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)

A wide spectrum of diseases may involve the clivus, such as primary neoplasms, metastatic disease, and inflammatory, vascular, hematopoietic, and infectious processes. Of these, osteomyelitis of the skull base and/or clival-petrous abscess are unusual, but may occur as a result of contiguous spread from the paranasal sinuses, namely, the posterior ethmoid and sphenoid, as was demonstrated by this patient. In this case report we discuss the pertinent anatomy, imaging studies, pathogenesis, and medical and surgical management of this case.
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PMID:Sinusitis with contiguous abscess involvement of the clivus and petrous apices. Case report. 1033 7

We reviewed the records of all patients who had received an epidural catheter for management of chronic cancer pain in a 3-year period (1993-1996). Patients with nervous system infections were identified, and pertinent clinical, radiological (magnetic resonance imaging), and bacteriological data were analyzed. We identified 11 patients who developed spinal epidural abscess (SEA). All of these had back pain; radicular signs occurred in seven patients and spinal cord compression in two patients. Magnetic resonance imaging revealed SEA in all 11 patients. SEA was iso- to hypointense on T1-weighted images and hyperintense on T2-weighted images relative to spinal cord. After gadolinium administration seven lesions showed characteristic rim enhancement while three showed minimal enhancement. No signs of diskitis or osteomyelitis were present, and the abscess was always localized to the posterior epidural space. Cultures were positive in all cases and revealed Staphylococcus epidermidis in eight and S. aureus in three. All patients were treated with intravenous antibiotics, and four had an additional decompressive laminectomy. Two patients died within 1 week of diagnosis from overwhelming septicemia despite apparently adequate antibiotic treatment. Within 4 weeks after diagnosis of SEA two patients died from widely metastatic disease, although infection may have contributed. One patient developed septicemia while receiving appropriate antibiotics and underwent emergency laminectomy. The neurological deficits recovered in all patients who survived the acute infectious episode. We conclude that patients with chronic epidural catheters for cancer pain require prompt neurological evaluation and magnetic resonance imaging when SEA is suspected. Early evaluation and treatment may lead to full recovery.
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PMID:Spinal epidural abscess complicating chronic epidural analgesia in 11 cancer patients: clinical findings and magnetic resonance imaging. 1052 80

Skin lesions are the best known manifestations of Mycobacterium ulcerans infection. However osteomyelitis is not uncommon with incidences as high as 14 p. 100 having been reported. The literature contains little specific data on bone lesions. This report describes a series of 33 patients presenting bacteriologically and/or histologically confirmed osteomyelitis induced by Mycobacterium ulcerans. In 64 p. 100 of cases, bone involvement occurred within the first year of the disease. In 70 p. 100 of cases, the site of involvement was on extremities. The median number of sites per patient was two (range, 1 to 5) and the number of bones was not correlated with the duration of disease. Overall, 41 p. 100 of bone sites occurred locally beneath skin lesions and 59 p. 100 were distant metastases. Osteomyelitis was associated with other germs in only 16 p. 100 of cases and superinfection was not a prerequisite for development of bone involvement. Clinical manifestations were usually low-grade with non-inflammatory, slightly painful local mass. The patient's general health status was unaffected in 79 p. 100. Histological examination allowed identification of the type of bone lesions induced by Mycobacterium ulcerans. For the first time, bone biopsy specimens were cultured. Based on bacteriological and histological findings, several postulations can be made about underlying pathophysiological mechanisms. The role of Buruli toxin is dealt with in the discussion.
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PMID:[Buruli ulcer: risk of bone involvement! Apropos of 33 cases observed in Benin]. 1125 59

Ewing's sarcoma is a rare malignant tumor of the foot in children. We report a case of Ewing's sarcoma of the talus in a four-year-old Chinese girl to highlight the initial difficulty in diagnosis and the clinical course of the disease. She was initially diagnosed as osteomyelitis of the talus and died eight months after presentation with pleural and spinal metastases. To the best of our knowledge, Ewing's sarcoma of the talus in a young child has never been reported in Malaysia.
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PMID:Ewing's sarcoma of the talus in a four-year-old child. 1181 59

Marjolin ulcers are malignant tumors arising in chronic wounds. Strictly defined, they include carcinomas that transform from the chronic open wounds of pressure sores or burn scars. They behave aggressively and have a propensity for local recurrence and lymph node metastases. A retrospective study was done at a single institution identifying six individuals who had chronic wound ulcers that underwent malignant transformation into a carcinoma. Sinus tract degeneration in osteomyelitis was not included. The average latency time between ulcer formation and documentation of a malignancy was 30 years. All wounds were about the pelvis or flank. Major oncologic surgical procedures were done in an attempt to eradicate the cancer. High-grade tumors had positive lymph node metastases, portending a grave prognosis. All four individuals with nodal metastases eventually died of systemic disease. Early recognition and proper staging offers the best chance for cure.
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PMID:Marjolin ulcers: secondary carcinomas in chronic wounds. 1213 63

Primary lymphomas of bone or skeletal muscle are rare entities. The most frequent among these diseases are primary non-Hodgkin's lymphomas of bone. They account for 3-5% of all bone tumors and 5% of all primary extranodal non-Hodgkin's lymphomas. Primary manifestations of Hodgkin's disease in bone or skeletal muscle are rarities. Primary non-Hodgkin's lymphomas of skeletal muscle are rarities as well. Primary non-Hodgkin's lymphomas of bone can be found in any patient age. A preference exists for the 3.-6. decade of life. The radiographic appearance of these entities resembles other aggressive bone tumors. Their differential diagnosis includes -- depending on the patient's age -- Ewing's sarcoma,malignant fibrous histiocytoma,metastases of small cell tumors and osteomyelitis.Further differential diagnoses are the peripheral primitive neuroectodermal tumor (PNET), osteosarcoma, eosinophilic granuloma and fibrosarcoma. Treatment of primary non-Hodgkin's lymphomas uses combinations of chemotherapy and radiation therapy. Operative treatment is reserved for the treatment of complications. The prognosis of primary non-Hodgkin's lymphomas is reflected by 10-year-survival-rates without recurrence of more than 80% in unifocal manifestations.
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PMID:[Musculoskeletal lymphomas]. 1248 52

Physical examination of a 9-year-old girl with a 2-month history of swelling of the left orbit demonstrated an orbital mass, blepharoptosis, and proptosis. Computed tomography revealed a 2 x 3-cm mass in the superior left orbit that expanded orbital dimensions. Radiography showed abnormalities in the parietal and frontal bones and distal right tibia. Magnetic resonance imaging demonstrated an 8.5-cm abnormality of the marrow space of the right mid-tibia. Bone marrow biopsy was unremarkable. Orbital and tibial biopsies showed a nonspecific chronic inflammation. Idiopathic inflammation that involves the orbit (orbital pseudotumor) and that has systemic manifestations may mimic more serious conditions, such as metastases from rhabdomyosarcoma or Ewing sarcoma, chronic recurrent multifocal osteomyelitis (CRMO), and SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis). Accurate diagnosis requires careful clinical and pathologic examinations.
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PMID:Orbital inflammatory syndromes with systemic involvement may mimic metastatic disease. 1287 85

This review gives a short history of the developments of immunoscintigraphy using radiolabelled monoclonal antibodies and will look at some clinical indications studied in close cooperation with international groups. Examples are presented of infected orthopaedic prostheses and the diagnosis of osteomyelitis in diabetic foot in which the method is considered diagnostically helpful. Furthermore, the accuracy of the bone marrow immunoscintigraphy is discussed in evaluating results of a multi-centre study, clearly demonstrating its diagnostic superiority over bone scanning in metastatic cancer. It is concluded that the future diagnostic trend is going towards more specific agents (antibodies, peptides) and a speedier availability of the diagnostic results in cases of supposed infection.
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PMID:Labelled monoclonal antibodies used for the detection of inflammatory processes and and bone marrow metastases. 1460 Sep

Sarcomas of the maxillofacial region are rare tumors presenting with wide variety of histopathological and clinical features. The authors treated six patients with sarcomas of the mandible over a period of ten years: 2 patients with fibrosarcomas, 2 with lymphosarcomas, one with osteogenic sarcoma and one with chondrosarcoma. The patients' ages ranged from 28 to 65 years, one was male and five - female. The present study reports three cases (osteogenic sarcoma, fibrosarcoma, chondrosarcoma) with specific clinical and radiographic characteristics, demonstrating the differences between the various types of sarcomas. Special attention is paid to the first clinical signs and symptoms, and to the differential diagnosis with inflammatory conditions (post-extraction alveolitis, chronic odontogenic osteomyelitis), benign tumors (osteoblastoclastoma, ameloblastoma, odontogenic cysts, fibrous dysplasia) and centrally developing jaw carcinomas. Particular emphasis is given to CT imaging and morphological examinations in making an accurate diagnosis and providing adequate treatment. Early diagnosis and precise surgical treatment (total resection or hemiexarticulation, or neck dissection if submandibular or cervical metastases are present) are essential to achieve satisfactory management of these malignant neoplasms. The radiotherapy and chemotherapy administered according to the histologic features of the tumor are also of significance.
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PMID:Sarcomas of the mandible. Literature review and case reports. 1550 48

Endometrial carcinoma is the most common invasive cancer of the female genital tract and accounts for 7% of all invasive cancer in women. Bony metastasis is uncommon with endometrial carcinoma and distal metastasis is very rare. The purpose of this paper is to present a case of an 86 year-old female with endometrial carcinoma metastasis to the distal phalanx of the hallux. The patient had a known history of endometrial carcinoma with metastases (FIGO IIIC), and had been diagnosed with pulmonary and bony metastases 2 months prior to presentation. Her initial foot complaint was of a painful, infected ingrown toenail. The infection continued to progress following avulsion of the nail, and the patient was then diagnosed with osteomyelitis. Given her past history, the possibility of metastasis to the hallux was also considered. A hallux amputation was performed, and the pathology report revealed the diagnosis of endometrial carcinoma metastasis to the distal phalanx of the hallux. While the amputation site healed uneventfully, the patient refused further treatment measures for her carcinoma and eventually succumbed to the disease.
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PMID:Endometrial carcinoma metastasis to the distal phalanx of the hallux: a case report. 1625 76


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