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 on a 63-year-old patient with rectal carcinoma that metastasized to a toe. Although bone metastases from malignant tumors are common, metastatic lesions of the small bones of extremities are very rare. We have found in the literature only 29 cases of carcinoma which have metastasized to the small bones of the feet. Twenty of these cases are verified histologically. The differential diagnosis includes osteomyelitis, gout, and Reiter's disease. The roentgenographic features and the possible pathogenetic mechanisms of peripheral metastases are discussed.
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PMID:Rectal carcinoma metastasizing to a toe. 736 90

A Tc-99m-methylene diphosphonate study in a 41-year-old man demonstrated multiple regions of intense activity in the appendicular and axial skeleton, characteristic of metastatic disease. However, bone biopsy demonstrated atypical mycobacterium osteomyelitis; there was no evidence of neoplasm.
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PMID:Unusual scintigraphic appearance of osteomyelitis secondary to atypical mycobacterium. 737 44

Mycobacterium avium-intracellulare osteomyelitis is an infrequently reported entity, especially in immunocompetent patients. When multifocal, the imaging findings can be confusing, simulating metastatic disease or other bone lesions. An immunocompetent patient with multifocal Mycobacterium avium-intracellulare osteomyelitis is presented who has been followed for 18 years and experienced episodes of exacerbations and further dissemination of her disease, followed by periods of partial remission and clinical quiescence. Bone scintigraphy was very useful in evaluating the extent of involvement and monitoring response to treatment.
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PMID:MAI osteomyelitis. 18-year scintigraphic follow-up. 755 59

A 60-year-old Chinese lady presented with a left flank mass and weight loss. Plain films showed a sclerotic L1 vertebral body, osteopenic L2 and L3 vertebral bodies and loss of left psoas outline. However initially unrevealed history of previous carcinoma of the cervix caused confusion as to the aetiology of a sclerotic vertebral body associated with an left flank collection. Psoas abscess with adjacent bony osteomyelitis was initially suspected. The left flank mass turned out to be an infected necrotic large metastatic lymph node compressing the lower pole of the left kidney. The sclerotic and osteopenic vertebral bodies represented an unusual presentation of bony cervical carcinoma metastases.
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PMID:Metastatic cervical carcinoma presenting as psoas abscess and osteoblastic and lytic bony metastases. 767 75

Acrometastases are rare and often misdiagnosed or overlooked. When it involves the feet, it generally attacks the larger bones containing the higher amounts of red marrow. The patient may or may not have a known history of cancer, which makes diagnosis much more difficult. The symptomatology is generally vague and can mimic other conditions, such as osteomyelitis, gouty rheumatoid arthritis, Reiter's syndrome, Paget's disease, osteochondral lesions, and ligamentous sprains. Therefore, the physician must consider metastatic disease in the differential diagnosis. Once the diagnosis is made, the prognosis is poor and treatment is limited to pain relief and maintaining function.
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PMID:Acrometastases. Initial presentation as diffuse ankle pain. 785 58

The occurrence of epidermoid carcinoma on fistulae of osteomyelitis has been known since the 19th century, and the four cases reported here show that this complication is still present. CASE-REPORTS. Four new cases developed on the tibia 33 to 54 years after the formation of fistulous osteomyelitis are presented here. The patients were three men and one woman, aged from 58 to 78 years. The lesions observed were ulcero-granuloma in three cases and common superficial ulceration in the fourth patient. In two out of four cases the diagnosis was difficult to ascertain and required deep surgical biopsy. The bone was invaded in three cases, but no regional or visceral metastases could be found. All patients were amputated, after failure of conservative radiotherapy in two of them. No recurrence was observed after a 2 to 3 1/2 years' follow-up. DISCUSSION. The frequency of this late complication cannot be measured precisely, but it has been estimated at 0.5 p. 100 of fistulous osteomyelitis. The warning signs are often not specific and delay the diagnosis; they consist of unusual pain, ulceration, granulation and discharge. The diagnosis rests on histology and requires a deep and wide surgical biopsy involving the entire sinus tract, but uncertainties sometimes persist concerning atypical pseudoepitheliomatous hyperplasia. The best treatment is amputation with removal and biopsy of regional lymph nodes when present, but it does not always avoid the occurrence of metastases which appear in 20 p. 100 of the cases, usually during the first three years following diagnosis. CONCLUSION. These four cases exemplify the need to consider this diagnosis in all patients showing changes in an old fistulous osteomyelitis and to confirm it by deep and wide biopsy.
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PMID:[Carcinomatous degeneration of chronic osteomyelitic fistulae. 4 cases]. 816 Oct 96

Since June 1991 the IORT facility has operated a dedicated linear accelerator, which was installed within the central operating theater of the Department of Surgery. As of 9/92 a total of 28 patients suffering from peripheral (n = 20) or centrally (n = 8) located soft tissue sarcomas had been were treated. Thirteen patients revealed a primary and 15 patients a recurrent tumor. Tumor resection with negative margins was performed in 20 patients, positive margins remained in 5 patients, and gross macroscopic residual disease in 3 patients. Combined intraoperative and external beam radiotherapy was applied in 22 patients, using IORT doses of 10-20 Gy and an external beam dose of 26-50 Gy. Three patients were irradiated intraoperatively twice with a time interval of 24 h. After a median follow-up of 9.9 months, 20 patients are disease free. Two patients died 4 and 5 months after the end of therapy with rapidly progressive distant metastases. An infield failure within the external beam target volume was seen in 1 patient and local failure at the field margin of the external field in 3 patients. So far, there have been no IORT infield failures. Follow-up is performed with magnetic resonance imaging. In 3 patients a second operation was necessary because of a severe wound infection, including one patient suffering from osteomyelitis of a neighboring bone. Mild sensory neuropathy occurred in 1 patient 7 months after treatment. Overall only mild and reversible postoperative and posttherapeutic complications were seen.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Methodology, technical prerequisites and postoperative morbidity of intraoperative radiotherapy (IORT) of soft tissue sarcomas. Heidelberg Krankengut 6/91-9/92]. 823 80

Two cases of carcinoma which had developed in chronic fistulating osteomyelitis are presented. In one case the patient was cured by an above-the-knee-amputation. In the other case the patient was also treated by amputation, but died of metastases. The need for active surgical treatment of chronic osteomyelitis is emphasized.
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PMID:[Squamous cell carcinoma developing in chronic fistulating osteomyelitis]. 832

The acquired hyperostosis syndrome (AHS) (best known synonym: pustulotic arthro-osteitis) is a system disease of the supporting and gliding tissue with sites of predilection characterized by inflammation-induced bony reconstruction of positive balance. This syndrome is affiliated with the seronegative spondylarthropathies. The main finding is the sternocostoclavicular hyperostosis in about 80% of patients. Focal hyperostoses also occur on the skeleton of truncus and extremities and joints. AHS is accompanied by psoriasiform and acneform dermatoses. Overlapping findings with spondylitis ankylosans are reported. Terminology, aetiology, nosology, pathogenesis, histomorphology, clinical and laboratory findings, complications, imaging diagnostic, differential diagnosis and therapy of AHS are discussed. Knowing AHS helps to prevent misdiagnoses (as especially bacterial osteomyelitis, spondylitis, osteoplastic tumor and metastases) and interventional diagnostic procedures.
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PMID:[Acquired hyperostosis syndrome (so-called pustular arthro-osteitis). Review of the literature including 73 personal cases]. 846 19

In order to assess the value of the SPIR (Spectral Presaturation with Inversion Recovery) sequence (a fat-suppression technique) with Gd-DTPA in the investigation of skeletal diseases, 50 patients were examined with conventional SE T1- and T2-weighted sequences, as well as with SE T1 and SPIR sequences after the i.v. injection of Gd-DTPA. Twenty patients were affected with a skeletal infection (11 spondylodiscites and 9 osteomyelitis) and 5 with a primary tumor; 15 had metastases and 10 a hemolymphopoietic disorder (6 myelomas and 4 non-Hodgkin's lymphomas). In the four groups of patients, the mean visibility of skeletal lesions was higher on SPIR images with Gd-DTPA than on the other images, even though a statistically significant difference was observed only in the group of infections (p < 0.002) and in myelomas and lymphomas (p < 0.001). In 13 cases with extraosseous spread, visibility was higher on contrast-SPIR images than on the other sequences, even though high sensitivity was also exhibited by SE T2-weighted sequences. Even though the SPIR sequence still exhibits some technical limitations, our study assesses the value of this sequences with Gd-DTPA in the investigation of skeletal lesions. The major advantages of contrast-SPIR imaging follow: 1) it shows skeletal lesions, which are isointense on enhanced SE T1-weighted images, 2) it provides better visibility of the lesion than the other sequences, more accurately defining their borders, 3) it provides better anatomical detailing than SE T2-weighted images and 4) its sensitivity is higher.
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PMID:[Comparative evaluation of the SPIR sequence with gadolinium and other sequences in bone diseases]. 851 61


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