Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Currently, the morphology of the adrenal glands can be demonstrated by different tomographic techniques: CT, MRI and ultrasound (US). The choice of the imaging modality and the examination procedure mainly depend on the suspected disease. In general, CT and MRI are superior to US due to the excellent visualization of the adrenals in nearly all circumstances, whereas sonography is strongly dependent upon the experience of the radiologist. Up to now CT is the procedure of choice in the evaluation of adrenal diseases with only minimal morphological disturbance, for example Conn's syndrome and hyperplasia. MRI and CT are nearly equivalent in the detection of adrenal masses larger than 2 cm in diameter, such as in Cushing's adenoma or pheochromocytoma. MRI has advantages compared with CT in the capability of tissue characterization, multiplanar imaging and in the visualization of blood vessels. For this reason MRI seems to be suitable for the distinction between adenomas and adrenal metastases.
 ...
PMID:[Computerized tomography and nuclear magnetic resonance tomography in adrenal gland diseases]. 307 52

Ninety-nine patients suspected of having pheochromocytoma were studied with MIBG scintigraphy and in 92 of them were studied with computed tomography. In 49 patients, the diagnosis was ruled out, in 3 patients it remained doubtful, and in 47 patients it was confirmed. Two patients had epinephrine--and/or norepinephrine--non-secreting tumors and 45 had secreting pheochromocytomas. In these latter patients, there were 4 scintigraphic false-negatives, all intra-adrenal, and 4 computed tomography false-negatives, 3 extra-adrenal and 1 intra-adrenal. For about 80% of the patients and/or the tumor sites, both methods were thus in agreement. They were complementary in the remaining 20%. The advantage of scintigraphy is to screen the whole body with high specificity and to locate extra-adrenal sites or metastases of pheochromocytoma with better accuracy than computed tomography. The limits of scintigraphy are the possibility of false-negatives in around 10% of patients whereas computed tomography visualizes more than 95% of intra-adrenal tumors.
 ...
PMID:[Comparison of MIBG scintigraphy and computerized tomography in the localization of pheochromocytomas]. 309 19

Iodine-131 MIBG scintigraphy may be used to determine the presence or absence of metastases to the appendicular skeleton in malignant pheochromocytoma and neuroblastoma. Normal bones show no uptake of [131I]MIBG and the joints are seen as photon-deficient areas surrounded by background muscle activity. Discrete concentrations of radioactivity in bone are often seen in patients with malignant pheochromocytoma and neuroblastoma. Bone marrow involvement in neuroblastoma may be indicated by diffuse uptake of [131I]MIBG or focal accumulation at the metaphyses. Uncommonly, bone involvement may not be displayed by the [131I]MIBG images. Since conventional bone scanning agents may also fail to detect these tumors, skeletal scintigraphy with both [131I]MIBG and [99mTc]MDP is necessary to reliably stage malignant pheochromocytoma and neuroblastoma.
 ...
PMID:Iodine-131 MIBG scintigraphy of the extremities in metastatic pheochromocytoma and neuroblastoma. 310 2

Twenty-four hepatic cavernous hemangiomas and 91 metastases from a variety of hypovascular and hypervascular primary neoplasms were prospectively studied with magnetic resonance (MR) imaging. In addition to qualitative analysis, quantitative analysis of signal intensity ratios of lesion to normal liver was performed with images obtained with 500/28-30 (repetition time msec/echo time msec) and 2,000/28-150 sequences. Quantitative data did not improve the ability to distinguish hemangiomas from metastases in our series compared with qualitative analysis. Hypovascular metastases, such as colon carcinoma, could be differentiated from hemangioma more frequently (97.5%) than hypervascular endocrine metastases, such as islet cell tumor, carcinoid, and pheochromocytoma (61%). These findings indicate that the utility of MR imaging in differentiating hemangiomas from metastases is dependent on the histologic type of the primary neoplasm.
 ...
PMID:Distinction of hepatic cavernous hemangioma from hepatic metastases with MR imaging. 317 88

A 38-year-old woman was operated on to remove a large tumor that replaced the left adrenal gland. The tumor was encapsulated and showed small areas typical of pheochromocytoma, and spindle cell or undifferentiated round cell sarcoma in most areas. Metastases of primitive round cell appearance were operated from the abdominal cavity and abdominal wall shortly after the initial surgery. Eighteen months after the first operation, the patient was alive with metastases in liver and retroperitoneal space. The pheochromocytomalike component showed a typical ultrastructural and immunohistochemical profile of pheochromocytoma and was positive for neurofilaments, synaptophysin, neuron-specific enolase, and S-100 protein in the sustentacular cells. The sarcomatous areas showed fibroblastoid spindle cells that were often surrounded by a basal lamina. Immunohistochemistry revealed S-100 protein positivity in many spindle cells, but markers of pheochromocytoma or epithelial differentiation were absent. The metastases lacked all markers except for vimentin, and the cells were undifferentiated by electron microscopy. These findings suggest that the neoplasm was a compound tumor with a typical pheochromocytoma component and a sarcoma resembling a malignant schwannoma. Neoplastic proliferation of the S-100 protein-positive Schwann-cell-like sustentacular cells of the pheochromocytoma would be an explanation for the genesis of this sarcoma associated with pheochromocytoma.
 ...
PMID:Pheochromocytoma combined with malignant schwannoma: unusual neoplasm of the adrenal medulla. 319 94

109 cases of surgery on the adrenal glands are reported. 8 cases (7.3%) were reoperated because of relapse. This was Cushing's disease in 5 cases, malignant neuroblastoma in 2 cases and benign pheochromocytoma in 1 case. Only the latter and 1 with Cushing's disease were cured. Reoperation revealed carcinoma in 3 cases of Cushing's disease, though microscopic examination did not show malignancy in the specimen taken at the first operation. In another case microscopic examination again failed to show malignancy, but the patient died from her metastases. 2 cases of malignant neuroblastoma were reoperated for palliation.
 ...
PMID:[Problems and results of reinterventions on the adrenal gland]. 321 78

The ability of a T1-weighted spin-echo magnetic resonance (MR) sequence to allow differentiation of benign from malignant adrenal masses at 0.5 T was investigated in 28 patients with 35 adrenal masses. All nine lesions with an adrenal mass-liver signal intensity ratio of 0.71 or less were metastases, and all 15 with a ratio of 0.78 or more were adenomas. Eleven masses (31%)--including six adenomas, three metastases, a pheochromocytoma, and a neuroblastoma--had ratios between these values. Nine of ten masses with adrenal mass-fat intensity ratios of 0.35 or less were metastases, and all 12 with ratios of 0.42 or more were benign. Eleven masses (31%), four malignant and one benign, had ratios between these values. The ratios for two masses could not be calculated due to lack of fat. The specificity of T1-weighted MR imaging in differentiating benign from malignant adrenal masses appears similar to that reported for T2-weighted imaging. However, significant overlap occurred, as has also been reported for T2-weighted imaging. While both imaging sequences may help distinguish benign from malignant adrenal masses in some cases, biopsy is still necessary when an accurate histologic diagnosis is essential.
 ...
PMID:Adrenal masses: characterization with T1-weighted MR imaging. 333 11

Since the adrenal or parathyroid cancer is a clinically rare entity. We often have difficulty in its diagnosis and treatment. The adrenocortical cancer is usually classified into two categories--endocrinologically functioning or non-functioning. The incidence is not different between them. It is often found in an advanced stage as it does not show clinical manifestation before it has grown up to a large tumor. Only an effective agent for the adrenal cancer is op'-DDD so far. Recently, cisplatin, VP-16 (etoposide) and others are administered as trial use. Most of malignant pheochromocytomas are endocrinologically active and they often cause hypertension leading to death. Therefore it is important to control hypertension in malignant pheochromocytoma. Chemotherapy and irradiation are not effective for it. Recently, 131I-MIBG (metaiodobenzylguanidine) is found to be useful not only for diagnosis but also treatment of malignant pheochromocytoma. 131I-MIBG is accumulated specifically in the chromaffin cells and with helpful to find out metastatic foci. It is also used in a large amount as a specific irradiation therapy for this malignancy. Parathyroid cancer is found in approximately 3 percent of primary hyperparathyroidism. Clinically it usually reveal serum calcium level higher than 14 mg/dl, bone lesions and renal dysfunction in addition to palpable cervical tumors adhering with skin. Sometimes it is difficult to differentiate malignancy from adenoma in histology. Most cases develop local recurrences and distant metastases in due course and dies of hypercalcemia. It is very important to control hypercalcemia in inoperable cases. As both chemotherapy and radiation therapy render no effect on this malignancy. Surgery is a sole strategy for it.
 ...
PMID:[Current therapy of endocrine organ tumors (adrenal and parathyroid glands)]. 334 84

During the years 1956-1982, 64 pheochromocytoma patients were operated upon without mortality. Twenty-eight patients had sustained hypertension and 29 paroxysmal hypertension only. In two patients high blood pressure was not related to pheochromocytoma and five subjects were normotensive. In two women the pheochromocytoma demonstrated malignancy by widespread metastases. Sixteen patients also had neuroectodermal manifestations other than pheochromocytoma. Preoperatively, heart disease was found in most of the hypertensive patients aged 50 years or more at operation, but was uncommon in the others. In these subjects, heart disease persisted after surgery. Young subjects with sustained hypertension were not less affected by preoperative cerebrovascular accidents than older subjects. After surgery, hypertension persisted in 12 patients, and was easily controlled by drug therapy in eight. Nine patients died 7 months-18 years after surgery. In no case was the death directly associated with the pheochromocytoma disease. Three died from other neuroectodermal abnormalities. The 55 surviving patients have been followed up for a mean of 12 years after surgery. During the observation time the survival of the pheochromocytoma patients was similar to that of the normal population. At the end of the study, 44 out of the 55 surviving patients were free from symptoms.
 ...
PMID:Long-term results in 64 patients operated upon for pheochromocytoma. 336 15

A study of 30 cases of pheochromocytoma encountered at our department between 1959 and 1986 is presented. Fourteen patients were males and 16 were females. Their ages ranged from 18 to 72 years with a peak incidence in the fifties. Hypertension was present in 87% of the patients. The incidence of extra-adrenal tumors was 30% and that of malignancy 7%. The 24-hr urinary level of catecholamine was to a certain degree in accord with the location of the tumor and type of hypertension. Computed tomography and venous sampling were very useful for the diagnosis which had an accuracy rate of 100% in this series. Preoperative management using an alpha-blocker was effective in controlling blood pressure and circulating blood volume in most cases. Postoperative blood pressure was normalized within a week after operation in 85% of the patients who had been suffering from hypertension, although elevated levels of norepinephrine in urine were still noted in 56% of the patients one week after operation. Of the 27 follow-up cases, 21 cases (78%) were in good health and 2 cases were alive with hypertension with a mean follow-up period of 8.1 years. Four patients died, one during angiography, one of pulmonary edema one day after operation and the other 2 of metastases of malignant pheochromocytoma.
 ...
PMID:[A clinical review of 30 pheochromocytoma patients]. 340 May 41


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>