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 73-year-old man was admitted to our hospital with chief complaint of macrohematuria. Computerized tomography revealed enlargement of right kidney, tumor thrombi and lymph nodal involvement. Distant metastases were found in liver, lung and pelvis. We performed conservative therapy including right renal embolization. However, serum calcium levels continued to increase. Patient died from renal failure and pneumonia after 2 months, and autopsy was performed. Histological examination revealed infiltrative transitional cell carcinoma of the right kidney. PTH like peptide was measured 1 ng/gram wet tissue from the primary tumor and 16.6 ng/gram wet tissue from the metastatic liver tumor.
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PMID:[A case of infiltrative transitional cell carcinoma of the kidney with hypercalcemia]. 192 77

We describe a 67-year-old man with severe rheumatoid arthritis of long duration. He developed a peculiar extraarticular rheumatoid complication consisting of localized lung consolidation with a pathological costal fracture, together with an abrupt systemic reaction that occurred in the course of immunosuppressive treatment. The diagnosis first proposed was lung cancer with costal metastases. However exhaustive studies performed in the search of malignancy were systematically negative and pathologic studies finally demonstrated bronchiolitis obliterans with organizing pneumonia (BOOP) as responsible for parenchymal lung consolidation with a rheumatoid nodule eroding bone at the level of the rib fracture. These findings, after long followup of the patient, attest to the rheumatoid origin of his bizarre manifestations and definitely rule out a neoplastic etiology.
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PMID:Rheumatoid disease resembling lung neoplasia. 208 46

Two Pediatric Intergroup Ewing's Sarcoma studies of patients with metastatic disease (IESS-MD) have used multimodal therapy consisting of intensive combination chemotherapy and radiation therapy (XRT) to areas of gross disease detected at the time of diagnosis. In IESS-MD-I, conducted from 1975 to 1977, 53 eligible patients were entered and received the chemotherapeutic agents vincristine, Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH), cyclophosphamide, and dactinomycin with concomitant XRT (VACA + XRT). In IESS-MD-II, conducted from 1980 to 1983, 69 eligible patients were entered and received 5-fluorouracil (5FU) in addition to the chemotherapeutic agents of IESS-MD-I; initial intensive chemotherapy was given and XRT was delayed until week 10 (VACA + 5FU, delayed XRT). The best response rate (complete and partial remissions combined) was 73% in IESS-MD-I and 70% in IESS-MD-II, so there was no statistical evidence of a difference in response rates (P = 0.62). The length of best response also was similar between studies (P = 0.79), with approximately 30% of the patients on both studies remaining in remission at 3 years. The percentage of patients surviving 5 years or more was 30 on the first study and 28 on the second study (P = 0.49). The major sites of relapse after a response were lung and bone, each occurring with nearly equal frequency. The age of the patient was related to both best response rate and survival: patients 10 years of age or younger had substantially higher response and survival rates than patients 11 years of age or older. The favorable prognosis for younger patients might be explained by a more favorable distribution of primary sites at diagnosis; 39% of patients 10 years of age or younger had rib primary sites, compared with only 16% for patients older than 10 years of age (P = 0.05). The frequency of life-threatening toxicity was substantially higher in IESS-MD-I (30%) than in IESS-MD-II (9%), but the frequency of fatal toxicity was similar (6% to 7%). Fatal complications included Adriamycin-induced cardiomyopathy, Pneumocystis carinii pneumonia, unspecified pneumonitis, and sepsis. The most common toxicity and complications were leukopenia and infections.
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PMID:Ewing's sarcoma metastatic at diagnosis. Results and comparisons of two intergroup Ewing's sarcoma studies. 220 33

Altogether 345 patients with pleural effusion were investigated; 22 nosological entities were diagnosed. Of them four diseases (tuberculosis, metastatic cancer, pneumonia, and pleural mesothelioma) accounted for 79.7%. Failures of outpatient clinical investigation and late referral of patients to special diagnostic departments were noted. Possibilities to diagnose the type of disease on the basis of x-ray symptoms, clinical and laboratory tests and their combinations were analyzed. A necessity of the use of various types of biopsy with respect to an x-ray picture was recommended. Early thoracoscopic biopsy was indicated for progressive or stable pleural effusion of obscure etiology.
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PMID:[Differential diagnosis of an accumulation of fluid in the pleural spaces]. 227 Jun 54

One day before his death, a 66-year-old man who had been suffering since childhood from a severely itching and repeatedly bleeding skin lesion was examined for the first time by a general practitioner who immediately advised hospitalization. On admission, an extensive rodent ulcer on his back was noted and septic shock diagnosed. Because of the hopeless diagnosis no life-supporting measures were undertaken. Postmortem examination revealed an 18 x 26 cm sized ulcerating basal cell carcinoma on the back with infiltration of the thoracic vertebrae and a fist-sized paravertebral abscess between the left upper and lower lobe of the lung and abscessing pneumonia. Two metastases each were found in the right lung and in both kidneys with the histologically characteristic picture of basal cell carcinoma. This case confirms the observation that this type of carcinoma has the potential for metastasizing, but it usually does not do so because of its biological characteristics and early curative excision.
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PMID:[Metastatic basal cell carcinoma]. 231 19

The treatment of carcinoma of the cervical esophagus remains controversial. Eleven patients with carcinoma of the high cervical esophagus were encountered over the past 7 years at our institution. There were 6 men and 5 women whose ages ranged from 51 to 72 years. Six patients had tracheal or laryngeal invasion. In all instances one-stage pharyngolaryngoesophagectomy with pharyngogastric (6 patients) or pharyngocolic (5 patients) reconstruction was performed. There was one hospital death. Six patients died 6 to 35 months postoperatively: 1 from recurrence, 2 from generalized metastases, and 3 with both local recurrent and metastatic disease. One other patient died free of disease 6 weeks postoperatively of pneumonia. The remaining 3 patients are alive 12 to 84 months after operation with excellent rehabilitation and good quality of life. We conclude that one-stage surgical resection and reconstruction for high cervical carcinoma of the esophagus offers good palliation and possible long-term survival with acceptable operative risk.
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PMID:Surgery for high cervical esophageal carcinoma: experience with 11 patients. 232 55

A 6 boy is described treated for two months for pneumonia. In view of absent improvement the diagnosis was verified and malignant tumour was recognized. Radiological examination and clinical observation showed presence of a tumour in the 4th rib with pulmonary metastases. Histological examination of a biopsy specimen from the rib demonstrated primary microcellular Ewing's sarcoma. Of importance are: the age of the patient, rarely described location and diagnostic difficulties in the initial stage of the disease.
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PMID:[A case od rare location of Ewing's sarcoma in a 6-year-old boy]. 2402 5

Between October 1980 and December 1985, 50 patients with esophageal cancer were treated with combined radiotherapy and chemotherapy (5-fluorouracil [5-FU] and mitomycin C). Thirty patients with stage I or II disease received definitive treatment consisting of 6,000 cGy in 6 to 7 weeks and 5-FU (1,000 mg/m2/24 h) as a continuous intravenous (IV) infusion for 96 hours, starting on days 2 and 29. Mitomycin C (10 mg/m2) was administered as a bolus injection on day 2. Twenty patients received palliative treatment (5,000 cGy plus chemotherapy) for stage III or IV disease (extraesophageal spread or distant metastases). All patients treated in this program had an Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2. Of the 30 definitively treated patients, 23 had squamous cell cancer, while seven had adenocarcinoma. Follow-up ranged from 6 months to 63 months. The complete response rate at 1 to 3 months following completion of treatment was 87% (26 of 30) documented by barium swallow and endoscopy (+/- biopsy). The actuarially determined local relapse-free rate at 1 year and beyond was 73%, and the actuarial survivals at 1, 2, and 5 years were 68%, 47%, and 32%, respectively. Of the 20 palliatively treated patients, ten had squamous cell carcinoma, eight had adenocarcinoma, and two had undifferentiated carcinoma. Seventeen patients were evaluable for freedom from dysphagia 1 or more months following completion of treatment. Eighty-two percent of evaluable patients (14 of 17) had no dysphagia posttreatment, while 64% (11 of 17) remained free of dysphagia until death or last follow-up, emphasizing the significant local control of those patients. The median survival for this group was 8 months. Treatment was well tolerated, and acute toxicity included esophagitis, stomatitis, oral candidiasis, and hematologic toxicities of thrombocytopenia and neutropenia. Late toxicities were predominantly manifested as a mild to moderate benign stricture, which required dilatation in four patients. One patient developed a perforation into the mediastinum in the absence of tumor, while two patients with persistent local disease developed tracheoesophageal fistula, and radiation pneumonitis was observed in two patients. This combination of radiation therapy with infusional 5-FU and mitomycin C is an effective and relatively well-tolerated regimen in the treatment of esophageal cancer. Surgical resection may not be necessary when high-dose radiation and chemotherapy are used.
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PMID:Nonsurgical management of esophageal cancer: report of a study of combined radiotherapy and chemotherapy. 244 31

Between October 1981 and November 1984, 291 patients with inoperable advanced non-small cell carcinoma of the lung (NSCLC) were randomized to a two-arm study. Eighteen of 291 defaulted treatment and were excluded from the study. Twenty-seven of 273 died during treatment; they were invaluable for treatment response but were included in survival analysis. Without correction for lung attenuation 45 Gy/18 fractions/4 1/2 weeks were given in arm 1 and 31.2 Gy/4 fractions/4 weeks were given in arm 2. One hundred twenty-eight of 273 were included in arm 1 and 145/273 in arm 2. The two arms were comparable in patient age, sex, performance status and symptoms, primary tumor site, histology, stage of the disease, and distribution of metastases and radiation portal size used. Prognosis was poor with an overall median survival of 20 weeks and was similar in both arms. Radiological tumor response was also similar: 53% in arm 1 and 50% in arm 2. However arm 1 was superior than arm 2 in achieving symptom palliation, 71% vs 54%, p less than 0.02. Treatment complications were mild and included mainly radiation oesophagitis and pneumonitis and pulmonary fibrosis. Treatments in both arms were equally well tolerated.
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PMID:A randomized study on palliative radiation therapy for inoperable non small cell carcinoma of the lung. 245 46

Twenty-nine untreated children diagnosed with nasopharyngeal carcinoma were consecutively admitted to St. Jude Children's Research Hospital from 1962 to 1986. The age of the patients ranged from 6 to 19 years (median of 13) at diagnosis. Histologically, all had lymphoepithelioma. Patients were retrospectively staged in the American Joint Committee System. Disease extent was T1 (n = 5), T2 (n = 7), T3 (n = 9), T4 (n = 8); N0 (n = 1), N2 (n = 7), N3 (n = 21). Two patients had distant metastasis (M1) on admission, both ultimately succumbed to their disease. Twenty-seven patients were seen initially without metastatic disease: one received pre-irradiation vincristine, 17 were treated with concomitant radiotherapy and cyclophosphamide. From 1981 to the present, four patients received pre-irradiation and one received post-irradiation cisplatin-bleomycin, vinblastine (CDDP-BLEO-VLB) regimens. Four patients received radiotherapy alone. All patients completed chemotherapy and radiation therapy. Twenty-five patients had complete tumor clearance and four had a partial response. Overall, 14 patients are alive continuously without relapse with a median follow-up of 11 years (range 4 to 20). All patients who relapsed did so within 2 years postirradiation. Four patients failed locally--all had advanced (T3-T4) local disease at presentation and three of the failures were at the margin of treatment portals. Thirteen patients failed with distant metastasis. The major prognostic factor in these patients was the local extent of disease. Among the 27 M0 patients, all ten patients with T1-2 tumors are disease-free, whereas four of nine patients with T3 and two of eight patients with T4 tumors are alive and well. In the 16 patients who are long term survivors, eight have mild neck atrophy, two have shortening of the clavicles; except for one patient who required a neck brace for shoulder drop, all had normal function. Among the seven pre-pubertal patients who are long term survivors, three have decreased growth, including one with documented decreased growth hormone. Two patients developed irregular menstrual periods. One patient developed hypothyroidism, and another had a thyroid adenoma. One patient developed bleomycin pneumonitis and one patient who received pre- and post-irradiation chemotherapy died of laryngeal edema and fibrosis, in remission. Radiotherapy is the major modality in the therapy of childhood nasopharyngeal carcinoma. The long term toxicity of radiotherapy plus or minus chemotherapy is acceptable. In early stage tumors (T1-2, N1-2), radiotherapy alone (55-60 Gy) appears to be sufficient for disease control.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Pediatric nasopharyngeal carcinoma: long term follow-up of 29 patients. 247 70


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