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 pattern of intracranial neoplasms in Ibadan Southwestern Nigeria appears to have evolved over three decades since the establishment of neurosurgical facility in 1962. Metastatic tumours to the intracranial compartment were the commonest neoplasms (23%); choriocarcinoma and multicentric involvement of the brain in Burkitt s lymphoma accounted for the great majority of the metastases. Well-differentiated glial tumours are now being increasingly recognized in Ibadan, Nigeria. Glial tumours accounted for 20% of neoplasms, second in frequency to metastases. Pituitary adenomas and meningiomas accounted for 17.1% and 11.4% respectively. Germ cell tumours are however uncommon in Ibadan Nigeria having a low frequency (1.4%). A notable difference exists in the tumours found in children and adults. Astrocytomas accounted for the largest single group of neoplasms in children while metastatic tumours are the dominant group in adults. Continued improvement in neurosurgical facilities may improve diagnosis and cause more tumours to be verified histologically. This will contribute to the evolving pattern seen in Ibadan Southwestern Nigeria.
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PMID:A pathological review of intracranial tumours seen at the University College Hospital, Ibadan between 1980 and 1990. 1193 56

Pituitary carcinomas are defined by their metastatic growth. Most of them also invade into surrounding tissues. They should be classified by the site of their metastases (cerebrospinal, systemic, or combined) and by the presumable cell type of origin, respectively with the hormone being demonstrable by immunohistochemistry (adrenocorticotrophic hormone [ACTH], prolactin [PRL], growth hormone [GH], hormone-negative). Pituitary carcinomas develop from invasive adenomas. Nearly all tumors had been treated by surgery or X-ray before they metastasized. Since 1976, 37 cases demonstrated with modern methods were reported: 23 had metastasized into the brain or meninges, 10 showed extracerebral metastases, and 4 showed both types of metastases. In our collection of pituitary tumors, three carcinomas (0.13%) were identified: two with systemic metastases (one ACTH secreting and one PRL secreting) and one with meningeal dissemination and ACTH production. The diagnosis of pituitary carcinomas should be based on four criteria: a demonstrable metastasis, identification of the primary tumor as a pituitary tumor, similarity between the structure and immunohistological marker expression of metastasis and primary tumor, and exclusion of an alternative primary tumor.
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PMID:Pituitary Carcinomas. 1211 77

Pituitary carcinomas are only defined by their metastatic growth, which may be intracranial or systemic. To establish further morphological and immunohistochemical differences between pituitary carcinomas and adenomas, 19 ACTH-secreting adenomas (10 non invasive and 9 invasive) and 2 ACTH-secreting carcinomas with their metastases were studied for expression of the intermediate filaments keratin and vimentin and the tumor-associated antigens Ki67, proliferating cell nuclear antigen (PCNA), epidermal growth factor (EGF), cathepsin D, p53, and carcinoembryonic antigen (CEA). Immunohistochemistry was performed using avidin-biotin techniques on formalin-fixed, paraffin-embedded tissue. With the exception of one noninvasive pituitary adenoma, one carcinoma, and the metastases, all tumors contained keratin; none contained vimentin. All tumors stained negative for CEA and p53. Eleven (58.5%) adenomas and both pituitary carcinomas contained Ki67-positive nuclei; 14 (74%) adenomas and one carcinoma revealed PCNA. No correlation was found between the two markers. Seven (38%) adenomas showed a labeling index <1 % for cathepsin D, whereas none of the carcinomas or metastases did so. EGF was found in 7 (38%) adenomas and in both carcinomas. A tendency to a higher rate of EGF positivity in the invasive adenomas was observed. The metastases showed a higher labeling index, and far more intense staining results for Ki67, PCNA, and EGF than the primary tumor. The metastases also had a higher proliferation rate and growth factor content than the carcinoma itself.
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PMID:Proliferation Markers and EGF in ACTH-Secreting Adenomas and Carcinomas of the Pituitary. 1211 89

Pituitary stalk thickening has a wide differential diagnosis, but almost all infundibular diseases present with diabetes insipidus (DI). We present a child with metastatic involvement of the pituitary stalk from a primary pontine tumour and a child with tuberculous infiltration of the pituitary stalk and associated meningeal inflammation. Neither child presented with DI. Even though both metastatic disease and tuberculous infiltration of the stalk have been reported in adults, these are the first reports with accompanying cross-sectional images of pituitary stalk involvement by these diseases in children.
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PMID:Two unusual causes of pituitary stalk thickening in children without clinical features of diabetes insipidus. 1281 37

Pituitary stalk involvement is seen in a variety of medical conditions such as infectious diseases, infiltrative diseases and tumors (intracranial and metastatic). Metastatic cancer has a greater propensity to involve the infundibulum and neurohypophysis. We report a case of a 68-year-old man who presented with thickening of the stalk, panhypopituitarism, diabetes insipidus and generalized lymphadenopathy. Lymphoma was diagnosed on axillary lymph node biopsy and lymphomatous involvement of the infundibulum was suspected. Although infundibular thickening resolved and diabetes insipidus improved after chemotherapy, panhypopituitarism persisted.
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PMID:A rare cause of pituitary stalk enlargement and panhypopituitarism. 1296 99

We describe a 61-year-old woman with diabetes insipidus caused by a pituitary stalk metastasis from breast cancer. She had a medical history of breast conservation therapy for early breast cancer 5 years previously. Pituitary, lung, liver, bone and neck lymphnode metastases was revealed at the same time. She received systemic chemotherapy consisting of docetaxel and cisplatin. After chemotherapy MRI finding in pituitary gland was improved, lung and liver metastases also improved, however, symptoms of diabetes insipidus did not improve. She is alive, receiving endocrine treatment for 2 years, since onset of diabetes insipidus.
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PMID:Pituitary stalk metastasis from breast cancer treated with systemic chemotherapy. 1453 28

Pituitary carcinomas, defined as distant metastases of a pituitary neoplasm, are rare; fewer than 140 reports exist in the English literature. The initial presenting pituitary tumor is usually a secreting, invasive macroadenoma, with adrenocorticotropic hormone (ACTH)--and prolactin (PRL)--secreting tumors being the most common. The latency period between the diagnosis of a pituitary tumor and the diagnosis of a pituitary carcinoma is 9.5 years for ACTH-producing lesions and 4.7 years for PRL-secreting tumors. Survival after documentation of metastatic disease is poor; 66% of patients die within 1 year. Treatment options include additional surgery, radiotherapy, and chemotherapy, all of which are associated with poor results. Future studies will focus on identifying those invasive pituitary tumors most likely to metastasize and treating them aggressively before they progress to pituitary carcinomas.
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PMID:Pituitary carcinoma: a review of the literature. 1619 64

Pituitary carcinomas are rare tumors which have been conventionally defined as primary adenohypophyseal tumors with cerebrospinal or extracranial metastases. According to the current criteria even a highly invasive tumor without metastases is not considered as malignant. A case of pituitary adenoma is reported with an unproven site of metastasis but with rapid increase in prolactin levels (35,000 ng/ml), showing extensive invasion on radiology, and pathological and immunohistochemical studies indicating a highly mitotic variety of tumor. On the basis of this case we want to emphasize that extracranial metastasis is not a must to label a pituitary adenoma as a malignant tumor. Such aggressive behavior of the tumor and clinico-pathological course in itself should be sufficient for the tumor to be labeled as malignant.
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PMID:Malignant prolactinoma: is metastasis a must? Clinico-pathologic and immunohistochemical study of a case. 1525 64

Pituitary carcinomas are uncommon and intradural metastatic spread to the spine is rarer still. We describe a 27-year old man with metastatic spinal cord compression from an adrenocorticotrophic hormone (ACTH) cell pituitary carcinoma, 16 years following the initial presentation. He had three previous resections of the pituitary tumour and post-operative radiotherapy. The intradural, extramedullary spinal metastases causing thoracic and lumbar cord compression were excised, with neurological improvement. Spinal metastases in pituitary carcinoma are uncommon, but aggressive surgical resection of the spinal metastases produces good symptomatic relief.
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PMID:Intradural metastatic spinal cord compression from ACTH-secreting pituitary carcinoma. 1534 56

The incidence of brain tumors in the elderly has been questioned, but recently several studies have tended to confirm its increase. This may be partially due to the improvement of diagnostic methods and progress in the collection of epidemiological data. However, should this increase be confirmed by further studies, the possible role of specific risk factors in the elderly should not be neglected. Metastases are three times more frequent than primary brain tumors. Depending on the state of the primitive cancer, local control of brain localization may be achieved by surgery or, more recently, by radio surgery. Among primary brain tumors, gliomas have the worst prognosis with a survival not exceeding 6-8 months, regardless of the type of treatment used. However, half of the primary tumors are benign, meningioma representing the most frequent variety. In function of their clinical impact and their localization, surgery may be proposed, if the physical condition of the patient so allows. Conformational radiotherapy is indicated if a remnant of the tumor is detected as growing post-operatively. Pituitary adenomas should be treated surgically if they are responsible for compression of the visual pathways; in case of a secreting tumor (mainly prolactinomas) a medical treatment can be proposed.
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PMID:[Brain tumors in the elderly]. 1568 66


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