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

Radiation therapy plays an important role as an adjunctive treatment modality with surgery and/or chemotherapy in a number of primary and secondary CNS neoplasms, including glioblastoma multiforme, lower grade gliomas, brainstem tumors, medulloblastoma, ependymoma, most pituitary and parapituitary tumors, brain metastases, and epidural spinal cord metastases; it also has an important function in the total management of childhood leukemia. Radiation therapy can also be extremely effective as the primary or sole treatment of pituitary adenomas, craniopharyngioma, and cerebral and epidural metastases. The relative roles of, and indications for, surgery versus irradiation have been discussed. There is clearly a need for more information regarding the natural history relative response of specific tumors to the various therapeutic modalities available, as well as the most effective and safe ways to combine treatments. To this end, it is mandatory that surgeons, radiotherapists, neurologists, pathologists, and internists begin to intercommunicate more freely and objectively. Hopefully, in areas that continue to be controversial, well-designed clinical trials can begin to furnish the necessary answers. This is particularly relevant as all of the disciplines mentioned are developing newer and hopefully more effective diagnostic and therapeutic capabilities.
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PMID:Role of radiation therapy in the management of neoplasms of the central nervous system. 18 Jul 77

Anatomo-pathological examination of 28 bronchic oat-cell carcinoma, all with cerebellar metastases and which are very often cerebral. In half of the cases, these localized cerebellar metastases contain palisades. These formations which haven't been described until now within intracranial metastases, can't be considered as artefacts as their frequency approaches 50% of the cases. Neither the primitive tumor nor the extracerebral metastases of the series reveal palisades; sometimes some of them exist in their cerebral metastases. As far as the epidemiology, the clinical evolution, the survival time and the extracerebral localization are concerned, these 28 cases are not different from those described in medical literature. The morphological, hormonal and biochemical knowledge we possess about this type of cancer tends to prove its neuroectodermic origin as well as its close relation with both the APUD- and the "endocrinien diffus" systems. The described palisading elements represent another very specific morphological point which tends to support this theory: they appear principally in the tumors of the central and peripheral nervous system. Although the author is not able to explain the reason of palisades' genesis in cerebellar metastases, he insists on the fact that it iw very important - as far as every days' biopsy's study is concerned - to proceed to a differential histological diagnosis in regards to certain primitive tumors of the nervous system (among these the medulloblastoma) and a cerebellar metastasis of this type of bronchic carcinoma.
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PMID:[Histology of cerebellar metastasis of bronchial oat cell carcinoma]. 22 51

Calvarial and extracranial metastases by hematogenous spread of primary intracranial neoplasms have been considered a rare occurrence. This report deals with the clinicopathological and radiological findings of a child with metastatic medulloblastoma. Correlation of serial postoperative computed tomography (CT) scans and the autopsy examination indicated hematogenous calvarial and intracranial spread of the primary lesion.
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PMID:Unusual metastases from a medulloblastoma: case report. 45 Feb 47

A case of desmoplastic cerebellar medulloblastoma with numerous metastases beyond the nervous system is reported. Fourteen months after the operation the patient began complaining about pains in hip and knee joints and dysphagia. One week before death profuse bleeding from the digestive tract developed. On autopsy numerous metastases were found in the bones, lymph nodes, spleen, pancreas and kidneys. Histological examination demonstrated that the metastases were composed of the same cells as the primary cerebellar tumour, but reticulin fibres were scant in them. In none of the metastatic lesions any significant reticulin proliferation was present, these fibres were found only around small vessels.
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PMID:[Medulloblastoma with multiple metastases beyond the nervous system]. 48 96

Fifty-one patients with medulloblastoma have been treated at the Children's Memorial Hospital during the past 11 years. The ratio between males and females was 2:1. The ages ranged from 4 months to 12 years; 7 patients were less than 12 months old at the time of diagnosis. After 1969, prior to definitive surgery, all patients were given a ventriculo-peritoneal shunt to decompress the hydrocephalus which was invariably present. There were no cases of systemic metastasis related to these shunts. Subsequently, posterior fossa craniotomy was performed, with total or radical resection of tumour in 13 cases, subtotal resection in 20 cases, and partial resection or biopsy in 14 cases. After completion of surgical treatment and radiotherapy, the three-year survival rate was 45.6 per cent and the five-year survival 34.5 per cent. The survival of children given total resection of the tumour was significantly longer, and females survived longer than males. Local recurrence and spinal cord or systemic metastases are discussed. Reexploration of the posterior fossa for recurrences failed to improve the prognosis. Recurrent or metastatic medulloblastoma should be treated by radiotherapy or chemotherapy, or both.
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PMID:Medulloblastoma in childhood. 51 84

A case of medulloblastoma with extracranial metastases was reported. A 20-year-old woman was operated on for cerebellar medulloblastoma twice during the past 5 years and a half. Two years after the second operation, she revealed the metastases to the cervical, axillar and inguinal lymphnodes, and to the skeletal system, such as the skull, scapula, humerus, sternum, spine, pelvis and femur. The cause of extracranial metastases in the very core in this case. While the tumor was located deep in the cerebellar hemisphere at the first operation, it spread over the cerebellar surface at the after the second operation, so that the tumor cells became infiltrative to the dura mater. Thus through lymphatic and circulatory system extracranial metastases occurred. The location of the tumor seems important in this case.
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PMID:[Medulloblastoma with extracranial metastases--a case report (author's transl)]. 52 48

Immunoelectrophoresis of extracts of 200 intracranial tumours against rabbit anti-glioblastoma serum gave positive results (= precipitation) in all cases of tumours of neuroectodermal origin such as glioblastoma, astrocytoma, oligodendroglioma, ependymoma, neurinoma, and spongioblastoma. No immunoelectrophoretic precipitation was seen for any of the tumours of mesenchymal origin, for instance meningioma and metastases of cancer. On the basis of these findings, immunoelectrophoresis is considered to be a reliable method for differentiation between tumour tissue of neuroectodermal and non-neuroectodermal origin. Among the 41 posterior fossa tumours some unusual observations were made. Cerebellar angioblastoma (Lindau tumour) showed an atypically located precipitation line, which for the present is interpreted as an immunological reaction to vascular wall tissue. Furthermore, among the group of so-called medulloblastomas, two subgroups were distinguished on the basis of three parameters. The first of these subgroups comprises tumours whose immunoelectrophoretic pattern resembles that of gliomas, which are histologically characterized by neuroectodermal structures and which occur in younger children (5--10 years). The tumours of the second subgroup, which do not show this neuroectodermal immunoelectrophoretic pattern, have a sarcomatous character histologically, and occur in patients aged between 10 and 50 years. The view that medulloblastoma comprises a number of different types of tumour seems to be confirmed by this finding.
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PMID:Immunoelectrophoresis in the diagnosis of neuroectodermal and mesodermal intracranial tumours, especially those of the posterior fossa. 57 8

Metastatic spread of medulloblastoma along the neuraxis by leptomeningeal seeding through the cerebrospinal fluid pathways is well known. The occurrence of extracranial metastases outside the neuraxis has been well established, but the occurrence of intramedullary spinal cord metastases not related to surface seeding is rare. A histologically documented case of the latter type is described.
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PMID:Spinal intramedullary metastatic medulloblastoma. Case report. 63 89

The course of 36 patients with medulloblastoma and ependymoma was evaluated prospectively by clinical examination, radionuclide (RN) studies and computed tomography (CT). Seventeen of the 36 patients (47%) had tumor recurrence. Twelve (41%) of the 29 patients with medulloblastoma had recurrent tumors of which 7 of 12 (58%) were at the primary site and 2 of 12 (17%) were within the ventricles while 10 of 12 (83%) were in the subarachnoid space. Five of the 7 patients with ependymoma had recurrent tumors. In 4 of the 5 patients tumor recurred at the primary site while subarachnoid seeding occurred in 2 of 5 patients (40%) and intraventricular metastases were found in 4 of 5 patients (80%). Progressive ventricular enlargement often accompanied subarachnoid seeding, presumably secondary to obstruction of cerebrospinal fluid (CSF) flow in the subarachnoid pathways. CT and RN scans were frequently complementary in detecting tumor recurrence.
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PMID:Computed tomography in the follow-up of medulloblastomas and ependymomas. 66 26

Three cases are reported of posterior fossa medulloblastoma in children. In each case metastatic spread occurred despite homogeneous field radiotherapy to the whole neuraxis; the secondary tumor was located in the subfrontal region. In the two cases in which operative removal of the metastasis was carried out, the tumor was found to be extracerebral and was attached to the dura in the region of the cribiform plate. The "face-down" position of patients during operations on the posterior fossa makes this area the most dependent part and therefore the most likely recipient of tumor cells shed at operation. This area has not previously been included in the field of maximum dosage for radiotherapy, but as a result of these findings a modification in technique of radiotherapy has been suggested.
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PMID:Recurrence of medulloblastoma after homogeneous field radiotherapy. Report of three cases. 68 6


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