Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Medulloblastoma, pineoblastoma, and cerebral neuroblastoma are malignant embryonal tumors of the CNS that may demonstrate similar histologic features, a propensity for neuraxis dissemination and sensitivity to radiation therapy and, in certain cases, chemotherapy. To evaluate the activity of preirradiation chemotherapy in such tumors, 11 newly diagnosed children with measurable residual disease and characteristics indicative of poor prognosis were treated postoperatively with cisplatin (CDDP) and etoposide (VP-16). Responses graded on the basis of radiographic findings in areas of either macroscopic residual tumor or metastatic disease included two complete responses (CRs), eight partial responses (PRs), and one stable disease (SD). Acute and subacute toxicity consisted of high-frequency hearing loss in four patients, reversible signs and symptoms of increased intracranial pressure in two patients, and transient neutropenia. Seven of eight patients with high-risk medulloblastoma and two of two with pineoblastoma remain free of tumor progression following neuraxis irradiation at 8 to 48 months postdiagnosis (median, 18 months). CDDP and VP-16 is a highly active drug combination when given before irradiation in children with high-risk medulloblastoma and other malignant embryonal tumors of the CNS, producing objective responses in at least one site of measurable disease in 10 of 11 newly diagnosed patients, including all of five with gross neuraxis dissemination.
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PMID:Preirradiation cisplatin and etoposide in the treatment of high-risk medulloblastoma and other malignant embryonal tumors of the central nervous system: a phase II study. 215 66

Extradural metastases in medulloblastoma appear to be rare. We describe a case associated with use of a lumbar drain and propose that in this situation, adjuvant chemotherapy and possibly extension of the radiotherapy field to include the entire sacral epidural fat-space to the lower border of S5, should be considered.
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PMID:Extradural metastases in a case of medulloblastoma. 226 30

The results of radiation therapy conducted after various schemes were compared in 77 patients operated on for medulloblastoma of the posterior cranial fossa: 1. irradiation of the posterior cranial fossa area; 2. irradiation of this area and the entire length of the spinal marrow; 3. total irradiation of the CNS. Stages in a metastatic process necessitate irradiation in stages, i.e. irradiation of the posterior cranial fossa and the length of the spinal marrow followed by irradiation of the cerebral hemispheres one year after the operation. Total irradiation of the CNS shortly after the operation is recommended only in the presence of early metastases.
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PMID:[The efficacy of gamma teletherapy in the combined treatment of medulloblastomas in the posterior cranial fossa of children]. 230 95

The results of treatment of 47 adults with medulloblastoma are reviewed. For those treated with ortho-voltage radiotherapy between 1952 and 1963 the actuarial 5- and 10-year survival rates were 38% and 23%, respectively. Of those treated with megavoltage radiotherapy between 1964 and 1981, the corresponding 5- and 10-year survival rates were 59% and 53%, respectively. Of patients treated with megavoltage radiotherapy and adjuvant chemotherapy between 1971 and 1981, 76% were alive at 5 years and also at 10 years. Treatment factors associated with an increased survival were complete or subtotal resection of the primary tumor, as opposed to partial removal, a radiation dose to the posterior fossa of 55 Gy or more and the administration of adjuvant chemotherapy. Neither the quality of life, nor the fertility of the surviving patients, have been impaired by the treatment. Six patients (13%) developed metastatic disease outside the central nervous system.
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PMID:Medulloblastoma in adults: a review of 47 patients treated between 1952 and 1981. 232 67

We report a patient with a history of a previously treated medulloblastoma, now presenting with generalized osseous metastases. Currently there is a complete remission under continuous therapy with VP-16. Since the frequency of systemic metastases in patients with medulloblastoma is approximately 5%, we recommend a more extensive initial evaluation in these patients.
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PMID:[Treatment of an extraneural metastasized medulloblastoma]. 235 23

Thirty children with medulloblastoma who were treated between 1980 and 1986 are presented. Flow cytometric DNA analysis using formalin-fixed and paraffin-embedded tissues showed that 15 were DNA aneuploid, 13 diploid and 2 tetraploid. After homogeneous treatment with a combination of radical resection and radiation therapy, patients with DNA aneuploid medulloblastoma showed significantly better outcome (p = 0.003). Among these 30 patients, 6 (20%) had bone metastases of medulloblastoma during a minimum of 2-year follow-up period. DNA ploidy of these patients was diploid in 5 and aneuploid in 1. Incidence of bone metastases appears to correlate with DNA ploidy (p = 0.046). At the time of discovery of bone metastases, 4 had no demonstrable recurrence in the central nervous system (CNS). Radionuclide bone scan was more sensitive in disclosing these lesions, while only one patient had positive results of bone marrow aspirates/biopsy. Three patients were treated with chemotherapy, two had a combination of regional irradiation and chemotherapy and one refused treatment. All treated bone metastases in 5 patients responded clinically and radiographically, but only one patient is alive 66 months after therapy. Four patients died due to either CNS recurrence of septic complication of chemotherapy. Early detection of bone metastases by use of frequent bone scans is important. Patients with diploid medulloblastoma should be treated with adjuvant chemotherapy in order to prevent recurrences and metastases.
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PMID:Bone metastases of medulloblastoma in childhood; correlation with flow cytometric DNA analysis. 235 45

Studies of twenty-five patients with loculated leptomeningeal tumor metastases diagnosed by CT and/or MR were analyzed retrospectively. Medulloblastoma was the most frequent primary tumor (8/25, 32%). Four subgroups of loculated patterns were identified. Type A included mass(es) limited to the subarachnoid space without obvious direct parenchymal infiltration; this pattern occurred in 12 patients, of whom five had associated diffuse pattern. Type B was characterized by mass(es) still predominantly in the subarachnoid space but with minor transpinal parenchymal infiltration; this pattern was found in five patients. Type C comprised subarachnoid mass(es) with marked transpinal extension mimicking parenchymal lesion; this pattern was observed in three patients. Type D consisted of subarachnoid mass(es) growing along the perineural CSF space; this pattern was noted in two patients. Additionally, two patients presented with combined A and C patterns, and one patient had a combined B and C pattern. More than half the patients (14/25, 56%) presented with a single lesion. The most frequent locations were the suprasellar cistern, ventricular walls, and lateral recesses of the fourth ventricle, Gd-DTPA-enhanced T1-weighted MR images appeared best for demonstrating the site and extent of disease. Recognition of the loculated patterns of leptomeningeal metastases, which are less common than the diffuse pattern, is important to radiologists and clinicians for correct diagnosis and proper management of patients with this disease.
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PMID:Loculated intracranial leptomeningeal metastases: CT and MR characteristics. 251 78

Medulloblastoma is the most common malignant childhood brain tumor in which aggressive growth produces recurrence in approximately 50% of appropriately treated cases and metastases along the neuraxis in 30%. To date, no studies exist concerning the production of autocrine growth factors by this brain tumor type. Malignant brain tumors in adults often produce platelet-derived growth factor (PDGF). A medulloblastoma cell line, TE-671, has been used for many years in pediatric neuro-oncologic studies. We assayed this medulloblastoma cell line for the production of PDGF. PDGF is produced by medulloblastoma cells grown in monolayer tissue culture and stimulates PDGF-sensitive 3T3 fibroblasts to incorporate tritiated thymidine in a dose-dependent fashion. This biologic activity is blocked by PDGF antibodies in a dose-dependent relationship. We postulate that PDGF produced by medulloblastoma cells plays a role in the growth of this tumor by stimulating mitogenic activity.
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PMID:Medulloblastoma cell line secretes platelet-derived growth factor. 220 65

During the last 4 yr, fine-needle aspiration cytology (FNAC) has been employed in 1,474 patients in 0-15-yr age group at our institute. Of these, 245 patients were found to have malignant disease, including primitive neuroectodermal tumors, hepatoblastoma, nephroblastoma, sarcoma, and epithelial malignancies. Four metastases from medulloblastoma and two each from astrocytoma and meningioma were confirmed without open biopsy. FNAC interpretation was easy when cytologic findings were correlated with relevant clinical and radiologic data.
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PMID:Role of fine-needle aspiration cytology in childhood malignancies. 261 14

Osseous metastases from primary central nervous system (CNS) tumors are rare. The CNS tumors that most frequently metastasize to bone are the glioblastoma multiforme and the medulloblastoma. In this report, a 22-year-old woman sought treatment for a lytic lesion in her right proximal femur 18 months after a craniotomy to remove a pinealoblastoma, a rare primitive neuroectodermal tumor of the pineal gland. An extensive evaluation demonstrated no other primary tumors. A biopsy of the femoral lesion revealed that it was morphologically identical to the pinealoblastoma, and special immunohistochemical stains were performed that verified neuronal differentiation. This may be the first report of a pinealoblastoma associated with an extracranial skeletal metastasis.
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PMID:Extracranial skeletal metastasis from a pinealoblastoma. A case report and review of the literature. 267 97


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