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)

Hypertrophic osteoarthropathy should be considered in any child who presents with a non-inflammatory synovitis of the knees, ankles and wrists and particularly if there is finger clubbing or soft tissue hypertrophy of the fingers. It is rare to get the typical facial appearances until after adolescence. Alteration in epiphyseal growth is associated with the periosteal reaction, as is change in the shape of the patella; whether this leads to premature osteoarthrosis is not yet certain. Secondary disease is common in cyanotic congenital heart disease, but its frequency appears to be decreasing with early treatment of such children. Chest infections are also better controlled so again it is less common, but does still occur, particularly in cystic fibrosis in the older age group who have intractable chest infections. It is seen but rarely in disorders such as inflammatory bowel disease or pulmonary metastases, particularly from bone tumours.
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PMID:Hypertrophic osteoarthropathy in the paediatric age. 162 66

Synovial sarcoma has been induced in the knee joints of rats by intra-articular injection of 9-10-dimethyl-1-2-benzanthracene. Tumours developed from three to six months after the last injection. The neoplasms obtained were classified as synovial sarcoma (50%), fibrosarcoma (25%), giant cell sarcoma (15%), malignant fibrous histiocytoma (10%). The synovial membrane in the treated knee joints presented a chronic synovitis associated with fibrosis and proliferation of the lining cells. The primitive tumour spread locally infiltrating muscle and the adjacent bones. Metastases occurred most frequently to the lungs (70%) and liver (20%); lymph nodes were involved in 10%.
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PMID:Experimentally induced synovial sarcoma. 626 56

Since 1972, 267 tumors or tumor-like lesions of the hand in 257 patients were examined at the bone tumor registry by the Swiss Society of Pathology in Basel, Switzerland. This is 9% of a total of 2,800 bone tumors submitted. An analysis revealed 254 benign tumors or tumor-like lesions and 13 malignant tumors, among them 2 metastases of tumors of unknown origin. As expected, enchondromas (n=81) and pigmented villo-nodular synovitis of the tendon sheath (n=104) were the most frequent tumors. All other tumors or tumor-like lesions appeared only as solitary cases or in small numbers. The radiologic characteristics of some of the lesions are reviewed and their histology is presented. Furthermore, some important points of differential diagnosis are discussed.
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PMID:[Radiologic-pathologic correlations in tumors and tumor-like lesions of the hand (author's transl)]. 628 91

One hundred fifteen cases of localized nodular synovitis (giant cell tumor of the tendon sheath) were reviewed. The optimal treatment for these lesions is unknown, and a high recurrence rate exists. Growths arose from most of the synovial sites of the hand, including joints, capsular ligaments, and tendon sheaths. Deformation of the bone surface was commonly seen; however, bone invasion was uncommon. The histologic features may vary, but the lesions are always benign and do not metastasize. Treatment consisted of thorough local excision and adjacent joint exploration when appropriate. Recurrence occurred in 10 cases (9%) with one to five additional surgical procedures needed to eradicate the lesion.
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PMID:Localized nodular tenosynovitis: experience with 115 cases. 632 3

We report on two patients with painful hyperostosis of the mandible and the thoracic skeleton. Other symptoms were arthralgia, arthritis, osteitis, and palmoplantar pustulosis. Radiographic analysis revealed regions of circumscribed hyperostosis which showed in increased uptake in scintiscan. Metastasis, chronic osteomyelitis, Ewing's sarcoma, or Paget's disease were excluded and the diagnosis Sapho syndrome was made. This recently introduced acronym describes a disease with Synovitis, Acne, Pustulosis, Hyperostosis and Osteitis. Because of the possible axial skeleton involvement, an association to the spondylathropathy group is still being discussed. The etiopathogenesis of this rheumatologic disease is not known.
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PMID:[Sapho syndrome: 2 case reports]. 788 32

Osteoclast-like giant cells (GC) may dominate the histologic pattern not only in conventional giant-cell tumor (GCT)--originating as a radiologically pure lytic, possibly trabeculated lesion especially within the epiphyses of long tubular bones (LB) and pelvic bones of adults--but also in many tumor-like lesions as well as in various benign and malignant bone tumors which may simulate each other. Although the mononuclear cells as well as the amount of collagene fibres don't differ significantly, these lesions can be distinguished by substantial differences concerning their site, radiomorphology and the patients age. The unique lesion which can be recognized by histology only is chondroblastoma--centered in epiphyseal regions as GCT, mostly in the 2nd decade--by its typical mononuclear cells independently of the typical chondroid matrix and calcifications. The brown tumor of hyperparathyreoidism is associated with elevated serum Ca and parathormon, which is not altered in the histologically identical giant cell granuloma. In contrast to GCT aneurysmal bone cyst prefers the metaphyseal area of LB and the posterior parts of vertebras in the 2nd decade. Metaphyseal fibrous defects occurring during growth period leave the epiphyses unaffected and display typical x-rays. Villondoular synovitis sometimes can produce osteolytic defects. GC-rich malignant tumors which present with clear cut atypia except some cases of GC-variants of osteosarcoma, are: Giant-cell rich osteosarcoma, the rare malignant GCT, giant-cell ("osteoclastic") sarcoma, MFH and GC-rich metastases of carcinomas. All of them occur in middle aged and older patients except osteosarcoma and don't affect the epiphyses primarily except malignant GCT. To avoid confusion in GC-lesions it is conditio sine qua non to take into account for diagnosis not only histology but especially radiomorphology as well as site of the lesion and patients age.
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PMID:[Differential diagnosis of giant cell tumor of bone]. 1009 27

Physical examination of a 9-year-old girl with a 2-month history of swelling of the left orbit demonstrated an orbital mass, blepharoptosis, and proptosis. Computed tomography revealed a 2 x 3-cm mass in the superior left orbit that expanded orbital dimensions. Radiography showed abnormalities in the parietal and frontal bones and distal right tibia. Magnetic resonance imaging demonstrated an 8.5-cm abnormality of the marrow space of the right mid-tibia. Bone marrow biopsy was unremarkable. Orbital and tibial biopsies showed a nonspecific chronic inflammation. Idiopathic inflammation that involves the orbit (orbital pseudotumor) and that has systemic manifestations may mimic more serious conditions, such as metastases from rhabdomyosarcoma or Ewing sarcoma, chronic recurrent multifocal osteomyelitis (CRMO), and SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis). Accurate diagnosis requires careful clinical and pathologic examinations.
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PMID:Orbital inflammatory syndromes with systemic involvement may mimic metastatic disease. 1287 85

Concerning bone and joint diseases therapy of rheumatic synovitis (= radiosynoviorthesis) was introduced in 1952 before clinically relevant diagnostic procedures were developed. Radionuclides of Sr and later on 99mTc phosphonates then started the wide use of bone scintigraphy since > 30 years. The diagnostic methods have an excellent sensitivity for detection of local abnormalities of bone metabolism, the specificity of such studies, however, is low. Modifications of the technique (3-phase-bone-scintigraphy, pinhole collimators, ROI-technique), increasing knowledge of pathological scan patterns and introduction of other radionuclide studies (67Ga, 201Tl, inflammation scans with 99mTc-leukocytes or 99mTc-HIG) as well as 18FDG-PET have increased the specificity significantly in recent years and improvements of imaging systems (SPECT) also increased the accuracy of diagnostic methods in diseases of bone and joints. Therapy of such diseases has made considerable progress: inflamed, swollen joints can effectively be treated with 90Y-, 186Re, 169Er-colloids or with 165Dy-particles by radiosynoviorthesis. Severe pain due to disseminated bone metastases of cancer or polyarthritis can be controlled by radionuclide therapy with 89Sr, 153Sm-EDTMP, 186Re- or 188Re-HEDP and possibly 117mSn-DTPA with an acceptable risk of myelodepression. Possibilities, technical details and limitations of radionuclide applications for diagnostic and therapeutic purposes must be considered if optimal benefit for individual patients should be achieved. Overall Nuclear Medicine can become an essential element in management of bone and joint diseases. The relationship of Nuclear Medicine to bone and joint pathology is peculiar: In 1952 treatment of rheumatic synovitis by radiosynoviorthesis with 198Au Colloid was started by Fellinger and Schmid before diagnostic approaches to bone pathology existed. Bone scintigraphy was introduced only in 1961 using 85Sr but obviously the unfavourable radiation characteristics of this radionuclide limited it's broad application and 87mSr did not improve this situation. Only when 99mTc phosphonates were developed by Subramanian the importance of bone scintigraphy became apparent: The excellent imaging properties of these radiotracers showed, that abnormal bone metabolism could be visualized even before morphological alterations in the skeleton become visible on radiographies or even CT-scans. Moreover, proposals made earlier to use 32P or 89Sr for palliation of pain in patients with disseminated skeletal metastases were picked up again and led also to other radiopharmaceuticals (186Re-HEDP, 153Sm-EDTMP, 117mSn-DTPA) which are applied today for the same purpose with very good success. Therefore Nuclear Medicine today has a broad program for diagnostic and therapeutic approaches to diseases of bone and joints. In bone scanning the high sensitivity led to inclusion of this method for routine staging and re-staging programs in a variety of cancer forms which have a trend to develop bone metastases (e.g. breast, lung, prostate, melanoma) but the low specificity of abnormal patterns on such scans can impair the diagnostic value of the technique. To increase specificity and to define inflammatory lesions, radiotracers used for "inflammation scanning" were introduced such as labeled granulocytes, 99mTc Human Immunoglobulin and others but also a simple modification of bone scanning--triple phase bone scintigraphy--was used. Recently the excellent properties of 18F for PET of the skeleton were rediscovered again and emission CT scanning--possibly with overlay with transmission CT or MRT pictures--can enhance the diagnostic impact of radionuclide bone studies.
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PMID:Nuclear medicine in diagnosis and therapy of bone and joint diseases. 1460 Oct

Radiopharmaceuticals not only are used for diagnostic purposes but also increasingly in the treatment of many orthopaedic-related disorders. With the development of specific bone-seeking radiopharmaceuticals, the side effects of treatment are minimized, therapeutic effects are sustained, and concomitant use with other modalities may have synergistic effects. These new radiopharmaceuticals, such as strontium 89 and samarium 153-ethylene diamine tetramethylene phosphate, have been used as palliative treatment for patients with bone pain from osseous metastases. Excellent clinical responses with acceptable hematologic toxicity have been observed, and clinical results rival those of external beam radiation therapy. Radiosynovectomy has become a procedure of choice at many institutions to treat recurrent hemarthrosis and chronic synovitis in patients whose hemophilia is poorly controlled with medical management. Radiosynovectomy also remains a viable option to treat chronic synovitis secondary to inflammatory arthropathies, particularly rheumatoid arthritis.
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PMID:Advances in radionuclide therapeutics in orthopaedics. 1475 98

When radio-iodine was first used in the treatment of metastasized thyroid carcinoma in 1943, its success in terms of tumour response, quality of life improvement and survival was considered a 'miracle', as in those days metastatic cancer was generally fatal. Inspired by this, many efforts have been made to apply radioisotope therapy to other tumours. Radionuclide therapy uses radioactive isotopes labelled with specific targeting agents that aim to deliver the irradiation of the isotope to the tumour, while sparing normal tissues. Its unique modality allows to systemically target radiosensitive tumours throughout the body. Another important principle is its so-called 'cross-fire' action, whereby, owing to the larger reach of the radiation in relation to the cell diameter, a tumour cell receives lethal hits also from isotopes in the neighbourhood that are not directly associated with this cell. The treatment is therefore less hampered by inhomogeneous distribution and metabolism than for example chemo- or immunotherapy. The European Association of Nuclear Medicine has issued guidelines on so-called 'established' therapies (www.eanm.org), i.e. hyperthyroidism, thyroid carcinoma, refractory synovitis, bone metastases, mIBG therapy, 32P therapy and Lipiodol therapy. Newer therapies include radio-peptide therapy, radio-immunotherapy of lymphoma and microsphere therapy for liver cancer. The aim of a recently held workshop at the ECCO13 conference 2005 and this review is to inform the oncology community about these new developing therapies.
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PMID:Clinical applications of newer radionuclide therapies. 1656 89


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