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)

Surgical management of germinal testis tumors other than seminoma is presented. Phase I consists of removal of the primary tumor; phase II, the surgical removal of retroperitoneal metastatic disease, and phase III, surgical management of chest metastasis. Seventy-two patients were explored with the intent of performing a simultaneous bilateral retroperitoneal lymphadenectomy. Each had a radical orchiectomy prior to exploration. Seven patients were found unresectable because of extensive disease above the renal pedicle and lymphadenectomy was not performed. The remaining 65 were found resectable and a transabdominal bilateral retroperitoneal lymphadenectomy was done. Of this number, 20, or 30%, had metastatic nodes. No other treatment was used. All had a 3-year follow-up and 53 were followed for 5 years or more. The 3-year survivals for stage I is 93%, and for stage II, 75%. Survivals of 5 or more years in stage I are 86% and in stage II, 70%. Thus, this experience with pathologic stage II cases clearly demonstrates the capability of surgery as a primary treatment to control 70% of patients with retroperitoneal lymph node metastases. This surgical technique is therfore recommended as primary therapy in stage I and II non-seminomatous geminal testis tumors.
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PMID:Surgical treatment of non-seminomatous germinal testes tumors. 86 91

The necropsy records of 78 patients with histologically proved germ cell tumors of the testis, who died as a direct result of their malignant disease, were reviewed to determine the usual modes of spread, distribution of metastasis, the histologic characteristics of the metastatic foci as compared with the morphology of the primary tumor and the specific cause of death. The sites of metastases in order of decreasing frequency for all cases were lung, retroperitoneal lymph nodes, liver, mediastinal lymph nodes, brain, kidney, gastrointestinal tract, bones, adrenals, peritoneum and spleen. The absence of metastases solely in the anterior mediastinum without involvement of other mediastinal nodes (middle/posterior) strongly supports the premise for a primary extragonadal origin whenever the anterior mediastinum alone is involved with malignant disease having the histologic appearance of a primary germ cell tumor. The histologic features of the metastatic lesions were usually similar in nature to those of the primary tumor except for seminoma in which the metastatic lesions proved to be of a different histologic pattern in almost one third of the patients dying from the disease. It should be axiomatic that whenever a patient with seminoma fails to respond appropriately to radiotherapy that his treatment be immediately discontinued and that appropriate biopsies be obtained to substantiate the histologic pattern present.
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PMID:Metastases from testicular carcinoma. Study of 78 autopsied cases. 98 34

Characteristic for the germinal cell tumors of the testis is their great variety. Collins and Pugh gave a classification of testis tumors under consideration of the genesis of the tumor and the clinical progressing. The staging should be done according to the TNM-system which is based on the UICC recommendations of 1973. If a tumor is suspected an exploration of the testis must be performed. After definitive histological diagnosis via immediate section for microscopic examination during surgery an enlarged orchiectomy and local lymph node dissection has to be performed. In cases of seminoma a 5-year-survival-rate of 90 to 97 per cent can be achieved by radiation of two fields (4 fields in case metastases are suspected). Because of the radio resistance of the teratoid tumors a retroperitoneal lymph node dissection has to follow the enlarged orchiectomy. With a subtile operating technique all the lymph nodes between diaphragm and aortic bifuraction can be removed in case of operability. Postoperative radiation therapy is only recommended in case of excessive lymph node metastases. By an adjuvant chemotherapy following retroperitoneal lymph node dissection a 5-year-survival-rate of more than 80 per cent can be obtained in cases of teratoid tumors.
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PMID:[Germinal testicular tumors]. 103 17

Serum human chorionic gonadotropin levels were determined in 20 patients with histologically proved seminoma. The test was positive in 2 of the 20 patients and was predictive of non-seminomatous metastasis in each case. Serum human chorionic gonadotropin is a useful tumor marker in detecting and following non-seminomatous metastases in men with pure seminoma of the testis.
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PMID:The seminoma decoy: measurement of serum human chorionic gonadotropin in patients with seminoma. 105 36

From 1956 til 1974, 1851 patients have been operated on a malignancy of the lung. 29 of them had a solitary lung metastasis and 2 of them a metastasis of the pleura. Among those, the primary malignancies showed the following frequency: 7 malignancies of the uterus, 7 sarcomas, 4 carcinomas of the breast, 4 carcinomas of the large bowel, 4 malignant goiters, 3 hypernephromas, 1 seminoma and 1 malignancy of the pancreas. The mean survival time was 3.3 years. 25.8% of the patients survived 5 years. Patients with a primary malignancy of the uterus appear to do best. In case of repeated metastases we did not operate upon again.
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PMID:[Follow up study of patients operated on metastases of the lung and pleura (author's transl)]. 108 19

Tumors of the testis are uncommon in childhood comprising only about 2% of all malignant tumors. Twenty-five children with testicular tumors seen in the last 25 yr had 11 orchioblastomas, nine differentiated teratomas, three paratesticular sarcomas, one seminoma, and one dermoid cyst. It must be stressed that, contrary to popular opinion, the prognosis for orchioblastoma is favorable today, eight of the 11 children with this condition have survived for more than 2 yr. Orchiectomy should be followed by rigorous treatment with anticancer chemotherapy for 1 yr. Excision of the para-aortic glands and radiotherapy are not beneficial in prophylaxis. Lymphadenectomy is indicated only if metastases are demonstrated by lymphangiogram. Patients who have survived for more than 2 yr should, in general, be regarded as cured.
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PMID:Testicular tumors in childhood. 111 82

The pedal lymphographic findings in 260 patients with testicular tumours are reviewed: 117 patients had a seminoma, 105 had a teratoma and 38 combined tumours. 26 percent of seminomas were associated with a positive lymphogram, corresponding figures being 42 percent for teratomas and 53 percent for combined tumours. The role of the lymphogram is (1) to stage the case so that the extent and form of the treatment can be logically assessed, (2) to plan accurately radiotherapy treatment fields, (3) to observe the results of treatment on serial follow-up films, (4) to detect the recurrence of tumour using "re-fill" lymphography if necessary, (5) to show possible unsuspected metastases involving supraclavicular and mediastinal glands, and (6) to give a prognosis, since a negative lymphogram suggests an excellent chance of survival. Three main types of lymphographic appearances are recognized: nodal, mass replacement and "pseudo-lymphomatous". Nodal deposits are most common. Most positive findings are in the para-aortic chain on the same side as the tumour. Iliac involvement is much less common. Seminomas in this series showed a 96 percent crude three-year survival rate. For teratomas and combined tumours the three-year survival rates were 59 percent and 61 percent respectively, but deaths are uncommon in the lymphographically negative Stage I cases. Bone deposits are rare. Only two were found in this series. We do not perform testicular lymphography, but consider there is a useful role for inferior venacavography when there is poor filling of upper para-aortic nodes at lymphography. The importance of taking follow-up films after the initial examination is stressed.
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PMID:A review of the role of lymphography in the management of testicular tumours. 112

The clinical and morphological features of 7 cases of anaplastic seminoma are reviewed. Although this tumor appears to behave more aggressively than classical seminoma, presenting with earlier metastases, it has the same prognosis when staging is taken into consideration. Radiotherapy remains the treatment of choice.
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PMID:Anaplastic seminoma. 114 5

Testicular tumors initially diagnosed as pure seminoma were irradiated following orchiectomy in 141 patients. Analysis of treatment failures reveals that (a) 2500 rads is adequate for elective irradiation and 3500 rads for small to moderate-size metastases; (b) elective irradiation of the mediastinum and left supraclavicular area is not indicated for Stage I, but is for Stage II; (c) patient with bulky retroperitoneal disease should be treated initially through total abdominal portais followed by additional treatment through reduced fields; and (d) presence of embryonal carcinoma, teratocarcinoma, or choricarconoma should be considered when regression is poor.
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PMID:Radiotherapy for pure seminoma of the testis. 117 6

Lymphography was performed in 130 patients with malignant neoplasm of the testes. The patients were treated by irradiation, supplemented by chemotherapy when lymph node metastases were present. The survival rates of the various pathologic subdivisions were analyzed according to the lymphography. The following 5-year survival rates were observed: seminoma: normal lymphography 94%, pathologic lymphography 69%; teratocarcinoma: normal lymphography 86%, pathologic lymphography 14%; embryonal carcinoma: normal lymphography 64%, pathologic lymphography 33%.
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PMID:Lymphography as a guide to prognosis in malignant testicular tumours. 123 38


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