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

Percutaneous transthoracic needle biopsy is a well-established method of obtaining cytologic and histologic samples from a pulmonary nodule. Properly performed, needle biopsy is a simple and safe procedure. Pneumothorax is the most common complication, which, if symptomatic or large, is easily treated by chest tube insertion or aspiration. Minor hemorrhage and hemoptysis is the other common complication, which is rarely serious. Rare complications include air embolism and needle tract metastases. Needle biopsy has a high sensitivity and specificity for malignancy. For benign lesion, a specific diagnosis is less common, although with core needle biopsy, the yield of a specific benign diagnosis is increased.
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PMID:Fine needle aspiration of the solitary pulmonary nodule. 1223 69

Radioisotope bone scanning is a sensitive indicator of metastatic disease. Localization of the hot spot for biopsy is difficult. Today, a hand-held gamma probe enables the surgeon intraoperatively to accomplish the localization procedure easily. As this technique is described in American literature exclusively, more recent European findings is presented here. During one month two patients were diagnosed with breast cancer. Bone scanning disclosed minor hot spots in the ribs. On the day of surgical biopsy the localization of the hot spots was guided by a gamma probe. For the biopsy a dermal punch biopsy needle was employed, and fine needle aspiration biopsies were also taken. The procedures were easy and completed within a few minutes. The post-operative courses were uneventful. In one patient, final histology showed malignancy in both biopsies. In the other patient, only the fine needle aspiration biopsy was malignant. The punch biopsy was abnormal, but did not contain malignant tissue. The gamma probe is an important tool in the performance of rib biopsies of nonpalpable lesions. The punch biopsy technique is simple and combined with fine needle aspiration biopsy the method has proven to be sensitive and accurate. The punch biopsy technique furthermore reduces the risk of postoperative pneumothorax.
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PMID:Radioisotope-guided surgical biopsy of costal metastases in breast cancer patients. 1255 81

Morbidity of lung cancer in Lithuania is increasing. Early diagnostics of this disease is important, difficult and necessary. During 2001, 169 patients with first and second stages of lung cancer were treated in Department of Thoracic Surgery at Kaunas Oncology Hospital. Age of patients was 30-80 years. We have analysed 20 patients with small peripheral lung tumors. Diagnosis was not confirmed by X-ray and fibrobronchoscopic examination. Percutaneous transthoracic fine needle aspiration of small lung tumors was determined by computed tomography (CT) examination. The diameter of tumors were 2.5-4.5 cm. After percutaneous transthoracic fine needle aspiration the diagnosis of lung cancer was confirmed to 15 (70.5 perc.) patients: carcinoma planocellulare - 13, Adenocarcinoma - 2 patients. Metastasis (solitary) from carcinoma renis to 1, abscessus pulmonis (necrotic masses) to 2, tuberculoma (tuberculosis) to 1 patients. After CT examination, percutaneous transthoracic fine needle aspiration and histologic examination diagnosis were confirmed: Carcinoma pulmonis stage I (T1N0M0-T2N0M0) to 5 patients, Carcinoma pulmonis stage II (T2N1M0-T3N0M0) to 9 patients, Carcinoma pulmonis III (T2N2M0) to 1 patient. There were 3 complications after percutaneous transthoracic needle aspiration: hemorrhage in tumor place to 2 patients, local pneumothorax to 1 patient. In all cases when we can not confirm diagnosis of small peripheral lung tumors we have to do CT examination and percutaneous transthoracic fine needle aspiration.
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PMID:[Percutaneous transthoracic fine needle aspiration of lung tumors by computed tomography examination]. 1256 Jun 20

Relapsing spontaneous pneumothorax can be the first manifestation of pulmonary metastases of soft tissues sarcomas. Standard imaging techniques and computed tomography may not be able to detect small malignant cystic lesion or to distinguish between them and benign bollous lesions. We report the case of a 33 year-old male who, in the past, underwent surgical treatment for a synovial sarcoma of the inferior limb. The patient was admitted to our hospital because of right spontaneous pneumothorax; both chest x-ray and CT scan didn't detect any metastatic pulmonary lesion. A few days after the discharge the patient was readmitted because of relapsed pneumothorax; high-definition CT of the chest revealed a pulmonary cystic lesion that was resected thoracoscopically. Histological examination revealed a pulmonary metastases of synovial sarcoma.
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PMID:[Spontaneous pneumothorax caused by lung metastasis of sarcoma of the thigh]. 1266 Dec 34

Spontaneous pneumothorax is a rare manifestation of metastatic lung cancers and described in advanced diseases or during cytotoxic chemotherapy which is manifested by sudden onset of dyspnea. The cause or mechanism of spontaneous pneumothorax has been unknown, as well as the association with site of metastases or type of cancers or side effect of chemotherapeutic drugs has been reported rarely. A 68-yr-old man underwent excision of angiosarcoma of the scalp. Chest radiography did not show any evidence of possible metastatic lung lesion at that time. Therefore, systemic doxorubicin and dacarbazine were given. After nineteen days of chemotherapy, he developed a bilateral spontaneous pneumothorax and palpable cervical lymph nodes. Both parietal and visceral pleura were intact and showed no evidence of metastatic and pathologic lesions on thoracoscopic evaluation. The patient managed with bilateral tube thoracostomy and both lungs were expanded. Lymph nodes became unpalpable during three cycles of the paclitaxel and doxorubicin, however, bilateral lung metastases were developed and progressed despite chemotherapy. The patient died due to respiratory failure after five months. This report underlines that spontaneous pneumothorax can occur as the first manifestation of metastatic angiosarcoma even if imaging studies do not show of a metastatic lesion.
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PMID:Bilateral spontaneous pneumothorax during cytotoxic chemotherapy for angiosarcoma of the scalp: a case report. 1269 29

We present the case of a 63-year-old woman with metastatic, high-grade pleomorphic sarcoma who had recurrent, bilateral pneumothorax while on a regimen of doxorubicin and dacarbazine. We postulate that her doxorubicin-based chemotherapy induced rapid cell lysis and necrosis of peripherally located, metastatic pulmonary nodules, leading to the pneumothoraces. Other potential mechanisms include bronchopleural fistula, rupture of dilated alveoli distal to a stenosis, chemotherapy-induced impairment of repair processes, and persistent local infection. Pneumothoraces related to pulmonary metastases tend to be refractory to conventional therapy and necessitate surgical intervention to prevent recurrences.
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PMID:Recurrent bilateral spontaneous pneumothorax complicating chemotherapy for metastatic sarcoma. 1451 29

A 50-year-old woman with breast carcinoma metastases in the left supraclavicular region was treated because of free air in the mediastinum, around the heart and vascular pedicle, below the diaphragmatic dome, and subcutaneous neck and supraclavicular emphysema, without radiologic signs of pneumothorax. Diverticulosis of the colon and an occult perforation of the diverticulum in the retroperitoneal region of the colon were diagnosed. The patient was treated by segmental resection of the colon with anastomosis, drainage of the abdominal cavity, and antibiotics. To our knowledge, this is the only report in the literature about pneumopericardium caused by peridiverticulitis of the colon.
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PMID:Pneumomediastinum, pneumopericardium, and pneumoperitoneum caused by peridiverticulitis of the colon: report of a case. 1499 17

We present laser-induced thermotherapy (LITT) of primary and secondary lung tumors analysing indications and technical concepts. Thirty patients with lung metastases of different primary tumors (n=24) as well as localized lung tumors (n=6) were prospectively treated in 41 sessions using laser-induced thermotherapy (LITT). An MR-compatible puncture system was used with direct puncture technique. The puncture was performed via CT guidance in care vision technique. Eight patients were thermoablated using MR tomographical monitoring, 22 patients using CT monitoring. Local therapy effects, tumor control rate, side effects, complications, and survival were evaluated. In 74% of cases (28/38 lesions) of 24 patients with lung metastases and in all cases of the 6 patients with lung carcinoma a complete local ablation could be achieved. The complication rate (pneumothorax) was 9,8%. One patient with bronchial carcinoma had to be thoracotomized and resected. 93% of the patients are still alive. Percutaneous LITT of lung tumors permits a complete ablation of lung metastases and lung carcinomas with a low complication rate. Indications for the procedure were defined for patients with no more than 5 metastases up to 3 cm in size.
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PMID:[Laser-induced thermotherapy of lung metastases and primary lung tumors]. 1522 Nov 52

Pulmonary metastases typically present as mostly multiple and bilateral, well-defined, non-calcified pulmonary nodules with predominantly basal and peripheral location. Ill-defined, cavitating, calcified and endobronchial metastases are uncommon. In the absence of pathognomonic findings precise differentiation from other-even benign-pulmonary nodules is almost impossible. Demonstration of contrast enhancement at CT or MRI or evidence of growth at serial examinations support the diagnosis of pulmonary metastases. In uncertain cases percutaneous fine-needle aspiration or cutting needle biopsy will allow diagnosis with acceptable risk of complications and patient discomfort. The only relatively common complication of pneumothorax can and should be controlled by the interventional radiologist by aspiration or drainage.
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PMID:[Radiological diagnosis of pulmonary metastases: imaging findings and diagnostic accuracy]. 1523 88

Assess the safety and evidence of efficacy of RFA for colorectal (CRC) lung metastases with follow up to 1 year. Twenty-three patients had percutaneous RFA for 52 colorectal pulmonary metastases under fluoro-CT. Patients received IV conscious sedation and local analgesia with routine hospitalisation/monitoring for 24 h post RFA. Patients had CT scanning at 1 month and then 3 monthly with serum CEA assessment monthly and 3 monthly. All ablations were technically successful. Tumor diameter ranged from 0.3 to 4.2 cm. Pneumothorax occurred in 43% (10 of 23) of patients. Six patients required intercostal chest drain placement. Six patients had a second RFA, 4 for new lesions and 2 patients had a previously treated lesion retreated. Median admission was 2.0 days (range 1-9). Median follow-up is 428 days (range 173-829), with data reported to 1 year in this paper. Five patients died at 5, 6, 8, 8 and 12 months post RFA from extra-pulmonary (1) or widespread (4) disease. One patient developed malignant pleural effusion at 6 months after RFA. Cavitation was seen in nine treated lesions (17%), all resolved with scar tissue contraction by 12 months. Eighteen patients with CT scan follow-up at one year have 40 lesions classified as: disappeared (17), decreased (5), stable/same size (4), increased (14). Percutaneous imaging-guided RFA of multiple CRC pulmonary metastases is a minimally invasive treatment option with modest morbidity. A significant proportion of patients show good evidence of successful local control at one year.
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PMID:[Radiofrequency ablation (RFA) of lung metastases from colorectal cancer (CRC)-one-year follow-up]. 1523 89


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