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

A series of cases is presented which illustrates unusual aspects in the presentation, diagnosis, and management of renal cell carcinoma. The entire "classic triad" of flank pain, gross hematuria, and palpable mass was not present at the time of diagnosis in any of the patients. Moreover, in only three patients did the initial clinical findings raise the suspicion of renal cell carcinoma. A diagnosis of polycystic kidney disease, cardiac failure, glomerulonephritis, analgesic abuse, and perirenal hemorrhage obscured the primary diagnosis in the other five patients. In four patients the tumor was probably present from 3 to 12 years before detection. These findings emphasize that knowledge of the hematologic, humoral, immunologic and vascular abnormalities induced by this tumor may provide a clue to early diagnosis. The systematic use of excretion urography, nephrotomography, ultrasonography, renal scanning, renal arteriography and cyst puncture then may allow the accuracy of radiologic diagnosis of this tumor to approach 100%. Lastly, the therapy of choice for this tumor is radical nephrectomy. Excision of apparently solitary metastases also may sometimes be feasible. However, partial nephrectomy to remove tumor in a solitary kidney was performed in one patient to avoid the need for end-stage kidney treatment. Where nephrectomy renders the patient anephric, chronic hemodialysis and renal transplantation should be considered as potential measures to sustain life. While hormonal agents, chemotherapy, and radiation therapy sometimes provide palliation, their use generally has been disappointing.
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PMID:Renal cell carcinoma: unusual systemic manifestations. 78 64

A brief description of the structure of collagen and the special features of each type of collagen, followed by a summary of its metabolism, serve as an introduction to the major pathological processes involving the collagen molecule; mutations, inflammatory syndrome bone diseases, basement membrane diseases. The measurement of hydroxyproline isomers in urine is the basic biochemical test for diseases involving the collagen molecule. 4-hydroxyproline is increased in bone disease of Paget and in cancerous metastases of bone, 3-hydroxyproline is increased in case of polycystic kidney. It is possible, but not very useful, to measure serum 4-hydroxyproline. Of more interest, is the radio-immunological measurement of the N-terminal extension of the type III procollagen molecule, which can differentiate ordinary hepatitis from cirrhogenous hepatitis. New and useful information can be gained from tissue biopsy: the proportion of the various types of collagen, the measurement of their hydroxylation and the activity of the enzymes acting on their biosynthesis.
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PMID:[Techniques for studying collagen in medical practice]. 676 Jul 52

A 67-year-old woman died after 4 years of treatment by haemodialysis. End-stage renal failure was caused by polycystic kidney disease. Malignancy was suspected in the last 6 months of treatment because of impressive weight loss and a suspect liver-scan. Macroscopic haematuria in the first period of treatment was noted only once. Necropsy revealed renal carcinoma of the right polycystic kidney and tumour metastases in various organs. The problem of development of renal carcinoma in polycystic kidney disease in the light of the increased incidence of malignancy during chronic renal failure is discussed.
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PMID:Development of renal carcinoma in a patient with polycystic kidneys undergoing chronic haemodialysis. 739 7

A 51-year-old patient with severe back pain had undergone resection of a benign cerebellar tumour when aged 15 years. In addition, polycystic kidney disease was diagnosed 24 years ago, bilateral phaeochromocytoma 2 years ago, and for 4 months before the present admission he had been on haemodialysis. The family history indicated autosomal dominant inheritance of the polycystic renal disease. His general condition was found to have deteriorated, he had pain on pressure over the upper thoracic and lower lumbar vertebrae, and the kidneys were enlarged on palpation. There were increased concentrations of calcium (3.01 mmol/l), parathormone (2.0 ng/l), carcinoembryonic antigen (13.5 micrograms/l) and TPA (69 U/l). Computed tomography demonstrated cystic and solid parts of much enlarged kidneys. Biopsy revealed a poorly differentiated clear-cell renal carcinoma. Further information concerning the previously removed brain tumour showed this to have been an haemangioblastoma of the cerebellar tonsils indicating the diagnosis of v. Hippel-Lindau disease. Nine other family members had been affected, but none had the full-blown picture of the disease. The patient died 3 weeks later from the rapidly advancing tumour. Autopsy showed the bilateral renal carcinoma, bilateral phaeochromocytoma and metastases to the sternum, femurs, vertebrae and liver.
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PMID:[The von Hippel-Lindau syndrome. Its differential diagnosis from cystic kidneys in adulthood]. 778 10

To provide information on the clinical presentation, diagnosis, pathology, and biologic behavior of renal cell carcinoma in patients with autosomal dominant polycystic kidney disease (ADPKD), three cases seen at this institution between 1955 and 1992, as well as the cases reported in the literature, were reviewed in detail. No male predominance was observed (12 men, 13 women) in the 25 patients who met the inclusion criteria. The age of presentation was earlier than that seen in the general population (45 versus 61 yr). Fever, night sweats, and weight loss were prominent at presentation. Fever is a more common presenting symptom of renal cell carcinoma in ADPKD (32%) than in the general population (7%). Twenty percent of the patients had metastatic disease at presentation. Even with computed tomography and magnetic resonance, the diagnosis was difficult and often delayed, and the accumulation of 111In-labeled white blood cells can wrongly suggest a cyst infection. Renal cell carcinoma in ADPKD is more often concurrently bilateral (12 versus 1 to 5%), multicentric (28 versus 6%), and sarcomatoid in type (33 versus 1 to 5%) than in the general population. Because previous studies have failed to demonstrate a higher prevalence of renal cell carcinoma in ADPKD, this information suggests either a malignant potential restricted to a small subset of patients with this disease or an alteration in the biologic behavior of renal cell carcinoma when it develops in the setting of ADPKD.
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PMID:Renal cell carcinoma in autosomal dominant polycystic kidney disease. 801 75

A case of autosomal dominant polycystic kidney disease associated with widely metastatic renal cell carcinoma is reported. The patient had presented with pneumothorax, weight loss, leukocytosis, lytic bone lesions, and hypercalcemia. Despite intensive diagnostic search for a neoplasm, no firm evidence of malignancy was found. However, at the autopsy, widely metastatic, papillary renal cell carcinoma was found originating in the left kidney. Many metastases showed central necrosis mimicking small cysts.
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PMID:Renal cell carcinoma in the presence of adult polycystic kidney disease. 828 67

From Sept. 1991 to Jan. 1999, we performed partial nephrectomy on 7 patients with renal cell carcinoma. The indication was imperative for 3 patients, and elective for 4 patients. The 3 imperative cases consisted of bilateral renal cell carcinomas, a polycystic kidney disease and a contralateral atrophic kidney. All 4 patients with elective indication revealed renal cell carcinoma with a normal functioning contralateral kidney. The tumor size ranged from 1.3 cm to 6.0 cm (2.7 cm on average). The mean clamping time of renal artery was 22 minutes and mean blood loss was 400 ml. The pathological stage was pT1a in 6 patients and pT1b in one patient. Postoperative follow-up ranged from 4 months to 92 months (mean: 43 months). One patient with bilateral renal cell carcinoma died of metastases to the lungs and brain at 25 months postoperatively. The remaining 6 patients are alive without recurrence and metastasis. We obtained a good postoperative course in our selected patients with low stage. Thus it was considered that partial nephrectomy is effective against small renal cell carcinoma.
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PMID:[Experience with partial nephrectomy for renal cell carcinoma]. 1128 Aug 89

Metastases to the pineal gland are rare and reported cases have consisted primarily of gastrointestinal and lung primary malignancies. Here we present the case of a 66-year-old female with autosomal dominant polycystic kidney and liver disease who was found at autopsy to have an unrecognized infiltrating ductal adenocarcinoma of the pancreas with metastases to the liver, lungs and pineal gland. As far as we are aware, this is the first report of a metastasis of infiltrating ductal adenocarcinoma of the pancreas to the pineal gland.
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PMID:Pancreatic adenocarcinoma metastatic to the pineal gland. 1882 24

Invasive ductal carcinomas (IDC) of the breast are associated with altered expression of hormone receptors (HR), amplification or overexpression of HER2, or a triple-negative phenotype. The most aggressive cases of IDC are characterized by a high proliferation rate, a great propensity to metastasize, and their ability to resist to standard chemotherapy, hormone therapy, or HER2-targeted therapy. Using progression tissue microarrays, we here demonstrate that the serine/threonine kinase protein kinase D3 (PKD3) is highly upregulated in estrogen receptor (ER)-negative (ER(-)) tumors. We identify direct binding of the ER to the PRKD3 gene promoter as a mechanism of inhibition of PKD3 expression. Loss of ER results in upregulation of PKD3, leading to all hallmarks of aggressive IDC, including increased cell proliferation, migration, and invasion. This identifies ER(-) breast cancers as ideal for treatment with the PKD inhibitor CRT0066101. We show that similar to a knockdown of PKD3, treatment with this inhibitor targets all tumorigenic processes in vitro and decreases growth of primary tumors and metastasis in vivo. Our data strongly support the development of PKD inhibitors for clinical use for ER(-) breast cancers, including the triple-negative phenotype.
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PMID:Effective Targeting of Estrogen Receptor-Negative Breast Cancers with the Protein Kinase D Inhibitor CRT0066101. 2585 60

The planar cell polarity (PCP) pathway orients cells in diverse epithelial tissues in Drosophila and vertebrate embryos and has been implicated in many human congenital defects and diseases, such as ciliopathies, polycystic kidney disease and malignant cancers. During vertebrate gastrulation and neurulation, PCP signaling is required for convergent extension movements, which are primarily driven by mediolateral cell intercalations, whereas the role for PCP signaling in radial cell intercalations has been unclear. In this study, we examine the function of the core PCP proteins Vangl2, Prickle3 (Pk3) and Disheveled in the ectodermal cells, which undergo radial intercalations during Xenopus gastrulation and neurulation. In the epidermis, multiciliated cell (MCC) progenitors originate in the inner layer, but subsequently migrate to the embryo surface during neurulation. We find that the Vangl2/Pk protein complexes are enriched at the apical domain of intercalating MCCs and are essential for the MCC intercalatory behavior. Addressing the underlying mechanism, we identified KIF13B, as a motor protein that binds Disheveled. KIF13B is required for MCC intercalation and acts synergistically with Vangl2 and Disheveled, indicating that it may mediate microtubule-dependent trafficking of PCP proteins necessary for cell shape regulation. In the neural plate, the Vangl2/Pk complexes were also concentrated near the outermost surface of deep layer cells, suggesting a general role for PCP in radial intercalation. Consistent with this hypothesis, the ectodermal tissues deficient in Vangl2 or Disheveled functions contained more cell layers than normal tissues. We propose that PCP signaling is essential for both mediolateral and radial cell intercalations during vertebrate morphogenesis. These expanded roles underscore the significance of vertebrate PCP proteins as factors contributing to a number of diseases, including neural tube defects, tumor metastases, and various genetic syndromes characterized by abnormal migratory cell behaviors.
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PMID:The involvement of PCP proteins in radial cell intercalations during Xenopus embryonic development. 2607 37


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