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)

Frequency and location of "cold lesions" has been analysed in 1000 consecutive bone scans. Among the 554 abnormal cases there were 18 (1,8% of the total) with localized diminished activity due to metastatic lesions and 5 (0,5%) secondary to radiation osteitis. 10 of the 18 patients with metastatic disease had pure defects while 8 showed a reactive margin. It is pointed out that the quality of the examination is crucial for the demonstration of such defects and that single scans of the different regions of the skeleton are superior to a whole body scan. The survey of the literature shows that "cold lesions" are predominant in malignant bone diseases, however no relation exists to a definite histology.
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PMID:["Cold lesions" in bone scintigraphy (author's transl)]. 16 Mar 84

Lumbar discovertebral abnormalities thought to be due to endogenous or subclinical trauma were evaluated in 22 cases. These consisted of predominantly lytic areas due to intrabody disc herniation in five cases, broad zones of vertebral body sclerosis due to reactive osteitis in 11, and destruction of the vertebral endplates surrounded by diffuse sclerosis in six. Spinal biopsy and negative bacterial cultures were consistent with the diagnosis in eight cases. Follow-up roentgenograms and further clinical evaluation in the remaining 14 showed either no progression or changes consistent with trauma. Only four cases had a history of exogenous trauma. Intrabody disc herniations usually affected the upper vertebral body with characteristic sparing of the adjacent endplate. The sclerotic lesions tended to occur in the anterior portion of the vertebral body, with the inferior aspect of L4 most frequently involved. These may be confused with osteoblastic metastases, particularly if adjacent disc narrowing is minimal. The lack of progressive vertebral fragmentation helps to distinguish this condition from neuroarthropathy. Lesions characterized by destruction of the vertebral endplates and reactive sclerosis simulate infection; absence of a soft tissue mass and clinical signs of sepsis as well as lack of progression are important differential features.
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PMID:Traumatic lesions of the discovertebral junction in the lumbar spine. 18 33

Two additional cases of condensing osteitis of the clavicle are reported. Technetium Tc 99m phosphate bone scans were positive in both cases. Clinical and roentgenographic manifestations may allow nonoperative diagnoses of this entity which mimics metastatic disease on bone scans.
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PMID:Bone scans in condensing osteitis of the clavicle. 66 8

The spectrum of musculoskeletal abnormalities seen on routine computed tomographic (CT) examinations of five patients with renal osteodystrophy are described. CT findings included multiple brown tumors, osteitis fibrosa cystica, abnormal sacroiliac joints, periarticular tumoral calcifications, prominent Schmorl's nodes, and slipped capital femoral epiphyses. In this small group of patients, the musculoskeletal abnormalities ranged from the subtle to the dramatic. Although CT examination is rarely used as a screening test for renal osteodystrophy, it is important to be familiar with its many appearances on CT, in order not to confuse the CT changes of renal osteodystrophy with metastatic disease, osteomyelitis, or inflammatory arthritis.
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PMID:Computed tomographic features of renal osteodystrophy. 251 63

The bony pelvis should be carefully evaluated on computed tomography (CT) scans of the lower abdomen and pelvis performed for staging cervical cancer or for evaluating suspected recurrence. CT provides optimal imaging of the spine and pelvis, frequently providing a clinically relevant supplement to bone scan or plain film information. In a study of eight patients with skeletal metastases from cervical carcinoma and three cases of radiation osteitis, overlap existed in their imaging characteristics. Metastases were always lytic but nearby sclerotic areas from radiation were often present. Radiation osteitis may be lytic, sclerotic, or mixed, and both may avidly accumulate bone-scanning radiotracers. The absence of a soft tissue mass, slow progression, blastic elements, and sharply defined borders on CT suggest radiation necrosis. However, in some lesions within a radiation portal, biopsy or MRI may be required for final diagnosis.
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PMID:Treated invasive cervical carcinoma. Utility of computed tomography in distinguishing between skeletal metastases and radiation necrosis. 276 78

Various tumoral diseases may induce hypophosphataemic osteomalacia. This is the case, in particular, with mesenchymal tumours and sclerosing metastases of prostatic cancer; much less common causes are diffuse connective tissue dysplasias and non-prostatic epitheliomas. Depending on whether osteomalacia results from a mesenchymal tumour or from osteitis of prostatic origin, the practical problems encountered are quite different. In the first case, the important point is not to miss a mesenchymal tumour when confronted with an acquired and apparently idiopathic hypophosphataemia; repeated examinations at regular intervals are sometimes necessary to detect the tumour which is usually benign; osteomalacia can then be cured by its removal. In the second case, the difficulty is to detect an osteomalacia which may be masked by bone metastases and to recognize its tubular origin in order to prescribe the appropriate treatment. Little is known about the pathogenesis of tumoral hypophosphataemic osteomalacia. The renal diabetes and low 1,25 (OH)2 D plasma levels frequently associated with the disease reflect a complex enzymatic disorder thought to be caused by a humoral mediator secreted by the tumour. Studies carried out in this field have already shown that 1,25 (OH)2 D is therapeutically useful when the tumour cannot be excised.
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PMID:[Tumoral hypophosphoremic osteomalacia]. 293 49

Parathyroid adenomas are subdivided into chief cell and oxyphil cell variants. However, the parathyroid carcinomas described thus far have been only of the chief cell type. Two cases of oxyphil cell carcinoma of the parathyroid gland are reported, with light and electron microscopic study. The patients presented apparent clinical hyperparathyroidism with x-ray finding of generalized fibrous osteitis and palpable parathyroid tumors. Initially, a pathologic diagnosis of parathyroid adenoma was made in both of them. However, in due course, pulmonary metastases developed in one patient and a local recurrence occurred in the other, 5 and 8 years after the primary operation, respectively. Review of the microscopic slides showed that both primary tumors met the criteria of parathyroid carcinoma. A matter of interest in both cases is that the neoplasms were composed principally of oxyphil cells. Electron microscopic study confirmed the existence of typical oxyphil cells packed with numerous mitochondria.
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PMID:Parathyroid carcinoma of the oxyphil cell type. A report of two cases, light and electron microscopic study. 397 40

We have experienced 186 patients with proven primary hyperparathyroidism operated on during past 16 years. In this series, 147 patients (79%) had adenoma, 24 patients (12.9%) had carcinoma and only 15 (8.1%) had hyperplasia. Because of a 92% of single gland involvement, the removal of an enlarged gland is adequate, if the remaining gland are grossly normal. Besides, interestingly enough, an incidence of parathyroid carcinoma is rather high in Japan, so that surgeons should be alert to recognize the parathyroid carcinoma on the basis of clinical and operative findings. In an effort to minimize recurrence, en bloc resection of the parathyroid carcinoma is important. When a patient with parathyroid carcinoma has a local recurrence or distant metastases, an aggressive surgical approach is recommended to alleviate hypercalcemic symptoms. The majority of patients with hyperplasia belong to multiple endocrine neoplasia, type 1. Recent development of the non-invasive diagnostic methods is remarkable. The last consecutive 31 patients underwent preoperative localization study by 201Thallium (201TI-CI) scanning and ultrasonography. 201TI-CI scanning gave the most accurate results and 100% correct localization was obtained when the parathyroid tumor was more than 1 g. However, it is noteworthy that the parathyroid tumor was less than 1 g in 64% of patients who had no evidence of generalized fibrous osteitis.
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PMID:[Surgical management of primary hyperparathyroidism]. 650 56

To evaluate the diagnostic value of percutaneous vertebral biopsy in noninfectious diseases of the spine, we retrospectively studied 41 cases seen between 1985 and 1992. The level of the lesion was lumbar in 29 cases, thoracic in 11, and cervical in one. There were 19 crush fractures, 11 lytic lesions, six sclerotic lesions, and three mixed lesions. The biopsy was done because of an abnormal magnetic resonance imaging signal in one patient and because of epiduritis in another. The thoracic and lumbar biopsies were done under x-ray guidance using the technique developed by Laredo and Bard. Computed tomography guidance was used for the cervical biopsy. There were no adverse events. The final histological diagnosis was metastatic disease in 17 cases (41.5%), myeloma or plasmacytoma in six cases (14.7%), primary vertebral neoplasia in two cases (4.8%), lymphoma in one case (2.4%), osteoporosis in nine cases (22%), Paget's disease in three cases (7.4%), amyloidosis in one case (2.4%), aseptic osteitis in one case (2.4%), and vertebral necrosis in one case (2.4%). A second biopsy procedure was done in three patients (surgically in two cases and percutaneously in one) because of discrepancies between histological findings and other data. The final diagnosis was metastatic disease in all three patients. Overall, the diagnostic yield of percutaneous vertebral biopsy was 92.6% and varied little with initial roentgenographic or computed tomographic findings. However, yield was only 56% for the diagnosis of tumorous lesions, with variations according to roentgenographic and computed tomographic changes, 90.1% for osteolytic lesions, 66.6% for mixed lesions, 47.4% for crush fractures, and 16.6% for sclerotic lesions.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Diagnostic value of spinal puncture-biopsy in non-infectious spinal diseases. Apropos of 41 cases]. 783 86

We report on two patients with painful hyperostosis of the mandible and the thoracic skeleton. Other symptoms were arthralgia, arthritis, osteitis, and palmoplantar pustulosis. Radiographic analysis revealed regions of circumscribed hyperostosis which showed in increased uptake in scintiscan. Metastasis, chronic osteomyelitis, Ewing's sarcoma, or Paget's disease were excluded and the diagnosis Sapho syndrome was made. This recently introduced acronym describes a disease with Synovitis, Acne, Pustulosis, Hyperostosis and Osteitis. Because of the possible axial skeleton involvement, an association to the spondylathropathy group is still being discussed. The etiopathogenesis of this rheumatologic disease is not known.
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PMID:[Sapho syndrome: 2 case reports]. 788 32


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