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 use and development of iodine-125 plaque therapy for choroidal malignant melanoma are described. Since 1975 experience has led to changes in plaque design and insertion techniques. Twenty-one patients were irradiated with local episcleral iodine-125 plaques. Three patients required a second plaque for tumour recurrence. Four eyes were enucleated because of continued tumour growth and a further eye was removed because of glaucoma secondary to radiation retinopathy. Two patients (9.5%) died of metastases. The remaining 19 patients are alive and clinically clear of metastases, with a mean follow up time of 73.1 months (range 43-142 months).
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PMID:Improved iodine-125 plaque design in the treatment of choroidal malignant melanoma. 173 23

Fifty-seven uveal malignant melanomas (T2: 36.8%; T3: 49.1%) were treated between 1983 and 1989 with Cobalt 60 or/and Ruthenium 106 Rhodium 106 plaques. The mean follow-up was 32 months (from 6 to 69 months). A diminution of tumor size was observed in 88% of the cases, either rapid and marked (57%), or slower and more moderate (31%). A multivariate study showed the radiation dose administered to the tumor edge to be the most significant parameter associated with the tumor control. Seven patients developed metastases, and the probability of survival at 60 months was 83.3%. This probability was identical to that of 59 comparable patients treated, some years before, by enucleation. The most frequent complications were radiation retinopathy (28.1%) and retinal detachment (15.8%). The treated eye was retained in 86% of cases. In 57% of treated eyes, vision remained better or equal to 0.1. The predictive parameters of vision impairment after treatment seemed to be tumor size, tumor site near the macula and the optic nerve, and the radiation dose to the tumor base. The use of Ruthenium 106 Rhodium 106 appeared to be advantageous in controlling the disease as well as in reducing the incidence of complications.
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PMID:[Oncologic and functional results of 57 malignant melanoma of the uvea treated by curietherapy]. 177 10

Cancer-associated retinopathy (CAR), a paraneoplastic syndrome, is characterized by the degeneration of retinal photoreceptors under conditions where the tumor and its metastases have not invaded the eye. The retinopathy often is apparent before the diagnosis of cancer and may be associated with autoantibodies that react with specific sites in the retina. We have examined the sera from patients with CAR to further characterize the retinal antigen. Western blot analysis of human retinal proteins reveals a prominent band at 26 kD that is labeled by the CAR antisera. Antibodies to the 26-kD protein were affinity-purified from complex CAR antisera and used for EM-immunocytochemical localization of the protein to the nuclei, inner and outer segments of both rod and cone cells. Other antibodies obtained from the CAR sera did not label photoreceptors. Using the affinity-purified antibodies for detection, the 26-kD protein, designated p26, was purified to homogeneity from the outer segments of bovine rod photoreceptor cells by Phenyl-Sepharose and ion exchange chromatography. Partial amino acid sequence of p26 was determined by gas phase Edman degradation and revealed extensive homology with a cone-specific protein, visinin. Based upon structural relatedness, both the p26 rod protein and visinin are members of the calmodulin family and contain calcium binding domains of the E-F hand structure.
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PMID:A photoreceptor calcium binding protein is recognized by autoantibodies obtained from patients with cancer-associated retinopathy. 199 65

A 72-year-old woman developed recurrent blindness on exposure to bright light (sunlight). Examination revealed total achromatopsia; bilateral central scotomas, predominant suppression of the cone response by electroretinography, and narrowing of the retinal arteries on ophthalmoscopy. The general examination revealed a pelvic tumor that later proved to be a pleomorphic carcinoma of presumed uterine origin. The patient died of metastatic disease 9 months after the ocular symptoms developed. Histopathologic examination of the eyes revealed loss of the photoreceptors, most extensive in the macular regions, and selective loss of the cones from the rest of the retinas. No ocular metastases of inflammation were found. The changes described are interpreted as paraneoplastic retinopathy of autoimmune origin.
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PMID:[Paraneoplastic retinopathy simulating cone dystrophy with achromatopsia]. 224 76

Between 1983 and 1987, 56 patients with choroidal melanoma were treated at the University of Southern California with episcleral plaque (RPT). There were 29 female and 27 male patients, with a mean age of 59 years. Tumor stage at diagnosis was T2 in 18 (32%) and T3 in 38 (68%) patients. The tumor height ranged from 2.9 to 15 mm (mean 6.8 mm). Radial dimensions ranged from 5 to 25 mm (mean 13.2 mm), and circumference ranged from 7 to 23 mm (mean 12.3 mm). Most (77%) patients had posteriorly located tumors, including 18% that were juxtapapillary. Custom-designed gold plaques were utilized in this study. Radioactive isotopes used were 125I for 26 procedures or 192Ir for 31 procedures. A total of 56 patients were treated, with one patient having two procedures. Radiation doses at the tumor apex ranged from 29.8 to 165.4 Gy (mean 94.5 Gy), with the dose at 5-mm depth ranging from 70.5 to 430 Gy (mean 161.5 Gy). Follow-up ranged from 29 to 57 months (mean 39 months). The overall 4-year survival was 96%, with a 91% incidence of free-of-disease progression at 4 years. The majority (84%) of patients experienced a decrease in tumor height, with 27 (48%) patients having greater than 50% decrease. Increase in tumor height was noted in 5 (9%) and no change in 4 (7%) patients. Useful vision (greater than 5/200) was observed in 59% of patients, including 21% who had improved vision. Metastatic tumor occurred in 5 (9%) patients, with a mean time to metastases of 14 months. There was a good correlation between radial tumor dimension and metastatic disease, p less than 0.001. Treatment complications were observed in 34 (61%) patients, with cataract and retinopathy being the most common. Enucleation was performed in 11 (20%) patients, with a mean time to enucleation of 14.5 months. Causative factors for enucleation were treatment complications in 6 and tumor progression in 5 patients. Enucleations were required primarily in patients with tumors greater than 8 mm in height (p = 0.009). Improved RPT techniques with three-dimensional dosimetry are needed to reduce the overall incidence of treatment complications. Adjuvant hyperthermia is being investigated in an attempt to improve tumor control in patients with larger tumors.
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PMID:Episcleral radioactive plaque therapy: initial clinical experience with 56 patients. 234 23

Twenty-three patients were treated with radon therapy for choroidal melanoma at the Ohio State University Hospitals, Columbus, between 1968 and 1976. We present an 18-year experience, including follow-up of at least eight years, in all those receiving therapy. Three patients (13%) died of metastatic disease. Four patients (17.4%) died of other causes. Sixteen patients (69.6%) were alive, with no signs of metastatic disease. Eight patients subsequently required enucleation due to inadequate tumor response. Of the 15 patients who demonstrated successful tumor destruction and retained their eyes, 13 (86.7%) developed substantial irradiation-induced retinopathy, including hard exudates, telangiectasias, neovascularization, microaneurysms, intraretinal and vitreous hemorrhages, secondary glaucoma, and irradiation-induced cataract. Our long-term results indicate a high incidence of both vascular complications and decreased visual acuity.
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PMID:Radiotherapy for choroidal melanoma. An 18-year experience with radon. 382 11

We report a case in which the diagnosis of prostatic carcinoma, metastatic to the orbit, was confirmed using an immunoperoxidase technique on cytologic specimens obtained by fine-needle aspiration. Computed tomography was valuable in localizing the tumor for biopsy and subsequent radiation therapy. The results of these studies correlated with the clinical history and other evidence of widespread metastatic disease. Ironically, the first evidence of malignancy in this patient was possibly also ophthalmologic, manifesting 14 months earlier with hemorrhagic retinopathy associated with thrombocytopenia. To our knowledge, this is the first report describing the combination of an immunoperoxidase technique with the fine-needle aspiration biopsy of an orbital tumor.
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PMID:Orbital metastasis from prostatic carcinoma. Identification by immunocytology. 619 8

Fluorophotometry using the Metricon Model 120 slit-lamp fluorophotometer showed, at an anterior focus, two peaks which corresponded to the cornea and ciliary region--the latter predominantly due to the ciliary body but contributed to by the lens--and following this, at a posterior focus, a mid-vitreous minimum and a chorioretinal peak. Tracings made both before and after fluorescein injection were similar but the levels were higher post-injection, with increasing age and with non-pigmented irides. The change in fluorescein distribution with time after injection is described. Abnormally high fluorescein levels were found in the normal fellow eye in retinal vein occlusion, in diabetes, in senile macular degeneration with neovascular membrane, in active central serious retinopathy and in acute optic neuritis. It is of use in the differentiation of primary choroidal melanoma from naevus and metastases. There was no correlation between isolated measurements of the haemoglobin A1C level and leakage; plasma and ultrafiltrate fluorescein levels in diabetics did not differ from normal.
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PMID:Experiences with fluorophotometry. 710 62

Metastases in the choroid of the eye are frequent in patients with disseminated malignancy. We here report the results using the precision radiotherapy technique described by Schipper et al. to treat 14 of 17 consecutive patients (21 eyes) with symptoms from such metastases. A beam defining collimator was used and a lateral field was given with the treated eye individually fixed. Varying fractionations and doses were used. The biologically effective dose for early effects (BED3) was 47 to 90 Gy and for late effects (BED10) 28 to 59 Gy. In 14 eyes (82%) the metastases regressed completely. The visual acuity was stabilized or improved in all patients and none needed local surgery. Three patients developed signs of radiation retinopathy, but only in one case the visual function was compromised. With this standardized technique no individualized dose planning was needed, the risk of radiation cataract was minimized and a dry eye avoided.
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PMID:Standardized precision radiotherapy in choroidal metastases. 751 93

A 50-year-old man with cancer-associated retinopathy was investigated using light and electron microscopy, immunofluorescence studies, and western blotting. He had visual disturbance, ring-like scotoma, and night blindness bilaterally. There were narrowed retinal arterioles and dilated retinal venules. Oral corticosteroid therapy had positive effects. Immunostaining using the patient's serum revealed a positive reaction in the ganglion cell layer of normal retina. Western blotting showed that the patient's serum antibody reacted with normal retinal proteins of 24 and 48 kDa. Multiple metastases were evident at autopsy.
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PMID:Cancer-associated retinopathy with retinal phlebitis. 811 Jun 75


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