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

In four of 28 patients (14%) with medulloblastoma who were treated at the University of Wisconsin, Madison, over a 20-year period, extraneural metastases developed. In an effort to delineate the causal factors involved in extraneural metastases, salient features of patients with metastases and without metastases were compared. Suboccipital craniectomy, radiation therapy, and patient longevity were not well correlated with metastases. However, subarachnoid tumor spread was a consistent precursor. A ventriculoatrial shunt may have been a factor in one patient and a serious infection that preceded diffuse metastasis may have been a factor in another patient. Half of the patients with metastases were found to have the desmoplastic variety of medulloblastoma while only one of 24 patients without metastases had this tumor type.
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PMID:Cerebellar medulloblastoma. An analysis of four cases of extraneural metastasis. 71 92

The authors report a diagnostic dilemma involving a child who, 8 years previously, had total excision of a medulloblastoma. On x-ray studies, lytic lesions of the skull were seen. The differential diagnosis and some of the clinical and pathological aspects of the nevoid basal-cell carcinoma syndrome versus metastases are discussed.
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PMID:Multiple nevoid basal-cell carcinoma syndrome (Gorlin's syndrome): possible confusion with metastatic medulloblastoma. Case report. 75 69

The authors review treatment and results in 45 cases of medulloblastoma arising in childhood. The surgical mortality rate observed was 11%. Of those completing postoperative cerebrospinal irradiation at this institution, 53% have survived for 3 years, 41% for 5 years, and 22% for 10 years. The extent of surgical resection of the cerebellar tumor had no significant bearing on the prognosis. Those cases remaining free of recurrent disease had received significantly higher doses of postoperative irradiation, approaching 5000 rads to the whole brain or posterior fossa and 4000 rads to the spinal axis. Repeat irradiation and chemotherapy (vincristine, the nitrosoureas, and methotrexate) provided good palliation in most cases and significantly extended the survival time. However, 28 of 29 patients who developed locally recurrent or metastatic disease have died. Vincristine was considered the chemotherapeutic drug of choice and in 14 cases its use was associated with remissions lasting 2 to 18 months. The combination of chemotherapy and repeat irradiation was followed by remissions of longer duration compared to retreatment by irradiation alone when the disease recurred within 2 years. The inherent value of ventricular shunting procedures and steroid therapy for recurrent intracranial disease could not be ascertained. The findings in this study suggest that the primary treatment of medulloblastoma should be extended to include chemotherapy and optimum radiation therapy, since once recurrent disease develops retreatment is essentially palliative and a fatal outcome is virtuallly certain.
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PMID:Medulloblastoma in children. Survival and treatment. 83 Aug 16

Twenty-three patients with previously treated medulloblastoma had brain scintigrams revealed posterior fossa recurrence in 15 patients and supratentorial metastases in 9; only 1 of the latter was clinically suspected. Two subdural hematomas and one calvarial metastasis were also detected. Comparison with other diagnostic evidence shows agreement in 13 out of 14 cases (93%) for posterior fossa recurrence and 8/10 (80%) for supratentiorial masses. Brain scintigraphy appears to be a sensitive and specific test for the detection of recurrence and metastasis in patients with treated medulloblastoma.
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PMID:Brain scintigraphy in recurrent medulloblastoma. 93

Osteoblastic bony metastases were observed in a case of medulloblastoma three years after surgery and radiation treatment. There was clinical response to COP therapy (cytoxin, oncovin, prednisone). Radiographic and isotopic bone scan study showed uniform increase in bone density. Serum calcium and phosphorous and acid phosphatase levels were normal. Alkaline phosphatase was elevated and declined with therapy without change in the bone appearance. This suggested an increase in bone deposition activity. However, no increase in calcitonin level was detected either during active disease or following a chemotherapy-induced remission.
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PMID:Generalized osteoblastic bony metastases from medulloblastoma. 102 58

A series of 35 primary cerebral neuroblastoma is reported. These rare tumours occur most often in children in the first half of the first decade. Grossly the tumors are often massive, discrete, lobular, firm and cystic. Histologically three variants, largely determined by the extent and distribution of the fibrous connective tissue stroma, are recognized: (1) a classical variant, which most resembles the peripheral neuroblastoma and is characterized by a high frequency of Homer Wright rosettes and a relatively high frequency of ganglionic differentiation; (2) a desmoplastic variant, which is characterized by an intense connective tissue stroma; and (3) a transitional variant, in which both the classical and the desmoplastic features may be present within the same case, either concurrently or consecutively. Both the desmoplastic and the transitional forms are less likely to exhibit differentiation to mature ganglion cells, but the importance of identifying the primitive cell elements as neuroblasts is emphasized. With rare exceptions, this can be established only by specific silver impregnations on frozen material. Occasionally the direction of growth may be largely leptomeningeal. Seven illustrative clinical histories with pathological correlations are described. The over-all clinical behaviour of these tumours is that of malignant neuroepithelial neoplasms, characterized by a high recurrence rate. Recurrence may, however, be a late development, in some cases occurring five or seven years after apparently successful surgical removal. The tumour shows shows a high incidence of metastatic spread, almost 40 per cent of the cases examined at autopsy having disseminated in the cerebrospinal pathways. Exceptionally, extraneural metastases may also develop. However, long post-operative survival occasionally occurs, and the subsequent clinical course is not always predictable in the individual case. The differential diagnosis is briefly discussed. The cellular nature of the tumour and its biological behaviour recall those of the cerebellar medulloblastoma. Post-operative radiation to the entire neuraxis should be considered for these neoplasms.
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PMID:Primary cerebral neuroblastoma. A clinicopathological study of 35 cases. 103 Jun 55

This freeze-fracture study was performed in 3 astrocytomas, 6 glioblastomas, 2 ependymomas, 3 medulloblastomas, 1 cerebellar sarcoma, 3 germinomas, and 1 medulloepithelioma. The number of nuclear pores/mum2 nuclear membrane was not correlated with biological malignancy. Fracture faces A and B were discernible in nuclear, Golgi and rough endoplasmic reticulum (ER), mitochondrial surface, and plasma membranes. Fenestrae were evident in Golgi and ER membranes. The transitional zone of cristae from the inner surface membrane appeared as a circular hole and broken-off neck on faces A and B of the inner surface membrane, respectively. The decrease in number of membrane particles in the plasma membrane seemed to correlate with the frequency of metastases, and, in addition, the membrane particles appeared to cluster in glioblastoma, medulloblastoma, and medulloepithelioma. The gap junctions were abundant in astrocytomas, moderate in number in ependymomas and germinomas, and rare in glioblastomas, cerebellar sarcoma, and medulloepithelioma. Tight junctions were often found in germinomas and medulloepithelioma, and rarely in ependymomas.
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PMID:Freeze-fracture study of human brain tumors. 117 38

Unsuspected metastatic medulloblastoma involving the spinal cord was detected by myelography in 2 of 3 patients with newly diagnosed medulloblastoma. Myelography revealed unsuspected spinal cord metastases in an additional patient with recurrent medulloblastoma in the posterior fossa. The authors suggest that myelography be performed prior to radiotherapy in all patients with either primary medulloblastoma or recurrence in the posterior fossa.
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PMID:Myelography in patients with medulloblastoma. 117 83

Four patients with skeletal metastases from retinoblastomas are presented. Radiologically, the metastases showed periosteal new bone formation and permeative-type bone destruction, particularly involving the long bones of the extremities, and they tended to be bilateral. The metastases resembled those of neuroblastoma and, to a lesser extent, medulloblastoma. The relationship between these three tumors is discussed.
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PMID:Skeletal metastases from retinoblastoma. 122 22

The authors have routinely inserted a ventriculoperitoneal shunt in all patients with a posterior fossa tumor and hydrocephalus some 7-10 days prior to craniotomy. Forty-one patients with medulloblastoma were treated in this fashion and of these, four metastasized through the shunt and died of systemic metastases without evidence of recurrent tumor in their central nervous system. A millipore filter which can be incorporated in the shunt has been used by the authors during the past 18 months in an effort to prevent metastatic spread through the shunt.
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PMID:Metastasis via ventriculoperitoneal shunt in patients with medulloblastoma. 126 15


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