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)

In the present report we describe a case of epidural hematoma with paraplegia subsequent to preoperative thoracic epidural catheter insertion. The hematoma co-localized with epidural metastases unknown at the time of catheter insertion. In addition to the description of the exact interventions, the conditions enabling early diagnosis and therapy of the described complication are discussed. Furthermore, we discuss the necessity of preoperative examinations if an epidural anaesthesia is planned.
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PMID:[Coincidence of an epidural hematoma and epidural metastases during thoracic epidural anaesthesia]. 1461 49

We describe the case of a patient who reported a 4-month history of edema in the lower right limb, which was accompanied by pain and paresthesia and which progressed to flaccid paraplegia. Two years earlier she had undergone a uterine curettage for hydatidiform mole. Metastases of a choriocarcinoma to the lumbar and sacral segments of the column were diagnosed.
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PMID:Metastasis of choriocarcinoma to lumbar and sacral column. 1503 24

Case 1. A 58-year-old man underwent radical nephrectomy due to a tumor in the left kidney (renal cell carcinoma, clear cell subtype, G3, pT1bpN0) in 1988. Thirteen years later, he underwent surgical resection of metastases to lung and cerebrum and gamma ray knife resection of two other sites of metastases to cerebrum in 2001. He had no evidence of disease in April, 2003. Case 2. A 53-year-old man underwent radical nephrectomy due to a tumor in the right kidney (renal cell carcinoma, clear cell type, pT1apN0) in 1987. From 1996 to 2001, irradiation therapy to multiple metastases to thoracic vertebrae (50 Gy), rib (50 Gy), para-aorta lymph nodes (40 Gy), sacrum (44 Gy) and sternum (44 Gy), and surgical resection of dermal metastasis were performed. Paraplegia occurred due to regrowth of thoracic bone metastasis in December, 2001. In February, 2002, he died of septic shock caused by infection of decubitus. Surgical resection and palliative therapy of recurrent metastatic foci was useful to improve the quality of life and probably prognosis.
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PMID:[Long-term survival in patients with metastatic renal cell carcinoma managed with conservative therapy: a report of two cases]. 1551 27

Postoperative paraplegia is a major complication, of which the pathogenesis is usually multifactorial. This report is to discuss the case of a 36-year-old male patient who, after total hip replacement (THR), right, sustained a sudden-onset postoperative paraplegia. On subsequent examination, it was discovered that the patient had multiple vertebral metastases from hepatocellular carcinoma (HCC) resulting in thecal sac compression at L1 and S1 levels. This instance of distal spinal metastasis from HCC, with initial presentation of a sudden onset of paraplegia immediately after THR surgery, is worth reporting because of its being a rare occurrence and traumatizing effects on the patient, family members, and the surgical team. More importantly, we bring forth this case in order to advance an opinion concerning prevention of this devastating complication. Hence, we discuss the contributory factors and the appropriate perioperative survey and management relevant to cancer patients who are to undergo a non-cancer surgery.
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PMID:Sudden onset of paraplegia after total hip replacement surgery in a patient with hepatocellular carcinoma--a case report. 1555 95

We present a case of retroperitoneal neuroblastoma in a 27-year-old male with extensive bone marrow metastasis at the first presentation. After the simple excision of the tumor, adjuvant multi-drug chemotherapy, consisting of vincristine, actinomycin-D, ifosfamide, doxorubicin, carboplatin and etoposide, was carried out for 17 months, leading to complete remission. Ten months after completion of the chemotherapy, the tumor recurred with bone marrow metastasis. He further developed thoracic vertebral metastases resulting in paraplegia, and died of the disease 41 months after the presentation. The clinical course of this case, with its emphases especially on the effect of the chemotherapy, is described in this report. Since the clinical characteristics and treatment strategies for adult neuroblastoma have not yet been well established, they remain to be investigated in detail.
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PMID:[A case of retroperitoneal neuroblastoma in an adult with extensive bone marrow metastasis]. 1557 Sep 42

The majority of spinal cord lesions observed in prostate cancer are related to extradural compression. Intradural (extramedullary or intramedullary) metastases are very rare. The authors report a case of probable carcinomatous myelitis secondary to prostate cancer in a 50-year-old man, 9 months after the initial diagnosis of advanced metastatic prostate cancer. Despite endocrine therapy initiated immediately after diagnosis, the patient rapidly developed leg pain due to vertebral osteolysis. He developed flaccid paraplegia despite radiotherapy of the lumbar spine combined with corticosteroid therapy and chemotherapy. Spinal cord magnetic resonance imaging (MRI) showed typical features of very probable carcinomatous myelitis in the cervicothoracic zone. The patient died shortly after without histological confirmation. Regardless of the primary cancer, intramedullary spinal cord metastases have a very poor prognosis. Based on a literature search, this case appears to be the first case related to prostatic cancer reported in the medical literature.
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PMID:[Spinal cord metastasis from prostate cancer]. 1577 12

Liposarcoma is a malignant tumor of soft tissue. The thoracic spine is an unusual location, even for metastasis, and to our knowledge, no case of primary pleomorphic liposarcoma of the vertebral body has been reported until now. A female patient presented with paraplegia. She had a previous medical history of mental depression, and complained of dorsal pain for three months following a road accident. Magnetic Resonance Imaging (MRI) revealed a collapse of T7-T8, and the diagnosis of plasmocytoma was made. She was treated with decompressive laminectomy and posterior instrumentation. Histological examination revealed a pleomorphic liposarcoma. She received a course of radiotherapy. At 13 months follow-up she developed pulmonary metastases and rib involvement. The spine is an unusual location for pleomorphic liposarcoma, even as metastasis. The differential diagnoses of this rare entity are discussed, as well as the criteria for diagnosing primary spinal liposarcoma. Although rare, our case demonstrates that liposarcoma should be considered in the differential diagnosis of spinal tumors.
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PMID:Primary liposarcoma of the thoracic spine: case report. 1586 68

We report 4 cases of spinal cord metastases of lung cancer detected by MRI. Histologically, 3 of the 4 cases were small cell carcinoma and the other was adenocarcinoma. All 3 cases of small cell carcinoma had neoplastic meningitis. MRI taken in these cases showed the multiple nodules in the cauda equina, which were seeded from brain metastases. One of them had intramedullary spinal cord metastases, which appeared as enlargement of the spinal cord or nodules in the spinal cord on MRI. Leg paralysis and incontinence progressed in all cases. The other case of adenocarcinoma had epidural spinal cord compression due to spinal metastasis. In this case irradiation and corticosteroids relieved her leg and back pain. Spinal cord metastases should be considered as a differential diagnosis in patients with numbness, pain or weakness in the extremities.
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PMID:[Spinal cord metastases in lung cancer: a clinical review of four cases]. 1596 11

We report an interesting case of a patient with collecting duct carcinoma arising from the left kidney who presented with paraplegia secondary to metastases. The diagnosis was based on CT and histology. To our knowledge this is the first case of collecting duct carcinoma to present with paraplegia. The literature review also highlights the rarity of this disease with less than a hundred cases reported to date and the aggressive nature and poor prognosis despite prompt interventions.
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PMID:Collecting duct carcinoma of the renal medulla presenting with paraplegia. 1630 19

The first step for treatment of bone metastases is to confirm the diagnosis, particularly if there is only one localisation, so as to exclude a primary bone tumour. Surgery and percutaneous injection of acrylic cement are both efficient to relieve pain. Their indications and timing have to be discussed in pluridisciplinary staff. Long bones metastases have to be nailed before pathologic fracture. If there is suspicion of hypervascularisation, the lesion has to be embolized before any procedure. Treatment of spinal metastases with neurological impairment is an emergency. Paraplegia may be a consequence within a few hours. They have to be treated in an orthopedic or neurosurgery department with the experience of posterior and anterior approach of the spine. Surveillance may be useful to diagnose these metastases before neurological impairment. Depending from the type of cancer, the chemo- and radiotherapy sensibility, the number of metastases, the condition of the posterior wall of the vertebra and the general condition of the patient, different surgical treatments may be possible going from complete resection of the lesion to percutaneous injection of acrylic cement. Conventional radiotherapy is associated to surgery. Satisfactory results of such treatments justify greater involvement of orthopaedic surgery team in multidisciplinary staff.
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PMID:[Surgery and percutaneous injection of acrylic cement in bone metastases]. 1692 60


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