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)

A 19-month-old black girl had a radical nephrectomy for a Wilms' tumor that contained areas of epithelium indistinguishable from renal cell carcinoma. She was treated with chemotherapy but subsequently had pulmonary metastases develop and massive abdominal recurrence. The recurrent tumor was histologically renal cell carcinoma with no identifiable Wilms' tumor elements. The child died with recurrent and metastatic tumor 13 months after nephrectomy. Pathologic, immunoperoxidase, and flow cytometric studies of this unusual case are presented.
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PMID:Recurrent renal cell carcinoma arising in Wilms' tumor. 170 57

Occurrence of embryonal kidney tumors in patients with primitive neuroectodermal tumors, so-called central nervous system-renal neoplasia has been reported. An infant who presented with masses in the right lateral ventricle and the cerebellar vermis is reported. Histological examination showed primitive neuroectodermal tumors. Further investigation revealed tumors in the bilateral kidneys, which were removed subtotally and pathologically shown to be Wilms' tumors. The patient was then treated with anticancer drugs and irradiation. However, he developed lung metastases from the renal tumors and expired. At autopsy, a small tumor was found in the inferior horn of the left lateral ventricle. Histological finding showed a primitive neuroectodermal tumor. Also, bilateral large masses of recurrent Wilms' tumors, multiple metastases to the lungs and peritoneal dissemination were found. There is no evidence that this association is based on the selective neoplastic transformation of embryonal cells of similar histogenetic or cytogenetic origin. Several reports demonstrate the presence of embryonal cells in the nervous tissue which could imply a neuroepithelial origin for Wilms' tumors.
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PMID:[Primitive neuroectodermal tumor with Wilms' tumor. Case report]. 172 36

Extrarenal Wilms' tumors are rare and have mainly been the subject of isolated case reports. This retrospective evaluation of 34 patients suggests a clinical course very similar to that of renal Wilms' tumor. While clinical presentation varies according to the extrarenal localization, investigations to determine the size of the primary tumor (T), regional lymph node involvement (N), and the occurrence of distant metastasis (M) are very similar, ie, chest x-ray, abdominal ultrasound (US), and computed axial tomographic (CAT) scan of the abdomen and chest. Stage grouping according to the pathologic TNM classification showed stage I in 30%, stage II in 10%, stage IIIa in 34%, stage IIIb in 23%, and stage IVa in 3%; four patients could not be staged. Evaluation of therapy and survival indicate the need for postoperative chemotherapy (CT) to all patients, while the same data suggest that the drugs used for renal Wilms' tumor are equally effective for extrarenal Wilms' tumor. Radiotherapy (RT) probably should be reserved for those patients with unresectable gross residual disease and for metastatic disease. The radiation dose used in the reviewed cases varied from 2,000 to 5,000 cGy. However, recent experience suggests that high doses are not justified in renal Wilms' tumor. The estimated overall 2-year survival of the 34 patients is 82% (95% confidence interval, 63% to 92%).
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PMID:Extrarenal Wilms' tumor: staging, treatment, and prognosis. 184 74

Multilocular renal cyst is a distinct renal tumor whose gross external appearance and absence of normal renal tissue within the septa of loculi distinguish it clearly from other renal cystic lesions. Interlocular septa may contain either (1) fibrous tissue alone or (2) embryonic tissue separating adjacent loculi. Of 29 patients with multilocular renal cysts, 24 underwent a renal-sparing procedure, and only 5 had radical nephrectomy. None of the histologic specimens showed evidence of immature renal tissue or neoplasia. Patients were followed from three months to eight years (mean, 39 months), and no evidence of local recurrence or metastatic disease was found. Because it is difficult to distinguish multilocular renal cyst from cystic Wilms tumor and multicystic clear cell carcinoma on the basis of imaging studies alone, surgical intervention is the only effective method to differentiate multilocular renal cyst from a malignant lesion of the kidney.
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PMID:Multilocular cysts of kidney. A study of 29 patients and review of literature. 184 92

Major advances have been made in the treatment of children with Wilms' tumor. Remaining areas of investigation include the role of adriamycin and the treatment of children with stage III and IV disease and the role of whole lung radiation therapy in the treatment of children with pulmonary metastases. Long-term follow up of successfully treated patients will provide valuable insight into the importance of genetic factors in the cause of Wilms' tumor.
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PMID:Remaining problems in the treatment of patients with Wilms' tumor. 184 90

Rapid advances in the understanding of Wilms' tumor (WT) and its management are being made both in the laboratory and the clinic. Molecular genetic research has implicated loss of a tumor suppressor gene on the short arm of chromosome 11 as one of the pathways responsible for the development of the neoplasm. Preconception maternal (hair dyes) and paternal (occupation) exposures to environmental agents have been the subject of epidemiologic studies of possible risk factors. Histopathologic analyses have identified several different and less common tumor types among those previously aggregated under the WT rubric. WT itself has been subdivided into the so-called favorable histology (FH) and anaplastic forms, the prognosis being worse for the latter. Clinical research has standardized management by surgery, chemotherapy, and radiation therapy (RT) and furthered the identification of risk factors. Patients can now be stratified according to tumor type and stage, and the intensity of treatment modulated accordingly; eg, RT at low doses is used in only 25% of National Wilms' Tumor Study (NWTS) patients without distant metastases. Before the NWTS, it had been given to almost all and at higher doses. Chemotherapy, whether given pre- or postoperatively, is based on dactinomycin and vincristine with Adriamycin [( ADR] doxorubicin; Adria Laboratories, Columbus, OH) added for high-risk patients. The currently used NWTS combined modality therapy for WT patients has dramatically improved survival rates; 95% now are alive 2 years after treatment. Remaining questions are the identification of the late effects of the treatments used and the further refinement of therapy to reduce iatrogenic complications to a minimum.
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PMID:Wilms' tumor: status report, 1990. By the National Wilms' Tumor Study Committee. 184 87

Magnetic resonance imaging (MRI) was performed in 126 children with malignant solid tumor between April 1984 and December 1990. The criteria of tumor visualization, localization, staging, prediction of kidney preserving and monitoring treatment were compared by MRI and CT for 47 children with neuroblastoma, Wilms' tumor, hepatoblastoma, rhabdomyosarcoma and teratoma, MRI and CT were viewed together and an assessment was made as to whether the studies yielded equivalent information or whether one study was superior to the other. 1) The tumor were better visualized in 47% cases by MRI than CT. 2) MRI was superior to CT in 43% cases in evaluating the local spread of tumor. 3) There was little difference between MRI and CT in identification of lymph node metastases. 4) Without requiring the injection of intravenous contrast agents, MRI accurately defined displacement, invasion of renal vessels by neuroblastoma. MRI was excellent in prediction of kidney preserving. 5) MRI was useful to detect bone marrow metastases in neuroblastoma. The best imaging plane for a demonstration of bone marrow involvement was coronal in lower limbs.
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PMID:[The role of magnetic resonance imaging for treatment in children with malignant solid tumor]. 194 73

Resection of hepatic metastases from carcinomas of the colon and rectum appears to extend the survival time in appropriately selected patients. Selection criteria have been widely published. Similar data for patients with hepatic metastases from primary sites other than the colon and rectum are lacking. To determine which, if any, patients in the latter category benefit from resections, we reviewed ten such instances treated at our institution plus 141 instances of resection for noncolorectal hepatic metastases previously reported. The over-all five year survival rate after resection of noncolorectal hepatic metastases is 20 per cent. When Wilms' tumor is excluded, the five year survival rate is 15 per cent. Approximately four of ten patients with metastases to the liver from Wilms' tumor or carcinoid survived five years after resection. Similar benefit is rarely obtained after resection of hepatic metastases of the breast, kidney, adrenal gland and carcinomas of the stomach; malignant melanoma, and leiomyosarcoma. No extension of survival is apparent for resection of hepatic metastases of gynecologic malignancies or carcinoma of the pancreas. Specific guidelines for selection are discussed in view of the limited prognosis when tumors other than carcinomas of the colon and rectum metastasize to the liver. Careful patient selection and minimization of complications are required.
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PMID:Results of resection and proposed guidelines for patient selection in instances of non-colorectal hepatic metastases. 194 2

Radiotherapy is one of the main therapeutic methods for malignant tumors, but on the other hand it can also induce new malignant tumors. Recently, we experienced a case of a 22-year-old woman with triple cancers (Wilms' tumor, thyroid cancer and mucoepidermoid carcinoma of the lung). She had been treated repeatedly for right-sided pulmonary metastases from the Wilms' tumor. The last cancer arose from a different organ in the field irradiated to treat the first cancer, after a latent period of about 20 years. Therefore, this case is classified as highly probable radiation-induced cancer (A-1 group) by the diagnostic criteria for radiation-induced cancer proposed by Sakai et al. Second cancers (radiation-induced cancers) mainly consist of soft tissue sarcomas, leukemias, skin cancers, urinary bladder cancers, large bowel cancers and other tumors. The occurrence of mucoepidermoid carcinoma of the lung as a radiation-induced tumor had not been reported. This patient also showed poor growth of the right breast and marked deformity of the right side of the thorax as late damage from irradiation. We must make efforts to decrease late damage from radiotherapy for pediatric cancers.
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PMID:[A case of radiation-induced mucoepidermoid carcinoma of the lung following radiotherapy for pulmonary metastasis of Wilms' tumor]. 196 24

MN is a rare benign mesenchymal tumour of the kidney which occurs most commonly in the newborn period or early infancy. Tumour is successfully treated by surgery only and local recurrence and metastases are extremely rare. There are presented morphological and clinical features of 6 cases diagnosed among 123 tumours of the kidney. Histologically, mesoblastic nephroma is classified in leiomyomatous and cellular type, but distinction between the two types has no implication for survival. It is important to distinguish cellular type of mesoblastic nephroma from clear cell type of Wilms' tumour as their prognosis and treatment are so different.
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PMID:[Mesoblastic nephroma: morphologic and clinical characteristics]. 196 69


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