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)

We report a case of extramammary Paget's disease (EMPD) arising in the knee region in association with an underlying sweat gland carcinoma. Inguinal lymph node metastases were present initially. Paget's cells, intradermal tumor cells, and metastatic tumor cells showed similar reactions to a variety of histochemical stains and positive results with immunohistochemical staining using carcinoembryonic antigen (CEA). Control sections in cases of Bowen's disease and superficial, spreading malignant melanoma showed a negative staining reaction with CEA, providing further evidence that this technique is useful in distinguishing Paget's disease (PD) from histologically similar conditions. We provide a summary of previous cases of EMPD arising in unusual locations and a brief consideration of possible mechanisms of the origin of PD.
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PMID:Extramammary Paget's disease. Arising in knee region in association with sweat gland carcinoma. 620 37

Seven patients with Paget's disease, mimicking the radiographic appearance of metastatic disease, are illustrated. This disorder may simulate metastases if the simultaneous processes of bone resorption and new bone formation are not apparent, especially if there is no evidence of bone enlargement. Additional confusion may arise if the lesion is monostotic, has an unusual location, or occurs in a patient with known or suspected malignant disease.
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PMID:Paget's disease of bone mimicking metastases. 621 12

Fifty cases of Paget's disease of the breast treated surgically at The Johns Hopkins Hospital during the past 30 years were studied. Nineteen patients had Paget's disease confined to the nipple and 31 had an associated palpable tumor. An underlying intraductal or infiltrating duct carcinoma of the breast was present in each case. In six cases, the underlying tumor was 2 cm or more from the nipple with no apparent anatomic connection to the Paget lesion, and one case was encountered in whom intradermal Paget's disease develop in the area of a congenitally absent nipple. These findings support the theory of an intradermal origin for the Paget cell. Survival rates of patients with Paget's disease and a palpable breast mass were similar to those of patients with infiltrating duct carcinoma, the presence of axillary node metastases being the most important prognostic factor. Actuarial five- and ten-year survival rates were 22% and 9.9% for patients with positive nodes. The modified radical mastectomy is recommended as primary therapy for this group of patients. In contrast, none of the patients with Paget's disease of the nipple and no evidence of a palpable breast mass developed recurrent carcinoma. A total mastectomy without an axillary node dissection is the treatment of choice in this type of patient.
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PMID:Pathogenesis and treatment of Paget's disease of the breast. 626 59

Serum carcinoembryonic antigen (CEA) levels were examined in ten patients with genital Paget's disease, using radioimmunoassay. Three of the patients showed elevated serum CEA levels, but the other seven patients had normal levels. All three patients with increased CEA levels had widespread metastases. The seven patients with normal levels had no metastasis or had only a very small metastasis in one lymph node. Elevated serum CEA levels are associated with Paget's disease only when it shows widespread metastases.
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PMID:Serum carcinoembryonic antigen level in Paget's disease. 632 Aug 60

Alpha-lactalbumin (ALA), a milk protein, was demonstrated by immunohistochemistry with polyclonal antisera from three different sources in primary and metastatic breast carcinomas, and mammary Paget's disease. ALA localization was observed in 67% of mammary carcinomas, and in 62% of their metastases to sites which included lymph nodes, lung, bone, liver, pericardium, skin, and subcutaneous tissue. There was close correlation between primary and metastatic breast carcinomas in ALA positivity, but no correlation between ALA positivity and histologic differentiation. A variety of nonmammary neoplasms were examined for ALA immunoreactivity. In contrast to ALA immunoreactivity of breast tissue, which was removed by preabsorption of antiserum with ALA antigen, a number of skin appendage tumors, salivary gland tumors, and mesotheliomas demonstrated positive staining which was not abolished by preabsorption and was most likely due to the presence of cross-reacting antibodies. One commercial ALA antiserum also reacted with pancreatic islet cells in a distribution similar to glucagon. Our results demonstrate the presence of ALA in breast carcinomas and its potential value to the surgical pathologist in the workup of metastatic carcinomas of unknown primary sites. However, the staining encountered in some nonmammary tumors necessitates caution in its interpretation.
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PMID:Alpha-lactalbumin as an immunohistochemical marker for metastatic breast carcinomas. 632 3

A case is reported of extramammary Paget's disease of the scrotum, with metastases to the superficial femoral lymph nodes. Extramammary Paget's disease and its urological spectrum are reviewed, and the management is discussed. Treatment consisted of surgery and irradiation therapy. The patient appears to be free of disease, despite metastatic nodal involvement, 2 1/2 years after diagnosis.
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PMID:Adenocarcinoma of the scrotum (extramammary Paget's disease): case report and review of the literature. 632 51

Employing ROI-technique, a ratio Q was obtained from relating accumulation of 99mTc-MDP at the site of the bone lesion (n = 150) with that of contralateral non-involved osseous areas. Values of Q were correlated with histologic tumor diagnosis, its dignity and frequency. Values of Q of greater than 3.0 were found in 95% of all sarcomas, in 100% of the osteosarcomas but in only 3.8% of all benign bone tumors. Values ranging from 1.0 to 1.2 were exclusively measured in benign tumors (e.g., in 52% of juvenile bone cysts and in 67% of non-ossifying fibromas). Since the threshold--separating benign from malignant lesions--at Q = 3.0 was blurred by tumorlike lesions, metastases and especially by Paget's disease, this method does not precisely predict dignity. However, this method may complement radiographic evaluation with low values supporting the diagnosis of a benign lesion. The combined findings of radiography and these rations gained by nuclear imaging may help determine the pathway of a patient through further diagnosis and treatment.
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PMID:[Value of the "region of interest" technique in the scintigraphic diagnosis of primary bone tumors (author's transl)]. 645 97

A 68-year-old man with old-standing Paget's disease of bone developed in 1975 an isolated sarcoma of the left elbow confirmed by biopsy. The sarcoma responded to irradiation and multiple chemotherapy. In August 1979, pain started along the right sciatic nerve. Clinical examination revealed a tumour deep in the right gluteal region, which was found to be another sarcoma close to the sacro-iliac joint, Cobalt irradiation produced little symptomatic improvement, and the patient died four months later, presumably of metastases. Since January 1979 the Paget's disease had been treated with dichloromethylene diphosphate with satisfactory clinical, biochemical and histological results, but the drug did not influence the course of the sarcoma.
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PMID:[Multifocal sarcoma associated with Paget's disease of bone. Effects of dichloromethylene diphosphate (author's transl)]. 645 48

Increased patellar uptake on bone scans is seen quite commonly but the possible or probable etiologies of this finding have not been previously well described. A review of 100 consecutive bone scans showed that the incidence of bilateral "hot" patellae is 15%. Identified etiologies include osteoarthritic degenerative disease (35%), fracture, possible metastatic disease, bursitis, Paget's disease, and osteomyelitis. The value of careful history, physical examination, and radiographs is stressed.
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PMID:The "hot" patella. 646 May 76

The three-phase bone scan has been reported of value in the diagnosis of osteomyelitis. The use of a radionuclide angiogram, an immediate postinjection "blood pool" image, and 2 to 3 hour delayed image have been useful in separating nonosseous inflammatory disease from osteomyelitis. However, dependence on increased blood flow and focal hyperemia for this diagnosis may limit the use of the study if other processes are shown to produce similar results. To identify limitations of the three-phase bone scan we studied 14 patients with metastatic bone disease and nine patients with Paget's disease. Blood flow results showed no increase in three of 14 patients with metastases, intermediate increase in seven of 14 patients with metastases and two of nine patients with Paget's, and intense increase in four of 14 patients with metastases and seven of nine patients with Paget's. All patients showed increased focal activity in the immediate "blood pool" and delayed images. We conclude that because of increased flow Paget's disease may be difficult to separate from osteomyelitis. However, metastatic disease can often be differentiated on the basis of quantitative focal hyperemia. The three-phase bone scan remains of value in the diagnosis of osteomyelitis, but other diseases of bone must be included in the differential diagnosis.
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PMID:Can the three-phase bone scan differentiate osteomyelitis from metabolic or metastatic bone disease? 646 58


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