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

Allergen-induced respiratory inflammation facilitates and/or elicits the extravasation of proinflammatory leukocytes by well-understood mechanisms that mediate the movement of multiple cell types. The nonspecific character of these pathways led us to hypothesize that circulating cancer cells use similar mechanisms, promoting secondary tumor formation at distal sites. To test this hypothesis, the frequency of metastasis to the lung as a function of allergic pulmonary inflammation was assessed following the i.v. injection of B16-F10 melanoma cells in mice. These studies showed that allergen-induced pulmonary inflammation resulted in a >3-fold increase in lung metastases. This increase was dependent on CD4(+) T-cell activities; however, it occurred independent of the induced eosinophilia associated with allergen provocation. Interventional strategies showed that existing therapeutic modalities for asthma, such as inhaled corticosteroids, were sufficient to block the enhanced pulmonary recruitment of cancer cells from circulation. Additional mechanistic studies further suggested that the ability of circulating cancer cells to extravasate to surrounding lung tissues was linked to the activation of the vascular endothelium via one or more Galpha(i)-coupled receptors. Interestingly, a survey of a clinical breast cancer surgical database showed that the incidence of asthma was higher among patients with lung metastases. Thus, our data show that allergic respiratory inflammation may represent a risk factor for the development of lung metastases and suggest that amelioration of the pulmonary inflammation associated with asthma will have a direct and immediate benefit to the 7% to 8% of breast cancer patients with this lung disease.
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PMID:Allergic pulmonary inflammation promotes the recruitment of circulating tumor cells to the lung. 1892 34

A carcinoid tumor is a rare malignant disease which can be cured when localized and treated by surgery. Chemotherapy is not effective, and somatostatin is used for palliation. Rarely is the disease aggressive, and thus does not contribute to a shortening of patient survival. The aim of this study was to define the treatment and survival of patients with primary lung carcinoid tumors. Forty-three patients (26 males, 17 females; median age 43 years, range 11-73 years), from 1993 to 2007, were included in this study. All patients had histologically confirmed carcinoid tumors. The site of the disease at diagnosis was the lung in all 43 patients. All patients underwent surgery which involved mainly typical or sleeve lobectomy. Eight patients had a pneumonectomy. One patient had the primary tumor excised for palliation as there were metastases in the liver. Somatostatin palliative treatment was administered to 4 patients; 1 with liver and 3 with lung recurrence. Two of the 43 patients died within 2 years after surgery. The median survival was not reached as all patients, apart from 2, were alive after a median follow-up of 5 years (mean survival 159 months). As a rule, a carcinoid tumor is an extremely slow-growing disease with some rare exceptions. All of our patients had primary lung disease. All, apart from 2, were alive at the end of the study, and 93% were without recurrence for a duration of 6 months to 13 years. The patients with liver metastases who underwent no specific treatment had a median survival as long as 8 years.
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PMID:Lung carcinoid tumor biology: treatment and survival. 1921 36

Pneumonia and primary lung abscesses may result from aspiration of infectious material from the oropharyngeal cavity and the upper respiratory tract. Most subjects suffer from an impaired mechanical or immunologic defense, for example alcoholism or dysphagia following stroke. The early course of the disease is uncharacteristic. Necrotizing pneumonia, pulmonary abscesses and the characteristic, foul-smelling, putrid discharge only occur 8-14 days after the initial aspiration event. Although common respiratory pathogens are frequently isolated from the lower airways of these patients, anaerobic bacteria play a pivotal role in cavitary lung disease following aspiration. Anaerobic coverage is therefore a requirement for an adequate antibiotic regimen, and antibacterial activity against common respiratory pathogens appears reasonable in most cases. Aminopenicillins/beta-lactamase inhibitors, newer fluoroquinolones with anaerobic activity (moxifloxacin) and clindamycin have demonstrated equal clinical efficacy in the treatment of aspiration pneumonia and primary lung abscess. Prolonged antibiotic therapy is required in cases with extensive damage of lung tissue. Since antibiotics can provide cure in 80-90% of cases, surgical procedures are limited to severe complications, such as pleural empyema. Cavitary lung disease has a broad differential diagnosis, including aspiration of sterile gastric content (Mendelson syndrome), staphylococcal pneumonia, tuberculosis, primary carcinoma of the lung, metastases and vasculitis.
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PMID:Aspiration pneumonia and primary lung abscess: diagnosis and therapy of an aerobic or an anaerobic infection? 2047 71

With ongoing technical improvements such as multichannel MRI, systems with powerful gradients as well as the development of innovative pulse sequence techniques implementing parallel imaging, MRI has now entered the stage of a radiation-free alternative to computed tomography (CT) for chest imaging in clinical practice. Whereas in the past MRI of the lung was focused on morphological aspects, current MRI techniques also enable functional imaging of the lung allowing for a comprehensive assessment of lung disease in a single MRI exam. Perfusion imaging can be used for the visualization of regional pulmonary perfusion in patients with different lung diseases such as lung cancer, chronic obstructive lung disease, pulmonary embolism or for the prediction of postoperative lung function in lung cancer patients. Over the past years diffusion-weighted MR imaging (DW-MRI) of the thorax has become feasible with a significant reduction of the acquisition time, thus minimizing artifacts from respiratory and cardiac motion. In chest imaging, DW-MRI has been mainly suggested for the characterization of lung cancer, lymph nodes and pulmonary metastases. In this review article recent MR perfusion and diffusion techniques of the lung and mediastinum as well as their clinical applications are reviewed.
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PMID:Diffusion and perfusion MRI of the lung and mediastinum. 2062 35

Vinorelbine (VNR; 5'-nor-anydro-vinblastine) is a new semisynthetic vinca alkaloid which has demonstrated significant clinical activity against non-small cell lung cancer, bronchial adenocarcinoma, breast cancer, and head/neck squamous cell carcinoma. Moreover, vinorelbine has been widely employed in combination with cisplatinum with or without 5-fluorouracil for the treatment of lung cancer and head/neck carcinomas. Sixteen consecutive patients with lung metastases from colorectal adenocarcinomas were treated with vinorelbine tartrate (Navelbine R) given at the dose of 25 mg/m(2) i.v. bolus every week for eight consecutive times employing metoclopramide as an antiemetic tool. All patients had previous surgery, two had adjuvant chemo-immunotherapy with i.v. 5-fluorouracil and oral levamisole, 5 patients had adjuvant radiotherapy, and 1 patient had chemotherapy with levofolinic acid and 5-fluorouracil for advanced disease. Sites of disease included lung in all cases, liver metastases in 3 patients and nodal tumoral deposits in 2 cases. All patients entered in the study had lung disease as predominant site of disease and showed multiple metastases. One patient was not evaluable for response, toxicity and survival because he was lost to follow-up before completion of therapy. No major objective response was seen. Four patients had stable disease which lasted a mean of 5.2 months, and the remaining 11 patients showed progressive disease. Mean survival was 6.7+ months (range 4.0-12.0+ months). The treatment was quite well tolerated by most patients, granulocytopenia being the most frequent side-effect. Nausea/vomiting was very mild with grade 1 episodes in 5 patients (33%). Grade 1 leukopenia was seen in 5 patients (33%), grade 2 leukopenia in 3 patients (20%), and grade 3 in 2 cases (13%). Grade 1 thrombocytopenia was recorded in 3 cases (20%). No significant neurotoxicity was observed, except mild constipation in 4 cases (26%). The activity of VNR on a weekly schedule against lung metastases from large bowel adenocarcinoma is very low, however it should be noted that the treatment was well tolerated by most patients.
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PMID:Single agent vinorelbine in the treatment of unresectable lung metastases from colorectal cancer. 2159 13

Adenoid cystic carcinoma (ACC) is characterized by a particularly aggressive behavior even many years after resection of primary tumor. The evolution of metastasis dramatically affects the final outcome but resection should always be evaluated. Herein is described a case of aggressive ACC of the parotid gland in a 30-year-old female. She developed local recurrence and lung metastases; then, she also developed two liver metastasis 112 and 132 months after the resection of the primitive cancer of the parotid gland. Both lesions were successfully managed by a laparoscopic approach. Intra-abdominal adhesions after the first surgery were mild, allowing an easier access for the second laparoscopic liver resection. At 1 year follow-up, the patient is liver disease free with a stable lung disease. To our knowledge, this is the first report of a double laparoscopic liver resection for parotid gland's ACC metachronous metastases. Patients with resected ACC need a strict and lifelong follow-up after the resection of the primitive cancer. Also for ACC, a laparoscopic approach to liver metastasis should always be considered as a viable alternative to open surgery. In our experience of over 90 cases, laparoscopic surgery causes less adhesions, allowing an easier approach for repeated resections.
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PMID:Recurrent adenoid cystic carcinoma in the liver: a repeated laparoscopic surgical approach. 2164 96

The aim of this paper is to focus attention on complex cases of lung disease that may benefit from being managed outside formal guidelines. A 52 year-old man who had previously undergone a laryngectomy for squamous cell carcinoma, presented with a 1.2 cm nodule in the right upper pulmonary lobe. Three months later a new CT scan found that the nodule had slightly increased in size and also detected two new smaller nodules in the middle lobe. A PET/CT scan showed metabolic hyperactivity of all nodules. Since needle aspiration of the upper one revealed malignant cells, the patient was considered to be suffering from metastatic cancer and started on chemotherapy. At follow-up both CT and PET scans found a significant reduction in volume and activity of the lower nodules but no change in the upper one. At diagnostic thoracoscopy, histology demonstrated that the upper nodule was an adenocarcinoma while the lower ones were inflammatory. An upper lobectomy and systematic nodal dissection were therefore performed. Histology established a diagnosis of upper pulmonary adenocarcinoma and sarcoidosis. Our report suggests that in complicated oncologic cases in which non-invasive diagnostic tools yield incongruous results surgery should be considered without delay.
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PMID:Multiple right-sided pulmonary nodules: metastatic cancer or resectable early stage tumor? 2189 47

Human anaplastic thyroid cancer (ATC) is a lethal disease with an advanced clinical presentation and median survival of 3 months. The BRAF(V600E) oncoprotein is a potent transforming factor that causes human thyroid cancer cell progression in vitro and in vivo; therefore, we sought to target this oncoprotein in a late intervention model of ATC in vivo. We used the human ATC cell line 8505c, which harbors the BRAF(V600E) and TP53(R248G) mutations. Immunocompromised mice were randomized to receive the selective anti-BRAF(V600E) inhibitor, PLX4720, or vehicle by oral gavage 28 d after tumor implantation, 1 wk before all animals typically die due to widespread metastatic lung disease and neck compressive symptoms in this model. Mice were euthanized weekly to evaluate tumor volume and metastases. Control mice showed progressive tumor growth and lung metastases by 35 d after tumor implantation. At that time, all control mice had large tumors, were cachectic, and were euthanized due to their tumor-related weight loss. PLX4720-treated mice, however, showed a significant decrease in tumor volume and lung metastases in addition to a reversal of tumor-related weight loss. Mouse survival was extended to 49 d in PLX4720-treated animals. PLX4720 treatment inhibited cell cycle progression from 28 d to 49 d in vivo. PLX4720 induces striking tumor regression and reversal of cachexia in an in vivo model of advanced thyroid cancer that harbors the BRAF(V600E) mutation.
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PMID:Late intervention with anti-BRAF(V600E) therapy induces tumor regression in an orthotopic mouse model of human anaplastic thyroid cancer. 2220 62

The article reports on a 60-year-old female patient with insulin-dependent diabetes who presented with coughing, chest pains and low-grade fever. Auscultation revealed a vesicular breathing noise bilaterally and the laboratory results showed slightly increased infection parameters. The initial diagnostic work-up included chest x-ray and contrast-enhanced computed tomography (CT). The diagnostics resulted in a pulmonary adenocarcinoma with osseous and hepatic metastases. Furthermore, widespread bilateral pulmonary cystic lesions were observed. Regarding the wide spectrum of differential diagnoses and the clinical pattern, the findings have to be regarded as cystic metastases and not as primary cystic lung disease.
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PMID:[Tumor and pulmonary cysts - Lice, fleas or both?]. 2261 28

We report the case of a 56 year-old Gabonese man under treatment by candesartan-hydrochlorothiazide for essential hypertension. After 2 months of treatment, he presented with pneumonia and severe respiratory failure. The chest radiography showed centrilobular nodules resembling tumor metastases, but no evidence of a primary tumor. Laboratory and imaging found no evidence of infectious or autoimmune disease. The computed tomography findings led to a diagnosis of diffuse alveolitis. The candesartan treatment was stopped and oral corticosteroid therapy (50 mg/day) initiated. The rapid favorable outcome supports the diagnosis of a drug-induced infiltrative lung disease.
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PMID:[Centrilobular nodules with ground-glass opacities in the lungs]. 2289 Jan 34


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