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 39-year-old Japanese woman presented with a swollen right hand and a right-sided pneumothorax. Chest CT revealed bilateral multiple pulmonary thin-walled cysts measuring<or=1 cm in diameter and small nodules. An initial skin biopsy led to a misdiagnosis of metastatic adenocarcinoma, as tumour cells were positive for cytokeratin, epithelial membrane antigen, carcinoembryonic antigen and cancer antigen 125. However, chemotherapy proved ineffective, and the skin biopsy was repeated. A final diagnosis of epithelioid sarcoma (ES) was made. Open lung biopsy showed that the pulmonary nodules represented metastases of ES. Although the pulmonary cyst walls did not contain tumour cells, bronchiolar wall adjacent to the cysts had been infiltrated by tumour cells. These findings suggested that pulmonary cysts, a rare form of pulmonary metastases from soft tissue sarcomas, had developed through a ball-valve effect of metastatic tumour in small airways. However, presence of cancer antigen 125 hindered obtaining a correct diagnosis of ES.
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PMID:Epithelioid sarcoma presenting as pulmonary cysts with cancer antigen 125 expression. 1705 16

Despite the indisputable and well-known advantages of general anesthesia in thoracic surgery, this can trigger some adverse effects including an increased risk of pneumonia, impaired cardiac performance, neuromuscular problems, mechanical ventilation-induced injuries, which include barotrauma, volotrauma, atelectrauma, and biotrauma. In order to reduce the adverse effects of general anesthesia, thoracic epidural anesthesia has been recently employed to perform awake thoracic surgery procedures including coronary artery bypass, management of pneumothorax, resection of pulmonary nodules and solitary metastases, lung volume reduction surgery, and even transsternal thymectomy. The results achieved in this early series have been encouraging, although indications and many pathophysiologic aspects remain to be elucidated. In this review we have tried to provide a first-step analysis of the anecdotal reports available in the literature on this topic. We also desired to provide insights into the main physiologic effects of awake thoracic surgery with epidural anesthesia, with particular attention to the several issues raised by its application in patients with chronic obstructive pulmonary disease, which can represent one of the most stimulating challenges in this setting.
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PMID:Epidural anesthesia in awake thoracic surgery. 1746 87

A 41-year-old woman presented with chest pain and a cough. There was a solitary pulmonary nodule in the upper-left lobe. The patient had no history of neoplasm except a hysterectomy for uterine leiomyoma five years before. Six months after the first presentation, the tumor showed a gradual increase in size; an explorative thoracotomy was performed. The histopathologic examination showed a tumor consisting of well-differentiated spindle-shaped cells with intervening collagen. She was readmitted 8 months after the operation because of right-sided spontaneous pneumothorax. Multiple pulmonary nodules appeared when the lung was re-expanded by chest tube drainage. In conclusion, uterine leiomyomas can metastasize to various organs, such as lungs, despite having a benign pathologic appearance.
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PMID:Benign metastasizing leiomyoma. 1835 90

A rare case of bilateral pneumothorax in a 54-year-old woman with advanced breast cancer associated with lung and pleural metastases is presented. The patient was admitted to our hospital complaining of unexpected severe dyspnea. A chest X-ray showed bilateral pneumothorax associated with multiple lung metastases and pleural effusions, followed by immediate pleural drainage. Although air leak and effusions of the right lung were well controlled by the conservative management, massive air leaks of the left lung had continued for 40 days. Because of patient's poor general status a surgical closure of the leaking site was selected using video-assisted thoracoscopic surgery techniques. Thoracoscopy revealed a ruptured bulla in the lower lobe (S(6)), thus, followed by a successful bullectomy with a stapling device. We speculate that multiple pleural metastasis may disturb the normal repair mechanism of the lung tissue and cause prolonged persistent air leaks.
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PMID:Bilateral pneumothorax associated with lung and pleural metastases of breast cancer. 1849 49

A 44-year-old woman who had undergone hystero-oophorectomy for uterine sarcoma presented to our hospital with palindromic pneumothorax and her chest CT revealed multiple cystic lesions. After admission video-assisted thoracoscopic surgery (VATS) showed the pulmonary lesions to be primarily leiomyoma, however, further examination revealed that her uterine sarcoma resected in 2000 exhibited not only mitosis but also venous invasion. We therefore considered her lung tumors as metastases from uterine leiomyosarcoma. Cases of secondary spontaneous pneumothorax (SSP) due to pulmonary metastases are rare and almost half are from mesenchymal tumors. Thin-wall cavities and cysts are formed by a check-valve mechanism in the process of pulmonary metastases formation. When multiple thin-wall cavities and cysts are found in the lung, pulmonary metastases should be considered as one of the causes, and pathological specimens obtained in past illness should be re-examined in detail.
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PMID:[Case of pneumothorax due to pulmonary metastases from uterine leiomyosarcoma]. 1851 14

A 61-year-old woman who had never smoked was given a diagnosis of adenocarcinoma of the lung with multiple pulmonary metastases. Systemic chemotherapy consisting of carboplatin and paclitaxel was not effective, thereafter daily oral administration of gefitinib was initiated. Six days later, bilateral pneumothorax was found. The extent of the pneumothorax was slight and she recovered without drainage within about one month although treatment of gefitinib was restarted. Gefitinib was effective for lung cancer in this case. Bilateral pneumothorax is a rare complication of chemotherapy for lung cancer. Only 3 such cases under treatment with gefitinib were reported in Japan.
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PMID:[Case of bilateral pneumothorax observed during the administration of gefitinib for lung adenocarcinoma with multiple pulmonary metastases]. 1859 95

Here, we describe two cases of lung metastasis of adamantinoma of long bones, a low-grade bone neoplasm that rarely metastasizes. In both cases, the clinical presentation of the metastases was characterized by spontaneous pneumothorax secondary to tumor cavitation, a phenomenon described in only three of the studies reviewed in the literature. Clinical, radiological, and anatomopathological findings, as well as the procedures adopted in the two cases, are described.
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PMID:[A rare case of pneumothorax: metastatic adamantinoma]. 1862 11

Only 25% of all lung cancers are diagnosed in an early stage allowing surgical treatment. Primary tumours usually concerning lung metastasis are breast, colon, kidney, uterus/cervix, prostate, and head and neck tumours. During recent years many publications have confirmed the effectiveness and reliability of lung radiofrequency ablation (RFA) alone or together with other techniques (chemotherapy, radiotherapy...). Results suggest that survival increase and curative rates of lung radiofrequency are similar to those achieved by more aggressive procedures and present lower rates of complications. Pneumothorax, pleural effusion and alveolar haemorrhage are the most frequent complications. Indications for lung RFA must be individually evaluated by lung cancer committees. Percutaneous lung RFA may be useful in patients with pulmonary primary tumours and metastases, especially in those with nodules smaller than 3 cm and a peripheral location (>1 cm from the hilum). PET/CT seems to be the most accurate technique in patient follow up.
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PMID:Radiofrequency thermocoagulation of lung tumours. Where we are, where we are headed. 1915 1

This study was undertaken to evaluate long-term results of radiofrequency (RF) ablation in patients with colorectal lung metastases and to stratify patients benefitting from lung RF ablation. Lung RF ablation was performed in 78 patients with 198 colorectal lung metastases. Safety, local tumor progression, and survival were evaluated retrospectively. The mean follow-up period after the 140 lung RF ablation sessions was 24.6+/-7.6 months. Pneumothorax and pleural effusion requiring chest tube placement occurred respectively in 18 (12.9%, 18/140) and 2 (1.4%, 2/140) sessions. The respective 1-, 3- and 5-year local tumor progression rates were 10.1% (95% CI, 2.9-17.3%), 20.6% (95% CI, 8.9-22.2%) and 20.6% (95% CI, 8.9-22.2%). The 1-, 3- and 5-year survival rates were 83.9% (95% CI, 75.2-92.7%), 56.1% (95% CI, 41.7-70.5%) and 34.9% (95% CI, 18.0-51.9%), with median survival time of 38.0 months. Univariate analysis revealed maximum tumor diameter of 3 cm or less, single-lung metastasis, lack of extrapulmonary metastasis and normal carcinoembryonic antigen (CEA) level as better prognostic factors. The latter two were significant independent prognostic factors. The 1-, 3- and 5-year survival rates were 97.7% (95% CI, 93.3-100%), 82.5% (95% CI, 68.2-96.8%) and 57.0% (95% CI, 34.7-79.2%) in 54 patients with no extrapulmonary metastases and 96.9% (95% CI, 90.8-100%), 86.1% (95% CI, 71.1-100%) and 62.5% (95% CI, 36.3-88.6%) in 33 patients with negative CEA levels. Lung RF ablation is a safe and useful therapeutic option. These identified prognostic factors will help to stratify patients who benefit from lung RF ablation.
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PMID:Long-term results of radiofrequency ablation in colorectal lung metastases: single center experience. 1972 69

Spontaneous pneumothorax is a rare manifestation of primary lung cancer or metastasis. We report a 39-year-old man with well-differentiated squamous cell carcinoma of the tongue and cervical lymph node metastases. He developed lung metastases and spontaneous pneumothorax 22 months later after intra-arterial infusion chemotherapy. The patient was managed with partial lung resection under thoracotomy. The pneumothorax resolved completely after the operation. Histological examination demonstrated metastatic squamous cell carcinoma, which had led to a bronchopleural fistula with subsequent induction of pneumothorax. The patient recovered uneventfully and continued to receive adjuvant chemotherapy in the oncology surgery outpatient department. Unfortunately, the tumors of the tongue and cervical lymph nodes progressively enlarged despite treatment. Eventually, the patient died of respiratory failure 5 months later. In most of the previously reported cases, pulmonary metastases associated with spontaneous pneumothorax usually originate from osteogenic or soft-tissue sarcomas. Although rare, pulmonary metastasis should be considered in the etiology of spontaneous pneumothorax. Despite advanced disease, surgical treatment may be feasible.
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PMID:Lingual carcinoma metastases presenting as spontaneous pneumothorax. 1977 13


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