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

The clinical details are presented of 29 fatal cases of pleural mesothelioma in the majority of which there was a history of exposure to asbestos during dockyard work in Portsmouth. Chest pain, breathlessness and weight loss dominated the clinical picture. Analgesia and repeated pleural aspirations provided temporary relief but symptoms invariably progressed. The mean survival time was 39 weeks. Only one patient survived longer than 2 years from hospital presentation. At autopsy, extensive local spread was usual but a high proportion of patients also had metastases at distant sites.
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PMID:Malignant pleural mesothelioma at St Mary's Hospital, Portsmouth--a review of 29 fatal cases. 664 89

Computed tomography is believed to have a definite role in the evaluation of malignant pleural mesothelioma based on a review of computed tomography findings in 23 of our patients and previous reports. Twelve patients had a single computed tomography examination, and 11 had two or more studies. Computed tomography permits better appreciation of the extent of the tumor. This permits appropriate selection of therapy and may demonstrate that surgery or radiotherapy is not indicated. computed tomography often permits more accurate evaluation following chemotherapy and may be the only means by which to follow a patient after radical surgery. Computed tomography also has a role in differential diagnosis. It facilitates distinction of malignant pleural mesothelioma from rounded atelectasis, pleural changes of asbestosis, and pleural involvement with lymphoma and thymoma. It aids, but may not be diagnostic, in separating malignant pleural mesothelioma from metastases to the pleura.
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PMID:Malignant pleural mesothelioma: the role of computed tomography. 669 81

A retrospective study is presented of 19 patients with pleural mesothelioma diagnosed over an 18-year period (1964-1981). Two patients are alive after observation for 12 and 16 months. In 16 fatal cases the post-diagnosis survival time was 1-113 (median 17) months. One patient was lost to follow-up after 6 months. The male: female ratio was 5.3:1. The disease was most commonly detected in persons in their sixties and seventies. Pain and dyspnoea, the most common of the presenting symptoms, occurred in half of the patients. Weight loss and malaise were reported by six patients. Mesothelioma was most common on the right side, but often spread to the left, infiltrating the pericardium and the diaphragm. Metastases to abdominal organs were found in five of the eight autopsies, and in three other patients there were clinical signs of abdominal spread. Thoracotomy was performed in 12 patients, in one of whom radical removal of the tumor was attempted, but the patient died of recurrent tumor. Radiotherapy and cytostatic medication had no demonstrable effect on survival. Pleural effusion developed in all cases and all had roentgenologically demonstrated changes. Exposure to asbestos was documented in 6 of the 19 cases. In three asymptomatic patients the mesothelioma was incidentally revealed by routine X-ray examination, and these patients had significantly longer survival than the others. One of these tumors, however, had a relatively benign histologic appearance. Frequent X-ray examination of risk groups seems to offer the only prospect of improving management by earlier diagnosis.
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PMID:Malignant pleural mesothelioma. A clinical review of 19 patients. 671 76

A Phase I trial of tricyclic nucleoside phosphate (1,4,5,6,8-pentaazaacenaphthylene-3-amino-1, 5-dihydro-5-methyl-1-beta-D-ribofuranosyl 5'-phosphate ester; NSC 280594) was conducted using a 5-day continuous infusion schedule. Thirty-seven patients with advanced cancer were entered on the study, of whom 33 patients were evaluable for response and toxicity. Dose levels ranged from 10 mg/sq m/day X 5 days to 40 mg/sq m/day X 5 days. Initially, courses were repeated every 3 to 4 weeks. As cumulative toxicity became manifested, the interval between courses was changed to every 6 weeks. Major toxicities included hyperglycemia, hepatotoxicity, and thrombocytopenia. Patients with a prior history of diabetes mellitus, extensive radiation therapy, or significant liver metastases were prone to severe toxicity. Other toxicities noted were nausea and vomiting, abdominal discomfort, anemia, and reduction in serum calcium, phosphorus, and albumin levels. Rare side effects included hypertriglyceridemia, hyperamylasemia, diarrhea, and stomatitis. Antitumor activity observed include improvement in s.c. metastases in a patient with papillary thyroid carcinoma, stabilization of disease in a patient with mesothelioma, and mixed responses in three patients (colon cancer, sarcoma, and tonsillar squamous cell cancer). Recommended schedule for Phase II studies is 20 mg/sq m/day for 5 days every 6 weeks.
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PMID:Phase I study of tricyclic nucleoside phosphate using a five-day continuous infusion schedule. 674 83

Epithelial or mixed mesotheliomas were detected in 38 patients in the region of Marseilles over a period of 9 years. Though an occupational element was involved in 80% of cases, no history of contact with asbestos could be obtained in certain of the patients. Confirmation of diagnosis requires wide pleural biopsies, because of the high level of false negatives and false positives from cytology and pleural needle biopsy. Hyaluronic acid levels are significant only when they are markedly enhanced. Local and regional tumor spread provides an aid to prognosis, but authentic metastases, with further worsening of prognosis, were detected in more than 75% of patients while still alive. Nodules appeared along the course of punctures of drainage tubes or in thoracotomy scars in 56% of cases, and appear to be a very frequent and characteristic feature of mesothelioma. Their therapy involves preventive irradiation.
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PMID:[Clinical aspects and course of 38 cases of malignant pleural mesothelioma observed in the Marseilles region]. 686 94

This review covers the following aspects: Cancer associated with asbestos and other fibers: Epidemiology. - Cancer types and location (mesothelioma; bronchogenic carcinoma; cancer of the upper respiratory tract; abdominal cancer). - Experimental asbestos cancer. - Other kinds of fibers and cancer (wool and cotton; glass; talc; others). - Cancer determining or influencing factors (individual predisposition; species susceptibility; type of material; shape and size of fibers; smoking). - Preneoplastic signs in man (fibrosis; ferruginous bodies; pleural plaques; milky spots). - Preneoplastic development in animals. - Fiber effects on cell cultures (macrophages; fibroblasts). Cancer associated with schistosomiasis: Epidemiology. - Patient age and cancer latency. - Pathology. - Foreign body reaction and preneoplastic development. Scar cancer. Foreign body cancer: In man. - Experimental (species differences in susceptibility; individual genetic differences in tumor incidence and latency; influence of sex, age, nutrition; tumor histopathology and ultrastructure; tumor growth, invasiveness, metastases, transplantability, immunology; search for tumor viruses). - Properties of foreign body materials in relation to tumorigenicity (chemical and physical properties; size and shape; surface properties; porosity). - Investigations and findings concerning the origin of foreign body sarcomas (the foreign body reaction; search for foci of tumor origin; an analytical method; monoclonal tumor origin; heterogenicity of carcinogenic events; surface dependency; identification of originator cells; time and location of the emergence of tumor originator cells; the carcinogenic initiation event; surface-independent and dependent preneoplastic maturation; the carcinogenic role of the foreign body). - Earlier hypotheses and theories in the light of new experimental findings. The results of experimental foreign body tumorigenesis in relation to foreign body-, asbestos-, schistosomiasis-, and scar-cancer in man. (Common factors of promotion; differences regarding induction mechanisms, cells of origin, latencies, frequencies; immune defense). Consequences for prevention: Asbestos cancer. - Fiber cancer. - Schistosomiasis cancer. - Foreign body cancer (assessing the peril in man; testing of materials for carcinogenicity; recommendations).
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PMID:[Investigations and review of literature relating to carcinogenesis. I. Communication: Cancer from asbestos, schistosomiasis, and cicatrization (author's transl)]. 700 8

Twenty-seven cases of desmoplastic diffuse malignant mesothelioma (26 pleural, one peritoneal) are described. In 19 cases the tumor cell type was sarcomatous and in six others it was biphasic (malignant elements of both epithelial and mesenchymal aspect). There were only two cases where the tumor cell type was purely epithelial. The clinical course was often rapid; the mean survival period in 11 cases of purely sarcomatous type was 6.18 months. Only one case of purely sarcomatous type lived for more than 1 year as opposed to four of eight cases with an epithelial component. Metastases occurred more frequently in desmoplastic (60.1%) than in nondesmoplastic diffuse mesothelioma (42.5%). The tumor cell type (epithelial, mesenchymal) accompanying desmoplastic mesotheliomas and not the extent of desmoplasia determines their behavior. Desmoplasia in diffuse mesotheliomas is often the result of tumor cells assuming the functional capacity of fibroblasts and has frequently been confused with reactive fibrosis. Cytologic abnormalities, tissue infiltration, and foci of necrosis indicate the neoplastic nature of the process in most instances.
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PMID:Desmoplastic diffuse mesothelioma. 710

An observation of malignant peritoneal mesothelioma in a man of 61 is presented. The clinical signs included fatigue, loss of weight, enlarged abdomen. The duration of the disease was 8 months. The autopsy revealed a whitish tumor of the peritoneum of cartilage density with numerous nodules 0.5-1.5 cm in diameter. The tumor overgrew the liver, spleen, pancreatic gland, stomach, and intestinal loops forming a single conglomerate. In the peritoneal cavity there were 4000 ml of transparent yellowish fluid. The visceral and parietal pleura on the left was thicker and covered with small whitish nodules. Histological examinations showed the peritoneum to be thickened, sclerosed and hyalinized. In the thickness of the fibrous stroma there were numerous slits lined with mesothelial cells. There were metastases in regional lymph nodes. The tumor had the structure of a malignant mesothelioma of the epithelial-like variant.
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PMID:[Malignant mesothelioma of the peritoneum]. 711 33

The differing clinical behaviour of malignant mesothelioma of different cell types was studied in 115 cases of pleural mesothelioma, classified histologically into epithelial (60), sarcomatous (25), and mixed (30). Epithelial mesotheliomas were associated with clinical features characteristic of carcinomas rather than sarcomas, including spread of tumour by direct extension, large pleural effusions, contralateral pleural effusions, ascites, metastases in regional lymph nodes, and occasional response to radiotherapy. Sarcomatous mesotheliomas were associated with clinical features more characteristic of sarcomas, with more frequent distant metastases, little or no effusion, and shorter survival. Mixed tumours had features of both, large pleural effusions occurring as frequently as with epithelial tumours, but survival being almost as poor as in sarcomatous cases. Despite these differences there is evidence from published reports that epithelial, sarcomatous, and mixed mesotheliomas have a common origin from mesothelial cells or their precursor cells.
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PMID:Malignant mesothelioma of the pleura: relation between histological type and clinical behaviour. 716 98

Twenty-five patients with malignant peritoneal mesothelioma have been seen in Memorial Hospital since 1950. None of them had a history of exposure to asbestos and no clear etiologic factor could be determined in any of the patients. Two patients had signs of ectopic hormone production. The tumors tended to be locally invasive but distant hematogenous metastases were not seen in any of the patients. Surgery was not effective, as most patients had extensive intra-abdominal disease at the time of laparotomy. There were four long-term survivors. All of them were treated with external radiotherapy and 32P instillation after surgery. The response to chemotherapy was poor except for one partial response to combined therapy with adriamycin and radiation. Most patients died of extensive abdominal disease with a median survival of only 12 months.
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PMID:Malignant peritoneal mesothelioma: review of 25 patients. 725 77


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