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)

Over the past 11 years (1974 to 1985) ten patients with perianal Paget's disease were treated. The average age was 64 years and half were male. Two patients were diagnosed as an incidental finding after hemorrhoidectomy and the remainder presented with a symptomatic perianal rash (itching and moisture) that averaged two years in duration. Physical examination in these patients demonstrated characteristic lesions (seven with erythematous or ulcerated, whitish gray lesions and one with a papillary lesion). Three patients presented with invasive carcinomas and, despite aggressive therapy, all developed metastatic disease. Two patients had local excisions with minimal margins and developed associated invasive cancers at four and ten years after diagnosis. The remaining five patients were treated by wide local excision and skin grafts. At present all are free of disease. The characteristic appearance of this lesion and its failure to respond quickly to conventional therapy should lead the clinician to obtain a biopsy which readily establishes the diagnosis. Experience confirms that wide local excision is adequate therapy, but adequate initial evaluation and close follow-up are necessary to identify other malignancies that may develop.
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PMID:Perianal Paget's disease. 303 Jun 76

We have investigated the hypothesis that carcinoma of the prostate with skeletal metastases is associated with increased bone resorption. In 54 affected patients a close correlation was observed between serum activity of alkaline phosphatase and urinary excretion of hydroxyproline (r = +0.818; P less than 0.001), comparable to that seen in Paget's disease of bone. The administration of synthetic salmon calcitonin (100 U subcutaneously) induced a significant fall in serum calcium and urinary excretion of hydroxyproline, proportional to the prevailing rate of bone turnover, as assessed by serum alkaline phosphatase or hydroxyprolinuria. Administration of the diphosphonate, etidronate, also decreased hydroxyprolinuria, suggesting that urinary hydroxyproline reflected increased rates of bone resorption in this disorder. Histology of bone in sites adjacent to and distant from skeletal metastases showed increased histological indices of bone resorption. These results suggest that the skeletal disease associated with prostatic carcinoma is characterized by generalized increases in bone resorption as well as focal increases in bone formation.
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PMID:Biochemical and histological evidence that carcinoma of the prostate is associated with increased bone resorption. 310 81

We present a 93-year-old man with prostatic carcinoma whose 99mTc-HMDP skeletal images showed multiple areas of abnormally increased radioactivity in the bone and virtual absence of renal activity. These findings were interpreted as representing multiple skeletal metastases. When correlated with concurrent radiographs, the abnormalities were found to be due to Paget's disease. Multiple areas of bone involvement are not rare in Paget's disease. We reemphasize that an abnormal bone scintigram should always be correlated with regional radiographs to rule out conditions other than malignancy.
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PMID:Paget's disease mimicing skeletal metastases in a patient with coexisting prostatic carcinoma. 318 Nov 94

A review of the total number of cases of osteosarcoma referred to the Tumour Centre at the Rizzoli Orthopaedic Institute between 1904 and 1986, revealed 11 cases of the disease localised in the vertebrae, 9 of which were fully documented. We excluded secondary forms of the disease due to irradiation or malignant degeneration in Paget's disease, also metastases from osteosarcoma of the limbs localised in the sacrum. It is extremely important to distinguish osteosarcoma from osteoblastoma; and this problem is even more highlighted by the statistical evidence that both neoplasms have an almost equal probability of being localised in the spine. Treatment has progressed from the initial purely palliative approach to a more aggressive type of surgery which, in association with modern chemotherapy, makes it a more reliable type of treatment from the oncological point of view. To this aim, we emphasize the importance of performing biopsy according to the required criteria.
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PMID:Vertebral osteosarcoma. 323 27

We measured the serum concentrations of 2 biochemical markers of bone formation, bone Gla-protein (BGP) and bone alkaline phosphatase (BAP), in 164 normal subjects and 164 patients with metabolic bone disorders. The data were reported as Z scores (deviation in SDs from the sex-specific age regression in normal subjects). Both serum BGP and BAP distinguished abnormalities well (mean Z scores for BGP and BAP, respectively) and gave concordant results in patients with hypoparathyroidism (-1.7, -1.4), hyperthyroidism (+1.1, +1.8), primary hyperparathyroidism (+3.6, +2.5), acromegaly (+1.2, +2.8), and postmenopausal osteoporosis (+0.4, +1.9). The 2 markers gave discordant results, however, in patients with glucocorticoid excess (-2.4, +0.9), Paget's disease (+1.8, +41.8), chronic renal failure (+16.3, +0.4), and osteolytic metastases (-1.4, +5.9). These discrepancies may have occurred because serum BGP and BAP concentrations reflect different aspects of osteoblast function or because there are differences in their clearance from the circulation. Consequently, more information is derived about the level of bone formation across the wide range of metabolic bone disorders when both biochemical markers are assayed.
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PMID:Concurrent assays of circulating bone Gla-protein and bone alkaline phosphatase: effects of sex, age, and metabolic bone disease. 325 70

Hypercalcemia is associated with a few primary malignant neoplasms and with a variety of tumors that have spread by metastases. Hyperparathyroidism is a diagnosis that is usually not considered in these patients. At our institution, 18 patients with malignant tumors presented over a 6-year period with hypercalcemia caused by hyperparathyroidism. There were five men and 13 women with a mean age of 48 years (range 24-87 years). Primary tumors in these patients included colon carcinoma (four cases), breast carcinoma (four cases), lymphoma (four cases), thyroid carcinoma (four cases), Paget's disease (one case), and lung carcinoma (one case). Metastases of the primary tumor occurred in seven patients, and in 11 patients the tumor was not metastatic or recurrent. Serum levels of calcium, phosphate, and chloride averaged 11.8 mg/dl, and 100 mEq/liter, respectively. C-terminal parathyroid hormone (PTH) levels ranged from 300 to 1,900 pg/ml with an average of 1,150 pg/ml (normal 50-340 pg/ml). At operation, a single parathyroid adenoma was discovered in 15 patients, and four-gland hyperplasia was noted in three patients. In all cases, serum levels of calcium returned to normal after operation. We conclude that patients with malignant tumors and concomitant hypercalcemia should be evaluated for the possibility of hyperparathyroidism. In cases of primary hyperparathyroidism, elevated C-terminal PTH level should be diagnostic. If hyperparathyroidism is determined to be the cause of hypercalcemia, neck exploration and parathyroidectomy are indicated.
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PMID:Malignancy and concomitant primary hyperparathyroidism. 333 14

Two men, aged 68 and 77 years, had metastases of carcinoma in pagetic bones. These cases were initially diagnosed clinically as Paget's sarcoma. Roentgenograms, scintigrams, and bone puncture biopsy specimens (BPBs) of the right scapula and the sacrum, respectively, showed only Paget's disease. However, an additional BPB obtained with the aid of computed axial tomography (CAT) revealed the presence of metastases of lung carcinoma in the right scapula and of a carcinoma of probable prostatic origin in the pagetic sacrum in the other. The observations testify to the usefulness of CAT-directed BPB when Paget's sarcoma is suspected, especially in cases located in the scapula, pelvis, or spine.
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PMID:Metastases of carcinoma in the pagetic bone. A report of two cases. 334 81

Genital tumors represent a special group requiring effective and curative treatment while functional and cosmetic demands require tissue sparing techniques. For these reasons, micrographic surgery is indicated. Over the past 5 years we have treated 24 such patients utilizing standard techniques for micrographic surgery. The patient population included twenty male and four female patients with ages ranging from 27 to 80 years. Histologically confirmed diagnoses included squamous cell carcinoma, Bowen's disease, verrucous carcinoma, basal cell carcinoma, Paget's disease, and leiomyosarcoma. These were located on the penis, scrotum, perineum, and buttocks. Seven of these patients were considered to have recurrent tumors. Preexisting conditions existed in 6 patients, including balantis xerotica obliterans, trauma, decubitus ulcer, and hidradenitis suppurativa. All surgery was performed under local anesthesia in the cutaneous surgery unit. Average pretreatment tumor size was 2.0 X 1.9 cm. Average postoperative defect size was 4.5 X 3.7 cm. Tumors were excised with an average of three stages and 18 sections. Most defects (65%) were allowed to heal by secondary intention, five (21%) were closed primarily, and three were referred for closure. After surgery five patients developed metastases in their regional lymphatic system. No patients developed local recurrence. Micrographic surgery is a most useful treatment modality in patients with genital tumors for control of local disease. However, patients with squamous cell carcinoma should be considered for elective regional lymph node biopsy and/or dissection in conjunction with micrographically controlled excision of the primary tumor.
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PMID:Genital tumors: their management by micrographic surgery. 334 95

Deep bone biopsies were performed in 58 patients over the last 2 years, in a radiology department in Tours, France, under television screen control. Data obtained included pathologic, cytologic and bacteriologic features in the 60 biopsies conducted, localization being the spine in 52 cases (12 dorsal, 36 lumbar, 4 sacroiliac) and the pelvis 8 times. Etiology was a tumoral process in 15 cases (14 metastases and 1 reticulosarcoma), 7 infectious processes including 2 cases of tuberculosis, 26 cases of decalcifying degenerative osteopathies, 1 Paget's disease, 1 ankylosing spondylitis and 1 bone infarct. Biopsy was unsuccessful in 9 cases, the success rate being an overall 85%. Complications were not observed. Conducted under local anesthesia, deep bone biopsy provides a rapid diagnosis and allows a shortened hospital stay. Surgery is generally avoided and appropriate treatment instituted more rapidly.
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PMID:[Percutaneous bone puncture biopsy with trocar. Apropos of 60 cases]. 404 94

The Authors report the results of treatment with synthetic human calcitonin in patients suffering from Paget's disease, osteoporosis, Sudeck's disease, osteolytic metastases and in one case adults Cooley's anaemia. They summarize the characteristic blood chemistry changes due to calcitonin in some cases and report a marked clinical improvement in the majority of the patients.
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PMID:[Clinical experience with human calcitonin]. 616 1


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