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)

Serum alpha1-fetoprotein (AFP) had been determined in 31 patient with (mostly malignant) teratomas before or immediately after operation, and later in the evolution of 3 other cases with clinical evidence of recurrence or metastases. Without knowledge of these serum AFP levels, histological slides of the same 34 teratomas were reexamined, especially for the presence of yolk sac components. Two pure yolk sac tumors and 6 teratomas containing yolk sac structures were associated with serum AFP levels above 500 ng/ml. Teratomas without yolk sac structures were associated with normal serum AFP levels (i.e. 10-500 ng/ml) in 14 cases, and high serum levels (i.e. above 500 ng/ml) in one case. Histologic analysis of the 14 cases with slightly elevated AFP levels did not reveal tissue possibly responsible for the low but nevertheless abnormal AFP synthesis. High AFP levels, which are easily detectable by counter-current immunoelectrophoresis, are, however, highly specific for the yolk sac tumor or the yolk sac component of teratomas, and hence suggest that this extra-embryonic structure should be distinguished from other teratoma components.
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PMID:[Vitelline components in teratomas and serum alpha-1 fetoprotein]. 6 46

Between 1973 and 1977, 247 patients with malignant teratoma have been treated in two units in London. Seventeen have developed brain metastases, an overall incidence of 6.2%. The median survival from diagnosis of cerebral metastases is 6 weeks and all patients except one have died. The survivor is disease-free 12 months after completing treatment, which included extensive use of chemotherapy, surgery and radiotherapy. Serum gonadotrophin (HCG) and alpha-foetoprotein (AFP) estimations have been performed in 264 patients as a means of monitoring the effects of therapy. In 42 patients (37 of whom had Stage IV disease) the peak HCG level was greater than 10(4) iu/l, and the incidence of brain metastases in this group was 26%, significantly higher than in the group with HCG levels below 10(4) iu/l, for which the incidence of cerebral deposits was 1.8% (P less than 0.0001). No significant correlation was seen between peak AFP levels and the incidence of brain metastasis. With the aim of improving results by earlier diagnosis, cerebrospinal fluid (CSF) specimens have been examined for HCG and AFP levels in 56 subjects, 9 of whom had brain metastases. A serum: CSF HCG ratio less than 40 is an accurate indication of the presence of brain metastases, and may have considerable predictive value. However, false-negative serum: CSF HCG rations (greater than 40) frequently occur in patients with proven brain deposits. Estimation of AFP in spinal fluid has not contributed to the early diagnosis of brain metastases in malignant teratoma.
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PMID:Brain metastases in malignant teratoma: a review of four years' experience and an assessment of the role of tumour markers. 8 52

Primary intracranila choriocarcinoma, either alone or with malignant teratoma, is a rare tumor. The 22 reported cases of primary intracranila mixed choriocarcinoma and malignant teratoma are reviewed, and a further case is added. This 4 1/2-year-old girl presented with multiple cranial nerve palsies, panhypopituitarism and markedly elevated blood and urine human chorionic gonadotrophin (HCG) titres. After subtotal removal of the suprasellar tumor, supervoltage radiation was given with a remarkably rapid and complete response. She died 14 months after diagnosis with no evidence of local recurrence nor of distant metastases.
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PMID:Primary intracranial mixed choriocarcinoma and malignant teratoma. 9 20

Records of 63 cases of testicular tumors treated at the Hunter Radiation Therapy Center, Yale-New Haven Hospital from 1962 through 1971 were reviewed. One hundred percent cure rate was obtained in the 36 Stage I and II pure seminoma (Group I) patients. For Stage I, the para-aortic and homolateral iliac lymph nodes were irradiated to a dose of 3,000 to 3,500 rads in three to four weeks. Elective irradiation of the mediastinum and supraclavicular areas was omitted. For Stage II, such extended field irradiation was employed to a dose of 2,000 to 3,000 rads in two to three weeks. Six (or 43 percent) of the 14 embryonal carcinoma (Group II) patients are alive for a minimum of three to a maximum of eleven years. Both teratoma (Group III) patients are alive at five and seven years as well. All eight Stage I teratocarconoma (Group IV) patients are alive with no evident disease at three to ten years. Our data indicate the difference in prognosis between patients who subsequently developed localized lung metastases and those who initially presented with pulmonary disease. We conclude that intensive combined efforts of both radiation and medical oncologists can salvage a considerable number of patients with metachronous onset of pulmonary metastases.
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PMID:Radiation therapy for testicular tumors metastasizing to the lungs. 17 93

Prognosis has been poor for patients with retroperitoneal metastases from non-seminomatous testis tumors that are initially unresectable and persist after chemotherapy and irradiation or those that recur after initial lymphadenectomy. Eleven such patients have had re-explorations at our center and are described herein. In 4 patients only histologically benign teratoma and/or fibrosis was found. Therefore, the presence of a retroperitoneal mass in these circumstances does not necessarily mean that malignant tissue was present. The procedure provided an accurate diagnosis in all patients and permitted the elimination or reduction of subsequent chemotherapy or radiation in 4 patients who had no tumor. In addition, 5 of 7 patients with symptoms caused by bulky masses were improved and 3 patients with unresectable disease had radiopaque markers placed to facilitate subsequent radiotherapy. The operation was often difficult because of retroperitoneal adhesions from previous treatment but there was no significant morbidity and no mortality. Nine patients have survived from 6 months to 4 years and 7 have no evidence of disease. Two patients died of recurrent tumor 2 and 9 months after re-exploration. A good prognosis was indicated if the mass found at re-exploration was completely resectable and contained only histologically benign teratoma and/or fibrous tissue. We believe that re-exploration should be considered for selected patients with testis tumors who have 1) a retroperitoneal mass that appears after initial lymphadenectomy and persists after interval chemotherapy or radiation therapy and 2) retroperitoneal metastases that are initially unresectable and persist after subsequent chemotherapy or radiation therapy.
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PMID:Re-exploration for retroperitoneal lymph node metastases from testis tumors. 17 34

A case of primary pure carcinoid tumor of the testis which occurred in a 71-year-old male is reported. The patient was treated by radical orchiectomy and remains well and symptom free 10 months after operation. Histologically as well as ultrastructurally the tumor showed typical appearances of carcinoid tumor of midgut derivation. 23 cases of carcinoid tumors of the testis were discovered in the literature. Of these 17 were primary testicular carcinoids, and 6 were metastatic to the testis. Of the 17 cases of primary carcinoid tumors, 14 were pure carcinoids and only 3 were associated with teratoma. None of the primary testicular carcinoids were associated with metastases and the prognosis after orchiectomy was excellent, thus indicating that no further therapy is necessary. The prognosis of patients with carcinoid metastatic to the testis is poor. In view of this it is very important to determine whether the tumor is primary or metastatic.
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PMID:Primary carcinoid tumor of the testis: case report, ultrastructure and review of the literature. 36 17

A rare primary carcinoid tumor of the ovary, found incidentally in a 68-year-old woman, is reported. There had been no symptoms of carcinoid syndrome. Grossly, the unilateral tumor was cystic, measuring 13 cm in greatest diameter. Microscopically it consisted mainly of solid epithelial cords. The demonstration of argentaffin cells and the absence of a concomitant teratoma, dermoid or pseudomucinous cyst led to the diagnosis of a pure primary ovarian carcinoid tumor. On average the prognosis of such lesions is good and recurrence or fatal metastases are rare. Treatment consists of salpingo-oophorectomy. To rule out a metastasizing carcinoid with similar histologic features, the contralateral ovary should be biopsied since metastases almost invariably occur bilaterally.
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PMID:[The primary ovarian carcinoid. Case report]. 43 4

The authors describe a case of testicle-based teratoma, in a 20-month old boy. Due to the characteristics of the palpation and its eventual transillumination, it may be confused with a hydrocele. They stress its rarity and on the basis of a review of the literature, they explain its histological peculiarities and refer to its prognosis, usually benign, when it is diagnosed at about 2 years of age, providing that a very careful examination of the histological sections rules out the presence of anaplastic cells. Finally there is a short discussion on the possibilities of complementary therapy when there are metastases.
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PMID:[Testicular teratoma in infancy]. 44 74

CT scans of the lungs, mediastinum and abdomen have been performed in 65 patients with malignant teratoma between August 1977 and June 1978. CT is superior to conventional radiology in detecting pulmonary metastases and mediastinal lymphadenopathy. It is a valuable technique for defining the full extent of para-aortic nodal disease and provides more information than lymphography alone. In this series sequential CT scans have been used to monitor treatment response to detect relapse and to assess operability of demonstrable residual disease.
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PMID:The role of computed tomography in the management of testicular teratoma. 45 96

The results of treatment of 199 patients referred to the Royal Marsden Hospital with testiclar seminoma from 1963 to 1975 are described. Of 190 previously untreated patients 16 (8.4%) have died of seminoma, 3 (1.5%) of teratoma and 9 (4.9%) of intercurrent disease. Of 121 Stage I patients the only death was due to a second testicular tumour. In orchiectomy and volume of abdominal node metastases. This was not, however, prognostically significant. Death from seminoma occurred in 6 out of 38 patients (15.8%) with nodal metastases less than or equal to 5 cm in diameter and 3 out of 16 patients (18.7%) with metastases greater than 5 cm in diameter; 2 of 8 Stage III patients died of seminoma. Thus radiation controlled nodal metastases in more than 80% of Stage I, II and III patients. In Stage IV patients and patients referred with disease relapse, 12 out of 16 patients died of seminoma. Chemotherapy experience is briefly reviewed. Cyclophosphamide as a single agent has produced a 50% response rate. There is no evidence to suggest a radiation-related increase in mortality from the group of long-term tumour-free survivors.
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PMID:The pattern of spread and treatment of metastases in testicular seminoma. 46 75


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