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 16-year-old student presented with a 4-week history of progressive shortness of breath, loss of appetite, and occasional blood-tinged sputum. The chest X-ray revealed massive right-sided pleural effusion with cardiomegaly. An echocardiogram revealed a large pericardial mass with massive pericardial effusion. Subsequent computed tomography of the thorax revealed a large heterogeneous mass in the right lung with extension into the pericardium. Lung biopsy revealed primitive neuroectodermal tumor (PNET) with small round blue cells, Homer-Wright rosettes, and CD99 positivity. We discuss pericardial metastases of PNET and its implication in this patient.
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PMID:Primitive neuroectodermal tumor of the lung with pericardial extension: a case report. 1800 74

Primary pericardial sarcomas are very rare. A 62-year-old Japanese man presented with cardiac tamponade. Echocardiography, computed tomography and magnetic resonance imaging revealed massive pericardial effusion and a large tumor in the pericardial cavity, attached to the pericardium of the left ventricular posterolateral free wall. Surgical excision of the tumor was performed and histopathological and immunohistochemical examinations identified high-grade myofibroblastic sarcoma. Because of local recurrence soon after surgery, the patient received adjuvant chemotherapy, including doxorubicin and ifosfamide, and subsequent radiotherapy. As of 6 months after completing radiotherapy, the patient was alive and no disease progression or distant metastases were evident. This may be the first report of primary high-grade myofibroblastic sarcoma arising from the pericardium.
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PMID:Primary high-grade myofibroblastic sarcoma arising from the pericardium. 1821 77

We report the case of a 51-year-old patient who presented with tiredness and leg swelling, with recurrent pericardial effusion; a right atrial tumor, suggestive of sarcoma, was diagnosed, which responded poorly to chemotherapy. In the absence of metastases, surgery for excision of the tumor was undertaken. Two months after surgery she had a new recurrence of pericardial effusion and chemotherapy was reinitiated. She is currently well and asymptomatic, with no signs of recurrence ten months after surgery and nearly 24 months after the initial diagnosis.
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PMID:Primary cardiac angiosarcoma. Extended resection of the right atrial wall. Case report. 1829 40

Imaging of the pericardium requires understanding of anatomy and the normal and abnormal physiology of the pericardium. MR imaging is well-suited for answering clinical questions regarding suspected pericardial disease. Pericardial diseases that may be effectively imaged with MR imaging include pericarditis, pericardial effusion, cardiac-pericardial tamponade, constrictive pericarditis, pericardial cysts, absence of the pericardium, and pericardial masses. Although benign and malignant primary tumors of the pericardium may be occasionally encountered, the most common etiology of a pericardial mass is metastatic disease.
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PMID:MR imaging of the pericardium. 1847 26

We describe a patient whose complaints were related to pericardial effusion due to prostatic carcinoma. An 80-year-old man was admitted to our hospital because of chest discomfort and dyspnea. The chest radiograph revealed cardiomegaly and computed tomographic scan showed a large pericardial effusion. Pericardiocentesis revealed sanguinous exudates. Cytologic study suggested metastatic adenocarcinoma or malignant mesothelioma. He died suddenly because of ventricular tachycardia. At autopsy, the major finding was poorly differentiated adenocarcinoma of the prostate with metastases to the mediastinum.
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PMID:[Pericardial effusion due to metastatic prostate cancer: a case report]. 1854 64

Women presenting with metastases from an unknown primary site represent a growing diagnostic challenge. Treatment is based upon the results of several diagnostic radiographic modalities that may locate the occult primary and determine the extent of metastatic tumor burden. Immunostaining represents another modality that can be used to facilitate identification and management of occult primary carcinoma. In patients who present with advanced disease, combining standard techniques with immunostaining can usually aid in determining the most effective regimen for optimal palliation and, in some cases, prolonged survival. We describe metastatic adenocarcinoma of unknown primary presenting as a pericardial effusion and coincident supraclavicular adenopathy. The patient completed the chemotherapy and had stable metastatic tumor burden with an acceptable quality of life. Two years after initial diagnosis, the patient expired because of disease progression. Although immunohistochemical staining initially suggested metastatic breast carcinoma, her clinical course confirmed a lung primary.
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PMID:Challenges of utilizing immunostains to facilitate the diagnosis and management of metastatic adenocarcinoma. 1947 2

We studied 19 patients with pericardial disease using two-dimensional and three-dimensional transthorathic echocardiography (2DTTE and 3DTTE, respectively) in order to determine whether 3DTTE provides incremental value on top of 2DTTE in the evaluation of these patients. With 3DTTE a more comprehensive assessment of pericardial effusion can be made and both the parietal and visceral layers of the pericardium can be visualized en face and examined for pathologies and fibrin deposits. In our series of patients, 3DTTE was superior to 2DTTE in uncovering mass lesions involving the pericardium such as tuberculous granulomas and metastatic disease. Furthermore, it provided a better assessment of the nature of pericardial lesions, such as pericardial and mediastinal hematomas, pericardial cysts, and metastatic disease to the pericardium by sequential cropping of the 3D data sets and visualizing the interior of the lesions in a manner not possible with 2DTTE. It was also valuable in determining the extent of pericardial calcification in pericardial constriction and in measuring the size of pericardial masses. These preliminary results suggest the superiority of 3DTTE over 2DTTE in the evaluation of pericardial diseases and that it provides incremental knowledge to the echocardiographer.
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PMID:Live/Real time three-dimensional transthoracic echocardiographic assessment of pericardial disease. 1992 71

Hyaluronan is an extracellular matrix component implicated in expansion of the extracellular space, organization of supramolecular architecture, cell motility, proliferation, tumour metastases and wound healing. Hyaluronan is highly expressed in the developing heart but it is only a minor component of the mature heart. The loss of hyaluronan synthase-2 (Has2) results in embryonic lethality with a phenotype remarkably similar to that of the versican-deficient heart defect mouse. Has2-deficient embryos lack hyaluronan-containing cardiac jelly, and at embryonic day 9.5 show arrested development, with an apparent absence of the right ventricle and underdevelopment of the conustruncus segment, and pericardial effusion consistent with heart failure. Cardiac cushions are totally absent, and endocardial cell migration over collagen gels is not detectable in Has2-deficient atrioventricular (AV) canal explants. Endothelial to mesenchymal transformation is also defective in AV explants from Has2-null embryos. The normal phenotype is restored in AV canal explants from Has2-deficient embryos by co-culture with wild type AV canal explants, with conditioned media from wild type AV explants or with exogenous hyaluronan. These results provide evidence for a direct role for hyaluronan during endocardial cushion and AV canal morphogenesis.
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PMID:Regulation of cardiac cushion development by hyaluronan. 2042 37

Malignant melanoma has a very high tendency to metastasize to the heart. Although most cardiac metastases of melanomas are clinically silent, the lesions may present with life-threatening cardiac morbidities, including dysrhythmia, right ventricular outflow tract obstruction, myocardial dysfunction, pericardial effusion, or heart failure. In selected patients who have a solitary intracardiac melanoma, surgical resection can provide relief from clinical symptoms and minimize potential cardiac sequelae of the tumor. Because tumor embolization of cardiac melanoma has been reported, the presence of atrial metastatic melanoma can be another indication for surgery.Herein, we present the case of a 31-year-old man who had a right atrial metastatic melanoma of unknown primary origin. He underwent surgical resection of the tumor before beginning a course of chemotherapy. After 1 year, he was well and had no symptoms. We describe the clinical features of this rare presentation of melanoma.
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PMID:Surgical resection of solitary metastasis of malignant melanoma to the right atrium. 2097 80

A 7 yr old, neutered female vizsla underwent an exploratory thoracotomy after diagnosis of recurrent hemorrhagic pericardial effusion and a right auricular mass. Staging tests were negative for metastasis. The patient underwent a right, fourth intercostal thoracotomy, subtotal pericardectomy, right auricular mass excision, and pericardial free patch graft. The patient experienced blood loss during surgery, which required a packed red blood cell transfusion. The patient experienced transient arrhythmias postoperatively, but was discharged from the hospital 48 hr later. Histopathologic diagnosis of the mass was hemangiosarcoma. The patient was treated with carboplatin single-agent chemotherapy and palliative radiation therapy. The patient died at home, presumably from metastatic disease 260 days postoperatively. Surgical mass removal or debulking along with pericardial free patch grafting may be considered as palliative treatment options for dogs diagnosed with right auricular masses. In this case report, other techniques failed to repair the defect in the heart and a free patch graft offered a good rescue procedure with a favorable outcome without the need for inflow and outflow occlusion when used in conjunction with adjunctive therapies.
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PMID:Pericardial free patch grafting as a rescue technique in surgical management of right atrial HSA. 2149 92


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