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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinical beginning of diffuse pleural mesothelioma is a pleurisy. Initially pleura may be normal at X-ray examination, then either a pachypleuritis or a tumorous pleura appears. Thery serious since there is in the literature no cured case. The average survival time from diagnosis to death is 15 months. At terminal stage mesothelioma does not invade the other coelomic cavities. It may remain limited to the hemithorax where it has started, invading then the organs by contiguity. Metastasis may occur but their frequency is very variable, from 30 to 70% according the literature. On a therapeutic point of view all was tried: Surgery is rarely curative but may reduce temporarily effusion pain and dyspnea. Radiotherapy at high doses produces a partial effect in some series, but results are variable. Chemotherapy: adriamycin could be the most promising agent. At present time according to many authors no treatment seems to change the course of the disease.
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PMID:[Evolutive patterns of diffuse pleural mesothelioma (author's transl)]. 11 73

The authors present a preliminary work on 37 pulmonary tomodensitometry performed on 18 bronchial cancers, 7 pleuro-pulmonary metastases, 4 normal lungs and 8 various respiratory diseases. This method presents a double advantage:--first it localizes the affection in relation to pleura, mediastinum or heart; specially interesting in case of a transparietal puncture in carcinology;--secondly, densitometry enables a differentiation between dense tumoral tissue and ventilatory disorders or pleurisy; it is also useful in determining the tumoral target volume. Finally this new technique can show air cavities (emphysema, tuberculous or cancerous caverns) as well as pleurisies of small volume.
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PMID:[The value of body tomodensitometry for diagnosis in pneumology]. 91 68

This paper describes a case of malignant pleurisy which showed evidence of the effectiveness of a new mode of cancer treatment, intrathoracic chemothermotherapy (ICT). ICT consisted of a bolus intrathoracic injection of 50 mg cis-diamminedichloroplatinum (CDDP) and local heating using 8 MHz radiofrequency waves for 60 min. A patient with multiple lung metastases and malignant pleurisy on both sides due to Ewing's sarcoma was treated on the right side with ICT, along with concomitant systemic administration of 50 mg CDDP. Intrathoracic temperatures were monitored by insertion of thermocouple temperature sensors, and temperatures of 43 degrees C or over were successfully maintained for about 40 min during each of three treatments. Although the patient died 3 months later of advanced metastases in the left lung and malignant pleurisy on the left side, lung metastases in the right lung were stable on radiographs, and autopsy results showed no cancerous lesions in the right thoracic cavity, which had been treated with ICT. Since no effective response had been obtained clinically or histologically before starting ICT, despite frequent administration of anti-cancer drugs, we conclude that heat acted synergistically with CDDP on drug-resistant cells in this case.
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PMID:Effectiveness of intrathoracic chemothermotherapy for malignant pleurisy due to Ewing's sarcoma: a case report. 228 94

A study was carried out on 85 patients suffering from breast cancer with pleural effusion. A thoracoscopy was done on each patient, both to establish the etiology of pleurisy and to perform pleurodesis in those patients whose diagnosis was established by other means. In addition to the gathering of general data on each patient, a description is given of the macroscopic characteristics of the effusions, their cytology, and the forms and locations of the pleural metastases. Differences were encountered in the tendency toward pleural metastases according to the different levels involved and to whether the tumor was homolateral or contralateral. Generally, the former exhibited a preference for the costal pleura, whereas contralateral cancers tend to affect the mediastinal pleura. Other data of interest are likewise briefly described.
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PMID:Macroscopic characteristics of pleural metastases arising from the breast and observed by diagnostic thoracoscopy. 238 13

Two hundred consecutive patients with malignant pleural effusion were reviewed. The pathologic etiology of malignant pleurisy was: primary lung cancer in 123 cases; five, mesothelioma; and 72 cases secondary to metastatic tumors. Adenocarcinoma of the lung and mammary cancer were the most frequent tumors causing malignant pleural effusion. The modalities employed in local treatment consisted of thoracocentesis in 62 patients, tube thoracotomy in 111 cases with local instillation of adriamycin, MMC, CQ, 5FU, OK432 or talc. Surgical procedures including pleuropneumonectomy or reduction surgery of the tumor with decortication were performed in ten patients. Tube drainage with local instillation of drugs was more effective than thoracocentesis with or without local therapy. Excellent initial results were obtained in patients who received reduction surgery with decortication and pleurodesis. Results of cytologic investigation were positive in 157 cases (78.5 percent). The tumor cells disappeared in 79.4 percent of primary cancer pleurisy cases and 81.1 percent of patients with metastases while disappearance or significant decrease in pleural effusion following treatment was obtained in 75.2 and 77.8 percent respectively. The median survival was 11.3 months in primary cases, and 11.7 months in patients with metastases.
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PMID:Treatment of malignant pleural effusion. 241 78

Sixty-one patients with T3 non-small cell lung cancer were surgically treated in our department from February, 1974, through April, 1986. The overall 5-year survival, excluding patients with pleurisy, was 23%, and the 5-year survival for patients undergoing complete resection and incomplete resection was 42% and 10%, respectively (p less than 0.01). Survival in patients with T3 N0 and T3 N1 or N2 disease was 33% and 0 at 5 years, respectively. The prognosis for patients with pleurisy was poor, and all died within 3 years. Therefore, complete lung resection should be done in patients with T3 N0 non-small cell lung cancer if complete resection is expected. Long-term survival is less likely for patients with lymph node metastases if complete resection cannot be performed.
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PMID:Results of surgical treatment of patients with T3 non-small cell lung cancer. 284 Aug 68

Placental protein 10 (PP10) was measured in benign (n = 47) and malignant (n = 10) ovarian cyst fluids and in pleural fluid specimens from 19 patients with pleural metastases of various carcinomas (n = 15) or infectious pleurisy (n = 4). PP10 was found in 9 out of 18 follicular or luteal cyst fluids (range 2.0-42.0 micrograms/l) and in 24 out of 29 benign ovarian tumours (range 2.6-38.0 micrograms/l). Nine out of ten malignant ovarian cyst fluids contained detectable PP10 (range 4.0-55.2 micrograms/l). PP10 was found in all the pleural fluids from 15 patients with metastatic bronchial, pulmonary, breast or pancreatic carcinomas (range 5.1-100.2 micrograms/l), as well as from four patients with pleurisy (range 5.0-28.6 micrograms/l). Our results indicate that PP10 is tumour-associated, but not tumour-specific.
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PMID:Placental protein 10: levels in benign and malignant ovarian cyst fluids and pleural exudates. 356 56

Sixty two patients with gestational trophoblastic disease were investigated and treated between January 1977-December 1983. The value of pelvic arteriography was examined. The cases included: 45 moles with a simple outcome. 14 cases of invasive trophoblastic neoplasia after evacuation of the mole. 3 choriocarcinomas after full term pregnancy. Pelvic arteriography was performed in 14 patients. 9 of the 14 patients presented with persistent HCG secretion 6 to 8 weeks after evacuation of the mole. Before chemotherapy was begun, we looked for unfavourable prognostic features such as extra-pelvic metastases, multiple pulmonary metastases, high HCG secretion, delay between the initial event and starting chemotherapy of more than six months. The Ishizuka score was calculated. Six arteriography type I readings suggested choriocarcinoma with an Ishizuka score above five. Double chemotherapy (oncovin-methotrexate) was started successfully (with a one year follow up). Only two patients had unfavourable factors. Two arteriography type III suggested persistent moles, with an Ishizuka score below five. Chemotherapy (only methotrexate) was successful). It was not possible to classify the last arteriography, so the patient was treated successfully with double chemotherapy. Three patients failed to recover with chemotherapy. Arteriography was indicated to determine the site of HCG secretion. Three hysterectomies were performed. Tissue choriocarcinoma was found. Two diagnoses of choriocarcinoma were confirmed by arteriography: In one case an unexplained pleurisy appeared six months after full term. HCG was then positive. In the other case, extrauterine pregnancy was first suspected, but the woman had not had intercourse for six months. Arteriography demonstrated tubal choriocarcinoma. So pelvic arteriography is useful for managing complicated gestational trophoblastic disease.
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PMID:[Importance of arteriography in complicated trophoblastic disease]. 609 10

We are reporting about an inoperable cell carcinoma of the stomach, which exclusively caused thoracal pains due to metastases into a pleural thickening. First this symptomatology with thoracal pains and recurring pleural effusions was thought to be a pleural mesothelioma. Only the immediate histological examination of the tissue showed the origin of the tumor. Although cancer of stomach appears very commonly, this tumor is often diagnosed too late and in most cases it is already inoperable. Even nowadays more than 75% of the patients with a cancer of the stomach die of their metastases, although diagnosis and therapy have been developed. - Pleural mesotheliomas are rare; nevertheless the possibility of a mesothelioma in connection with all pleural effusions of a vague genesis should be considered. The exposure to asbestos strengthens the suspicion that this tumor is existing. In connection with a pleural mesothelioma an indurative pleurisy, a primary cancer of the lung and - like in our case - pleural metastases of a primary cancer of another site have to be differentiated.
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PMID:[Pleural metastases can simulate a mesothelioma]. 627 5

In an attempt to distinguish reactive from neoplastic mesothelial proliferation, the histological material and clinical records of 153 patients on whom open or closed pleural biopsies were performed during 1976 were reviewed. In six of the 10 patients subsequently shown to have malignant mesothelioma the specimens from closed pleural biopsy had been reported as negative or equivocal but in retrospect showed changes not observed in reactive pleurisy. These included papillary mesothelial proliferation, exfoliated papillae, sheets of atypical mesothelial cells, and abnormal fibroblastic proliferation. In contrast, in inflammatory conditions the mesothelial lining was usually replaced by granulation tissue, although sheets or clumps of exfoliated mesothelial cells were often present in the corresponding pleural fluid clot. Some multilayering of parietal mesothelium was occasionally seen in chronic pleurisy and around metastases.
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PMID:Pleural biopsy in the diagnosis of malignant mesothelioma. 716 99


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