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)

Primary paraganglioma arises infrequently in the urinary bladder. We present the clinicopathologic, immunohistochemical, ultrastructural, and DNA flow cytometric findings in three cases (one man and two women). Ages at diagnosis were 19, 35, and 45 years. One female presented with paroxysmal headaches and hypertension that followed urination; the remaining two patients presented with hematuria. Immunohistochemical studies revealed positive reactivity for chromogranin (three patients), met-enkephalin (three), leu-enkephalin (three), vasoactive intestinal polypeptide (two), serotonin (one), and S-100 protein (one; sustentacular cells only). Neurosecretory granules were identified in all cases; in the patient with hypertension, the granules were small with eccentric cores similar to those of adrenal pheochromocytomas. A nondiploid DNA flow cytometric pattern was present in all three patients, an aneuploid pattern was present in two, and a tetraploid pattern was present in one. After diagnosis, one patient was alive without progression at 7 years, one died of an uncertain cause at 5 years, and one suffered multiple recurrences over a 24-year period before developing metastatic disease. While the presence of aneuploidy has been shown to be a predictor of malignant behavior in adrenal pheochromocytomas, our study illustrates that DNA ploidy cannot be used as a diagnostic criterion for malignancy in urinary bladder paraganglioma.
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PMID:Paraganglioma of the urinary bladder: immunohistochemical, ultrastructural, and DNA flow cytometric studies. 174 2

Sixteen cases of paragangliomas of the head and neck including 8 of the vagal body, 3 of the carotid body, 2 jugulotympanic, 2 vagal or jugulotympanic and 1 of the larynx were analysed. Clinically, 13 tumors were benign, 2 showed local aggressivity and 1 showed metastases. All tumors were tested with antisera directed against neuron-specific enolase (NSE), chromogranin A (CGA), S-100 protein, neurofilaments (NF), glial fibrillary acid protein (GFAP) and cytokeratin (CK). Immunohistochemical results were compared with those of 5 cases of neuroendocrine carcinoma (NC) (1 of the oral vestibule, 1 of the larynx, 1 Merkel-cell tumor of the skin and 2 medullary thyroid carcinomas). Immunoreactivity for NSE and/or CGA was always positive in all paragangliomas and NC. S-100 protein was positive in sustenticular cells in all cases of paragangliomas and focally in two cases of NC. NF and GFAP were focally positive in 3 and 2 paragangliomas respectively; and in 1 NC. CK was constantly negative in all cases of paraganglioma and constantly positive in all cases of NC. Antibody anti-CK is the single most useful immunomarker for differential diagnosis between paraganglioma, frequently benign neoplasms and NC commonly aggressive in the head and neck. These findings are consistent with the current concepts of the neuroendocrine system.
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PMID:Paragangliomas of the head and neck. Immunohistochemical analysis of 16 cases in comparison with neuro-endocrine carcinomas. 175 7

Our experience with [131I]metaiodobenzylguanidine (131I-MIBG) therapy in a 10 year old boy is reported. At disease onset, in May 1988, this boy presented a large mass in the upper left abdominal quadrant, which was resected with a histopathological diagnosis of extra-adrenal malignant pheochromocytoma (paraganglioma). He subsequently underwent two further surgical resections and chemotherapy. When 131I-MIBG therapy was started, in June 1990, skeletal and abdominal metastases were present. These localizations were revealed by 131I-MIBG scans and confirmed by x-ray examination. At present 6 courses of therapy have been performed with a cumulative activity of 29.6 GBq. Side-effects have been limited to vomiting and mild thrombocytopenia, lasting 2 weeks during the second course of therapy. After 15 months of therapy, a progressive reduction of MIBG uptake, coupled with a stabilization of the lythic lesions, has been observed.
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PMID:[131I]metaiodobenzylguanidine therapy in paraganglioma. 182 45

Paragangliomas, tumors derived from the extra-adrenal paraganglion system, have commonly been found in the retroperitoneum, abdomen, mediastinum, skull base, and neck. Rare intraspinal cases have included involvement of the cauda equina and filum terminale, and a recent case has been reported of thoracic cord paraganglioma with metastasis to the cauda equina. The authors present the case of a patient with a cervical paraganglioma who underwent subtotal resection followed by postoperative irradiation; she subsequently developed multiple intracranial and intraspinal metastases 7 months following the first decompression procedure.
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PMID:Cervical paraganglioma with subsequent intracranial and intraspinal metastases. Case report. 207 74

This paper describes the case of a malignant retroperitoneal paraganglioma with extensive metastases. The patient presented with a supraclavicular mass and an absence of hypertension. Exclusively raised dopamine metabolites were detected which may be a marker of a malignant process and account for the lack of hypertension.
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PMID:Raised dopamine metabolites in a case of malignant paraganglioma. 221 99

Isolated vertebral body metastases from paraganglioma are exceedingly rare. They have been reported to occur in the presence of active primary tumor in the neck, local recurrence, or widespread metastases. A unique case of carotid body tumor (paraganglioma) is reported with the following features: (1) multiple vertebral body metastases (C6, T9, and L3) presenting with spinal cord compression, and no evidence of local recurrence or other metastatic disease; (2) absence of mitoses on the original specimen or the metastatic deposit; and (3) a prolonged interval (9 years) to the development of symptomatic metastases.
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PMID:Multiple spinal metastases from paraganglioma. 222 78

We report two cases of primary paraganglioma of the urinary bladder. Case 1. A 61-year-old man was hospitalized with the chief complaints of gross hematuria, dysuria and headache. The patient had a history of hypertension. Cystoscopy disclosed a nonpapillary, sessile tumor in the retrotrigonum of the bladder. An attack of paroxysmal hypertension was induced by bimanual palpation of the tumor, and paraganglioma was suspected. Partial cystectomy with staging pelvic lymphadenectomy was performed. Case 2. A 65-year-old man was hospitalized with the chief complaints of gross hematuria and urinary retention. The patient had no history of hypertension. Cystoscopy disclosed a nonpapillary tumor in the right lateral wall of the bladder. Transurethral resection was performed with no cardiovascular complication. Prostatic needle biopsy showed the histological evidence of prostatic adenocarcinoma. Radical retropubic prostatectomy with limited lymphadenectomy was performed. There was no histological evidence of lymph node involvement of paraganglioma or adenocarcinoma. The histological and biochemical examinations revealed a chromaffin positive, functioning and non-malignant tumor in Case 1, and a chromaffin negative, non-functioning and non-malignant tumor in Case 2. In total, 29 cases of primary paraganglioma of the urinary bladder have been so far reported in Japan. The tumor recurrence, multiple or metastases were recorded in 8 of 29 cases (27.6%), mainly in regional lymph node metastases. We recommend lymphadenectomy at the initial operation, irrespective of pathological finding of the primary paraganglioma of the urinary bladder.
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PMID:[Primary paraganglioma of the urinary bladder: a report of two cases]. 223 62

A case of malignant paraganglioma arising from the posterior mediastinum and presenting with a chest wall metastasis is reported with immunocytochemical and ultrastructural documentation. The pathobiologic features of this rare disease are reassessed with a review of the literature. Cytoarchitectural features do not provide reliable information regarding malignant potential. However, evidence of local invasiveness at surgical exploration and/or lack of initial surgical control are likely to be associated with synchronous or metachronous metastatic disease. Although there are clinicopathologic differences warranting distinction between benign paragangliomas arising in the anterior and posterior mediastinal compartments, there is no apparent pathobiologic difference with regard to the malignant group.
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PMID:Malignant paraganglioma of the posterior mediastinum. A case report and review of the literature. 240 59

A malignant nonfunctioning paraganglioma of the pelvic retroperitoneum (left external iliac artery) with metastases to the femoral lymph nodes was found in a 68-year-old woman at exploratory laparotomy. Light microscopy showed a typical alveolar pattern with fine vascular stroma. The tumor cells had finely granular eosinophilic cytoplasm and oval to round nuclei with pleomorphism and mitotic figures, Grimelius stain showed no argyrophilic granules, but S 100 protein was demonstrated in the cytoplasm by the PAP method of Sternberger. Formaling fixed tissues were examination by electron microscopy, and dense core granules consistent with neurosecretory granules were found in the cytoplasm of some tumor cells.
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PMID:[Malignant paraganglioma of the peri-iliac artery]. 242 Oct 24

Two cases of familial, malignant, nonfunctional paraganglioma are reported. Uptake of iodine-131 metaiodobenzylguanidine ([131I]MIBG) by the tumors and metastases was demonstrated. In the first case, with multicentric and locally invasive disease, [131I]MIBG correctly localized a right carotid body paraganglioma which had been missed arteriographically. In the second case, with widespread, symptomatic metastatic disease, a therapeutic dose of [131I]MIBG produced palliation of bone pain after the failure of radio- and chemotherapy. Uptake of [131I]MIBG by paragangliomas does not correlate with catecholamine secretory activity. Iodine-131 MIBG should be considered as a therapeutic option in unresectable, malignant paragangliomas which take up this radiopharmaceutical.
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PMID:Localization and treatment of familial malignant nonfunctional paraganglioma with iodine-131 MIBG: report of two cases. 243 68


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