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)

An analysis of more than 18,000 primary central nervous system (CNS) tumors revealed only 18 cases (0.01%) in which dropped spinal metastases had caused the presenting symptoms. This group included 11 males and 7 females in whom there was no history of surgical intervention or irradiation. Primitive neuroectodermal tumors ( PNET , medulloblastoma), comprised the largest group (11 patients) followed by high-grade astrocytomas (anaplastic and glioblastoma) (5 patients). One case each of germinoma and ependymoma were also identified. The clinicopathologic data of these cases, and a brief review of the literature are presented.
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PMID:Spinal metastases. A rare mode of presentation of brain tumors. 632 8

The histogenesis of the medulloblastoma has been controversial since the original description of the tumor over 50 years ago. Recent debates have focused upon whether the tumor differentiates along glial or neuronal lines. In order to address this question, we reviewed the clinical histories, histopathologic features, and immunocytochemical staining for glial fibrillary acidic protein (GFAP) in 20 patients seen at our hospital from 1970 to 1980. Primary tumors, local recurrences, and metastatic tumors were all included. Five of the 20 primary cerebellar tumors contained weakly GFAP-positive foci. Local recurrences occurred after treatment in seven patients and extracranial metastases in two, all of which were GFAP-negative. Interpretation of GFAP positivity was problematic. In most instances it occurred in areas where astrocytes might predictably be found: at the interface of tumor and adjacent brain and around blood vessels. Only rare single positive cells were identified in the midst of tumor nodules where cytologic distinction between neoplastic and reactive astrocytic cells was difficult. We conclude that GFAP positivity may not be intrinsic to medulloblastomas and must be interpreted with a degree of skepticism.
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PMID:Glial differentiation in medulloblastomas. Histogenetic insight, glial reaction, or invasion of brain? 635 53

Individual masks have been applied for about one year at the Radiotherapeutic Hospital of Erlangen in order to treat tumors situated in the head and neck region, the superior aperture of the thorax and the brain as well as tumors situated in the posterior cranial fossa showing a tendency to form metastases within the spine (medulloblastoma and ependymoblastoma). The advantages of this method are the reproducible position of the patient, the facilitation of exact focussing and the absence of marks on the patient's skin. The disadvantages are the increase of radiodermatitis and increased expenditure of cost and work. However, the advantages are preponderant, so the irradiation mask is routinely applied in our hospital.
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PMID:[The individual irradiation mask--a means for improving focussing accuracy]. 640 17

Cells of two human glioma lines (UC-35AG, UC-58EG), a human medulloblastoma line (UC-51MB), two rat glioma lines C6, RG2), and a rat schwannoma line (Lew-MS) were injected i.v. into male nude mice (BALB/c nu/nu). Each animal was injected with 10(6) viable cells of a particular line; for each line there was a group of eight to nine animals. The mice developed disseminated (metastatic) tumors from all lines. The incidence of mice developing metastatic tumors was different for the various lines: 2/8 for the UC-34AG, 7/9 for the UC-58EG, 1/8 for the UC-51MB, 7/8 for the C6 line, 8/8 for the RG2 and 1/9 for the Lew-MS line. The shortest survival of the mice with tumors was observed with C6 (all died on days 10-14 post injection), and with RG2 (all died from day 32 to day 39 following injection). With the remaining lines, all mice survived until they were killed on day 40 after injection. Most frequently the tumors developed in the lung. Other organs, e.g., kidney or liver, were sometimes also involved, but usually to a considerably lesser degree than the lung. Metastases never developed in the CNS. It was observed that tumors of certain glioma lines tended to grow in the lung in characteristic patterns and involved or spared other organs.
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PMID:Disseminated (metastatic) tumors in nude mice produced by intravenous injection of cells of human and nonhuman neurogenic tumor lines. 646 77

Actuarial progression-free survival rate at 5 years of a series of 34 patients with medulloblastoma treated by combined surgery, radiotherapy, and chemotherapy was 71%. No relapses were observed in 14 patients followed for more than 5 years. Treatment consisted of a short postoperative course of vincristine (VCR) and intrathecal (IT) methotrexate (MTX) followed by irradiation to the entire cranio spinal axis. Maintenance chemotherapy (CCNU, VCR, and IT MTX) was then continued to encompass 2 years from surgery. Failure occurred in nine patients: four had local recurrence, four dissemination within the central nervous system, and one widespread skeletal metastases. Poor prognostic factors such as presence of malignant cells in the cerebrospinal fluid, non-radical surgery, young age, and radiation doses less than 50 Gy to the tumor bed, did not adversely affect the outcome of patients in this series. Long-term sequelae from the treatment program could be observed in all patients, and in 58% they were severe enough to interfere with normal, active life.
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PMID:Medulloblastoma. Results of a sequential combined treatment. 647 30

Medulloblastoma is a malignant cerebellar tumor seen primarily in the pediatric age group that has a known ability to metastasize extraneurally. The skeleton is the most common site of extraneural metastases, but metastases to the bone marrow can also occur. Four cases of medulloblastoma metastatic to the marrow are reported. In addition, 31 cases from the medical literature are reviewed. Clinical features include bone tenderness, cytopenias and elevated serum alkaline phosphatase and lactic dehydrogenase levels. Skeletal involvement, especially of the pelvic bones, is frequently seen radiographically. Weight loss, soft tissue masses and a requirement for blood transfusion are also associated features. Marrow biopsy specimens are characterized by the presence of a small cell tumor often with fibrosis, necrosis and osteoblastic activity. The symptomatic response to chemotherapy is rapid, but chemotherapy resistance appears quickly. Only 1 in 4 cases diagnosed antemortem in this review lived for more than a year. We conclude that marrow aspiration and biopsy are indicated in the evaluation of patients with medulloblastoma and may serve to diagnose the cause of cytopenias, to verify extraneural spread and to provide prognostic information.
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PMID:Medulloblastoma metastatic to the marrow. Report of four cases and review of the literature. 650 96

In a population-based series of 368 children undergoing surgery for medulloblastoma, 304 (83%) survived to complete a course of radiotherapy. Among those patients who completed radiotherapy, the short-term survival rates were lower for young children (those aged under 5 years) than for older children, but by 6 years the survival rates were very similar (approximately 35%) for children in both age groups. Higher survival rates were obtained in the young children where total macroscopic excision of the tumour was achieved. For older children there was no difference in survival rates between those with total or partial excision, though the survival rate was lower for those whose surgery was limited to biopsy. In young children radiotherapy dose had no effect on survival rates. In older children, survival rates were appreciably higher where doses had been at least 45 Gy to the posterior fossa and 30 Gy to the spinal cord, and there were also fewer spinal cord metastases among those who received a higher spinal cord dose. Ninety (30%) of the 304 children also received chemotherapy as part of their initially planned treatment; a wide variety of protocols was used and no conclusions could be drawn as to the effects on survival rates.
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PMID:Childhood medulloblastoma in Britain 1971-77: analysis of treatment and survival. 665 23

A 24-year-old female complained of headache and vomiting. The brain-CT scan demonstrated a tumor shadow in the right cerebellar hemisphere. The tumor was partially resected, and irradiation therapy was started. She died of intraventricular hemorrhage about 6 months after the onset of symptoms. Autopsy revealed a recurrent tumor mass in the cerebellum extending to the brain stem. It showed systemic metastases to the leptomeninx, liver, bones and ovaries. Histological examination showed a tumor which was a primarily composed of typical medulloblastoma cells with occasional Homer-Wright type rosettes. It partly showed glioblastoma-like configuration. Some tumor cells were positive for GFAP by the PAP method, suggesting glial differentiation.
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PMID:[Autopsy case of atypical medulloblastoma in an adult]. 666 12

A clinical and pathologic review of primary intracranial tumors (917 cases in a 62-year period) at The Hospital for Sick Children, Toronto, identified 21 cases with systemic metastases (2.3%). This included 15 cases of medulloblastoma and 1 case each of astrocytoma, meningeal sarcoma, malignant melanoma, ependymoblastoma, teratoma, and endodermal sinus tumor, adding to the pediatric literature of 94 previously reported cases (72 medulloblastoma and 22 cases of other brain tumors). Like adults, children with medulloblastoma tend to develop bone and bone marrow metastases, while those with other brain tumors frequently invade adjacent tissues, and then spread to regional lymph nodes and the lungs. The prognosis is almost uniformly fatal, although prolonged palliation could be achieved with radiation and/or chemotherapy. The pathogenesis of systemic metastases is related to breakage of the blood-brain barrier, whether at surgery, or with tumor invasion into vascular channels, and especially with preoperative systemic-cerebrospinal fluid shunting. Thirteen of 16 patients who developed systemic metastases, including 5 with peritoneal involvement, had ineffective or no millipore filters within their shunts, suggesting their possible prophylactic role against tumor dissemination. A greater understanding of the pathogenesis of systemic metastases may aid the design of future effective preventive measures.
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PMID:Extracranial metastases in childhood primary intracranial tumors. A report of 21 cases and review of the literature. 669 95

During the period from January 1962--June 1979, 17 adults (greater than or equal to 16 years of age) received postoperative supervoltage neuraxis radiation therapy for medulloblastoma. An actuarial five- and ten-year survival rate of 46% was achieved, and the major site of recurrence postirradiation was in the posterior fossa. Compared to previous pediatric series, adults may demonstrate more visceral metastases and fare less well after tumor recurrence. Compared to prior series of adult patients, the demonstrated improved survival is attributed to increased doses delivered to the posterior fossa.
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PMID:Medulloblastoma in adults: improved survival with supervoltage radiation therapy. 680 Jun 35


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