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)

We reviewed the clinical features, essential laboratory data, pituitary imaging findings (computerized tomography and magnetic resonance imaging), management, and outcome of 353 consecutive patients with the presumptive diagnosis of pituitary tumor investigated from January 1984 through December 1997 at University Hospital, Lausanne, Switzerland. In 18 cases primary empty sella turcica was diagnosed, and in 13 cases of pseudacromegaly there were no endocrine abnormalities. The remaining 322 patients disclosed abnormal pituitary masses, including 275 pituitary adenomas, 18 craniopharyngiomas, 6 cases of primary pituitary hyperplasia, 6 intrasellar meningiomas, 6 cases of distant metastases, 4 intrasellar cysts, 2 chordomas, 1 primary lymphoma, and 1 astrocytoma. Biologic data and immunohistochemical analysis of the excised tissues demonstrated that prolactinomas and nonsecreting adenomas (NSAs) were the most frequent pituitary tumors (40% and 39%, respectively), followed by somatotropic adenomas with acromegaly (11%) and Cushing disease (6%). In contrast with the vast majority of NSAs, which significantly expressed glycoprotein hormones in tissue without secreting them, there was a small group of glycoprotein hormone-secreting adenomas (2%), which had a more severe clinical course after surgery. Thirty-eight pituitary masses were incidentally discovered, most of them NSAs. The expansion of pituitary adenomas into the right cavernous sinus was twice as frequent as to the left cavernous sinus. For the differential diagnosis of hyperprolactinemia, basal prolactin (PRL) levels above 85 micrograms/L, in the absence of renal failure and PRL-enhancing drugs, and a PRL increment of less than 30% after thyrotropin-releasing hormone (TRH) accurately ruled out functional hyperprolactinemia due to NSA, and were typical of prolactinomas. For screening and follow-up of acromegaly, basal growth hormone (GH) and insulin-like growth factor 1 (IGF-1) levels, as well as the paradoxical GH response to TRH (present in 2/3 acromegalic patients), could be used as convenient tools, but the most accurate test for diagnosis and prediction of outcome after therapy was GH (lack of) suppression during oral glucose tolerance test. In Cushing disease, single evening plasma cortisol was as good as the overnight dexamethasone suppression test for screening, and a combined dexamethasoneovine corticotropin-releasing hormone (oCRH) test was as accurate as the long dexamethasone suppression test to confirm the diagnosis. Bilateral inferior petrosal sinus catheterization coupled with oCRH test confirmed the pituitary origin of excess adrenocorticotropic hormone (ACTH) in all patients, including those with normal pituitary on magnetic resonance imaging (50% of the cases). However, this procedure failed to predict tumor localization correctly within the pituitary in 21% of patients. Pituitary cysts, meningiomas, and craniopharyngiomas with an intrasellar component were correctly diagnosed based on pituitary imaging in 75%, 67%, and 44% of cases, respectively. The remainder, as well as the cases of pituitary hyperplasia, metastases, and other less frequent pathologies, were initially diagnosed as NSAs or as masses of unknown nature. When surgery was indicated, pituitary adenomas and other intrasellar masses were operated on by the transsphenoidal route, with the exception of 100% of meningiomas, 83% of craniopharyngiomas, and 10% of NSAs, which were operated on by the transcranial route. Favorable late surgical outcome of prolactinomas could be predicted by a restored PRL response to TRH. However, dopamine agonist (DA) therapy, usually resulting in satisfactory control of PRL levels and in tumor shrinkage, progressively displaced surgery as primary treatment for prolactinomas throughout the study period. After full-term pregnancy, the size of prolactinoma decreased in 7 of 9 patients, and PRL was normal in 2. Surgery was the first treatment for NSAs, with a tumor rela
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PMID:Diagnosis, treatment, and outcome of pituitary tumors and other abnormal intrasellar masses. Retrospective analysis of 353 patients. 1042 6

A 70-year-old man, who had undergone total gastrectomy for Borrmann III gastric cancer one year previously, was referred to us with a complaint of left scrotal swelling. Physical examination showed left scrotal hydrocele and a hard nodule in the ipsilateral inguinal area. Excretory pyelography and abdominal computed tomography showed mild left hydronephrosis and no stone. A left orchiectomy was performed. The mass in the spermatic cord was 2.5 x 1.0 x 1.0 cm in size, and the pathological diagnosis was tubular adenocarcinoma, identical to that of the previous gastric cancer. Five months after orchiectomy, the patient underwent percutaneous nephrostomy to manage postrenal renal failure caused by massive metastasis of retroperitoneal lymph nodes. He died one month later. We found a total of 84 cases of metastatic tumors of the spermatic cord reported in Japan, approximately half of which were metastases from gastric cancer. In 10 cases, including ours, the tumor was accompanied by hydrocele of the scrotum or spermatic cord. Although this association is rare, cancerous lesions should be considered in the management of hydrocele.
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PMID:[A case of metastatic tumor of spermatic cord with hydrocele from gastric cancer]. 1065 23

Etoposide and cisplatin (EP) has been the standard therapy for non-small cell lung cancer (NSCLC) at many cancer centers for over a decade. We analyzed our experience with EP in NSCLC to provide a baseline for comparison with new drugs. From 1986 through 1994, 46 of our patients with NSCLC received EP as first-line chemotherapy. Radiation therapy was administered to 25 of them, including 20 who received it immediately before or concomitantly with chemotherapy. Toxicity was mild and included only 1 episode of neutropenic fever and 1 case of reversible renal failure. Overall response was 22%. In 3, response was complete (pathologically documented in 2 of them) and in 7 partial. Median survival in locally advanced (stage III) and metastatic disease (stage IV and recurrent) were 12 months and 7 months, respectively. 2 patients are alive and free of disease more than 6 years after diagnosis. Our results are consistent with other published studies of EP in NSCLC. EP provides modest benefit in locally advanced NSCLC, with minimal toxicity.
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PMID:[Etoposide and cisplatin for non-small cell lung cancer: trial at the Soroka Medical Center 1986-1994]. 1088 99

Malignant hidradenoma is a very rare tumor that originates from sweat glands. We present a 61-year-old man with an ulcerated tumor in his right flank, 4 cm in diameter, that was excised with a wide free margin. Histopathologic study showed an ill-defined, epithelial neoformation, formed by lobules of clear polygonal cells in the deep dermis and subcutaneous tissue, diagnosed as malignant nodular hidradenoma. 1.5 years after excision there was enlargement of the right axillary and inguinal lymph nodes, which showed metastatic, adnexal neoplastic cells. Axillary resection and superficial dissection of the right inguinal nodes were performed. After 3 months the tumor had spread to other lymph nodes and acute obstructive renal failure required insertion of a pig-tail catheter into the right ureter. Radiotherapy was followed by chemotherapy, but he died from end-stage metastatic disease in multi-organ failure.
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PMID:[Malignant nodular hidradenoma--sweat gland tumor]. 1095 88

S-100 serum concentrations were analyzed in 39 healthy people, 130 patients with benign diseases and 304 patients with malignancies, including 49 patients with locoregional diseases and 255 with advanced diseases. S-100 was determined by a commercial immunoluminometric assay, and 0.20 ng/ml was considered to be the upper limit of normality. In none of the healthy people was S-100 higher than 0.2 ng/ml. Slightly high S-100 concentrations were found in 33 out of 130 patients (25%) with benign diseases (mean 0.21 +/- 0.45 ng/ml). Significantly higher S-100 serum levels were found in patients with liver cirrhosis (63%, 10/16) (p = 0.024) or renal failure (45%, 8/18) (p = 0.03) than in patients with other benign diseases or in healthy people. Abnormal S-100 serum levels were found in 68 of the patients (22.5%) with malignancy (mean 1.01 +/- 5.9 ng/ml). The highest S-100 concentrations were found in patients with malignant melanomas (p = 0.001). Excluding melanoma patients, the S-100 serum levels in patients with malignancies were not related to tumor origin or stage but were clearly related to the site of metastasis, with patients with liver metastases showing higher values than patients with metastases without liver involvement (p = 0.02). No statistical differences were found among patients with liver cirrhosis, primary liver cancer or liver metastases. In conclusion, S-100 is a useful marker for melanoma, but abnormal levels of this tumor marker may be found in benign and malignant diseases associated with liver or renal injury.
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PMID:S-100 protein serum levels in patients with benign and malignant diseases: false-positive results related to liver and renal function. 1189 5

We administered chemotherapy in three cases of small-cell lung cancer (SCLC) with renal failure under different situations. Hemodialysis (HD) was used in 2 out of the 3 cases. Case 1 was complicated by acute renal failure from extensive bilateral tumor invasion. After chemotherapy (CBDCA + ETP) under HD, renal metastases regressed and renal function improved, although the final response was PD. In case 2, HD had been introduced for diabetic nephropathy. After 2 cycles of chemotherapy (CBDCA + ETP) under HD, the patient attained a PR. Case 3 is an example of paraneoplastic nephrotic syndrome with renal failure. Chemotherapy including CBDCA or CDDP was performed and the QOL of the patient improved. Pro-GRP and serum creatinine changed in parallel during the clinical course of 6 admissions. In conclusion, individualized therapy is necessary to increase survival time of SCLC patients with renal failure. Although chemotherapy is useful, further study is needed for the selection of suitable chemotherapeutic regimens, optimal dosage of each drug and the timing of HD.
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PMID:[Chemotherapy for small-cell lung cancer (SCLC) patients with renal failure]. 1191 35

Retroperitoneal fibrosis (Ormond's disease) is rare chronic inflammatory process, that can occur at any age. It is characterised by development of periaortic fibrous mass leading to progressive obstruction of vessels around the abdominal aorta and ureters. In the one third of cases we can find the causes of disease. There are ergotamine abuse, radiation, retroperitoneal surgery or hemorrhage, urine extravasation and response to different cancers. The other cases are idiopathic disease. We report a case of prostate cancer with unique course. The first manifestations of disease were diffuse peritoneal fibrosis and ureteral obstruction leading to bilateral hydronephrosis. Clinical course and histopathology showed idiopathic Ormond's fibrosis. Patient received oral immunosuppressive treatment (prednisolone 1 mg/kg/day + azathioprine 1 mg/kg/day), followed by intravenous methylprednisolone puls (2 g). Treatment also consisted of DJ-stent placement on the left side. On the right side we were unable to overcome the obstruction of ureter. Because of persistent renal failure, thrombocytopenia, DIC and progressive lower back pain we did control MR and CT scan. The CT scans showed multiple osteolytic bone metastases in vertebral column (the sizes of them were between a few millimetres and 1.5 centimetre). Patient died due to renal failure and haemorrhagic diathesis in the course of disseminated cancer of unknown origin. The postmortem examination revealed diffuse peritoneal infiltration surrounding the ureters, intramural ventricular metastases, pulmonary metastases and vertebral metastases. The prostate was only slightly enlarged. Histological and immunohistochemical examinations of prostate showed primary low-differentiated prostate carcinoma (CK/+/, PAP/+/, PSA/+/). Peritoneal, ventricular and bone infiltrations also were metastases from low-differentiated carcinoma of prostate origin (CK/+/, PAP/+/, PSA/-/).
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PMID:[Ormond's fibrosis, bone osteolysis and stomach intramural metastases in the course f low-differentiated prostatic cancer]. 1192 71

Authors report their own experience on the treatment of pancreatic neoplasms. Two-hundred-ninety-four patients were observed during the years 1959-95. Resectability rate was 18%. Fifty-three patients underwent pancreatic resection: 22 distal pancreatectomies (41.5%), 2 total pancreatectomies (3.7%) and 29 pancreaticoduodenectomies (54.7%) (7 PPPD). Overall morbidity rate was 15.6% with decrease during the years of major postoperative complications. More frequent complications were renal failure (4%), bleeding (1.7%) and acute pancreatitis (5.6%), which was absent during the 1981-95 period. Pancreatic fistula occurred in 5.6%, but in the years 1981-95 only one patient suffered from it (1.8%). During the years 1959-70 operative mortality rate after pancreatic resection was 22.7%, during 1971-80 was 12.5% and during 1981-95 decreased to 4.3%. Patients with stage I tumours survived curative pancreatic resection for about 18.2 months, compared with those with stage II and III tumours, who survived for about 15 and 13 months, respectively. Recent studies have demonstrated a reduction in the morbidity and mortality of pancreatic resections and improvement in the actuarial 5-year survival for patients with resected ductal adenocarcinoma. In the presence of lymphnode metastases, pancreaticoduodenectomy offers good palliation and meaningful survival. In the absence of lymphnode metastases, pancreaticoduodenectomy offers encouraging long-term survival rates and a chance for cure.
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PMID:[Resective surgical treatment of exocrine pancreas neoplasms. Retrospective study of 294 cases and review of the literature]. 1199 39

The postoperative outcome and survival were studied in patients operated for renal cancer with involvement of the liver. 9 patients have undergone radical nephrectomy and 12 patients--hepatic resections for direct hepatic involvement (2), synchronous (2) and metachronous (8) metastases of renal cell carcinoma. Right hemihepatectomy was performed in 2 and wedge resection in 10 cases. A complete resection was performed in 8 of 9 patients while one patient with direct hepatic invasion was found to have positive surgical margins. Postoperative lethality was absent but complications occurred in 6 patients: pancreatitis (1), pneumonia (3), hepatic abscess (1), hepatic and renal failure followed by GI bleeding (1). At follow-up, two patients died of progressive disease 4 and 68 months after the surgery and one was lost for follow-up. One patient with positive surgical margins is alive with pulmonary and liver metastases 16 months after surgery. Five patients are alive with no evidence of relapse 6, 10, 12, 19 and 56 months after the operation. Thus, the aggressive surgical approach is justified and should be considered in patients with renal cancer and hepatic involvement.
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PMID:[Liver resection in locally-spread and metastatic kidney cancer]. 1207 26

We report a case of clear cell adenocarcinoma of the urinary bladder. A 59-year-old male was referred to our hospital complaining of oliguria, left lower abdominal pain and loss of appetite. Ultrasonography revealed bilateral hydroureteronephrosis and obstructions at the ureterovesical junction. Magnetic resonance imaging demonstrated an invasive irregular tumor located in the posterior wall of the urinary bladder and urinary infiltration to the left retroperitoneal space. The clinical diagnosis was acute post renal failure due to bilateral ureteral obstructions from an invasive bladder tumor. After we performed bilateral percutaneous nephrostomy, the patient underwent trans urethral biopsy of the bladder tumor, which showed clear cell adenocarcinoma extending from the submucosa to the muscular layer, histopathologically. The patient died of metastatic disease 8 months after diagnosis. To our knowledge, the present case is the 23rd to be reported and demonstrates the shortest survival period in the related literature.
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PMID:Clear cell adenocarcinoma of the urinary bladder inducing acute renal failure. 1222 45


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