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 case is presented of a 59 year old Saudi Arabian woman with sternal and vertebral tuberculous osteomyelitis and a benign breast mass simulating metastatic disease. This case illustrates the diagnostic difficulties that may be encountered in the diagnosis of tuberculous osteomyelitis.
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PMID:Tuberculosis of the sternum presenting as metastatic disease. 855 85

The majority of skeletal lesions affecting the patella are benign and include entities such as chondroblastoma, giant cell tumor, osteomyelitis, and gout. Malignant processes involving the patella are distinctly unusual. Isolated occurrences of plasmacytoma, osteosarcoma, hemangiosarcoma, and metastatic disease have been reported. Malignant lymphoma involving the patella is extremely uncommon, although lymphomatous infiltration of the skeletal system is not a rare event, especially with the histiocytic lymphoma. The most frequent radiologic manifestations of skeletal lymphoma include osteolytic lesions with ill-defined margins involving the metaphysis of the long bones of the lower extremities. Involvement of the short tubular and flat bones, as well as the axial skeleton, occurs less commonly. The prognosis for lymphoma involving the skeleton is poor.
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PMID:Malignant lymphoma involving the patella. 895 29

The contrasting radiological appearances of metastatic deposits in the mandible of prostatic adenocarcinoma in two patients are described. The clinical presentation was similar in that both presented with altered sensation of the lower lip. Radiologically, they differed in that one patient suffered from a large predominantly osteoblastic mass, while the other, who gave a history of previously treated prostatic adenocarcinoma, presented with a rather small osteolytic deposit. Investigations for bony metastatic disease usually include a bone scan which is a highly sensitive technique although non-specific. A skeletal survey can be useful although less sensitive than a bone scan. Blood investigations such as acid phosphatase and prostate specific antigen levels are also indicated in male patients where prostatic disease is suspected. Reasonable long term survival using relatively simple drug therapy without significant local surgery, highlights the need for accurate recognition and tissue diagnosis to differentiate this condition from osseous malignancy of the jaws, other metastatic disease or osteomyelitis.
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PMID:Case report. Two contrasting radiological presentations of prostatic adenocarcinoma in the jaws. 916 Nov 83

Twenty-nine patients with anterior spinal cord compression underwent decompression and fusion through a laterally based approach to the thoracic and thoracolumbar spine. The lateral extracavitary approach allows access to the vertebral bodies as well as the posterior elements through a single incision. This approach was chosen for patients who had complicating medical conditions that made staged procedures less desirable. Ten men and 19 women with an average age of 53 years were studied. Diagnoses included post-traumatic deformity, metastatic disease, osteomyelitis, and primary neoplasms. Twenty-three patients had frank neurologic loss preoperatively, and 28 patients had significant medical comorbidities as evidenced by American Society of Anesthesiology classes II, III, and IV. One patient died postoperatively from pneumonia, which developed in a lung with metastatic disease, and two patients developed seromas that subsequently became infected. The average intensive care unit stay was less than 2 days. Patients remained intubated for an average of 13 hours after surgery. In this population of medically compromised patients with difficult spinal disease, the lateral extracavitary approach provided an effective means of one-stage treatment. Patients tolerated the procedure, and cardiopulmonary complications were minimal. This approach is most appropriate in patients who require posterior stabilization in conjunction with anterior stabilization.
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PMID:Lateral extracavitary approach to the thoracic and thoracolumbar spine. 924 71

Thirty-two patients affected with skeletal conditions were examined with MRI using Short TI Inversion Recovery sequence and Spectral Presaturation with Inversion Recovery (SPIR) sequence as well as Spin-Echo (SE) T1-weighted sequence and Fast Spin-Echo (FSE) T2-weighted sequence to compare their value in the assessment of skeletal lesions. SPIR sequence was performed after intravenous injection of Gd-DTPA. The lesions included primary bone tumors (10 cases: 1 osteosarcoma, 1 periosteal sarcoma, 1 Ewing's sarcoma, 1 chondrosarcoma, 2 non-ossifying fibromas, 1 chondroma, 1 chondromyxoid fibroma, 1 desmoplastic fibroma and 1 bone cyst), metastases (7 cases: 3 prostate, 3 breast, 1 lung-squamous cell carcinoma), infections (12 cases: 9 osteomyelitis, 3 spondylodiscitis), sacroiliitis (1 case) and posttraumatic bone bruise (2 cases of bone marrow edema). The four sequences were compared by using both qualitative and quantitative evaluation. Qualitative evaluation showed that STIR sequence was better than SPIR sequence (performed with Gd-DTPA) for lesion conspicuity (p < .016) and for signal intensity uniformity (p < .03). Compared with SE T1 and FSE T2 sequences, fat-suppressed sequences were superior for conspicuity, margins, and extension of the lesions (range of p < .001-.017). Only SPIR with Gd-DTPA sequence, compared with SE T1 sequence for lesion conspicuity was not statistically significantly different. Quantitative evaluation showed statistically significant higher values of percent contrast (%C) and contrast-to-noise ratio (C/N) for STIR sequence compared with SPIR sequence (%C p < .004; C/N p < .040). This study suggests that STIR sequence and SE T1-weighted sequence provide high sensitivity in lesion detection and good anatomical definition. The use of a fat-suppressed sequence with Gd-DTPA can be useful for lesion characterization.
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PMID:[Comparison of magnetic resonance Spin-echo sequences and fat-suppressed sequences in bone diseases]. 928 Sep 29

In a 12-month period, metastatic cancer was diagnosed in eight patients. Six of them presented with pain mimicking toothache, temporomandibular joint disorders or trigeminal neuralgia, while two showed osteopenic bone lesions in the panoramic radiography, and perimandibular swelling. Anesthesia of the lower lip was the only common clinical feature. In seven of the eight patients, a whole body bone scintigraphy and single photon emission computed tomography (SPECT) of the skull in combination with a whole body and SPECT anti-granulocyte (Tc-99m MAK 250/183) bone marrow scintigraphy was performed. One patient did not have combined scintigraphy performed secondary to severe systemic illness. In six of the seven, the results were conclusive for a metastatic bone lesion. Biopsies confirmed three patients to have a previously unrecognized primary cancer, one patient to have previously unrecognized recurrent cancer, and three patients to exhibit new metastatic spread of an already diagnosed cancer. Histology revealed breast, lung, renal cancer and a malignancy of inconclusive origin. In the remaining patient, combined scintigraphy suggested osteomyelitis, yet biopsy revealed a prostate cancer metastasis with acute inflammatory cell infiltration. Thus, the scintigraphy pattern of a hot spot in the bone scan and a cold lesion in the bone marrow scintigraphy is highly suggestive of a mandibular metastasis, if accompanied by anesthesia of the lower lip.
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PMID:Clinical manifestations and diagnostic approach to metastatic cancer of the mandible. 932 88

In MRI of the skeleton, marrow edema is a frequent finding that can be caused by avascular necrosis, fracture, bone bruises, transient osteoporosis, osteomyelitis, primary tumors, metastases, and altered biomechanical properties. We examined a 29-year-old woman golfer with mild pain and swelling of the proximal phalanx II of the left hand. No signs of a stress fracture were seen on the MR images or plain radiographs. MRI revealed increased signal intensity on T2-weighted images in the metacarpal and proximal phalanx II in the left hand. We concluded that bone marrow edema may be the result of physiologic bone response to stress and may not necessarily correspond with severe trauma. Our case complements recent observations outlining the influence of altered biomechanics as a reason for marrow edema.
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PMID:Overuse edema in the bone marrow of the hand: demonstration with MRI. 944 56

Bone metastases from colorectal cancer are uncommon and usually present late in the natural history of metastatic disease. This case report describes a 48-year-old man who developed an unusual distribution of bony metastases with multifocal osteolytic tarsal metastases 50 months after excision of a rectal carcinoma. An open biopsy was required to establish the diagnosis, exclude osteomyelitis and allow palliative radiotherapy to be given.
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PMID:Tarsal metastases in a patient with rectal cancer. 948 58

Osteosarcoma is the most common primary malignant bone tumour with the exception of myeloma. The majority of osteosarcoma cases arise within bone and are called conventional osteosarcoma. Intraosseous variants include telangiectatic, small-cell, low-grade intraosseous and cortical osteosarcoma. Less than 10% of osteosarcomas arise on the surface of bone and are subdivided into periosteal, high-grade surface and parosteal varieties. The imaging features of these subtypes of osteosarcoma are described and the impact on diagnosis highlighted. Using material from over 750 osteosarcomas treated at the author's centre, this article reviews the role of imaging in the management of this condition. Detection still relies principally on the conventional radiograph with bone scintigraphy and MR imaging useful in occult tumours. Establishing the radiological diagnosis depends on careful analysis of the radiographs, with particular attention paid to the nature and extent of bone destruction, periosteal new bone formation and matrix mineralization. The prudent radiologist will be wary of those bone conditions, such as stress fractures and osteomyelitis, which are frequently mistaken for osteosarcoma. Appropriate surgical staging requires MR imaging of the primary tumour to show the bony and soft tissue extent of the lesion and to confirm/exclude skip metastases and local lymph-node involvement. Staging should also include bone scintigraphy to confirm/exclude multiple lesions and chest CT to confirm/exclude pulmonary metastases. Following definitive surgery, imaging is used in the follow-up to monitor potential local recurrence and the development of pulmonary or osseous metastases.
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PMID:[Imaging of primary osteosarcoma]. 970 Jul 70

Diagnostic difficulties of Gaucher disease, a disorder resulted from a deficient activity of glucocerebrosidase is reported. Gaucher disease was described in the 16 year old male, 5 years after manifestation of the very first symptoms (fracture and osteomyelitis). At the age of 14, the cirrhosis due to viral hepatitis accompanied with splenomegaly was diagnosed. This findings was not associated with the earlier osseous disorders. Histopathologic examination of the removed spleen facilitate the diagnosis. The second case refers to 20 year old female. Clinical symptoms and additional test pointed to malignant neoplasm of thyroid, the reproductive organs or cancer of indistinguishable primary focus with metastases in the liver. Trepanobiopsy of bone marrow had made an accurate diagnosis possible, while determination of beta-glucosidase activity in peripheral white blood cells, chitotriosidase activity, and molecular investigations of gene specific to beta-glucocerebrosidase proved it.
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PMID:[Diagnostic difficulties in Gaucher disease: report of two cases]. 1033 43


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