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

The authors review the cases of 144 children with medulloblastoma treated between 1950 and 1980. Duration of time between onset of symptoms and initial treatment was less than 1 1/2 months in 51% of cases, and less than 3 months in 76%. The tumor was located in the cerebellar vermis in 93% of patients. Brainstem infiltration was noted in 32%. Classical medulloblastomas comprised 82% of the total number reviewed, and desmoplastic medulloblastomas 15%. The majority of desmoplastic medulloblastomas were found in the midline of the cerebellum and in patients under 10 years of age. The prognosis for patients with desmoplastic medulloblastomas was worse than that for children with classical medulloblastomas. Spontaneous hemorrhage associated with primary or recurrent medulloblastoma occurred in 5.6% of the patients. Supratentorial metastases were found in 14.6% of cases, spinal cord metastases in 12.5%, and systemic metastases in 9%. The overall 5-year survival rate was 47%, and the 10-year survival rate 42%. Extent of surgical excision proved to be a statistically significant prognostic factor. Two patients developed recurrence after the "period of risk" as defined by Collins' rule. Delayed complications of radiotherapy were found to be substantial. Intelligence quotient (IQ) testing on 16 survivors revealed verbal IQ, performance IQ, and full-scale IQ to be within the normal range in 11, seven, and nine cases, respectively. Two were retarded on all scores.
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PMID:Medulloblastoma: clinical presentation and management. Experience at the hospital for sick children, toronto, 1950-1980. 682 49

A 26-year-old woman complained of subacute bilateral exophthalmos, one year after the extirpation of a cerebellar medulloblastoma. The clinical picture and the orbital computed tomographic scan suggested orbital pseudotumor or endocrine ophthalmopathy rather than orbital medulloblastoma metastases. The latter diagnosis was confirmed by histologic examination. The occurrence of extraneural medulloblastoma metastases including bilateral orbital involvement is discussed.
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PMID:Subacute bilateral malignant exophthalmos due to orbital medulloblastoma metastases. 686 Jan 83

Metastatic behavior of neuroblastic tumors was analyzed to determine whether the secondary distribution of tumor was random, or whether the pattern of metastases was predictable and related to tumor type. The authors reviewed the 64 patients subjected to complete autopsy who had metastases from a neuroblastoma, retinoblastoma, medulloblastoma, or pinealoblastoma. The organ and tissue distribution of metastases was recorded in relation to location of primary tumor, type of therapy, survival, and presence of central nervous system metastases. Data were analyzed using chi-square contingency tables, correlation coefficients, and cluster analysis. The results indicate that: (1) the development of central nervous system metastases from neuroblastoma correlates with the pattern of extracentral nervous system metastases; (2) the pattern of tumor metastases is altered by chemotherapy and/or radiation; and (3) regardless of the site of origin, neuroblastic tumors behave in a uniform manner with a nonrandom metastatic distribution in particular tissues within the central nervous system. Cluster analysis demonstrated patterns of neuroblastoma tumor metastases which were consistent with both Hutchison and Pepper syndromes. The findings suggest that a random distribution, as might be secondary to blood flow, does not account for metastatic patterns, but rather that there are preferential patterns of growth, possibly reflecting trophic tendencies in neoplasms.
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PMID:Nonrandom distribution of metastases in neuroblastic tumors. 687 32

Six of 19 patients treated for medulloblastoma over an 8-year period developed extraneural metastases. The most common sites of metastatic disease were bone (5 patients), and bone marrow (4 patients). Radionucleotide bone scans and/or bone marrow aspirates detected disease in all such cases. Four patients also had recurrence within the central nervous system. Four of six patients relapsed within one year of initial treatment. All recurrences were treated with radiotherapy and/or chemotherapy with symptomatic improvement. The use of bone scans and bone marrow aspirations in the follow-up of patients with treated medulloblastoma would seem to be indicated.
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PMID:Extraneural metastases from cerebellar medulloblastoma. 714 67

Twenty-six patients with medulloblastoma had complete myelography and spinal fluid cytology and tests for polyamine levels in the evaluation for spinal metastases. The nature and location of abnormalities are presented in this report. Metrizamide was demonstrated to be safe and effective for complete myelography in children. The usefulness of myelography in detecting spinal metastases at the time of initial diagnosis (11%) and at the time of first intracranial recurrence (33%) is discussed.
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PMID:Complete myelographic evaluation of spinal metastases from medulloblastoma. 722 Aug 86

Four cases of bone and pulmonary metastases of medulloblastoma histologically diagnosed and with an exhaustive clinical-radiological and scintigraphic documentation, are described. In three patients, one of which non operated, the metastases of the osteolytic and osteoblastic type affected diffusely the skeleton; in the fourth patient the bone lesions were associated with a single pulmonary metastasis. The modality of metastatic spread and the clinical course of the illness in the diagnostic and therapeutic aspects are discussed.
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PMID:[Extracranial metastases from medulloblastoma: report of four cases (author's transl)]. 723 83

One hundred and twenty-two patients with medulloblastoma received postoperative irradiation at the Princess Margaret Hospital, Toronto, from 1958 to 1978, inclusive. The surgical procedure in these patients was total resection (44 patients), subtotal resection (66 patients), or biopsy alone (12 patients). Twenty-five patients received adjuvant chemotherapy. Overall 5- and 10-year survival rates were 56% and 43%, respectively. Improved survival rates were associated with an increased degree of resection and with posterior fossa radiation doses of 5200 rads or more. The posterior fossa was the common site of first relapse (in 56 patients, 46%). Systemic metastases at first relapse occurred in 18 of 52 patients (35%), and were associated with the use of ventriculosystemic shunts. Millipore filters did not prevent systemic relapse in shunted patients. A subset of 15 patients who received a posterior fossa dose of 5200 rads or more after a total resection had a 5-year survival rate of 77%, which remained constant to 10 years. This result is considered to be the upper limit that can be achieved by current treatment methods.
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PMID:Radiation treatment for medulloblastoma. A 21-year review. 724 Dec 14

Forty-seven children with histologically confirmed medulloblastoma are considered. Forty-five cases were surgically by direct approach to the tumour, while two cases were treated only with a shunt. A shunt was inserted preoperatively in 14 cases, postoperatively in 4 cases. Surgical resection was total or subtotal in 52% of cases, partial in 35%, and limited to a biopsy in 13%. Radiation treatment to the entire neuraxis was done in 37 cases: 10 of these cases received additional chemotherapy--mostly with CCNU--as primary treatment for medulloblastoma. Ten patients died within 30 days after surgery. Twenty-two patients died months after treatment, mainly from tumour recurrence (19 cases). One patient was lost to follow-up. Thirteen patients are survivors from 10 months to 20 years after treatment. As a whole, the one year survival rate has been 67%, 3 year survival 43%, and 5 year survival 27%. Complications affecting prognosis have been presented by tumour recurrence and metastases. CSF shunting and lack of prophylactic irradiation to the cerebral hemispheres have been considered responsible for the high incidence of supratentorial metastases in our series. Factors influencing prognosis have been the extent of tumour resection and association of primary chemotherapy with radiotherapy. Within 3 years after surgery survival has been 52% in cases with total resection against 31% in cases with partial resection of tumour. As regards chemotherapy, 3 year survival has been 60% for patients with combined treatment (chemo- and radiotherapy) against 37% in patients with radiotherapy alone. It is concluded that the best results in children with medulloblastoma are achieved by a radical resection, associated with a combined primary treatment of radiotherapy and chemotherapy.
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PMID:Treatment of medulloblastoma in children: long-term results following surgery, radiotherapy and chemotherapy. 728 44

The clinical and pathologic data from two cases of medulloblastoma with systemic metastases, and 101 previously reported cases were evaluated to define better the clinical presentation and natural history. Patients ranged in age from six months to 48 years, with a mean of 13 years; two thirds of the patients were male. Ventricular shunts had been inserted in 20% of the patients. Systemic metastases occurred on an average of two years after the diagnosis of the primary tumor in patients without shunts, but only 1.3 years in patients with shunts. Fifty-nine percent of the patients were known to have experienced recurrence or spread of medulloblastoma within the central nervous system by the time systemic metastases appeared. Ninety percent showed radiologic evidence of bone metastases, of which 60% were osteoblastic. Bones most frequently involved were pelvis, femur and vertebrae; pain was the most common initial symptom. At autopsy, lymph node metastases were found in 65% and liver metastases were found in 28% of all cases in addition to bone metastases in 82%. Lung metastases occurred in 9% of the patients without shunts, compared with 30% of patients with shunts. The average survival was seven months after the appearance of systemic metastases for patients both with and without shunts. Approximately 5% of patients with medulloblastoma may be expected to develop systemic metastases. This development is associated with increased morbidity and a shortened life expectancy.
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PMID:Systemic metastases from medulloblastoma: report of two cases and review of the literature. 729 79

Medulloblastoma is a rare tumor in adult. High doses of megavoltage irradiation of the posterior fossa have been resulted in a better survival (48 to 78% at 5 years) of the patient. It is sensitive to a wide variety of chemotherapy drugs, but adjuvant chemotherapy has not been proved effective in adults although data are limited. We report the case of a cerebellar medulloblastoma with bony and medullar metastases. High-dose chemotherapy with peripheral stem-cell transplantation was performed while the patient was in remission following conventional chemotherapy. Complete remission lasted for 8 months. This therapeutic approach of metastatic medulloblastoma might be of value as this tumor is chemosensitive and not cured by conventional treatment. Internal radiotherapy by Samarium-153 was also carried out and proved to be an effective palliative treatment of pain.
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PMID:High dose chemotherapy with stem-cell transplantation in a metastatic medulloblastoma in an adult: a case report and review of the literature. 752 58


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