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 case of asynchronous renal carcinoma with a 15-year course is described. Right nephrectomy and left heminephrectomy were performed. Solitary metastases to pancreas and striated muscle were treated with total pancreatectomy and local excision, respectively. The patient died of renal failure due to progressive immune complex glomerulonephritis, which was documented histologically as well as by clinical observations of intensifying excretion of urinary protein with decreasing selectivity. The glomerular lesion is suggested to have been caused by deposition of tumour-related immune complexes arising from an immune response by the host to his tumour.
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PMID:Asynchronous metastasizing renal cell carcinoma associated with progressive immune complex glomerulonephritis and proteinuria. 623 72

Colostomy and ileostomy stomal hemorrhage is a rare and potentially fatal complication of portal hypertension. We describe two patients with colostomy stomal hemorrhage who had both undergone abdominoperineal resection for carcinoma of the rectosigmoid colon. Patient 1, in the absence of metastatic disease with minimal to moderate functional hepatic impairment, undersent a mesocaval interposition graft shunt and had no recurrence of stomal hemorrhage during the four-month postoperative period. Patient 2, in the presence of metastatic disease to the lungs and liver, was not shunted and died of hepatic and renal failure. Angiography, in particular splenoportography, is extremely helpful in establishing the diagnosis of portal hypertension and planning appropriate operative procedure. We reviewed the literature on ileostomy and colostomy hemorrhage in the presence of portal hypertension and conclude that control of major stomal hemorrhage by local measures is often ineffective and that portasystemic shunts may significantly improve long-term prognosis.
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PMID:Management of colostomal hemorrhage resulting from portal hypertension. 696 64

We report a case of hemolytic uremic syndrome (HUS) with advanced renal failure and metastatic adenocarcinoma of the prostate. The HUS rapidly improved after treatment with blood transfusions, Plasmanate infusions, aspirin and dipyridamole, and hemodialysis for uremia. No cancer chemotherapy was given. This case illustrates that, in adults, HUS may have an excellent prognosis even with advanced renal failure, and that the presence of metastatic cancer does not necessarily imply a relationship between the two diseases.
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PMID:Hemolytic uremic syndrome and metastatic malignancy. 714 74

Assays of serum immunoreactive parathyroid hormone are clinically useful in the differential diagnosis of hypercalcaemic states and in the assessment of the severity of parathyroid bone disease in uraemic patients. Serum immunoreactive calcitonin measurements are essential in the investigation of individuals who might be suffering from medullary carcinoma and may be used in the detection of metastases. Serum 25-hydroxyvitamin D assays should be performed in patients receiving pharmacological doses of vitamin D to monitor patient compliance and to prevent the occurrence of vitamin D intoxication. Low values in patients with renal failure and in patients with malabsorption are highly suggestive of the presence of osteomalacia. The measurement of serum levels of dihydroxylated vitamin D metabolites is currently of doubtful relevance though such measurements may become useful in monitoring patients receiving these compounds therapeutically.
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PMID:The measurement of calcium-regulating hormones in clinical medicine. 720 1

A total of 24 patients with renal cell carcinoma involving the inferior vena cava underwent thoracoabdominal radical nephrectomy with removal of tumor thrombus by an open or closed technique. The tumor extended in the inferior vena cava to the level of the renal or lower hepatic veins in 18 patients and it reached the level of the diaphragm or right atrium in 6. Of the 24 patients 3 with preoperative findings minimally suggestive of disseminated disease were shown later to have metastases in the questionable areas, 3 with disease at the level of the diaphragm had incomplete resections, 4 had metastases to regional lymph nodes and 1 had questionable preoperative findings and lymph node metastases. Only 13 of the 24 patients (54 per cent) did not have either disseminated or residual tumor postoperatively. The mean survival duration of this subgroup (20 months) was comparable to that of the group as a whole (21 months). However, 4 patients from this subgroup are free of disease, with a mean followup of 30 months. There was 1 postoperative death. Morbidity, including renal failure, intraoperative hypotension and sepsis, was common. The results in this series suggest that the prognosis for patients with renal cell carcinoma and inferior vena cava involvement is guarded.
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PMID:Results of inferior vena cava resection for renal cell carcinoma. 724 72

A 68 year old man with prostatic carcinoma and extensive painful osteoblastic metastases was discovered to have hypocalcemia (serum calcium 7.1 mg/dl) without evidence of hypoalbuminemia, renal failure or malabsorption. Baseline studies revealed hypocalciuria (24 hour urine calcium less than 5 mg/day), normal serum phosphate (3.4 mg/dl), low tubular reabsorption of phosphate (68 percent), undetectable serum calcitonin, normal serum 25-hydroxyvitamin D, slightly elevated serum parathyroid hormone level and increased urinary cyclic AMP (8.87 mumol/g creatinine). These studies were compatible with secondary hyperparathyroidism. The intravenous administration of parathyroid extract produced no further change in urinary phosphate but a 25-fold increase in nephrogenous cyclic AMP. Three days administration of intramuscular parathyroid extract slowly and temporarily restored serum calcium to normal levels while increasing urinary cyclic AMP and phosphate. Chemotherapy with cyclophosphamide and 5-fluorouracil rendered the patient free of pain while reducing serum acid and alkaline phosphatase levels and restoring serum total and ionized calcium and urinary cyclic AMP excretion to normal.
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PMID:Hypocalcemia with osteoblastic metastases in patient with prostate carcinoma. A cause of secondary hyperparathyroidism. 724 80

Microangiopathic hemolytic anemia and thrombocytopenia secondary to disseminated intravascular coagulation is a well-described complication of widely metastatic carcinoma. The authors report four cases of gastric carcinoma, one case of colon cancer, and one case of adenocarcinoma of unknown primary in which the patient developed a syndrome analogous to thrombotic thrombocytopenic purpura, consisting of microangiopathic hemolytic anemia, thrombocytopenia, and renal failure without definite evidence of disseminated intravascular coagulation. In contrast to previous reports, postmortem examination in three of the cases revealed no recurrence or only microscopic foci of residual tumor. In the remaining three, there was clinical and pathologic evidence of grossly disseminated carcinoma. Also in contrast to previous cases, all patients evidenced azotemia and proteinuria at the onset of the syndrome and ultimately uremia was a contributing cause of death. Coagulation profiles showed prolonged thrombin times and elevated fibrin degradation products in four instances and did not distinguish the patients with grossly metastatic disease from those with no tumor or only microscopic residua. Circulating immune complexes containing carcinoembryonic antigen were found in the patient with metastatic colon carcinoma. The syndrome was clinically identical whether or not grossly metastatic tumor was present, and it should not be attributed to advanced disease without definite clinical or pathologic evidence of a recurrence.
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PMID:Microangiopathic hemolytic anemia, thrombocytopenia, and renal failure in patients treated for adenocarcinoma. 728 73

Two patients with epidermoid carcinoma treated with mitomycin-C (Mit-C) and 5-fluorouracil (5-FU) developed microangiopathic hemolytic anemia (MAHA), renal failure, and altered mental status. Patient 1 was free of metastatic disease, on maintenance Mit-C and 5-FU when MAHA changes appeared. Patient 2 had recurrent carcinoma in the pelvic area when MAHA changes appeared. In both patients, MAHA changes and neurologic function improved after exchange plasmapheresis. This is the first report of epidermoid carcinoma manifesting MAHA changes after chemotherapy. Speculation as to pathogenesis and appropriate therapy are discussed.
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PMID:Microangiopathic anemia observed after treatment of epidermoid carcinoma with mitomycin C and 5-fluorouracil. 737 25

A 67-year-old woman died after 4 years of treatment by haemodialysis. End-stage renal failure was caused by polycystic kidney disease. Malignancy was suspected in the last 6 months of treatment because of impressive weight loss and a suspect liver-scan. Macroscopic haematuria in the first period of treatment was noted only once. Necropsy revealed renal carcinoma of the right polycystic kidney and tumour metastases in various organs. The problem of development of renal carcinoma in polycystic kidney disease in the light of the increased incidence of malignancy during chronic renal failure is discussed.
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PMID:Development of renal carcinoma in a patient with polycystic kidneys undergoing chronic haemodialysis. 739 7

On the basis of a case of partial nephrectomy of a single functioning kidney performed with immediate success in a 77-year-old woman, the author reviews the main data from the literature concerning this particular treatment of carcinoma of the kidney. In the great majority of cases the carcinoma required partial nephrectomy only because the affected kidney was single. Operative mortality was low : 2.6 %. Three year survival is 61 % of cases and it is important to note that terminal renal failure and recurrences in the remaining portion of the kidney are rare. Metastases represent the chief cause of death. Survivals ranging from 6 to 14 years have been reported. When the fact that the kidney is single is not because of nephrectomy for a carcinoma, the prognosis after partial nephrectomy is the same as that after wide excision for carcinoma (in patients with both kidneys). When the opposite kidney had been the site of a carcinoma and even more so in the presence of metastases, the prognosis becomes far less good. With a single kidney, the development of a carcinoma does not necessarily imply the need for total excision of the kidney followed by intermittent haemodialysis. A partial nephrectomy is worth the attempt when it appears to be reasonable. A number of particular technical features are emphasised : - the need for prior arteriography which defines the respective topography of the tumour and the renal vessels, - the safety of temporary clamping of the renal artery when the kidney is made hypothermic by cooling using ice piled up in contact with the kidney, - the possibility of performing such an excision in situ via an appropriate surgical approach.
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PMID:[Carcinoma affecting a single kidney. Conservative surgery. One case (author's transl)]. 746 58


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