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)

Three patients with advanced seminoma that metastasized to the prostate, the kidney, and a lumbar vertebra are presented. The implications of such metastases regarding the management of residual lesions after chemotherapy are discussed.
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PMID:Uncommon sites of recurrent seminoma and implications for therapy. 241 87

Between February 1979 and March 1985, 126 patients with clinical stage I non-seminomatous germ-cell testicular tumors were entered into a surveillance study after orchiectomy. Of this group, 36 (28%) have relapsed. The prognostic significance of 13 clinical, histopathologic, and biochemical factors has been analyzed. Vascular invasion and lymphatic invasion (LI) within the primary tumor, histology, and involvement of the epididymis and rete testis were significantly associated with an increased risk of relapse. However, multiple regression analysis showed that only histology and LI were significant, independent prognostic factors. These findings provide the basis for the consideration of adjuvant chemotherapy for patients with apparent clinical stage I testicular non-seminoma who are at high risk of harboring occult metastases.
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PMID:Prognostic factors in stage I non-seminomatous germ-cell testicular tumors managed by orchiectomy and surveillance: implications for adjuvant chemotherapy. 242 60

A 33-year-old patient with a locally advanced seminoma in an inguinal testis, without metastases, was treated by cis-platinum-based combination chemotherapy followed by resection of the residual mass which was clear of viable tumour. After 31 months there is no evidence of disease.
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PMID:Therapy of a locally advanced testicular seminoma without metastases. A case report. 244 Jan 18

Intermediate filament keratin is regarded as a good marker for epithelial and mesothelial tumors. In the intracranial and intraspinal spaces keratin has been demonstrated only in the endocrine cells of the adenohypophysis, squamous epithelial islands in the pars tuberalis of the hypophysis and in the choroid plexus epithelium. Since gliomas and meningiomas do not express keratin, this marker provides an additional help for differentiating between primary and secondary CNS tumors. Indirect immunofluorescence using an anti-keratin serum was used in a retrospective search for keratin in 80 tumors of the cranium and intraspinal space. Of the primary CNS tumors keratin positivity occurred in craniopharyngiomas, epidermoid tumors, pituitary adenomas, chordomas, a plexus papilloma as well as in the majority of germ cell tumors. Only 3 renal cell carcinoma metastases of 21 metastatic epithelial cell tumors (7 bronchial carcinomas, 6 breast cancers, 6 renal carcinomas, 1 rectum carcinoma, 1 cervix carcinoma) were keratin-negative. Similar findings were made in two melanoma metastases which we examined, whereas in a seminoma metastasis a few keratin expressing cells were found. Primary CNS tumors such as myxopapillary ependymomas, medulloepitheliomas, malignant meningiomas and paragangliomas which are often difficult to distinguish from these metastases proved to be keratin negative.
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PMID:[Significance of immunohistochemistry in neuro-oncology. V. Keratin as a marker for epithelial differentiation of primary and secondary intracranial and intraspinal tumors]. 244 Feb

Neuron-specific enolase (NSE) was evaluated as a serum marker in 105 patients with testicular cancer and compared with the established tumor markers alphafetoprotein (AFP) and human chorionic gonadotropin (HCG). Increased serum NSE activity was measured in eight of 11 (73%) patients with metastatic seminoma. Serum NSE concentrations fell to within the normal range following chemotherapy. Localization of NSE in seminoma cells was demonstrated immunohistochemically. Only six of 40 (15%) patients with metastatic nonseminomatous germ cell tumors showed elevated serum NSE levels. AFP and HCG were both positive in 70% of patients in this group, and NSE determination gave no additional information. Serum NSE concentrations were normal in 53 of 54 testicular cancer patients after orchiectomy and there was no evidence of metastatic disease; only one had borderline NSE levels, indicating the specificity of serum NSE determination. NSE is a new marker of seminoma and its measurement may be of clinical value in monitoring chemotherapy in patients with metastatic seminoma.
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PMID:Serum neuron-specific enolase. A marker for responses to therapy in seminoma. 244 May 52

The incidence and epidemiology, pathophysiology, diagnosis and staging, and therapy of testicular cancer are reviewed. Although relatively rare, testicular cancer is an important disease because it is the first disseminated solid tumor occurring in adults for which truly effective therapy has been developed. More than 90% of testicular neoplasms are of germ-cell origin; about 40% of cases involve pure seminoma, 15%-20% are pure embryonal carcinoma, and the rest are of mixed types. Clinically, the major distinction is between pure seminoma and other types because of therapeutic differences. Most men with testicular neoplasms initially complain of a painless testicular mass. Surgical exploration follows, with orchiectomy and complete excision of the spermatic cord if a neoplasm is documented. Seminoma is a highly radiosensitive tumor, and overall cure rates now approach 95%-98%. Combination therapy with cisplatin has been effective in treating patients with extensive disease. Nonseminomatous testicular cancer patients who do not have metastases are treated with a traditional orchiectomy and retroperitoneal lymph-node dissection; about 10% of patients will relapse and must be treated with antineoplastic agents. Patients with disseminated disease require systemic treatment with cisplatin-based combination drug therapy. Reduction of toxicity and identification of patients who can be spared extensive treatment are the current thrusts of research; efficacy is excellent for several regimens. Major advances have been made over the last two decades in curing patients with testicular cancer.
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PMID:Current concepts in clinical therapeutics: testicular cancer. 244 18

We measured human chorionic gonadotropin by 2 immunometric assays that require that the entire human chorionic gonadotropin molecule is intact, and by a competitive radioimmunoassay that measures intact human chorionic gonadotropin and its free beta-chain. The sera tested were samples from male cancer patients with elevated human chorionic gonadotropin levels obtained by the radioimmunoassay method. Elevated levels were confirmed in 67 of 92 samples (72 per cent) with the immunometric methods. However, in 25 of 97 patients (28 per cent) elevated human chorionic gonadotropin was found with the radioimmunoassay, whereas the values were in the normal range when measured with the immunometric assays. These discrepancies were found in 22 patients with seminomatous tumors, including 2 extragonadal germ cell tumors, which constitutes 42 per cent of all seminoma patients tested. Of the remaining 3 discrepant patients 2 had lung cancer and 1 had metastases from an unknown primary cancer.
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PMID:High frequency of incomplete human chorionic gonadotropin in patients with testicular seminoma. 244 47

A 28-year-old man, evidencing a painless swelling of the right scrotal content, was admitted and, after a diagnosis of a right testicular tumor, a right high orchiectomy was performed. A histological examination of the right testicular tumor revealed a seminoma. Eleven months after this operation, the patient returned, complaining of a painful swelling of the left testis. An examination revealed that his alpha-fetoprotein (AFP) was elevated (3319 ng/ml). A left high orchiectomy was performed after he was diagnosed as a non-seminomatous tumor. Later, a histological examination revealed, however, an embryonal carcinoma. Two months after the second operation, a metastases of right supra-clavicular lymph nodes was uncovered and adjuvant chemotherapy was started. Although he died from the progression of this metastases, at autopsy, the retroperitoneal and para-aortic metastatic lymph nodes revealed a mature teratomatous and embryonal carcinoma.
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PMID:[An autopsy case revealing bilateral successive testicular germ cell tumors of different cell types]. 245 63

A case of metastatic spermatocytic seminoma with metastases to homolateral retroperitoneal paraaortic lymph nodes in a 50-year-old man is described. The metastases were detected 18 months after orchiectomy. A retroperitoneal biopsy with cytoreductive lymphadenectomy was performed followed by radiotherapy and consecutively by combination chemotherapy. The patient died 25 months after orchiectomy of complications arising after a second course of chemotherapy. No signs of further tumor spread were observed. Autopsy was not performed. The tissue of the metastases fulfilled the light microscopic criteria for spermatocytic seminoma and ultrastructurally showed intercellular communications with typical intercellular bridges. The absence of placental alkaline phosphatase in tumor cells is also consistent with this diagnosis. The metastases differed from the primary tumor in the presence of focal lymphocytic infiltration and granulomatous reaction. This patient represents the first fully documented case of a metastasizing spermatocytic seminoma.
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PMID:Metastatic spermatocytic seminoma. A case report with light microscopic, ultrastructural, and immunohistochemical findings. 245 27

A 57-year-old woman developed severe tumor lysis syndrome characterized by acute hyperuricemic nephropathy, hyperphosphatemia, hyperkalemia, and hypocalcemia after therapy with cyclophosphamide, methotrexate, and 5-fluorouracil for metastatic infiltrating ductal carcinoma of the breast involving the chest wall, lungs, pleurae, and liver. Similar metabolic derangements developed in a 58-year-old man after therapy with vinblastine and bleomycin for classical seminoma with widespread, bulky lymph node metastases. Both patients died of infection associated with granulocytopenia within 2 weeks after the initiation of chemotherapy despite significant improvement in the manifestations of tumor lysis syndrome. At autopsy, there was anatomic evidence of extensive tumor necrosis in each case. The pathogenesis of this problem in the present cases is discussed, and this unusual complication of the treatment of nonhematopoietic malignancies is reviewed.
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PMID:Tumor lysis syndrome in nonhematopoietic neoplasms. 247 63


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