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 clinical appearance, typical localization, diagnostic procedure and the treatment of hemangiosarcoma--the most frequent malignant tumor of the heart are reported by the case of a 27 years old woman. The patient suffered from dyspnea, congestion of the superior caval vein and paroxysmal tachycardia. X-ray showed cardiac enlargement due to pericardial effusion. Echocardiography revealed a large tumor in the right atrium. Computertomography and angiocardiography showed tumor masses at the orifice of the superior caval vein and a bypass of the blood flow via the azygos vein. Thoracotomy yielded an inoperable hemangiosarcoma. By the combined treatment of irradiation and chemotherapy the cardiac tumor completely disappeared, the patient was temporary symptomless. Later metastases occurred and the patient died 13 months after diagnosis.
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PMID:[Hemangiosarcoma of the heart]. 380 60

A 47-year-old man was admitted because of a left axillary tumor. A biopsy of the tumor disclosed adenocarcinoma. The bone survey showed multiple sclerotic metastases. Thirteen months after his first admission, a left breast tumor developed and a simple mastectomy revealed a papillotubular carcinoma. Skin metastases appeared postoperatively and were exacerbated with accumulation of pericardial effusion and a high CEA level (401.7 ng/ml) despite radiation and chemotherapy. Estrogen therapy with diethylstilbestrol sodium phosphate was started, resulting in the disappearance of pericardial effusion and skin metastases. The patient remains well 10 months after starting estrogen therapy with a normal CEA level.
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PMID:[A case of advanced male breast cancer treated effectively with estrogen]. 392 44

The present work is based on the analysis of clinical data and instrumental studies of 240 patients with metastases and malignant tumors extended to the heart and pericardium. Tumor lesion process of the pericardium is accompanied by the complex of symptoms of acute pericarditis (fibrosis, effusional, constrictive), rapid enlargement of the heart shadow, in combination with changes of voltage and ECG complexes, appearance of echo-free spaces, presence of atypical cells in pericardial effusion. The process of tumor extension to the myocardium is characterized by the following factors: progressive refractory cardiac decompensation, steady rhythm disturbances without any dynamic changes, appearance of stenosal murmurs, enlargement and blurredcontours of the heart shadow on chest roentgenograms, appearance of echocardiographic spaces with akinesia and hyperkinesia.
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PMID:Secondary malignant lesions of the heart and pericardium in neoplastic disease. 395 84

Eleven patients with invasive thymoma (seven males and four females) were seen from 1977 to 1983. All patients were adults with a median age of 46 years (range, 24-62), and presented after surgical exploration with nonremovable primary and with one or more of the following patterns of tumor extension: supraclavicular lymphadenopathy (four patients), superior vena cava syndrome (two), pleural effusion (nine), and pericardial effusion (three). The following distant metastases were also observed: lung (six patients), liver (one), skin (two), peritoneum (two), bone (one), and brain (one). The chemotherapy was administered in 4-day courses. All patients received the following: 50 mg/m2 of cisplatin iv and 40 mg/m2 of doxorubicin iv on Day 1, 0.6 mg/m2 of vincristine iv on Day 3, and 700 mg/m2 of cyclophosphamide iv on Day 4. The course was repeated every 3 weeks. Toxic effects were tolerable, as expected for the drug combination adopted. Four of 11 patients achieved objective complete regression of disease and six of 11 had partial remission, for an overall response rate of 91%; one patient had stable disease for 7 months. Six patients have died and the median survival has been 12.5 months, ranging from 5 to 23 months.
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PMID:Chemotherapy of invasive or metastatic thymoma: report of 11 cases. 654 51

Pericardial metastases are frequently found and often cause cardiac tamponade which requires emergency treatment. Pericardiocentesis or subxiphoid pericardiotomy and pericardial drainage can be performed; the latter is a safe and effective method for the management of continuous pericardial effusion since it can be done under direct visualization and local anesthesia. We had four patients with neoplastic cardiac tamponade who were treated successfully with subxiphoid pericardiotomy and pericardial drainage. In three of them neoplasms had not been found until cytology of pericardial fluid proved to be malignant when they were attacked by cardiac tamponade. If the patient with malignancy is attacked by cardiac tamponade, subxiphoid pericardiotomy and pericardial drainage should be performed considering neoplastic cardiac tamponade. We have described pathophysiology, diagnosis and treatment of neoplastic cardiac tamponade.
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PMID:[Neoplastic cardiac tamponade]. 688 70

A 57-year-old white woman presented with pericardial effusion and an anterior superior mediastinal mass protruding through the sternum. The diagnosis of thymoma was established by the light and electron microscopic features of a biopsy specimen and a pericardial aspirate. The tumour was a thymic carcinoma, a recently described variant characterized by cellular atypia, enhanced invasiveness, and a higher incidence of metastases. Presentation as an anterior chest wall mass has not been described. Response to radiotherapy was slow and incomplete, and tumour progression occurred during treatment with cisplatin. The chemotherapy of thymoma is reviewed: some apparent responses to agents that are primarily lympholytic may represent the elimination of non-neoplastic lymphocytes from the tumour mass, with spurious radiological improvement and theoretically a risk of tumour enhancement.
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PMID:Invasive thymoma: unique presentation as an anterior chest wall mass. 688 42

Of 60 cases with pericardial metastatic disease, 26 had significant effects on the cardiovascular system. Pericardial metastases were suspected in 18 of these cases before death. The most common features reported were dyspnea on exertion and pleural effusion. While these were nonspecific for circulatory disturbance, ECG features of ST-T changes and low voltage QRS complexes were helpful in suspecting pericardial metastases. Thoracic roentgenograms were not helpful unless there was a large pericardial effusion. Echocardiography reported in one case promises a higher incidence of suspicion in the future.
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PMID:Clinical and pathologic features of metastatic neoplasms of the pericardium. 705 81

Eighteen patients with cardiac tamponade were treated by subxiphoid pericardiotomy performed with the patients under local anesthesia. This group included 9 cases of uremic pericarditis (50%), 5 cases of metastatic cancer (28%), 2 cases of trauma (11%), 1 case of tuberculosis (5.5%), and 1 case of unknown cause. Immediate relief from acute cardiac tamponade was obtained in all 18 cases with only minor and self-limiting postoperative complications, including transient supraventricular arrhythmias (five cases) and fever (five cases). There were no deaths related to either the operative procedure or reaccumulation of the pericardial effusion. The drainage period averaged 9.6 days (range, three to 28 days). Pericardial biopsy was performed in 15 of 18 cases. We conclude that subxiphoid pericardiotomy is a safe and effective method for the management of pericardial effusion of diverse causes. The ability to perform this technique safely using local anesthesia and the capacity to obtain a biopsy specimen under direct visualization make this technique superior to both needle pericardiocentesis and pericardiectomy in the acutely ill patient.
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PMID:Management of acute cardiac tamponade by subxiphoid pericardiotomy. 705 4

Cross-sectional echocardiography was performed on 69 patients with pericardial effusion. The etiology of the pericardial effusion was malignant infiltration of the pericardium in nine patients; chronic renal failure in 10; postcardiac surgery in 31; viral pericarditis in three; tuberculous pericarditis in two; and undetermined in 14. Seven of the nine patients with pericardial metastases were noted to have irregular cauliflower-like masses protruding from the pericardium and the epicardium into the echo-free space of the pericardial effusion. These masses demonstrated a to-and-fro motion within the pericardial space during ventricular systole. The presence of pericardial metastases was confirmed at operation in four cases and the three others had intrathoracic or colonic malignancy with widespread metastases. None of the patients without pericardial metastasis showed the characteristic abnormality seen in patients with pericardial metastases. Six patients had dense linear echoes connecting the pericardium and epicardium that probably represented adhesions (confirmation at surgery in one, and confirmation at autopsy in another), with an appearance that was different from that seen in pericardial metastases. We conclude that cross-sectional echocardiography may be useful for detecting pericardial metastases.
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PMID:Detection of pericardial metastases by cross-section echocardiography. 743 93

A case of lung cancer manifested as cardiac tamponade was reported. A 64-year-old male had anterior chest pain and dyspnea. A chest X-ray films showed an enlarged heart with a solitary round shadow in the left lung hilus. Echocardiogram disclosed a large amount of pericardial effusion. Emergency pericardiectomy with drainage was accomplished. The patient lived for 8 months without effusion accumulation. Histologically adenocarcinoma of the lung with prominent lymph nodes metastases was disclosed. Surgical decompression such as pericardiectomy or pericardial fenestration is a valuable selection in the treatment of pericardial effusion and tamponade.
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PMID:[Lung cancer manifested as cardiac tamponade: a case report]. 747 96


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