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

A report is presented on 12 patients with extrapulmonary small cell carcinoma. In 9 patients the primary tumor could be localized (cervix in 3, esophagus in 3, prostate in 2, pancreas in 1) whereas no primary was found in 3. Seven of 12 patients presented with distant metastases and four developed metastases later. Five of 12 had CNS metastases (brain metastases in 4, spinal cord compression in 1). Six patients were initially treated by surgery or radiotherapy (2 and 4 respectively). All six developed distant metastases during or shortly after local treatment. Five of 6 patients initially treated with chemotherapy responded to the treatment. Three of 12 patients are surviving 18+, 80+ and 81+ months after the initial diagnosis without evidence of disease. The biology and clinical course of extrapulmonary small cell carcinoma are similar to those of its pulmonary counterpart. In planning therapy for extrapulmonary small cell carcinoma, particular importance should be attached to systemic treatment.
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PMID:[Extrapulmonary small-cell carcinoma - a rarity with important therapeutic consequences]. 632 92

Two children presented with acute spinal cord compression by primary and metastatic intraspinal mesenchymal chondrosarcoma, a rare pediatric malignancy. Patients with the primary intraspinal tumor usually present early and often respond well to combined surgery, irradiation and chemotherapy. Patients with intraspinal metastases present late in the course of their disease and their prognoses are poor.
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PMID:A rare cause of spinal cord compression in childhood from intraspinal mesenchymal chondrosarcoma. A report of two cases and review of the literature. 646 41

The oncology patient can experience medical or surgical emergencies as a result of effects of the primary tumor, metastases, or systemic effects of the disease. Emergencies unrelated to the primary oncologic diagnosis, such as acute myocardial infarction, drug overdose, or gastrointestinal hemorrhage, also may occur. For this reason routine emergency protocols and diagnostic procedures should be followed in the treatment of oncology patients. We review the major oncologic-related emergencies, including central nervous system and spinal cord compression, airway obstruction, cardiac tamponade, gastrointestinal obstruction, adrenal insufficiency and hypercalcemia, sepsis, and coagulopathies. Medical and surgical emergencies in the oncology patient should be treated aggressively in the emergency department because a determination about the quality of life of the patient, or the reversibility of the acute process, often cannot be answered quickly in the emergency setting.
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PMID:Emergency evaluation of the cancer patient. 646 53

A fusiform longitudinal hemorrhagic necrosis of the spinal cord is described in a patient with spinal cord compression caused by metastases from an adenocarcinoma of the prostate. The lesion extended from the D3 down to L2 level with maximal involvement of the D7-D8 segments. The shape, location, and distribution of the lesion and its prominent hemorrhagic component corresponded to Jellinger's category of cylindrical liquefaction necrosis, probably due to venous obstruction. The multiple thrombi found in epidural veins supported such a pathogenic mechanism, which although extremely rare has been reported previously in five cases.
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PMID:Massive hemorrhagic necrosis of the spinal cord in metastatic cord compression. 662 75

Epidural spinal cord compression from metastatic disease is a common neurological complication of cancer. The incidence is probably increasing owing to continual advancements in the treatment of cancer that have led to prolongation of life and a greater probability of secondary involvement of the spinal cord. A problem often encountered by the oncologist treating patients with epidural spinal cord compression is the recurrence of compression by metastatic tumor both in and out of the original treatment field. Radiotherapists are often presented with the difficult task of trying to determine the optimal dose/time fractionation with the hope of improving the therapeutic ratio. We have examined the charts of 80 patients treated at the Rhode Island Hospital during the last five years (1975-1980) with myelographic evidence of cord compression in order to determine 1) the recurrence rate of cord compression by metastatic tumor after radiotherapy treatment both in and out of the original treatment field; 2) the influence of various dose/fractionation schedules on the disease-free interval; 3) the percentage of recurrence out of the treatment field that might represent "skipped lesions" at the original time of diagnosis. Our results show 1) that 9 patients (11.3%) experienced recurrence within the original treatment field; 2) that 21 (26.3%) experienced recurrence within the spinal canal, but out of the original treatment field; 3) that 9 of the 21 (42%) cases of recurrence out of the original treatment field occurred within 1 week and thus were determined to be "skipped lesions" at the time of diagnosis; and 4) that there appears to be a dose-response relationship for those patients treated successfully without recurrences who did not have presenting symptoms of complete paraplegia.
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PMID:Treatment of spinal cord compression: a retrospective analysis. 663 26

Myeloma may be complicated or revealed by spinal cord compression. Out of 105 cases of myeloma admitted to this Department, 6 cases of spinal cord compression were observed, with a favourable outcome after treatment by laminectomy combined with radiotherapy. In 5 cases out of 6, spinal cord compression was either the presenting sign or occurred within the first months after diagnosis. Compression occurred in the thoracic cord in 5 cases, and in the lumbar cord in 1 case. The interval between the first symptom and diagnosis varied greatly (from a few hours to 1 year), as did the degree of paraplegia, which ranged from paraparesis to flaccid paraplegia. A favourable outcome occurs in most other reported cases, in contrast with spinal cord compression from metastases. Treatment (laminectomy-radiotherapy or both) remains controversial.
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PMID:[Spinal cord compression in malignant plasmacytic diseases. Apropos of 6 cases]. 671 66

Spinal cord compression from metastatic cancer is a medical emergency. Prompt intervention affords the best chance for successful recovery, while delay may result in devastating neurologic impairment. In the appropriate clinical setting, emergency myelography should be done to confirm the diagnosis of metastatic disease. Dexamethasone should then be started, followed by immediate radiation therapy or surgical decompression.
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PMID:Metastatic spinal cord compression. 682 90

Clinical interest in spinal compression and resultant paraplegia due to metastases has mounted in recent years. This has stimulated attention to the neuropathology of the condition. Fourteen cases of spinal cord compression due to vertebral metastases are compared with over 100 traumatic cases. In the traumatic lesions there is central haemorrhagic necrosis leading to cavitation and gliosis with nerve root regeneration in the late stages. In the metastatic cases, lesions are often peripheral, pie-shaped and are related to vascular factors. The neuropathology of cord necrosis due to metastatic spinal disease is therefore different to trauma. These observations have clinical importance in planning treatment.
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PMID:Vertebral metastases and spinal cord compression. 683 91

Spinal cord compression is a rare but serious complication of malignant diseases in children. Epidural cord compression was noted in 81 patients within the past 17 years at this center. The complication developed at different times during the course of the primary disease. For 29 of our patients, cord dysfunction was one of the initial signs of cancer--Ewing sarcoma, neuroblastoma, Hodgkin disease, and malignant lymphoma. By contrast, for most of the patients with osteosarcoma and rhabdomyosarcoma, it appeared later in their clinical course. The treatment outcome of patients who were paraplegia with complete loss of sensory function for greater than or equal to 48 hours was poor. Only four of 22 in this group became ambulatory. Ten patients with osteosarcoma did not undergo laminectomies because they all had multiple metastases and terminal disease. Paraplegia developed in all ten. There was no difference in ambulatory rates among other patients, with or without laminectomies.
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PMID:Metastatic epidural tumors in children. 695 58

This article reviews the clinical and pathologic features of intrathoracic paravertebral paragangliomas. Including the present case, there have been 31 tumors reported in the English literature; the average age of patients was 29 years, with a sex distribution of 20 men and 11 women. Fifteen patients (48%) had symptoms related to excess secretion of catecholamines; the remaining 16 tumors were clinically nonfunctional. Seven patients (22%) had multiple paragangliomas. Complete surgical resection was attempted in 25 patients, 13 were alive with no evidence of tumor an average of 2.2 years later. Tumor was locally invasive in five patients, with involvement of the vertebral canal and symptoms of spinal cord compression. Malignant behavior with distant metastases was observed in two patients. As shown by the present case, the Grimelius stain is a useful diagnostic technique for demonstrating cytoplasmic argyrophilia of neoplastic chief cells. Electron microscopy demonstrated neurosecretory granules (average core diameter, 100 nm). "Light" and "dark" chief cell types were inconspicuous. Due to important clinical and pathologic differences, paravertebral paragangliomas should be distinguished from similar tumors occurring in the anterosuperior mediastinum (aorticopulmonary paragangliomas).
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PMID:Intrathoracic paravertebral malignant paraganglioma. 698 88


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