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 case of sarcoma arising in a left temporal oligodendroglioma is described in a 39-year-old male. The postoperative evolution was marked by a paraplegia linked to medullary and subarachnoid metastases. Then a relapse of the cerebral tumor occurred, and the patient died 6 months after the onset of the symptoms. Histologically, the mesenchymal component appeared fibrosarcomatous and angiosarcomatous. Those facts argue in favor of the histogenic hypotheses put forward in exceptional cases previously described, according to which the sarcoma develops from vascular elements of the glioma.
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PMID:Sarcoma arising in oligodendroglioma of the brain: a case with intramedullary and subarachnoid spinal metastases. 72 72

Among 400 observations by the authors, 2 per cent were admitted without and another 22 per cent with slight neurological disturbances. An incomplete transverse lesion of the cord with paraplegia was found in 61.7 per cent, a complete paralysis in 14.3 per cent of the cases. Meningiomas and neurinomas were found in 60 per cent of the patients. The average age of the tumour patients was 43,8 years. Meningiomas and metastases show a tendency to occur in older age groups. The "Glioma Age" was around 25 years. The majority of the tumours were located at the level of the thoracic cord. When breaking down according to the kinds of tumours, a different picture is obtained: neurinomas are chiefly located in the region of the cervical medulla and the thoracolumbar region; gliomas are mainly found in the cervical part of the medulla up to the central thoracic cord. A dissociation of the cerebrospinal fluid was found in 90 per cent of the examinations; in 50 per cent of the patients it was above 200 mg%. Within a period of four weeks after the operation, the following results were obtained: 5 per cent free from complaints, improvement in 39 per cent, aggravation in 10 per cent and 46 per cent still uninfluenced. Meningiomas and neurinomas showed the highest degree of improvement. 24 per cent of the patients suffered from transitory rectovesical disturbances, 15 per cent from urinary tract infections, 12 per cent from decubitus, 9 per cent from wound healing disturbances and another 9 per cent from pneumonia. Meningitis was found in 2 per cent. Within four weeks post operationem, the death rate was 10.5 per cent, but this was in the phase before the introduction of microsurgery. On the accuracy of the diagnoses: in 18 per cent the neurological findings were in agreement with the diagnosis and in 49 per cent they showed differences of 1 to 3 segments; in 11 per cent no definite diagnosis could be made. In 46 per cent the native X-ray picture showed pathological changes. Myelography with positive contrast media showed positive findings in 97 per cent and 98 per cent of positive findings were obtained with myeloscintigraphy.
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PMID:[400 intraspinal space-narrowing processes--a clinical study]. 74 32

Clinical interest in spinal compression and resultant paraplegia due to metastases has mounted in recent years. This has stimulated attention to the neuropathology of the condition. 14 cases of spinal cord compression due to vertebral metastases are compared with over 100 traumatic cases. In the traumatic lesions there is central haemorrhagic necrosis leading to cavitation and gliosis with nerve root regeneration in the late stages. In the metastatic cases, lesions are often peripheral, pie-shaped and are related to vascular factors. The neuropathology of cord necrosis due to metastatic spinal disease is therefore different from that caused by trauma. These observations have clinical importance in planning treatment.
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PMID:Vertebral metastases and spinal cord compression. 75 26

40 patients with prostatic carcinoma were treated with parenteral and/or oral Estracyt (estramustine phosphate) until 55 months. Metastases were present in 37 patients (stage D). 35 of the 40 patients developed metastases in spite of estrogen therapy and/or orchidectomy. Diminution of metastasic bone pain as well as improvement of hydroureteronephrosis was frequently observed. Paraplegia secondary to metastatic disease improved in 1 case for 6 months. Side effects were relatively rare and were mainly gastrointestinal. A possible hepatotoxic action of the compound has been pointed out previously. On the basis of our studies Estracyt is recommended in the treatment of primary estrogen resistent prostatic carcinoma and in metastatic carcinoma of the prostate not responding to conventional antiandrogenic therapy anymore.
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PMID:[Treatment of advanced carcinoma of the prostate with Estracyt (author's transl)]. 82 40

A retrospective series of 12,478 patients with breast cancer included 2467 patients with spinal metastases. Local treatment was not necessary in 688 patients. Neurological dificit did not develop in 1735 patients who underwent radiotherapy. Forty-four patients developed myelopathy due to spinal cord compression as demonstrated by neurological examination and myelography. Twenty-six of these patients were initially treated by laminectomy and 18 were initially treated with radiotherapy. The two groups did not significantly differ in their outcome with respect to motor power, pain relief, or ability to walk. Six patients who underwent radiotherapy deteriorated during 2 months of treatment. Four of these patients were not operative candidates because of poor general condition (three patients) or long duration of paraplegia (one patient). Of two patients who underwent emergency laminectomy, one became paraplegic; however, the other patient was significantly improved. For this reason it is essential that patients undergoing radiotherapy for spinal cord compression be followed closely by a neurosurgeon. The authors believe that in appropriate cases radiotherapy alone can yield results as good as laminectomy combined with radiotherapy.
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PMID:Indications for nonoperative treatment of spinal cord compression due to breast cancer. 90 30

A proportion of W-256 tumour cells injected intravenously into a tail vein of the rat are diverted into venous plexuses en route to the lungs; here tumour cells remain trapped, proliferate and form invasive solid tumours in the pelvis and hindquarters, which cause paraplegia, metastases and death. Also, cells trapped in veins produce tumour nodules distributed along the length of the tail; this effect in markedly enhanced by temporarily arresting the outflow of blood from the tail for a few seconds only immediately after cells are injected. Continous monitoring of the radioactive signal over the lungs after W-256 cells labelled with 125IUDR were injected showed that massaging the tail or intravenously injecting isotonic saline into the tail dislodged cells trapped in veins. In heparinized rats, tail trapping was markedly reduced, although not entirely abolished, and venous trapping in vertebral and pravertebral regions was decreased. The anatomical distribution of growth of the trapped cells in rats closely resembled metastases involving dissemination via the "vertebral venous system" produced by certain cancers in man. Labelled tumour cells trapped in the lungs of untreated mature rats commenced dying rapidly in situ wiht 1-2 h after injection; the majority had disappeared within 24 h, and less than 1% of the injected tumour cells survived to form lung colonies. Experimental evidence is presented which indicates that the lungs play a vital role in rapidly eliminating a high proportion of blood-borne cancer cells in the adult individual.
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PMID:Venous diversion trapping and growth of blood-borne cancer cells en route to the lungs. 115 8

A twenty-three year old patient had simultaneously a left sided seminoma and a right sided malignant teratoma. Two years later a left nephrectomy had to be carried out because of left paraaortic and renal metastases. The patient received radiation therapy and cytostatic therapy with Velbe, Actinomycin D and Prednisone and survived five years with few symptoms. He died with multiple metastases following paraplegia due to a T 4/5 lesion.
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PMID:[Simultaneous occurrence of a malignent teratoma in the left testis and a seminoma in the right testis (author's transl)]. 126 35

The results of surgical intervention for metastatic disease on 56 consecutive patients since 1980 were reviewed. Two patients underwent a second procedure to stabilize remote levels of spinal involvement, for a total of 58 surgeries. All 56 patients presented with pain. After surgery, significant relief was noted by 51 (91%). Twenty-seven patients presented with neurologic compromise. After operation, neurologic improvement was noted in 20 (74%). No patient's neurologic function deteriorated secondary to surgical intervention. Twenty-one patients were bedridden before surgery secondary to pain or paresis. After operation, improvement in activity level was achieved in 16 (76%) of these patients. In summary, the goal of surgical treatment of metastatic spine disease is to improve the quality of the remaining life, by the relief of pain and preservation or restoration of neurologic function. The dismal consequences of prolonged bed rest, paraplegia, and a painful premature demise can be avoided with thoughtful and timely surgical intervention.
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PMID:Surgical treatment of metastatic spine disease. 127 15

The focus of Guttmann's treatment concept had been to set up a comprehensive rehabilitation system, aimed not only at saving the life of a person with paraplegia or tetraplegia but at giving it meaning as well. Progress made in the fields of rescue services, anaesthesia, intensive medicine, in spinal surgery, neurourology and diagnostics (CT, MRI) as well as in pharmacology, have decisively enhanced the possibilities of clinical rehabilitation, and have in some respects entailed deviations from Guttmann's classical treatment principles. Moreover, the patient population has changed in profile in the course of time, due to better chances of survival also in high-level tetraplegia, greater numbers of higher-age SCI patients and of patients with non-traumatic SCI (tumours, metastases, infections). A higher life expectancy achieved by better possibilities as regards prevention and treatment of SCI-related complications, new challenges for the future emanate from age-related diseases occurring in addition to the spinal lesion.
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PMID:[Clinical rehabilitation of the spinal cord injury patient--is the Guttmann concept still valid?]. 141 Jul 74

A case of paraplegia occurring after a spinal anaesthetic is reported. The 79-year-old man was admitted for a fractured neck of femur. Twenty years previously, he had had pharyngeal surgery and a tracheostomy. He had also undergone a prostatectomy for prostate cancer, and had been on oestrogen therapy for two years. He complained of dyspnoea at rest and his chest film showed diffuse pulmonary opacities. In order to avoid possible intubation and respiratory complications, spinal anaesthesia was performed without any problems in the L4 space. After the surgery, the patient recovered all his motor and sensory functions in the lower limbs. On the second postoperative day, he suffered from a motor paralysis of the right leg, which spread to the left leg on the fourth day. NMR imaging showed several vertebral metastases, together with anterior and lateral epidural invasion responsible for cord compression. Treatment with tetracosactide was begun, but the patient died six weeks later in his home, not having recovered any neurological function at all in his lower limbs. In fact, it was only after the procedure that the anaesthetist was informed that, at the time the prostate cancer had been diagnosed, vertebral body metastases, of which the patient had not been informed, were already present. The part played by the spinal anaesthetic in the occurrence of the paraplegia is not clear. It is reminded that such a technique should be used with extreme care in patients having a neoplasm with a very often high incidence of vertebral metastases.
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PMID:[Paraplegia after spinal anesthesia]. 150 98


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