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)

The clinical courses of 111 patients with osteosarcoma treated at UCLA between 1971 and 1982 were reviewed to ascertain the evolution of the natural history of this disease. Only patients with classic high-grade intraosseous osteosarcoma of the extremity, scapula, or pelvis were considered. Patients with low-grade parosteal osteosarcomas; primary osteosarcomas of the face, skull, vertebra, or ribs; and osteosarcomas arising in Paget's disease or previously irradiated bones were not included. Fifty-nine patients developed clinically evident distant metastases. Of these, 36 developed pulmonary metastases alone as the initial site of recurrence. Eighteen of 19 (94.7%) patients treated between 1971 and 1974 by amputation alone developed pulmonary relapse as the initial site of recurrence, whereas only 18 of 40 patients (45%) treated after 1974 with surgery and adjuvant chemotherapy developed pulmonary metastases alone as the initial site of recurrence. Although no patients in the early group developed an extrapulmonary metastasis as the initial site of recurrence, 11 of 40 patients (27.5%) treated with adjuvant chemotherapy developed an extrapulmonary metastasis as the initial site of recurrent disease, and 11 patients developed simultaneous pulmonary and extrapulmonary metastases. Although it is impossible to attribute this alteration in metastatic pattern to adjuvant chemotherapy alone, it is apparent that nonpulmonary metastases are becoming more common among patients currently treated for osteosarcoma.
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PMID:Changing metastatic patterns of osteosarcoma. 659 14

The reactions of a monoclonal antibody to the MCF7 breast cancer cell line were immunohistochemically studied on a variety of breast tumors, primary and metastatic, on mammary epithelium and on nonneoplastic breast lesions. A high proportion of positive reactions was observed in ductal, lobular, and tubular carcinomas as well as in mammary Paget's disease. Mucinous, medullary, and papillary carcinomas showed a low incidence of reactivity. Carcinomas with metaplasia, carcinoids, and nonepithelial breast tumors were unreactive with the antibody. Positive immunostaining was documented also in nodal and extranodal metastatic lesions. The staining of nodal metastases was correlated with the positive reaction of the primary tumor. Reactivity was widely distributed in normal breast epithelial cells and in benign breast lesions. Staining of nonneoplastic mammary epithelial was associated with reactivity of adjacent neoplastic tissues. Staining differences between nonneoplastic and neoplastic mammary tissues were related to the intensity and cytologic distribution of the labeling. Heterogeneous reactivity of morphologically similar cells was documented in nonneoplastic and neoplastic breast epithelial cells as well as in nodal and extranodal breast carcinoma metastases. Immunohistologically detectable antigen was not correlated with prognostic factors such as histologic grade or nodal status. A retrospective study of T1NO cases failed to substantiate any prognostic value for the reactivity of primary breast tumors with this monoclonal antibody.
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PMID:Reactivity of a monoclonal antibody with tissues and tumors from the human breast. Immunohistochemical localization of a new antigen and clinicopathologic correlations. 671 80

Minimal breast cancer includes noninvasive cancer (Paget's disease, ductal, or lobular) and/or small invasive cancers which measure less than 0.5 cm. These cancers can be multicentric and bilateral, may have regional or distant metastases, and are occasionally lethal. Surgical treatment ranges from none to radical mastectomy, although total mastectomy in continuity with low axillary lymphadenectomy is the most common. Primary radiation therapy is used to a lesser extent.
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PMID:Minimal breast cancer. 730 78

Carcinomas of the prostate and breast are the most common sources of osteosclerotic metastases. The osteoblastic response is related to stromal bone formation and reactive bone formation. Purely osteosclerotic or mixed osteolytic-osteosclerotic lesions are encountered. Frequent differential diagnoses are enostoses and Paget's disease. The classical MRI pattern is a signal of low intensity on T1 and T2- weighted sequences, but some osteoblastic metastases have an inhomogenous signal. Evaluation of the response to treatment is difficult and requires confrontation with clinical and biological data.
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PMID:[Imaging of osteosclerotic metastases]. 747 96

Skeletal metastases from prostate cancer is common and usually do not pose a diagnostic dilemma. This study reviews radiographic appearances of prostatic metastases to the appendicular skeleton in four patients where the appearances simulated osteosarcoma, Paget's disease and Paget's sarcoma. Prostatic metastases to long bones can produce appearances considered characteristic of other lesions and suggest misleading alternative diagnoses.
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PMID:Appendicular metastatic prostate cancer simulating osteosarcoma, Paget's disease, and Paget's sarcoma. 748 3

The symptom of back pain may be the result of many different pathologies. As such, patients with back pain require careful assessment to determine whether the cause is from the spine or other systems. For acute mechanical back pain, treatment is often symptomatic. Symptomatic treatment may include analgesics, anti-inflammatories and/or muscle relaxants. Patients may also need hypnotics in the short term to help them sleep at night. However, drug therapy should be reduced and stopped as soon as possible. Furthermore, too much bedrest may be counterproductive. Paracetamol (acetaminophen) is the standard treatment for transient back pain. More severe pain may require the addition of an opioid, such as codeine or dextropropoxyphene. Morphine and pethidine (meperidine) may be necessary in patients with back pain due to neoplastic disease or osteoporotic fracture. However, the opioid analgesics are associated with dependence, tolerance and adverse effects. Nonsteroidal anti-inflammatory drugs (NSAIDs) have analgesic efficacy comparable with paracetamol. Individual patients respond differently to different NSAIDs, and several agents may have to be tried. Long term therapy with NSAIDs is necessary in diseases with an inflammatory component such as ankylosing spondylitis. Calcitonin reduces bone resorption and bone blood flow, and has been suggested to have central analgesic effects. As such, it has been used successfully in patients with Paget's disease, osteolytic bone disease and osteoporosis. Bisphosphonates also inhibit osteoclastic bone resorption and may be useful in Paget's disease, osteolytic metastases and osteoporotic fractures. Other drugs which may be useful in relieving back pain associated with specific circumstances include the tricyclic antidepressants, anxiolytics, antiepileptic agents, corticosteroids, colchicine and chymopapain.
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PMID:Pharmacological management of back pain syndromes. 752 24

Samarium-153-EDTMP is an effective agent for palliation of widespread skeletal metastases because it concentrates in bone metastases which have an osteoblastic component. Similar concentration in areas of osteoblastic activity in ankylosing spondylitis, Paget's disease and rheumatoid arthritis suggests a possible new treatment approach. Three patients with ankylosing spondylitis, one patient with Paget's disease and one patient with rheumatoid arthritis were treated with 153Sm-EDTMP. Objective and subjective improvement was noted, especially in ankylosing spondylitis patients. Samarium-153-EDTMP has disease-modifying potential in ankylosing spondylitis and Paget's disease and has palliative value in resistant rheumatoid arthritis. Further trials to determine optimal dose, treatment scheduling, long-term disease-modifying potential and toxicity are needed.
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PMID:Samarium-153-EDTMP for palliation of ankylosing spondylitis, Paget's disease and rheumatoid arthritis. 754 45

Part I discusses the correlation between the clinical, radiology and histologic features with the three phases (incipient, mid- and late phase) of Paget's disease. In this section, we will discuss in detail the radiologic features by location as well as aberrant radiographic presentations in addition to secondary tumors such as post radiation sarcomas and giant cells tumors which occur in Paget bone. Because Paget's disease generally affects people in their middle and late ages, the differential diagnosis often includes metastatic disease and the differentiation can often be quite challenging. Moreover, metastatic disease to bones afflicted with Paget's disease can further add diagnostic confusion. These critical aspects will be discussed in this section of Paget's disease of bone.
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PMID:Paget's disease of bone: review with emphasis on radiologic features, Part II. 761 Apr 9

The pagetic bones in the active phase of the disease with brisk lysis and sclerosis manifest intense tracer uptake on planar bone and SPECT images. Intense tracer uptake, however, can occur also in infections, dysplasias and metastases. Pinhole bone scintigraphy has been shown to portray specific diagnostic signs in a number of skeletal diseases. In an effort to identify useful bone scan signs, we prospectively carried out 99mTc-oxidronate pinhole bone scintigraphy of the skull, vertebrae, ribs, humerus, sacrum and ilium in two patients with Paget's disease of the bone. The pinhole bone scintigraphy findings correlated with radiographic, CT and MRI findings and in the vertebra with the pathological study. Interestingly enough, pinhole bone scintigraphy revealed intense tracer uptake preferentially in the bone cortex and the rim of the affected bones. Thus, the cranial inner table, humeral cortex and vertebral endplates and rims were the seats of characteristic tracer uptake, respectively creating a scintigraphic version of the radiographic "cotton wool" sign, "casket" sign and "picture frame" sign. The pagetic lesions in the sacrum and ilium also showed intense cortical and rim uptake. Correlation of pinhole bone scintigraphy with radiography, CT and MRI indicated that such cortical or rim uptake is characteristic of Paget's disease.
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PMID:Bone pathologic correlation of multimodality imaging in Paget's disease. 762 88

In the present study, we have examined whether or not the Paget cells in cases with dermal invasion or metastasis exhibit a different DNA distribution pattern to that seen in the epidermis in extramammary Paget's disease. The DNA contents of Paget cells from the epidermis and the tumor were determined by flow cytometry in two cases of extramammary Paget's disease with tumor formation, dermal invasion and metastases. The DNA histogram of Paget cells from the epidermis of two cases appeared to be close to the normal ploidy, whereas the histogram from the tumors was aneuploid in both cases. Our data suggest that the behavior of Paget cells in the epidermis is different from that in the tumor.
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PMID:A flow cytometric analysis of the DNA content of Paget cells in the epidermis and the tumor of extramammary Paget's disease. 777 Nov 88


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