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)

The term "teratoid" Wilms' tumor has been used recently to describe an unusual type of tumor in which, although classic nephroblastoma tissue is present, there is a significant diversity of cell types and tissues present. Examination of tissue samples from 290 patients treated at St Jude Children's Research Hospital from 1964 to 1987 disclosed that three children had teratoid Wilms' tumor. All three children had renal tumors and two of them presented with bilateral pyeloureteral obstruction, uremia, and hypertension. When compared with classic nephroblastoma, two of the children with teratoid elements responded poorly to chemotherapy and irradiation, although no metastatic disease was identified. One child died with sepsis and renal failure; the other two are surviving disease-free for 7 1/2 years and 26+ months since diagnosis. Because of the tendency for bilateral involvement, ureteral obstruction, and uremia, and their relative resistance to chemotherapy and irradiation, surgery is the principal form of therapy for patients with these tumors.
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PMID:Teratoid Wilms' tumor: the St Jude experience. 285 18

The course of the disease of critically ill patients is complicated and prognosis worsened by failure of one or more organs. During intensive care monitoring and treatment of vital functions most attention usually is paid to the cardio-pulmonary and renal system; liver function is neglected rather often. In a retrospective study 100 critically ill patients were evaluated, who had serum bilirubin levels above 3,0 mg/dl, but no primary liver disease. Excluded were patients who had liver destruction caused for instance by liver abscess or metastases, and patients with acute hemolysis and extrahepatic cholestasis. Severe infection was the primary cause of disease in 64% of these critically ill patients without primary liver dysfunction; 52% patients had septicemia, 37% patients were in a post-operative or post-traumatic status, 28% patients had severe gastrointestinal complications, 23% had myocardial pump failure, 32% had protracted shock, 29% had hematological disease, 59% had lung failure, and 58% renal failure. It was tried to find a correlation between the different liver function parameters in this group of patients. In spite of rather pronounced pathological findings a statistically significant correlation could only be found between SGPT and SLDH. This study demonstrates the importance of liver involvement in critically ill patients on the one side and the necessity of comprehensive and repeatedly performed investigations of liver function in such patients on the other side.
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PMID:[Liver function disorders and damage in critically ill intensive care patients]. 286 63

Disorders of calcium homeostasis are frequent and seldom diagnosed in the Emergency Department. In both the adult and pediatric population, the causes of increased or decreased calcium are many, and the index of suspicion needs to be raised for these disorders. Selective ordering is warranted for patients with altered mental status, seizures, neuromuscular irritability, or in patients with diseases known to have abnormalities of calcium as a complicating factor. These include renal failure, multiple myeloma, metastatic cancer, granulomatous disease, and endocrinopathies.
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PMID:Calcium. 293 31

The trial drug was ICI 118.630 (Zoladex). Inclusion criteria were histologically confirmed advanced prostate cancer (T greater than 2 or N+ or M+), life expectancy greater than 3 months, and no previous radiotherapy, orchiectomy, or chemotherapy. Treatment started in November 1984; 30 patients were recruited. The period of treatment ranged from 6 to 144 weeks (median of 59.5 weeks). One patient died after 6 weeks of rapidly progressive renal failure. Data were updated to the end of August 1987. The mean age was 67.9 years (53-83 years). Subjective response was evaluated by a mean symptoms score (using daytime micturition, nocturia, dysuria, hesitancy, and flow) and a score of three different items: patients' activity, bone pain, and use of analgesics. Only 7.1% of the patients showed a permanent positive response. Four different objective responses (complete, partial, stable disease, and progression) were possible after evaluating the T category, tumor dimensions, metastases, and prostatic acid phosphatase. Testosterone (T) and plasmatic LH levels rose after administration: T dropped below the castration level (1 ng/ml) within a few days and remained constantly low. The rate of progressive disease was 27.6%; disease control was possible in 72.4% of the patients (PR or SD).
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PMID:LH-RH analogue treatment for advanced prostate cancer. 297 66

A case of fatal hepato-renal failure occurring during mithramycin treatment is reported. A 64 year-old female patient was admitted to hospital in a state of acute renal failure. She also presented with hypercalcaemia and bilateral pulmonary metastases. She had been operated on 10 years previously of a parathyroid cancer. Despite treatment with mithramycin (total dose 8.25 mg) and haemodialysis, the hypercalcaemia returned; it was then decided to remove the secretory lung metastases (parathormone 420 micrograms X ml-1). 48 hours before surgery, the patient was again given 1.25 mg mithramycin. Immediately after surgery, she developed hepatic failure with massive cell destruction and anuria. The patient died 48 h after the operation. The hepatic and renal complications of mithramycin are discussed.
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PMID:[Acute fatal hepatorenal failure during treatment with mithramycin]. 316 Feb 68

We conducted parallel phase II trials of cimetidine as a single agent and the combination N-phosphonacetyl-L-aspartate (PALA) plus L-alanosine among 40 previously untreated patients with biopsy-proven, measurable disseminated malignant melanoma. We did not design the trial to be a comparative assessment of the two regimens. Among 19 patients treated with cimetidine, 300 mg orally four times daily, there was one complete response of extensive pleural and pulmonary metastases for 16+ months and two partial regressions of soft tissue lesions for 7 and 21+ months, respectively. Among 21 patients treated with the combination regimen, there was only one partial response in soft tissue for 1 month. The median times to progression and death were 1.4 and 6 months, respectively, for cimetidine, and 1.3 and 4 months, respectively, from the combination of PALA plus L-alanosine. Among patients who progressed on initial treatment, there were no responses in 12 who received crossover therapy with cimetidine and 11 with the combination regimen. Two patients treated with the combination program had severe stomatitis, two developed renal failure, and one had severe leukopenia and thrombocytopenia. Recognizing the limitations of small sample size, these early observations suggest that cimetidine may have intriguing implications in the management of disseminated malignant melanoma.
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PMID:Phase II studies of single-agent cimetidine and the combination N-phosphonacetyl-L-aspartate (NSC-224131) plus L-alanosine (NSC-153353) in advanced malignant melanoma. 359 11

The surgical challenge of resection of renal cell carcinoma with vena caval invasion may require close cooperation between the urologist and cardiovascular surgeon. From 1977 to 1986, 13 patients with renal cell carcinoma and tumor thrombus invading the inferior vena cava (IVC) underwent radical surgical resection. In three of 13 patients the thrombus extended into the heart (right atrium two patients and right ventricle one patient). The tumor originated in the right kidney in 10 patients and in the left kidney in three patients. There were 10 men and three women with a mean age of 64 years (range, 46 to 75 years). Surgical management included midline incision, seven, with median sternotomy, four, and thoracoabdominal, two. After exposure of the renal vessels and IVC, all patients underwent radical nephrectomy. Two patients had caval sleeve resection, one had a partial caval resection, and seven had a 1 cm caval cuff. Planned cardiopulmonary bypass was used in three patients. The tumor thrombus was extracted by simultaneous atrial and caval approaches. One patient underwent unplanned emergency cardiopulmonary bypass after intraoperative cardiac arrest caused by a large tumor embolus of the pulmonary artery. No operative deaths occurred. Postoperative morbidity was significant in five of 13 patients, caval thrombosis in one, lower limb swelling in two, renal failure in one, and pulmonary edema in one patient. Two patients required long-term anticoagulation therapy for confirmed pulmonary emboli within 1 month of surgery. These complications resolved. The follow-up period ranged from 7 to 64 months with a mean of 36 months. Two patients died of metastatic disease at 24 and 48 months after surgery. Three patients are alive with metastatic disease at 6 to 64 months while one patient had a solitary metastatic lesion removed from the frontal lobe 4 years after nephrectomy and has been disease free a subsequent 18 months. Eight of 11 patients are disease free at 7 to 64 months (four patients greater than 52 months). Our 83% survival rate at a mean follow-up of 36 months suggests that this group of patients should not be denied aggressive resection. Documentation of tumor source and caval extension are essential to plan operative procedures, including use of cardiopulmonary bypass.
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PMID:Caval tumor thrombus complicating renal cell carcinoma: a surgical challenge. 366 Feb 38

A 3,900 g full-term male newborn had to be operated on for suspected intraabdominal bleeding due to birth injury. Intraoperatively, a tennis-ball sized, ruptured tumor between right kidney and liver was found to be the source hemorrhage. The tumor was excised in toto. The newborn died 25 hours after the end of operation from protracted shock and renal failure. Post mortem examination did not reveal further malformations or metastases. Histological diagnosis: congenital neuroblastoma of the adrenal gland. Improved antenatal ultrasound diagnosis followed by cesarian section could help to improve the prognosis in such cases in future.
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PMID:[A case of ruptured congenital neuroblastoma caused by birth injury]. 388 96

Two cases of triple primary neoplasm and two cases of quadruple primary neoplasm including transitional cell carcinoma (TCC) of bladder are reported. The first case was a 70-year-old male who had bladder cancer, occult cancer of prostate (adenocarcinoma) and highly differentiated adenocarcinoma of pancreas. He died of cachexy. The second case was a 69-year-old male. This case was also triple primary neoplasm including bladder cancer, squamous cell carcinoma (SCC) of penis and SCC of larynx. The third case was a 78-year-old male who had bladder cancer, adenocarcinoma of prostate similar to that of the first case, adenocarcinoma of stomach, and SCC of lung. He died of obstructive jaundice and renal failure owing to massive metastases of gastric cancer. The fourth case was a 78-year-old male who had four primary neoplasms such as bladder cancer, branchiogenic epithelial carcinoma, SCC of buccal mucosa and adenocarcinoma of rectum.
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PMID:[Two cases of triple primary neoplasm and two cases of quadruple primary neoplasm including bladder cancer]. 409 Nov 30

Four patients in terminal renal failure who had various malignant tumours were treated by haemodialysis and cadaveric renal transplantation. One patient with a testicular seminoma and one with leiomyosarcomatous changes in polycystic kidneys were successfully grafted after removal of the tumours and both were healthy at three and two-and-a-half years afterwards without evidence of recurrence of tumour.One patient with an invasive carcinoma of the renal pelvis was successfully transplanted and remained well for eight months but rapidly deteriorated and died of extensive metastases. Another patient with a malignant melanoma died more than one year after unsuccessful grafting.The presence of concomitant malignant disease in patients with chronic renal failure need not necessarily exclude them from the chance of long-term treatment, including renal transplantation. Each patient should be considered individually from the point of view of the nature of the malignancy, its duration, and treatment.
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PMID:Renal transplantation in patients with carcinoma. 460 59


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