiding in the differentiation of benign and malignant tumors. Twenty-six patients had metastatic disease at time of diagnosis. Liver, regional lymph nodes, bones, and peritoneum were common sites of metastases. The average survival was 3.9 years. The cumulative five-year survival rate was 65%.
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PMID:Islet cell carcinoma of the pancreas. 16 33

L-asparaginase (140,000 units) infused into the hepatic artery resulted in a remission from disabling hypoglycaemia for nine months in a man with islet cell carcinoma of the pancreas and hepatic metastases. The tumour produced insulin and gastrin with resulting hypoglycaemia and recurrent peptic ulceration which were unresponsive to other drugs. Following L-asparaginase there was a fall in both plasma and insulin and gastrin.
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PMID:Prolonged control of hypoglycaemia by L-asparaginase in islet cell carcinoma producing insulin and gastrin. 17 39

A case of carcinoma of the stomach associated with severe hypoglycemia is reported. Diagnosis of insulinoma was excluded on the basis of history as well as laboratory tests. Postmortem examination revealed widespread small metastases to various organs; no metastasis was found in the pancreas; the histology of this gland did not show any pathological finding. No impairment in pituitary, thyroid, adrenal and liver function was detected. Fasting blood sugar ranged from 18 to 56 mg/100 ml. An oral glucose tolerance test showed a diabetic pattern with low insulin. Tolbutamide, glucagon and glucose injected i.v. gave only a moderate rise in plasma insulin levels; plasma glucagon response to arginine was subnormal. The determination of NSILA-s and gastrin in the serum of this patient gave normal values. Diazoxide infusion induced an increase in blood glucose and subsequent treatment with diazoxide relieved hypoglycemia for some months. The occasional detection of an islet cell antibody by immunofluorescence in this case is not easily understandable, but it might partly account for the carbohydrate intolerance. An impairment in gluconeogenesis dependent upon some substrate deficiency might account for the hypoglycemia in this patient.
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PMID:Gastric carcinoma associated with severe hypoglycemia sensitive to diazoxide. 39 98

This report documents a case of a fatal primary malignant neoplasm of the liver with metastases to the lymph nodes of the porta hepatis and the pubic bone. Profound, intractable hypoglycemia was seen during the course of the disease. No immunoassayable insulin was found in the blood during episodes of severe, symptomatic hypoglycemia. The neoplasm was composed of uniform polygonal cells with distinct cytoplasmic borders growing in broad strands with a tendency toward nesting and was morphologically similar to neoplasms of neural crest derivation. The presence of osmophilic, membrane-bound granules in the neoplastic cells was documented by ultrastructural studies. The tentative conclusion that the hypoglycemia was produced by the secretion of a substance with insulin-like activity, probably a polypeptide, by the secretory granules in the neoplastic cells is supported by clinical and laboratory data.
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PMID:Malignant apudoma of the liver with symptomatic intractable hypoglycemia. 67 61

The history, clinical course and pathological findings are reported of a patient who developed a recurring, malignant meningioma. Widespread extracranial metastases occurred, particularly in the liver. Hypoglycaemia was a prominent feature during the late course of the disease. The influence of the histological type of meningioma and the effects of surgical interventions on the development of extracranial metastases are discussed together with the relationship of the tumour to hypoglycaemia.
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PMID:Malignant meningioma with liver metastases and hypoglycaemia. A case report. 96 86

Tumours of the pancreas occur most commonly in dogs and cats and only rarely in other domestic species. The incidence of neoplasms, both exocrine and endocrine, increases with age. Exocrine adenocarcinomas are the most common malignant tumours and have three fairly distinct morphological patterns: small tubular, large tubular, and acinar cell (rare). They readily metastasize, usually before clinical signs are apparent. A "starry sky" pattern with clear histiocytes scattered among tumour cells is a regular feature of poorly differentiated areas of small tubular adenocarcinomas and undifferentiated carcinomas. Islet cell tumours occur in a significant number only in dogs. Metastases are found in about half of the tumours, but malignancy cannot always be predicted by the morphological appearance. Slightly more than half of the islet cell tumours reported in the dog have been associated with clinical signs of hypoglycaemia. Nodular hyperplasia and exocrine adenomas are sometimes difficult to differentiate. Adenomas are considered rare while nodular hyperplasia is common in old animals.
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PMID:Tumours of the pancreas. 108 50

A functional, insulin-secreting pancreatic (islet cell) carcinoma was diagnosed in a 17-year-old male Siamese cat. Diagnosis was made on the basis of clinical signs (i.e., seizures and stupor) that resolved temporarily after correction of hypoglycemia with feeding or intravenous administration of glucose, the finding of an inappropriately increased serum insulin concentration in the face of hypoglycemia, and prolonged resolution of hypoglycemia after surgical removal of the tumor. Primary islet cell tumor of the pancreas was confirmed by biopsy. The cat died 18 months later, and necropsy revealed metastases to regional lymph nodes and liver. Specimens of the tumor and metastatic lesions both stained positively for insulin.
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PMID:Insulin-secreting pancreatic (islet cell) carcinoma in a cat. 132 Jan 19

A case of malignant islet-cell tumor with oncocytic features occurring in a 54-year-old woman with symptoms of organic hypoglycemia is reported. The tumor was composed of ribbons of cells arranged in an endocrine pattern. The cytoplasm of these cells was eosinophilic and finely granular. Ultrastructurally, the cells contained numerous mitochondria and dense-core neurosecretory granules. Tumor cells were focally immunoreactive for neuron-specific enolase, insulin, glucagon and VIP. Capillaries invasion and metastases to lymph nodes argued in favor of malignancy but there was no subsequent malignant involvement during a 3-year follow-up after surgery. Such insulinomas with oncocytic features have not been previously described. Endocrine features in oncocytomas of the pancreas and of other locations are discussed.
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PMID:Malignant pancreatic oncocytoma. An unusual cause of organic hypoglycemia. 132 Jun 40

Tyr-3-Octreotide is a synthetic derivative of somatostatin and a somatostatin-receptor analogue. The iodine-123-labelled compound localizes somatostatin-receptor-positive tumours. In this paper two patients are reported in whom somatostatin receptors were demonstrated in vitro. In a 60-year-old female with an islet cell carcinoma of the pancreas, multiple liver metastases and previously unrecognized bone metastases in the right acetabulum could be diagnosed as the reason for a persistent hypoglycaemia. In a 60-year-old male an islet cell carcinoma of the pancreas was localized with 123I-Tyr-3-octreotide. The somatostatin receptors were demonstrated in vitro and the tumour was successfully treated with somatostatin. These studies demonstrate that 123I-Tyr-3-octreotide offers the possibility of localizing somatostatin-receptor-positive tumours and their metastases. Moreover the method makes it possible to determine the receptor status of a tumour in vivo.
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PMID:Octreotide scintigraphy localizes somatostatin receptor-positive islet cell carcinomas. 168 23


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