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

Metastatic spread of nonpulmonary malignancies to the lung is a common clinical problem. However, the evaluation and treatment of metastatic lung disease may be confusing. This article considers both pulmonary and pleural metastases. The basic biology of the metastatic process is discussed, together with the pathologic, clinical, radiologic, diagnostic, and therapeutic features of pulmonary metastases. Metastatic disease to the pleura is reviewed in detail, including etiology and incidence, pathogenesis, clinical manifestations, diagnosis, prognosis, and treatment.
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PMID:Pulmonary and pleural manifestations of extrathoracic malignancies. 268 73

Between 1977 and 1985, 44 patients with osteosarcoma and pulmonary metastases were treated at Institut Curie and Marie-Lannelongue. Twenty patients were able to undergo operations according to our criteria. Of 17 patients who immediately after surgery were clinically and radiologically free of disease, six are alive with no evidence of disease and one suffered recurrent pulmonary disease; their 5-year survival is 37%. In 24 patients, various schemes for aggressive chemotherapy for measurable lung disease could be assessed. Only one patient had a complete response; there was one partial response, and three patients experienced stabilization of their disease for 6 to 8 months. Of five patients who had second line postoperative adjuvant chemotherapy, four relapsed within 2 months of stopping treatment. Surgical resection of lung metastases appears definitely to improve the outcome in osteosarcoma patients. Chemotherapy offers no advantage in treating bulk disease, but the prevention of new micrometastatic disease remains a possibility and should be assessed in randomised multicenter trials.
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PMID:Resection of pulmonary metastases in osteosarcoma. A retrospective analysis of 44 patients. 272 Jun 3

Interleukin-1 (IL-1) release by alveolar macrophages (AMs) from 29 patients with primary bronchogenic carcinoma, lung metastases, acute pneumonitis, and chronic infection was evaluated in response to a standard stimulus, lipopolysaccharide (LPS). The results were compared to those of AMs from normal smokers or nonsmokers (volunteers). AMs derived from healthy smokers secreted significantly more IL-1 than AMs from nonsmokers. In contrast, AMs from smokers affected with primary lung cancer have lost their capacity of secreting high levels of IL-1, whereas IL-1 secretion was high in nonsmokers with hematogenous metastases. AMs release high IL-1 levels in patients with acute bacterial infections. A significant correlation exists between numbers of AMs and IL-1 levels in normal individuals, a relationship which disappears in patients. These observations suggest that AMs in inflammatory lung disease, even discrete, have an increased capacity to secrete IL-1 on stimulation with LPS. They also suggest that an intrinsic dysfunction of AMs may accompany primary bronchogenic carcinoma. The influence of tobacco in modifying the functions of AMs is stressed.
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PMID:Interleukin-1 secretion by lipopolysaccharide-stimulated alveolar macrophages. Relationships to cell numbers--influence of smoking habits. 281 73

A mixed differentiated thyroid carcinoma was found in a small asymptomatic nodule in a 44-yr-old woman with recurrent chest infections and bronchiectasis. After total thyroidectomy and 162 mCi (6 GBq) radioiodine ablation there was uptake in the thyroid remnant and in both lungs, interpreted as lung metastases. In 2 years she received further three 162 mCi (6 GBq) doses of 131I, as scans showed very similar lung activity. Another scan, during thyroxin suppression, showed again activity in the lungs. A 47-yr-old male patient with similar respiratory disease and no history of thyroid disorder volunteered to undergo radioiodine scan while on triiodothyronine suppression. His scan, too, showed concentration in the lungs. The female patient died 7 years after the diagnosis of lung thyroid metastases was made. No metastasis was found at autopsy. Radioiodine lung uptake may occur in patients with chronic inflammatory lung disease, presenting a potential diagnostic pitfall in patients with differentiated thyroid carcinoma.
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PMID:Iodine-131 uptake in inflammatory lung disease: a potential pitfall in treatment of thyroid carcinoma. 337 6

From 1958 through 1985, a total of 113 consecutive patients had completion pneumonectomy (CP). Indications for pulmonary resection resulting in CP were lung cancer (LC) in 64 patients, pulmonary metastases (PM) in 20, and benign lung disease (BLD) in 29. Operative mortality was 12.4% (14 deaths) but varied according to the indication for CP. Mortality was 9.4% for LC, 0% for PM, and 27.6% for BLD. Forty-three patients (38.1%) had major complications (26 of 64 with LC, 40.6%; 1 of 20 with PM, 5.0%; and 16 of 29 with BLD, 55.2%). Five-year actuarial survival for patients with LC was 26.4% but varied according to stage. Five-year survival for patients with PM was 40.8% and with BLD was 27.2%. We conclude that CP for BLD carries marked operative mortality and morbidity, usually due to intense reaction around hilar structures and concurrent active infection or fistula. In contrast, CP for LC and PM can be performed with low mortality, acceptable morbidity, and gratifying long-term survival.
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PMID:Completion pneumonectomy: indications, complications, and results. 340 Oct 74

Soft tissue sarcomas are uncommon malignancies, less than 10% of which arise on the distal upper extremities. Consequently, experience with treatments which preserve both the limb and its function is lacking for tumors in this region. Sixteen patients with sarcomas arising in the hand and wrist and one with an aggressive desmoid tumor were treated by combined modality therapy at the Massachusetts General Hospital. Two patients had wide resections for multiple recurrent lesions, 5 had excisional biopsies, and 9 had incomplete excisions to preserve anatomic structures of the hand. One patient refused an amputation and had no surgery. Sarcoma patients were given postoperative radiation with a dose range of 50.2 to 69 Gy (median 68 Gy). The desmoid tumor received 44 Gy. A shrinking field technique with customized castings and cerrobend blocks was used to assure precision and minimize treatment volumes. Chemotherapy was reserved for metastatic disease. Local control was achieved in 14 patients who received combined modality treatment (87%), with a follow-up 1-12 years (median 33 months). Two of the three patients with local failures subsequently obtained a local control after salvage surgery and radiation. Four patients developed metastases, one with epitrochlear lymph node metastases was salvaged by amputation, the others died with lung disease 17, 37, and 111 months after treatment. Functional integrity of the limb was primarily dependent on the extent of surgical resection required. Among 12 patients with local and distant control, one patient (who had multiple wide resections of an extensive desmoid tumor preceding irradiation) lost over 50% use of her limb, but no patients required amputation for edema or pain control. Ten of the 12 patients with local and distant control had less than a 25% decrement in limb function and had no pain or edema associated with normal use of their hand. We conclude that for selected patients with sarcomas of the distal upper extremity, combined modality therapy consisting of conservative resection and careful radiation therapy is a viable alternative to amputation.
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PMID:Extremity preservation by combined modality treatment of sarcomas of the hand and wrist. 377 12

Nineteen patients with recurrent or metastatic transitional cell carcinoma of the urinary tract were treated with a 3-weekly combination of methotrexate 200 mg/m2 as a 24-h infusion with folinic acid rescue and cis-platin 100 mg/m2. An objective response rate of 68% was obtained, with 4 patients (21%) achieving complete remission. Pulmonary disease and lymph node metastases were particularly sensitive to this therapy. The median duration of response was 21 weeks with a median survival of 54 weeks in the responding patients. This regimen warrants further investigation in the treatment of invasive bladder carcinoma.
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PMID:Cis-platin and methotrexate in the treatment of transitional cell carcinoma of the urinary tract. 387 76

A case of a rare entity, pulmonary tumorlets that metastasized to a peribronchial lymph node, is reported. The patient, a 38-year-old man, underwent a right pneumonectomy for end-stage lung disease caused by bronchiectasis, chronic bronchitis, and pulmonary fibrosis. No tumors were detected on radiologic or on gross examination of the lung. Microscopically, multiple tumorlets were identified in the fibrotic pulmonary parenchyma. Five peribronchial lymph nodes were found and appeared grossly normal. A microscopic focus of metastatic tumor, histologically identical to the pulmonary tumorlets, was discovered in one of these nodes. This metastasis was identified only because a diligent search for peribronchial lymph nodes was undertaken, and because sections of each node were obtained. Pathologists usually do not extensively examine peribronchial lymph nodes in cases of chronic inflammatory disease of the lung, even when small tumorlets are discovered as incidental findings, because it is presumed that the tumorlets have not metastasized. As shown by our case, this presumption is not always correct. Pulmonary tumorlets may metastasize to peribronchial lymph nodes more frequently than has been previously recognized.
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PMID:Carcinoid tumorlets of the lung with metastasis to a peribronchial lymph node. Report of a case and review of the literature. 398 42

Malignant fibrous histiocytoma is a recently accepted member of the mesenchymal group of tumors. Hypertrophic pulmonary osteoarthropathy is rarely seen with metastatic lung disease but when it occurs it is most frequently described with sarcomatous tumor metastases. In the case reported here, this phenomenon developed with pulmonary metastases from a malignant fibrous histiocytoma, indicating that this tumor resembles other sarcomas in giving rise to this unusual clinical syndrome.
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PMID:Hypertrophic pulmonary osteoarthropathy and metastases from a malignant fibrous histiocytoma. 624 11

An analysis is made of the contribution of clinical examination to the diagnosis of primary bronchopulmonary cancer in a lot of 355 patients. As it is known bronchopulmonary cancer does not have a characteristic and patognomonic clinical symptomatology. In two thirds of the patients (236/66.4%) the disease' onset was marked by respiratory symptoms. In half of these patients (120/33.8% of the total number of cases) the respiratory syndromes for which the patient had requested medical help could have suggested the diagnosis, and were marked by a pseudo-pneumonia, or pneumopathy with long evolution, intensified coughing in a patient who had been coughing for a long time, or an onset marked by hemopthysis. In the other half of the patients in this group the onset symptoms had nothing characteristic. The onset marked by metastases was noted 69 of the patients (19.4%), and para-neoplastic syndromes were noted in 10 (2.8%). These certainly suggested the presence of pulmonary cancer. It appears that in over half of the patients 9195, or 54.1%) the clinical examination could suggest the existence of bronchopulmonary cancer, and this percentage increases if patients are included in those whose respiratory symptoms are not characteristic but in those which physical examination will evidence suggestive changes. Only in a very small number of patients (12, or 3.3%) the clinical examination did not provide any diagnostic element. These were the asymptomatic cases, accidentally identified in the course of a radiological examination. It should be stressed that the clinical suspicion of pulmonary cancer should always be confirmed by paraclinical investigations.
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PMID:[The contribution of the clinical examination to the diagnosis of bronchopulmonary cancer]. 629 7


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