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

Small caliber needle aspiration of lung lesions has been successfully and safely used for diagnostic purposes. We report our initial experience using computed tomography-guided fine needle percutaneous implantation for direct intralesional high-dose rate brachytherapy for malignant pulmonary lesions. Twenty patients with primary lung cancer or metastatic cancer which involved the lung or chest wall were treated with a high-dose rate remote afterloader. Eighteen of the 20 patients also received external beam radiation in conjunction with intralesional radiation therapy. Fourteen patients had primary lung cancer. A complete response was obtained in 5 of the 14 patients. Ten of the 14 patients with primary non-small-cell carcinoma of the lung showed a significant response to treatment (greater than 50 percent reduction in tumor measurement). Six patients with metastatic lesions also were treated. Five of the six showed a significant tumor response measured as either 50 percent reduction in tumor measurement or complete pain relief. The only significant complication was pneumothorax (6 of the 20), which did not prevent completion of any treatment plan.
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PMID:Percutaneous computed tomography-guided fine needle brachytherapy of pulmonary malignancies. 802 Feb 83

We describe 12 patients with simultaneous bilateral spontaneous pneumothorax (SBSP). They represent 4 percent of patients with spontaneous pneumothorax seen at our hospital from 1971 to 1990. Five of the 12 had no underlying lung disease. In the seven remaining patients, SBSP was secondary to histiocytosis X, lymphangioleiomyomatosis, osteogenic sarcoma with pleural and pulmonary metastases, Hodgkin's disease, mesothelioma, cystic fibrosis, or miliary tuberculosis. Nineteen of the 56 patients with SBSP (34 percent) described in the literature (this series included) had pulmonary disease related to disorders of cells of mesenchymal origin. Emphysema and bullous lung disease were not associated with SBSP. Long-term prognosis was a function of pulmonary status. Four of the patients described herein died during the period reviewed. All suffered from severe underlying disease. In no case was SBSP the main cause of death. With timely treatment, the short-term prognosis is benign even for patients with underlying lung disease. Surgical pleurectomy should be attempted early, especially in SBSP secondary to underlying lung disease.
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PMID:Simultaneous bilateral spontaneous pneumothorax. 816 40

A 51-year-old man was treated for bilateral pneumothorax secondary to pulmonary metastases from malignant fibrous histiocytoma. After failure of regular therapy, Heimlich flutter valves were used producing disappearance of the bilateral pneumothorax and adequate outpatient management.
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PMID:Heimlich valve treatment and outpatient management of bilateral metastatic pneumothorax. 818 64

A case of autosomal dominant polycystic kidney disease associated with widely metastatic renal cell carcinoma is reported. The patient had presented with pneumothorax, weight loss, leukocytosis, lytic bone lesions, and hypercalcemia. Despite intensive diagnostic search for a neoplasm, no firm evidence of malignancy was found. However, at the autopsy, widely metastatic, papillary renal cell carcinoma was found originating in the left kidney. Many metastases showed central necrosis mimicking small cysts.
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PMID:Renal cell carcinoma in the presence of adult polycystic kidney disease. 828 67

Percutaneous transthoracic needle biopsy (TNB) is a simple and safe procedure with high diagnostic accuracy for the diagnosis and staging of cancer in the lung, hilum, and mediastinum. The complication rate is low and consists primarily of pneumothorax, with only a small percentage of these requiring chest tube reexpansion. Major complications are rare. Computed tomographically guided biopsy is a powerful adjunct to fluoroscopic biopsy and expands the application of TNB to include most thoracic lesions. TNB is the initial diagnostic procedure of choice in peripheral lung lesions, suspected focal metastases, and most hilar and mediastinal masses. Its proper role in the diagnosis and staging of lung cancer requires the close collaboration of the radiologist, cytopathologist, and the patient's primary physician.
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PMID:The role of transthoracic needle biopsy for the diagnosis and staging of lung cancer. 846 51

The patient was a 72-year-old man who underwent operation for bilateral pneumothorax due to rupture of cystic lung lesions. Two months after the operation, intrathoracic bleeding redeveloped. The patient developed a tumor on his head. Pathological examination of the scalp lesion revealed cutaneous angiosarcoma. A biopsy of thickened pleura showed that the bleeding was due to pleural metastatic angiosarcoma of the skin. The multiple cystic lesions were considered to be metastases of angiosarcoma. We conclude that pneumothorax or hemothorax in the elderly should be differentiated from malignant metastatic lung tumor. Cystic lung lesions should be considered as possible metastatic angiosarcoma from the skin.
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PMID:[Case report of metastatic cutaneous angiosarcoma causing bilateral pneumothorax]. 851 23

An 80-year-old woman with angiosarcoma of the scalp was treated with radiation and interleukin 2. The patient experienced dyspnea one month later because of pulmonary metastases, and underwent video-assisted thoracoscopic surgery for a right pneumothorax. Right hemopneumothorax recurred 3 weeks after the surgery and left hemopneumothorax occurred 4 months later. Both were successfully treated with intrapleural OK432 and drainage. As of March 1995 the patient had been alive and well for one year since the right pneumothorax developed.
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PMID:[Successful treatment of hemopneumothorax with intrapleural OK432 in pulmonary metastases of cutaneous angiosarcoma]. 858 32

Percutaneous biopsy of intraabdominal masses is a safe and accurate means of obtaining a tissue diagnosis without surgical exploration. It is often sufficient to determine treatment plans and in many instances, obviates the need for surgery. Percutaneous biopsy of renal masses has traditionally had a limited role in the United States. However, with a recent increase in the detection of small renal masses because of the widespread use of abdominal computed tomography (CT), there is an increasing role for percutaneous biopsy in the management of renal masses. Percutaneous biopsy of renal masses is indicated to differentiate between a primary renal cell carcinoma and metastatic disease in patients with a known extrarenal primary. Percutaneous biopsy is also indicated to establish a diagnosis of renal lymphoma and abscess. Complications of percutaneous biopsy include bleeding, pneumothorax, and tumor seeding along the needle tract; fortunately, these complications are uncommon. We will review the indications, techniques, complications, sensitivity, and accuracy of CT and ultrasound-guided biopsy of renal masses. Urologists and radiologists should both be familiar with the indications and contraindications of percutaneous biopsy to insure the appropriate management of renal masses.
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PMID:The current role of percutaneous biopsy in the evaluation of renal masses. 859 48

Prognosis of Stage III NSCLC remains dismal, particularly when mediastinal nodal involvement is present. In order to improve local control and to reduce early distant failures, we have treated Stage III patients with concurrent chemoradiotherapy since 1989. From September 1989 to February 1994, 140 patients were treated with concurrent chemoradiotherapy. Among these, 24 initially inoperable patients became operable after induction chemoradiotherapy. Characteristics: median age 51 years (35-70); squamous: 45.8%; non squamous: 41.7%; median tumor size: 8 cm; T3 (79.2%); T4a (12.5%); N2 (62.5%) and N3 (8.3%). Preoperative radiotherapy was delivered at a dose of 45 Gy (25 f) over 5 weeks to the mediastinum. Concurrent chemotherapy was continuous infusion cisplatin (n = 10) or cisplatin plus etoposide (n = 14). Five weeks later, radical surgery was carried out (lobectomy n = 14, pneumonectomy n = 10), followed by additional chemotherapy (n = 12) and/or radiotherapy (n = 6), according to histological response. Pathological CR rate was 29.2%. Grade III toxicities were digestive (12.5%), hematologic (8.3%) and infectious (4.2%). Three patients had severe non-lethal postoperative complications with one hemorrhage and two pneumothorax (12.5%). With a median follow-up of 41 months, overall survival at 2 and 5 years was 77.5%, and 72%, respectively. Actuarial local control at 5 years was 82.4%. Nine patients presented with distant metastases, including six with isolated brain metastases. This preoperative chemoradiotherapy regimen appears feasible without overwhelming toxicity and with an acceptable rate of postoperative complications. Despite a significant incidence of isolated brain metastases (25%), 5-year survival is highly encouraging since and appears substantially better than primary surgery.
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PMID:[Preoperative radio-chemotherapy of stage III unresectable non-small cell lung cancer: results of a pilot study]. 868 81

The main pleural disorders are: effusion, thickening, masses and pneumothorax. Chest radiography is the first approach to evaluation of pleural disease; further evaluation is based upon ultrasounds (US), computed tomography (CT), and high-resolution CT (HRCT). The typical appearance of free pleural effusion is a homogeneous opacity with concave upper boundary; subpulmonic or intrafissural collections may also occur; the exudative effusions can be organized by adhesions between the pleural layers; consequently, loculated collections result. Radiographs allow us to assess the presence, amount and arrangement of effusions, but US and, especially, CT are needed to detect the modifications of the underlying pleura: circumferential thickenings, irregular and more than 1 cm thick are mostly malignant and denote mesothelioma or metastases: subtle and regular thickening is the typical appearance of fibrosis; a normal pleura does not exclude a malignant effusion. CT plays a major role in the diagnosis and management of empyema and in differentiating it from the pulmonary abscess. With CT it is also possible to differentiate the true pleural thickening from the false one due to a simple increase of extrapleural fat, and to disclose the activity of a fibrothorax through the detection of a small amount of fluid between the pleural layers. Pleural plaques are clearly visible by conventional radiography, especially with oblique views; US and CT are needed in the assessment of pleural tumors (fibroma, lipoma, fibro- and liposarcoma) and in determining the involvement of the lung and the chest wall. Pneumothorax is easily detected by conventional radiographs in the upright patient; when supine, the air collects in the anterobasal regions and particular projections are required; CT can reveal small amounts of air and is recommended in critically ill or trauma patients.
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PMID:Imaging of pleural diseases. 868 Mar 81


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