Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We have conducted a retrospective review of 134 cases of neurogenic tumors of the thorax, including 66 in infants and children and 68 in adults. Nerve cell tumors were the majority in infants and children (84.8%) and were mostly malignant (67.2%). Nerve sheath tumors were more frequent in adults (73.5%). Nerve cell tumors were the most frequent tumors in males and nerve sheath tumors in females. Nineteen tumors were associated with von Recklinghausen's disease. The tumors were symptomatic in 76.4% of children and 36.7% of adults. Spinal cord compression was observed in 8 infants and children and in 2 adults. Neo-adjuvant treatment was administrated to 3 patients. Resection was complete for 80 benign tumors out of 86 (93%) and for 26 malignant tumors out of 48 (54%). Postoperative chemo- or radiotherapy (or both) was administrated to 17 children and 8 adults. The mean followup periods were 11 years for the infants and children and 8 years, 6 months for the adults. There was one postoperative death. There were no late deaths related to benign tumor. The prognosis of spinal cord compression depended on the malignancy and staging of the tumors. At 5 years postoperatively, 21 children out of 28 with neuroblastomas and 8 out of 9 with ganglioneuroblastomas were alive. The possibility of maturation of neuroblastomas and survival with hepatic metastases was confirmed. The prognosis in cases of chemodectoma depended on the extension. Patients with malignant schwannomas had very poor prognoses, especially when associated with von Recklinghausen's disease.
 ...
PMID:Neurogenic tumors of the thorax. 794 57

We previously reported that urokinase (uPA) is produced by the human prostate cancer cell line, PC-3, and could function as a growth factor for cells of the osteoblast phenotype. To examine the role of uPA in metastasis to the skeleton and to extraskeletal sites, we have developed a homologous model of uPA overexpression in a rat prostate cancer cell line. Full length cDNA encoding rat (r) uPA was isolated and subcloned as a 1.4-kilobase XbaI-BspHI fragment in the sense and antisense orientation into the Moloney murine leukemia retroviral vector pYN. The control (pYN) and experimental (pYN-ruPA, pYN-ruPA-AS) plasmids were transfected into Dunning R 3227, Mat LyLu rat prostate carcinoma cells. Experimental clones expressing at least 5-fold higher (pYN-ruPA) or 3-fold lower (pYN-ruPA-AS) than controls were selected, and control and experimental cells were inoculated into the left ventricles of inbred male Copenhagen rats. Animals were sacrificed at timed intervals to examine the evolution of metastatic lesions. Control animals developed metastases to the lumbar vertebrae resulting in spinal cord compression and hind limb paralysis at 20-21 days postinoculation. Animals inoculated with cells overexpressing uPA developed hind limb paralysis significantly earlier (by day 14-15 postinoculation). Additionally, more widespread skeletal (ribs, scapula, and femora) metastases were seen. Serum from experimental animals showed a progressive elevation in alkaline phosphatase levels, and histological examination of lumbar metastases revealed markedly increased osteoblastic activity over that observed in control animals. In contrast to this, animals inoculated with cells underexpressing uPA developed hind limb paralysis significantly later (days 25-29 postinoculation) and displayed decreased tumor metastasis. These studies support a role for the catalytic domain of uPA in enhancing both skeletal and nonskeletal prostate cancer invasiveness and are consistent with a role for the growth factor domain of uPA in mediating an osteoblastic skeletal response.
 ...
PMID:Urokinase overproduction results in increased skeletal metastasis by prostate cancer cells in vivo. 816 83

The symptoms in metastatic compression of the spinal cord or cauda equine are described after a systematic recording of the sequence of symptoms in 153 patients. Radicular pain was predominant in patients with metastases located in the lumbar area, while the severity of motor symptoms was positively correlated with thoracic metastases. The most common initial symptom was radicular pain, followed, with decreasing frequency, by motor weakness, sensory complaints and bladder dysfunction. The progression of motor weakness influenced the probability of establishing the diagnosis of spinal cord compression by stepwise marked increased probability when patients lost gait function or progressed into total paralysis.
 ...
PMID:Symptoms and signs in metastatic spinal cord compression: a study of progression from first symptom until diagnosis in 153 patients. 820 66

Fourty-three cases with metastatic spinal cord compression were reviewed post-operatively to clarify the usefulness of the procedures concerning restoration of neurological function, and pain relief. Only patients with pathological spinal instability and neurological sequelae were included. Posterior decompression and stabilization was performed in all but six patients. All but four patients (91%) reported decrease of pain symptoms. Amelioration of neurological function was achieved in 58%. Re-establishment of walking ability was obtained in 57%. Post-surgery life expectancy averaged 11 months. In patients with widespread metastatic disease and/or multi-level instability of the spine restriction to palliative dorsal procedures is sensible. Post-operative ancillary treatment is necessary.
 ...
PMID:Metastatic spinal cord compression--options for surgical treatment. 823 91

Normal skeletal integrity is maintained by physiological bone turnover through a coupled process of bone resorption, mediated by osteoclasts, followed by new bone formation, mediated by osteoblasts. Major features of the pathogenesis of cancer-associated skeletal destruction are enhanced osteoclast-mediated bone resorption and disruption of normal bone formation. In this article, the literature on the pathogenesis and clinical manifestations of metastatic bone disease is discussed. Animal and clinical trials investigating novel bone targeted agents, emphasizing the bisphosphonates, are critically assessed. The most frequent clinical manifestations of bone metastases are pain, fracture, immobility, spinal cord compression, and hypercalcemia. New treatments under study for patients with bone metastases include agents specifically targeted to the skeleton such as bone-seeking radioisotopes and bisphosphonates. Studies in animal models of metastatic bone disease show that these bisphosphonates are able to inhibit tumor-induced osteolysis and are potentially useful in this condition. Bisphosphonates have been investigated in several clinical trials of patients with skeletal metastases from breast cancer, prostate cancer, and multiple myeloma. Overall, the studies investigating bone targeted radioisotopes or bisphosphonates for the treatment of morbidity due to skeletal metastases have been inconclusive. An improved understanding of the pathogenesis of metastatic bone disease and preclinical studies with bisphosphonates suggest that these agents may have a role in the treatment of this disorder. Additional trials of new generation bisphosphonates, employing a rigorously controlled, randomized study design with adequate numbers of subjects, are needed to demonstrate the safety and efficacy of this class of agents in this setting.
 ...
PMID:New bisphosphonates in the treatment of bone metastases. 824 77

Having found, in the same medical centre, an abnormally high (15%) frequency of bone metastases from colorectal carcinoma, the authors report a series of 8 cases and review what is now known of this reputed rare (4%) metastases. Their clinical and imaging features are not very different from secondary bone lesions of other origins. They usually appear approximately 5 years after the primary tumour has been diagnosed; and they are rarely isolated, being part of a diffuse metastatic disease; their prognosis is in fact conditioned by visceral metastases (liver, lung, peritoneum). Concerning treatment, pain relieving radiotherapy is crucial, as witnesses by the authors. Chemotherapy must always be prescribed for its proven effectiveness against visceral lesions. The other medicinal treatments (e.g. analgesics, bisphosphonates) are very useful. Surgery must be reserved to emergency situations (spinal cord compression) and to patients in good general condition. To our 8 patients these treatments brought comfort and increased survival. Survivals of at least 6 to 9 months were obtained, and one patient is still alive 14 months after the diagnosis of bone metastasis. These results compare favourably with the 4 months median survival observed in other series.
 ...
PMID:[Bone metastases of colorectal cancers: apropos of 8 cases]. 837 52

Of 35 patients with prostate carcinoma and suspected spinal cord compression 26 (74%) had myelograms and/or magnetic resonance imaging studies demonstrating epidural spinal cord compression. In 5 of 26 patients (19%) spinal cord compression was the first indication of prostate cancer. All patients were initially treated with radiation, steroids and androgen deprivation therapy. Three patients underwent laminectomy. Of 12 patients (100%) ambulatory at presentation 12 remained ambulatory. Of 12 patients (83%) who were paraparetic at presentation 10 were ambulatory after treatment. However, 2 of these patients subsequently had recurrent compression and became paraplegic. Overall, 7 of 26 patients (27%) had recurrent compression. Of 5 patients who either presented with paraplegia or in whom paraplegia developed secondary to recurrent spinal cord compression 4 remained paraplegic despite treatment. The average survival of these 5 patients after treatment was 3.9 months versus 18 months for the group as a whole. In ambulatory or paraparetic patients radiation, androgen deprivation therapy and steroids are effective palliative therapy. However, patients who present with paraplegia or in whom paraplegia developed secondary to recurrent compression are often not palliated by this combination therapy. Prophylactic radiation of vertebral metastases discovered concurrently with compressive metastases may be valuable in preventing paraplegia.
 ...
PMID:Spinal cord compression secondary to prostate carcinoma: treatment and prognosis. 842 13

Rising incidence, resulting from diagnosis together with the increasing age in the population, and high mortality combine to make cancer of the prostate a leading cause of death in men. Despite early, and unfortunately overly optimistic, hopes placed in oestrogen therapy, management of patients with metastatic cancer of the prostate remains one of the major challenges facing urologists. For stage D1 (invasion of the iliac nodes), systemic treatment is required, based on androgen deprivation, with five years disease free survival ranging from 55% to 95%. Radical prostatectomy is not indicated in cases of pathologically confirmed macroscopic nodal involvement, but the question remains controversial for patients with microscopic metastases. Pelvic radiotherapy at "curative doses" is not indicated because of the lack of any improvement over hormone therapy alone. Controversies still exist about timing of androgen deprivation (early or deferred endocrine treatment) either for stage D1 or stage D2 asymptomatic patients, but controlled studies are ongoing. Immediate endocrine therapy is however clearly indicated in stage D2 symptomatic disease and leads to improvement of symptoms (mainly bone pain) in up to 80% of patients. When there is spinal cord compression adding corticosteroids can be useful; surgery or radiotherapy are indicated particularly in cases of vertebral instability or neurological involvement. Current protocols are based on maximal androgen deprivation combining medical or surgical castration and anti-androgens. Prognosis is very poor at relapse despite hormone therapy (stage D3). Survival rate at 1 year is only 50%. It is essential that anti-androgens be withdrawn at this time since clinical improvement can be observed in some patients (anti-androgen withdrawal syndrome). None of the second line treatments (hormonal or chemotherapy) have led to any improvement in survival time. Treatments only alleviate patient discomfort and improve quality of life. The lack of progress over the last 50 years in the treatment of advanced stage cancer of the prostate means that the only way to cure future patients will be conditioned by early diagnosis and treatment during the less advanced stages.
 ...
PMID:[Treatment of metastatic cancer of the prostate]. 854 43

The authors report the case of a patient with breast cancer who developed spinal cord compression due to the expansion of an epidural bony tumor from an osteoblastic vertebral metastasis into the spinal canal. Magnetic resonance imaging revealed an epidural mass that was compressing the spinal cord but that did not demonstrate the bony elements contained within the epidural mass. These bony elements were demonstrable only by computed tomography. The patient did not respond to radiotherapy but did recover after surgical decompression. Therefore, the authors recommend the use of computed tomography for patients who have osteoblastic vertebral metastases and epidural spinal cord compression diagnosed by MRI. Once an epidural bony mass expanding from a vertebral metastasis into the spinal canal is demonstrated by computed tomography, surgical decompression is indicated.
 ...
PMID:Metastatic epidural bony tumor causing spinal cord compression: a case report. 865 62

Paget's disease, often an incidental finding, sometimes presents in the form of pain or signs of complications, such as spinal cord compression, malignant transformation or fissures. The diagnosis is established by laboratory tests, but essentially by radiological findings, based on three basic criteria: cortical thickening, loss of cortico-cancellous differentiation and enlargement of the bone, which deformity is a later sign. The diagnosis can usually be made on plain x-rays, but CT is useful in the case of early, difficult or unusual lesions and complications. CT can reveal mouth-eaten, vacuolar, network, clumped or mixed, fibrillary or ivory images. MRI is a last resort examination. Angioma, metastases and ivory vertebrae are the main differential diagnoses.
 ...
PMID:[Vertebral localizations of Paget disease]. 874 98


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>