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)

Cardiac toxicities in 39 consecutive patients with breast cancer receiving high-dose chemotherapy (HDC) with stem cell transplantation were reviewed. All 39 patients received various anthracycline-containing regimens in adjuvant settings and/or for metastatic disease before HDC. As a cytoreductive regimen, all received cyclophosphamide 2000 mg/m2 and thiotepa 200 mg/m2 for 3 consecutive days. No immediate fatal toxicities were observed, but one patient developed chronic congestive heart failure and two had transient left ventricular dysfunction. Pericardial effusion was observed in another three patients. ST-T abnormalities during HDC were observed in two patients and arrhythmias were observed in nine, four of which occurred during stem cell infusion (SCI). There were three atrial arrhythmias, two ventricular arrhythmias, and four atrioventricular (AV)-block episodes. Two patients developed advanced and complete AV-block with an asystolic pause. Notably, three patients experienced AV-block with uncontrolled vomiting. No relationship was observed between the cumulative dose of anthracycline and cardiac toxicities during HDC. These results suggest that abnormalities in the conduction system during HDC may be more frequent than previously reported. Vagal reflex secondary to emesis may play an important role in the development of AV-block. Bone Marrow Transplantation (2000) 25, 185-189.
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PMID:Cardiac conduction abnormalities in patients with breast cancer undergoing high-dose chemotherapy and stem cell transplantation. 1067 78

Two case reports of primary cardiac sarcoma, which is uncommon, are presented. The first case, a 38-year-old male, complained of chest tightness. Chest roentgenograms showed enlargement of the cardiac shadow and left pleural effusion. Transthoracic echocardiography and chest magnetic resonance imaging showed a tumor in the right atrium, and pericardial effusion. The tumor involved the right atrial wall and interatrial septum, and was partially resected. Pathohistological examination revealed angiosarcoma. He died 1 month later. The second case, a 19-year-old male complained of dyspnea and orthopnea. Chest roentgenograms showed pulmonary congestion. Transthoracic echocardiography showed a large mobile mass in the left atrium. An emergency operation was performed and the tumor was totally resected. Pathohistological examination demonstrated leiomyosarcoma. The postoperative course was uneventful, but the tumor rapidly recurred. Second and third operations were performed at intervals of 2 months. After the third operation, he was treated with radiotherapy. Local recurrence was not found but multiple distant metastases were found 2 months after completion of radiation therapy.
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PMID:Primary cardiac sarcoma: two case reports. 1823 85

A 64-year-old woman presented with right heart failure caused by a cardiac tumor centered in the free wall of the right ventricle, accompanied by pericardial effusion. A match between the biopsy specimen and tissue removed 4 years earlier resulted in the diagnosis of a cardiac metastasis from a chordoma. Immunohistochemical staining was also useful in establishing the diagnosis. To alleviate the right ventricular outflow obstruction, a palliative operation was planned, resecting the tumor and performing a right ventriculoplasty, which was cancelled due to the extent of infiltration of the tumor, and instead a right atrium to pulmonary artery shunt was attempted using a vascular prosthesis, only to fail due to an inability to maintain blood flow through the prosthesis. Presently there are no definitive treatment options available, and some palliative chemotherapy is being performed. Single cardiac metastases from a chordoma are extremely rare.
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PMID:Isolated cardiac metastasis from sacral chordoma. 1095 63

We report a case of metastatic esophageal carcinoma successfully treated with chemoradiotherapy. A 61-year-old man, diagnosed as suffering from advanced esophageal carcinoma with liver and lymph node metastases, was treated with a combination of nedaplatin (90 mg/m2/day, 1 h drip infusion, day 1), 5-fluorouracil (800 mg/m2/day, continuous infusion, days 1-5), and radiotherapy (2 Gy/day, days 1-5, 8-12 and 15-19). The cycle was repeated twice every 5 weeks from July 2, 1997. He achieved a complete response 1 month after finishing two courses of chemoradiotherapy followed by an additional three courses of chemotherapy without radiation. Seven months after the completion of radiotherapy, pericardial effusion with negative cytology was recognized. The effusion was treated by pericardiocentesis and drainage for several days. After drainage, the effusion could be easily managed with diuretics. This patient is still alive with no evidence of disease more than 2.5 years after the initiation of the treatment.
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PMID:A case of inoperable esophageal carcinoma with hepatic and nodal metastases which showed a long-term survival after chemoradiotherapy including nedaplatin. 1109 39

A 62-year-old man with a history of surgical therapy for papillary thyroid carcinoma was admitted because of chest pain, dyspnea on effort, pretibial edema, and slight fever. An electrocardiogram showed ST segment elevation in the precordial leads and low voltage in the limb leads. A large solid mass was demonstrated in both ventricles, with pericardial effusion, by echocardiography, thoracic computed tomography scan, transesophageal echocardiography, and angiography. A punch biopsy of the tumor revealed metastatic papillary carcinoma. During radiation therapy, the patient suddenly died of ventricular fibrillation. At autopsy, the tumor occupied almost the entire right ventricular cavity, expanding toward the main trunk of the pulmonary artery with a mobile peduncle and it had infiltrated the left ventricular wall through the interventricular septum. Microscopic examination confirmed metastatic papillary thyroid carcinoma. Only 2 other cases of cardiac metastases of papillary thyroid carcinoma have been reported and this case is the first report of metastases in both ventricles with a mobile right ventricular pedunculated tumor.
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PMID:Metastatic cardiac papillary carcinoma originating from the thyroid in both ventricles with a mobile right ventricular pedunculated tumor. 1111 Apr 37

Metastases to the heart and pericardium are much more common than primary cardiac tumors and are generally associated with a poor prognosis. Tumors that are most likely to involve the heart and pericardium include cancers of the lung and breast, melanoma, and lymphoma. Tumor may involve the heart and pericardium by one of four pathways: retrograde lymphatic extension, hematogenous spread, direct contiguous extension, or transvenous extension. Metastatic involvement of the heart and pericardium may go unrecognized until autopsy. Impairment of cardiac function occurs in approximately 30% of patients and is usually attributable to pericardial effusion. The clinical presentation includes shortness of breath, which may be out of proportion to radiographic findings in patients with pericardial effusion or may be the result of associated pleural effusion. Patients may also present with cough, anterior thoracic pain, pleuritic chest pain, or peripheral edema. The differential diagnosis of pericardial effusion in a patient with known malignancy includes malignant pericardial effusion, radiation-induced pericarditis, drug-induced pericarditis, and idiopathic pericarditis. Any disease process that causes thickening or nodularity of the pericardium or myocardium or masses within the cardiac chambers can mimic metastatic disease.
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PMID:Metastatic involvement of the heart and pericardium: CT and MR imaging. 1125 6

A 32-year-old man presented with cough, dyspnea and orthopnea ten years after amputation of the right humerus because of osteosarcoma. Chest radiographs and chest computed tomographs showed left pleural effusion, pericardial effusion and a giant intrathoracic mass, which was histologically diagnosed as a recurrence of the osteosarcoma. After 4 courses of chemotherapy combined with CDDP, the mass in the left upper lobe of the lung decreased in size, and it was then resected. Three months later, new metastatic lesions were detected in the thoracic area. Therefore, 29 additional courses of chemotherapy were administered (36 courses in total over 4 years; including regimens combined with CDDP, carboplatin, high-dose methotrexate, ifosfamide, dacarbazine, vindesine, etoposide, vincristine, taxotere and gemcitabine). In spite of the several courses of chemotherapy, brain and spinal cord metastases appeared, and the patient eventually died of cerebral hemorrhage. During the four years after the first recurrence he had good quality of life as a result of the chemotherapy.
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PMID:[An autopsy case of pulmonary and central nervous system metastatic osteosarcoma treated with thirty-six courses of chemotherapy over four years]. 1192 23

The case concerns a 56 year old male with the diagnosis of squamous cell carcinoma, which clinically presented as a rapidly increasing cardiac tamponade. The patient underwent a pericardio-centesis. Due to the expansion of the process within the bronchus, the patient underwent chemotherapy according to the Taxol + Carboplatine scheme. After 8 months of treatment the patient was hospitalized again due to a further increase in fluid in the pericardium, and symptoms of cardiac insufficiency which lead to patient death. Autopsy revealed neoplastic change within the pericardium (fibrinous-hemorrhagic pericarditis and hemopericardium). Cardiac tumors occur rarely, they may be primary or secondary. Squamous cell carcinoma metastases may be the cause of pericardial effusion, which is associated with poor prognosis.
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PMID:[Cardiac tamponade as the first clinical manifestation of squamous cell carcinoma]. 1215 50

Embolized mesothelial-like cells were detected within pericardial lymphatics and mediastinal lymph nodes of three golden retrievers with idiopathic haemorrhagic pericardial effusion. Morphological, cytochemical, and immunohistochemical investigations indicated that the embolized cells most likely originated from the pericardial mesothelium. None of the dogs showed evidence of an underlying neoplastic disorder. Such findings have not been reported previously in animals, but so-called "benign mesothelial cell inclusions" have been reported in mediastinal lymph nodes of human patients with pleuritis and pericarditis but no history of neoplasia. The present findings in dogs indicate the need to distinguish between lymphatic emboli arising from reactive mesothelial cells and metastases arising from a mesothelioma.
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PMID:Embolized mesothelial cells within mediastinal lymph nodes of three dogs with idiopathic haemorrhagic pericardial effusion. 1263 86

In a dog presenting with the clinical signs of exercise intolerance and ascites, cardiac tamponade due to suspected idiopathic pericarditis was diagnosed based on thoracic radiographs, electrocardiogram (EKG) and cardiac ultrasound. Pericardial effusion recurred soon after pericardiocenteses, prescription of colchizine and again after balloon pericardiotomy. After partial pericardectomy by thoracoscopy and after obtaining a histological diagnosis of mesothelioma adjuvant intracavitary chemotherapy using cisplatin was performed. Already one week later the dog developed marked dyspnea due to severe pleural effusion. The dog was maintained at acceptable life quality judged based on playfulness and appetite using repeated pleuro-centeses for an additional two months, when the dog was euthanized due to uncontrollable pleural effusion. Despite extensive treatments life span from initial presentation to euthanasia was only 5 months. Necropsy revealed extensive mesothelioma metastases covering the whole pleura, epicardium and remaining pericardium. Diagnostic and therapeutic aspects of (recurrent) pericardial effusion are discussed based on this case.
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PMID:[Cardiac tamponade due to pericardial mesothelioma in an 11-year-old dog: diagnosis, medical and interventional treatments]. 1264 54


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