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)

Between 1968 and 1978 82 radical pneumonectomies were performed in our clinic because of a bronchial epidermoid carcinoma. In 49 patients the operation was performed at least 5 years ago (December 31, 1973). 23 patients had a radical pneumonectomy with intrapericardial ligation of the vessels, atriumwall resection or pericardial resection (group A). In addition 13 patients had a dissection of the mediastinal lymphnodes (group B). In the remaining patients (n = 13) parts of the thoracic wall had to be removed (group C). The postoperative lethality (30 days) is 17.6% in group A, 38.5% in group B (2 patients died because of hematogenous metastases, 2 of pulmonary embolism and 1 of generalized pneumonia) and 10% in group C. The 5-year survival is 13% for group A, 8% for group B and 10% for group C.
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PMID:[Results following radical pneumonectomy for bronchial carcinoma]. 744 Feb 7

Several types of neoplastic conditions are included in the differential diagnosis of pneumonia. Bronchial obstruction with cancer can produce obstructive pneumonia that results in intractable infection. Bronchogenic carcinoma and metastatic cancer involving the airways may produce this clinical presentation. Bronchioloalveolar carcinoma is a relatively common form of primary lung cancer that characteristically presents as a chronic infiltrate associated with cough, hypoxemia, shortness of breath, and mucus hypersecretion. This cancer has two distinct histological types with markedly different prognosis. The mucinous variety is much more likely to be multicentric and rapidly progressive whereas the nonmucinous variety may be localized. Lymphoproliferative diseases may also present in an infiltrative appearance. Kaposi's sarcoma infiltrating the lungs, particularly associated with acquired immune deficiency syndrome, presents a diagnostic dilemma because of the high incidence of pulmonary infection in these patients.
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PMID:Neoplastic mimics of pneumonia. 748 Nov 27

Primary intracranial yolk sac tumor (Endodermal sinus tumor, YST) is quite rare, and most usually involves the pineal gland. This report concerns a rare case of unknown origin of yolk sac tumor with intracranial and spinal metastases. The 6-year-old boy initially manifested symptoms of acute urinary retension and paraparesis. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed an intrathecal tumor spreading below the third lumbar segment, and tumors also appeared in the left temporal area and right cerebellar hemisphere. The pineal region was free of neoplastic involvement and the gonads were normal. The patients underwent operation to remove intracranial and spinal tumors, and postoperative radiotherapy was administered. The histological findings showed metastatic yolk sac tumor. Multiple intracranial and spinal seeding were noticed postoperatively. The patient died of recurrent YST and pneumonia three months after operation. The origin of secondary YST can always be found in specific midline sites. This is a rare case since the primary lesion is unknown.
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PMID:Yolk sac tumor of unknown origin with intracranial and spinal metastases. 749 Jul 97

The lung is a common site for cancer to occur, for both primary as well as metastases. The presence of such tumours can give rise to symptoms such as haemoptysis, cough, breathlessness and pneumonia. In most cases, treatment is strictly for palliation. We present a case report of a patient with an endobronchial metastasis from a primary hypernephroma which recurred following external beam radiotherapy. He was treated with a single fraction of intraluminal brachytherapy to a dose of 10Gy at 1 cm from the axis on a High Dose Rate Ir192 Remote Afterloading Machine. There were no adverse effects following treatment. On follow-up 7 months later, the patient did not have any further recurrence of breathlessness although his disease had progressed at other sites.
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PMID:HDR intraluminal brachytherapy for lung tumours--a case report. 752 39

Between October 1990 and November 1991, a total of 16 male patients with advanced nasopharyngeal carcinoma were treated by neoadjuvant chemotherapy before conventional radiotherapy. They belonged to the AJCC stage IV with multiple bulky neck nodes metastases. The chemotherapy consisted of bleomycin, epirubicin, and cisplatin. Six patients completed 3 cycles, 9 patients finished 2 cycles, and 1 patient received 1 cycle of chemotherapy. Seven of the 16 patients (44%) were in complete response, and 50% (8/16) achieved partial response. The overall response rate was 94%. The major toxicities consisted of leucopenia (12/37 cycles had grade III-IV), nausea/vomiting, alopecia. Aplastic marrow developed in 1 patient, and one died of bleomycin-induced pneumonitis. Subsequent radiation therapy was well tolerated. After a minimal follow-up time of 24 months, the 2-year actuarial survival rate was 56%. Although we confirmed the impressively high response rate of this regimen, the toxicities were high and most patients failed at distant site(s). The efficacy of neoadjuvant chemotherapy for advanced nasopharyngeal carcinoma is doubtful and should be further studied in prospective randomized trials.
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PMID:Neoadjuvant chemotherapy for advanced nasopharyngeal carcinoma. 753 76

The goal of any treatment strategy for cancer is to improve not only patient survival but also quality of that survival. Between March 1990 and February 1993, we treated 10 patients with advanced RCC (9 men and 1 woman) by combined immunotherapy using natural interferon-alpha (IFN-alpha), recombinant interleukin-2 (rIL-2) and lymphokine-activated killer (LAK) cells, and resulting the quality of life (QOL) issues examined. The ages of the patients ranged from 36 to 78 years (mean: 60.2) and the performance status (PS) ranged from 30 to 100% (mean: 77%). There were 8 lung, 3 bone, 2 brain and 1 neck and para-aortic lymph node metastases. We could evaluate 8 patients, 2 patients dropped out because of bone fracture and acute pneumonia. The protocol was as follows; 1 x 10(6) IU of rIL-2 as an intravenous infusion and 6 x 10(6) IU of IFN-alpha intramuscularly on days 1-7 and 15-21. In additions LAK cells obtained from the patients were given on days 14, 21, 28, and 35 intravenously. This protocol was repeated for more than three cycles (mean: 4.13 cycles) in each patient. The maintenance therapy on outpatient basis were performed in 4 patients after confirmation of the safety of the combined immunotherapy. This outpatient regimen was composed of 1 x 10(6) IU of rIL-2 intravenously, 6 x 10(6) IU of IFN-alpha intramuscularly on days, 1, 8, 15, 22, and 29, plus LAK cells on days 15 and 29. We repeated this protocol for 3-5 cycles (mean: 4.25 cycles).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Combined immunotherapy using interferon-alpha, interleukin-2 and lymphokine-activated killer cells--improvement of quality of life in patients with advanced renal cell carcinoma]. 760 59

We have treated 14-patients with metastatic tumors located in eloquent cortical areas by a stereotactic-guided keyhole craniotomy and total microsurgical excision utilizing the Pelorus stereotactic device. Patients ranged in ages from 26 to 82 years with a median age of 59 years. There were 9 women and 5 men. Ten patients presented with hemiparesis and 4 with aphasia. Primary tumor location was lung in 7, colon in 2, melanoma in 2, and breast, renal, and bone in 1 case each. Gross total resection was accomplished in all cases, with postoperative imaging confirmation of complete removal. Single metastatic tumors were removed in 12 cases, and multiple lesions in 2 cases. Twelve patients had postoperative whole brain irradiation (30 Gy/10 fractions); 2 patients had previously received whole brain irradiation, yet demonstrated tumor growth. Complete resolution of neurologic deficits was accomplished in 8 patients, 3 had improved and 2 were unchanged. One patient had resolution of preoperative deficit but developed hemiparesis secondary to a hemorrhagic infarction contralateral to the operative site. Nonneurologic morbidity includes deep venous thrombosis in 3 patients, and pneumonia in 1. Thirty-day perioperative mortality is zero, and to date no patient had died of intracranial disease. We believe that with the assistance of stereotactic localization, metastases in vital regions of the cortex can be removed with very low neurologic morbidity, and with a high proportion of patients having improvement in their level of neurologic function. The morbidity in this series compares favorably with that of stereotactic radiation series reported in the literature with local disease control and resolution of neurologic deficits that equals or exceeds stereotactic radiation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Stereotactic resection of brain metastases in eloquent brain. 762 49

A case of intracranial malignant meningioma with remote metastases to the bones is reported. A 66-year-old man with regrowth of right sphenoid ridge meningioma, whose meningioma had partially been removed 15 years before, was admitted to our clinic. The tumor was large enough to protrude into the lateral and third ventricles, and involved the right internal carotid, middle cerebral, anterior cerebral artery and optic nerve. The tumor had irregular contour, and was heterogeneously enhanced by Gd-DTPA on MRI. An operation was performed, but a part of the tumor around these main arteries could not be removed. Histopathological examination revealed anaplastic meningioma, resulting from malignant change. Radiotherapy was performed postoperatively and the patient was discharged. Seven months after the operation he complained of posterior nuchal, back, and lumbar pain. Radiological examination revealed multiple punched-out lesions in the ribs and vertebrae, which were histologically demonstrated to be metastases of intracranial anaplastic meningioma. Radiotherapy was carried out for the cervical vertebrae, but his symptoms persisted. He died of pneumonia 10 months after the operation.
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PMID:[A case of intracranial malignant meningioma with extraneural metastases]. 763 48

The CT simulator is a real-time, CT-linked, 3-D treatment planning system which consists of a CT scanner, a multi-image display, a treatment planning device with real-time visual optimization, and a laser beam projector. The clinical benefit of this system was evaluated in breast cancer patients undergoing breast-conserving therapy. Between December 1987 and March 1993, 244 breasts in 243 patients underwent breast-conserving therapy at Kyoto University Hospital. Clinically, there were 159 stage I and 85 stage II tumors. Pathological staging showed 216 stage I, 24 stage II, and 4 stage III tumors. All except 10 tumors were invasive ductal carcinomas. Eleven tumors were margin-positive by histopathological examinations. As surgical treatment, quadrantectomy or wide excision with complete axillary dissection was performed. Radiation therapy consisted of 50 Gy delivered to the whole breast by opposed tangential fields over 5 weeks using 60Co gamma rays. For patients with a positive margin, boost electron irradiation was given to a total of 10 Gy. We used the CT simulator for individualized optimization of the tangential fields. Prompt and accurate determination of the tangential portals was possible by using the simulator to determine various parameters, including the beam angle and head rotation angle. During follow-up for 2-66 months (median: 20 months), unrelated death occurred in 2 patients and distant metastases developed in 5 (bone 4, lung 1). However, neither local recurrence nor symptomatic radiation pneumonitis has since occurred. The cumulative survival rate and the disease-free survival rate at five years were 95.2% and 91.8%, respectively. The CT simulator appears to be a useful tool for individualized optimization of tangential irradiation fields in breast-conserving therapy.
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PMID:Clinical results of breast-conservation therapy using a CT simulator. 766 90

Twenty-five patients with metastatic and/or recurrent nasopharyngeal carcinoma were treated with cisplatin 20 mg/m2/day on days 1-5 i.v. with hydration; 5-fluorouracil (5-FU) 1,000 mg/m2/day by continuous infusion (CI); and bleomycin 15 mg/m2 on day 1 also by CI. These cycles were repeated every 4 weeks. Twenty-three (92%) had distant metastases. Bone was the most frequently involved site (72%), followed by lungs (44%) and liver (40%). More than half the patients (14/25) presented with at least 3 organ sites involved or had local T3/T4 or N3 lesions with a distant metastasis. The median time from relapse to start of chemotherapy was 7.5 months. We observed 1 (4%) complete response (CR), and 9 (36%) partial responses (PR). The objective response rate (CR + PR) was 40%. Hematologic toxicities were frequently encountered. Twenty (80%) patients experienced leukopenia during the treatment courses and 9 (36%) had severe (grade 3 or 4) leukopenia. Eight patients had grade 3 or 4 infections. Two of them died of sepsis and 1 succumbed to uncontrolled pneumonia. The objective response rate was inferior to other series. Possible explanation included longer delay before initiation of definitive treatment, larger tumor burdens, higher severe hematologic toxicity and lower dosage of bleomycin. The results suggested metastatic and/or recurrent nasopharyngeal carcinoma is chemosensitive, however, for patients with large tumor burdens, more intensive chemotherapy regimens with support of hematopoietic growth factors may be required to achieve a better control.
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PMID:Chemotherapy with cisplatin and continuous infusion of 5-fluorouracil and bleomycin for recurrent and metastatic nasopharyngeal carcinoma in Taiwan. 768 18


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