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

The influence of experimental hypothyroidism induced by a synthetic antithyroid drug, methylthiouracil, upon the development of metastases was studied on male Wistar rats, inoculated intravenously with Walker 256 carcinosarcoma cells. The experimental results reveal obvious differences between the control group and the group previously treated with methylthiouracil, concerning the incidence, latent period, localization and tumor extension. Hypothyroidism promoted metastasis, increasing significantly the metastatic incidence (88% against 62% in controls), shortening the latent period and extending the localization of tumor metastases to unusual sites, such as liver and spinal column.
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PMID:Influence of experimental hypothyroidism on the development of metastases in rats. 644 97

The incidence of chemical hypothyroidism, as manifested by elevated thyroid stimulating hormone (TSH) levels, has been estimated to be as high as 25% after radiation therapy and 45% after radiation therapy and surgery to the neck for treatment of nodal metastases from squamous carcinoma of the head and neck. We prospectively evaluated 43 previously untreated patients seen in the Dana Farber Cancer Institute Interdisciplinary Head and Neck Service who were treated with aggressive combination chemotherapy in addition to standard surgery and/or radiotherapy. All patients were serially monitored for serum TSH, serum T4, and clinical evidence of hypothyroidism. Following cis-platinum, bleomycin, and methotrexate chemotherapy and subsequent surgery and/or radiotherapy, decreased thyroid reserve appeared in 37% of patients at a median follow-up of 9 months. Thirty percent of patients receiving radiotherapy alone and 43% of patients receiving surgery and radiotherapy developed elevated TSH levels. Only one patient developed clinical symptoms. Other patients were asymptomatic despite persistently elevated TSH levels. Abnormalities appeared within the first 4 months after completion of all therapy and were slowly progressive. The addition of combination chemotherapy does not appear to increase the incidence or severity of thyroid dysfunction following radiation therapy and surgery to the neck. In view of the extended survival seen in patients treated with interdisciplinary regimens, we recommend that all patients receiving irradiation to the neck--particularly those patients having neck dissections or total laryngectomies--have routine thyroid function studies performed following the cessation of treatment.
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PMID:Incidence of hypothyroidism following multimodality treatment for advanced squamous cell cancer of the head and neck. 670 88

The local growth rate of Morris Hepatoma 44 (generation time, 6 months) was inhibited by 66 to 87%, and host survival was prolonged by 36 to 78% after the induction of hypothyroidism within 2 weeks of tumor implantation by propylthiouracil (0.1% in Purina chow), 131I(1 mCi/100 g body weight i.p.), or surgical thyroidectomy. In additional experiments, we studied the effects of inducing hypothyroidism (131I) at different stages in the natural history of Morris Hepatoma 44 on local and metastatic growth as well as on host survival. Induction of hypothyroidism within 2 weeks of tumor implantation (Group I) reduced local tumor growth as well as the number and size of pulmonary metastases, and prolonged survival by 70 to 80%. Induction of hypothyroidism at 6 weeks postimplantation when tumors were palpable (Group II) inhibited local growth by 39%, reduced the number and size of pulmonary metastases by approximately 80%, and prolonged host survival by 35%. Initiation of 131I treatment at 11 weeks when microscopic pulmonary emboli were present in most animals (Group III) reduced local growth by 19% and the number and size of pulmonary metastases by 72 and 50%, respectively. In this case, survival was prolonged by 17%. We conclude from these results that the local and metastatic growth of Morris hepatoma 44 as well as host survival are thyroid hormone-dependent processes. The mechanisms responsible for these observations remain to be explained.
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PMID:Inhibition of local and metastatic hepatoma growth and prolongation of survival after induction of hypothyroidism. 724 60

Pregnancies and deliveries of ten patients are reported who underwent a complex treatment (surgery, 131J, thyroid hormone) for highly differentiated follicular and papillary thyroid carcinomas. Out of ten cases, in 3 cases two were pregnant and in two cases two delivered. Besides papillary and papillofollicular carcinomas, surgery revealed that six patients had regional lymph node metastases of N1 or N2. On the evidence of the deliveries, follow-up examinations after the operation, and complementary treatment of these two types of tumor, pregnancy is not contraindicated, since a progression of the primary disease, neonatal hypothyroidism, and factitious hyperthyroidism have not been found.
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PMID:[Thyroid neoplasms and pregnancy]. 738 92

The etiology, prognosis, and optimal management of primary gastric carcinoids remain controversial. Records of 36 consecutive patients with gastric carcinoid (15 men) were reviewed retrospectively between 1975 and 1990. Follow-up was complete in 97% of cases. Mean age at diagnosis was 58.4 years (range 24-82 years). The clinical presentations included anemia (72%), pain (69%), and carcinoid syndrome (11%). Associated autoimmune and endocrine abnormalities were common and included atrophic gastritis (67%), pernicious anemia (58%), hypothyroidism (39%), diabetes (19%), Addison's disease (6%), and hyperparathyroidism (6%). Lesions were nonantral in 78%, involving only the corpus in 42%, the fundus in 28%, and only the antrum in 8%; 42% were multiple. Urinary 5-hydroxyindoleacetic acid (5-HIAA) and serum gastrin levels were elevated in 17% and 50% of those tested, respectively. Histologic examination revealed that 28% of lesions were > or = 2 cm, and 33% had liver metastases on presentation or developed them during follow-up. Eight patients (22%) died of tumor with a median survival of 39 months. The presence of metastases, atypical histology, serosal involvement, and size > 2 cm were adverse prognostic factors. In patients without hypergastrinemia (n = 6), 66% developed metastases, 60% had elevated 5-HIAA, and 50% died of carcinoid tumor. In sharp contrast, those patients with hypergastrinemia and "typical" gastric carcinoids (n = 15), metastases and death did not occur (p < 0.003 and p < 0.005, respectively, compared with eugastrinemic patients).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Diverse clinical and pathologic features of gastric carcinoid and the relevance of hypergastrinemia. 772 31

A 11-year-old girl presented in 1990 with bilateral goiter, hypothyroidism and thyroid auto-antibodies and was treated for Hashimoto's thyroiditis. In 1991, a cervical lymph node metastasis revealed diffuse sclerosing papillary carcinoma (DSPC) of the right thyroid lobe and chronic lymphocytic thyroiditis of the left lobe. The patient is in remission in 1993 (total follow-up, 39 months). The review of 60 previously reported cases of DSPC shows a predilection for young people, a high incidence of lymph node and pulmonary metastases; however the mortality rate is quite low, reflecting either the good prognosis linked to a young age in papillary thyroid carcinomas, or the short duration of the follow-up preventing assessment of the behaviour of DSPC.
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PMID:[Diffuse sclerosing papillary carcinoma of the thyroid gland. Apropos of a pediatric case of association of an unilateral tumor with diffuse lymphocytic thyroiditis]. 807 40

Hypothyroidism is a well known cause of pericardial effusions and cardiac tamponade; thyroid carcinoma metastatic to the heart and pericardium is rarely encountered in clinical practice. The authors report the case of a 68-year-old male who presented in acute distress from cardiac tamponade. Cytological examination of the pericardial and pleural fluid, and histological examination of a pericardial biopsy revealed a metastatic papillary carcinoma with psammoma bodies. Subsequent reexamination of the patient demonstrated a thyroid nodule and bilateral cervical lymphadenopathy. Fine needle aspiration of the thyroid nodule and cervical lymph nodes detected a papillary thyroid carcinoma with metastases to the lymph nodes. The literature relevant to hypothyroidism, thyroid malignancy and cardiac tamponade is briefly reviewed.
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PMID:Cardiac tamponade as the initial presentation of papillary thyroid carcinoma. 814 31

Radioiodine, 131I, has been used for treatment of hyperthyroidism and metastases of well differentiated thyroid carcinoma since 1942. The use of 131I to treat hyperthyroidism and metastatic foci of thyroid cancer is one of the least invasive and most effective methods since the ionization produced by beta rays of 131I and it's high target-to-nontarget ratio are suitable. The feature of therapy with 131I on hyperthyroidism has a slow improvement of symptom, a high incidence of hypothyroidism, and an exact therapeutic effect. And, there is no significant difference between the patients with late-onset hypothyroidism and euthyroidism after 131I-therapy in the pretreatment factors, such as thyroid hormone levels, thyroid weight, 131I administration dose, and absorbed dose and also in the course of follow-up studies. On the treatment of metastases of thyroid cancer with 131I, it is very effective for the patients with fine or occult type of pulmonary metastases on chest XP, who are younger than 40 years old. On the other hand, the response to bone metastases of 131I therapy is limited to only a part of tumors and/or temporally in most cases though high grade of 131I accumulation is seen on scintigram. Both surgery and a curative dose of external irradiation should be combined with radioisotope therapy for the patients of bone metastases.
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PMID:[Radionuclide therapy of thyroid disease--radioactive iodine therapy]. 837 5

This study documents dosage to radiation sensitive organs/structures located outside the radiotherapeutic target volume for four treatment situations: (a) head and neck, (b) brain (pituitary and temporal lobe), (c) breast and (d) pelvis. Clinically relevant treatment fields were simulated on a tissue-equivalent anthropomorphic phantom and subsequently irradiated with Cobalt-60 gamma rays, 6- and 18-MV x-ray beams. Thermoluminescent dosimeters and diodes were used to measure absorbed dose. The head and neck treatment resulted in significant doses of radiation to the lens and thyroid gland. The total treatment lens dose (300-400 cGy) could be cataractogenic while measured thyroid doses (1000-8000 cGy) have the potential of causing chemical hypothyroidism, thyroid neoplasms, Graves' disease and hyperparathyroidism. Total treatment retinal (400-700cGy) and pituitary (460-1000 cGy) doses are below that considered capable of producing chronic disease. The pituitary treatment studied consisted of various size parallel opposed lateral and vertex fields (4 x 4 through 8 x 8 cm). The lens dose (40-200 cGy) with all field sizes is below those of clinical concern. Parotid doses (130-1200 cGy) and thyroid doses (350-600 cGy) are in a range where temporary xerostomia (parotid) and thyroid neoplasia development are a reasonable possibility. The retinal dose (4000 cGy) from the largest field size (8 x 8 cm2) is in the range where retinopathy has been reported. The left temporal lobe treatment also used parallel opposed lateral and vertex fields (7 x 7 and 10 x 10 cm). Doses to the pituitary gland (5200-6200 cGy), both parotids (200-6900 cGy), left lens (200-300 cGy) and left retina (1700-4500 cGy) are capable of causing significant future clinical problems. Right-sided structures received insignificant doses. Secondary malignancies could result from measured total treatment thyroid doses (670-980 cGy). Analysis of three breast/chest wall and regional nodal irradiation techniques demonstrated a 25-50% decrease in secondary lung dose with use of independent collimation compared to use of custom alloy blocking material. However, it is unlikely that a reduction in secondary dose of this magnitude would reduce the risk of treatment sequellae. In four-field "box" pelvic irradiation, secondary testes dose may result in temporary (clamshell shield) or permanent azoospermia, but is unlikely to impair androgen production.
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PMID:Doses to radiation sensitive organs and structures located outside the radiotherapeutic target volume for four treatment situations. 840 17

The diagnostic and therapeutic use of radioactive iodine in patients with thyroid cancer requires a sufficient serum concentration of thyrotropin (TSH) for efficient thyroid tissue uptake of radioiodine. Recombinant human TSH (rhTSH) is a promising new agent, which appears to facilitate radioiodine scanning with similar efficacy to thyroid hormone withdrawal without the immunologic side-effects of bovine TSH (bTSH) administration. Patients with thyroid cancer and concomitant secondary hypothyroidism are particularly difficult to treat because of their inability to elevate endogenous TSH and the limitations of bTSH administration. We describe a patient with metastatic thyroid carcinoma and secondary hypothyroidism with metastases visible only after administration of rhTSH previously unappreciated on thyroid hormone withdrawal scans. This patient exemplifies the usefulness of rhTSH administration before radioactive iodine for this group of patients.
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PMID:Diagnostic accuracy of 131I scanning with recombinant human thyrotropin versus thyroid hormone withdrawal in a patient with metastatic thyroid carcinoma and hypopituitarism. 862 23


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