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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Metastatic disease is the first clinical manifestation of differentiated thyroid carcinoma (DTC) in less than 5% of cases. Bone metastases as the first sign of DTC are associated with a poor prognosis, both for being resistant to treatment and for complications due to them. Spinal cord compression is a rare development in DTC, which may present late in the course of the disease. An initial presentation of DTC with a spinal cord compression is an extremely rare condition.
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PMID:[Spinal cord compression as a primary manifestation of occult thyroid carcinoma]. 163 37

In a prospective study of 30 patients with newly diagnosed spinal metastases the benefit of different imaging techniques in planning palliation was studied. Magnetic resonance imaging (MRI) was compared to scintigraphy, conventional radiography and computerized tomography (CT), prior to radiotherapy or surgery. In the first comparison, a total of 159 pathologic lesions could be evaluated. MRI was superior in the detection of suspect metastases compared to conventional radiography and scintigraphy (P less than 0.0001 and p less than 0.01, respectively). MRI also gave useful information about adjacent soft tissue components, vessels, nerves and spinal cord compression, i.e. useful information when planning stabilizing surgery. Both MRI and CT were sensitive and specific methods but when comparing 120 pathologic lesions the detection rate of MRI was significantly higher than that of CT (p less than 0.01). In conclusion, scintigraphy and conventional radiography are adequate enough if palliative radiotherapy is planned. When considering surgery MRI is advocated preoperatively for defining operability.
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PMID:Diagnostic methods in planning palliation of spinal metastases. 169 79

We have reviewed the role of radiation therapy in the palliative treatment of patients with non-small cell lung cancer. The use of radiation treatment results in effective palliation of chest symptoms such as dyspnea, cough, hemoptysis, and chest pain. In addition, the pain and suffering associated with skeletal and hepatic metastases are effectively alleviated by radiation therapy with minimal morbidity. Devastating neurologic complications can be avoided or alleviated in a great proportion of patients undergoing radiation therapy for cerebral metastases and spinal cord compression. Therefore, radiation therapy is a potent modality in relieving or reducing the suffering of patients with lung cancer. This is also a modality that has wide applicability; very few patients are not suitable candidates for that has wide applicability; very few patients are not suitable candidates for treatment regardless of their performance status. The aim of the treatments should always be prompt intervention using radiation therapy schedules that will minimize treatment time yet produce the desired results in a high proportion of patients. Protracted radiation schedules are not warranted in such patients except in special clinical situations. Palliation with radiation therapy is achieved quite promptly, with minimal side effects and a very small risk of any long-term consequences in patients who have a limited life expectancy.
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PMID:Palliative radiotherapy. 170 80

This is a retrospective study of 90 patients who developed distant metastases after radical radiotherapy for nasopharyngeal carcinoma. The skeleton was the commonest site of distant metastases. Clubbing, hypercalcemia and malignant fever occurred in about 10% of patients with pulmonary, skeletal and hepatic metastases respectively. An effective chemotherapeutic regimen for palliation of pulmonary and hepatic metastases was cisplatinum/carboplatin-5FU which gave a complete response rate of 29% and partial response rate of 21%. This was considered superior to some non-cisplatinum-containing regimens. One patient with hepatic metastases had good palliation by hepatic irradiation. The median survival of all patients with distant metastases was eight months. Five (6%) patients survived more than two years with one surviving free of disease at 31 months. Hepatic metastases and spinal cord compression were associated with short survivals.
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PMID:Clinical features and management of distant metastases of nasopharyngeal carcinoma. 170 23

Radiotherapy is an indispensable modality in the palliation of cancer. All palliative care programs should be acquainted with its indications and have a close working relationship with a radiation oncology department. The technical aspects of the subject may be intimidating to many staff and patients, and departments need to improve their outreach and education. The main indications are: pain relief (particularly bone pain), control of hemorrhage, fungation and ulceration, dyspnea, blockage of hollow viscera, and the shrinkage of any tumors causing problems by virtue of space occupancy. In addition, it has an important role in the palliation of three oncological emergencies: superior vena caval obstruction, spinal cord compression, and raised intracranial pressure due to cerebral metastases. More pragmatic fractionation schedules are being developed that are compatible with good results in terms of palliative end points, giving shorter courses with fewer hospital attendances for patient and family comfort and convenience. More clinical research and evaluation of palliative radiotherapy are required.
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PMID:The role of radiotherapy in palliative care. 171 70

Metastatic tumours of the bone system occur up to 60% in the spinal cord. The epidural spinal cord compression is also found by metastatic tumour, so patients with metastatic disease in this localisation carry a poor prognosis. From 1986 to 1988 35 patients with symptomatic spine metastasis are operated upon. 43% of these patients recover their capability of walking. 90% from the operated collective show a reduction of pain. The primary tumour is first found from cancer of the lung and second from the kidneys. The most common localisation of metastatic tumour is the thoracic spine. The ratio from male to female is 2:1. If the risk of operation and differential therapy is discussed, the decompression and tumour resection will be the first. The concept for postoperative mobilisation and therapy concludes the stabilisation of spinal cord with internal fixation. Treatment of metastatic tumours takes aim at the improvement of life quality.
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PMID:[Diagnosis and interdisciplinary therapy of spinal cord compression caused by spinal metastases]. 175 Feb 86

Last month, the author discussed epidural spinal cord compression. This month he describes the incidence, clinical presentation, and management of CNS complications from intradural, extramedullary metastases; leptomeningeal carcinomatosis; intramedullary spinal cord metastasis; paraneoplastic myelopathies; radiation myelopathy, and chemo-induced myelopathy.
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PMID:Myelopathies in the cancer patient: incidence, presentation, diagnosis and management. 183 75

The determination of the etiology of spinal cord compression in cancer patients is essential for appropriate therapy. Patients with metastatic disease are not immune to the development of superimposed nonmalignant disease. Although metastatic epidural compression may occur in up to 9% of breast cancer patients, care must be taken to rule out other nonmetastatic lesions causing compression. The association of concurrent breast carcinoma and a spinal neurilemoma simulating a metastatic lesion seems not to have been previously reported. A neurilemoma was observed in a 50-year-old woman. A neurilemoma suspected to be a metastatic lesion may produce the clinical features of pain, neurologic deficit, and weakness. Differentiation will be aided by roentgenograms, radionuclide bone scans, computed tomography, and possible magnetic resonance imaging. Radiologic differentiation hinges on the recognition and the slow-growing nature and noninvasive boundaries of the nonmalignant lesion. Ultimate verification is by biopsy. Treatment should consist of neurectomy, if severely symptomatic, and stabilization as indicated.
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PMID:Cauda equina compression associated with breast cancer. A case study in differential diagnosis. 185 Mar 37

Bone scintigraphy (RN) and magnetic resonance imaging (MR) were prospectively and retrospectively correlated in 64 patients with suspected spinal metastatic disease and possible spinal cord compression. Images were retrospectively interpreted and compared with the prospective official RN and MR reports to help decide relative prospective lesion conspicuity. Spinal lesions were confirmed by radiography, computed tomography, myelography or MR and RN follow-up in 56 patients (88%). Prospectively, MR detected 11 lesions not reported on RN while RN detected two lesions not reported on MR. Retrospective review of RN detected six lesions previously not reported. Retrospectively MR showed all lesions. Those lesions seen only in retrospect by RN were rather subtle and would be difficult to detect prospectively. In general, lesions not well seen on RN had relatively more bone marrow abnormality and less cortical bone involvement. In some cases, MR imaging shows spinal marrow lesions not well seen on planar RN.
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PMID:Spinal MR imaging in suspected metastases: correlation with skeletal scintigraphy. 188 Dec 53

We present three cases of Lhermitte's sign out of twenty consecutive cases of epidural spinal cord compression due to metastatic cancer. The three patients were diagnosed with epidural thoracic compressions. The literature on Lhermitte's sign is reviewed with emphasis on the differential diagnosis of this symptom in oncological patients.
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PMID:On the significance of Lhermitte's sign in oncology. 189 61


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