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)

Forty patients with retroperitoneal metastasis from nonseminomatous testicular cancer treated with chemotherapy were retrospectively studied to (1) evaluate the predictive value of mass size as detected by computerized tomography (CT) as an indicator for postchemotherapy surgery and (2) determine the factors that influence relapse. Patients received two further courses of chemotherapy after their serum biomarkers became normal and computed tomography indicated a complete response or presence of a residual but stable mass. We found that patients with initial metastases less than 2 cm had a low frequency (14%) of residual masses after chemotherapy, vs. 59% for those with masses of 2-5 cm and 75% for those with masses of greater than 5 cm (P = 0.03). Of 22 patients with primary embryonal carcinoma, three of seven (43%) with residual masses after chemotherapy had mature teratoma at surgery. Six patients had small (1-2 cm) residual abnormalities that were not removed, and three of these patients relapsed. In conclusion, increasing size of retroperitoneal metastasis by CT scan predicts for increased likelihood of a residual mass after chemotherapy; patients who have a residual mass greater than or equal to 1 cm require retroperitoneal lymphadenectomy after chemotherapy, whether the tumor histology is embryonal carcinoma or teratoma. The role of surgery for patients who have residual retroperitoneal masses less than 1 cm after chemotherapy could not be determined from our study.
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PMID:Clinical and radiological correlation of retroperitoneal metastasis from nonseminomatous testicular cancer treated with chemotherapy. 292 Jul 67

A monoclonal antibody (H17E2) was used in a solid-phase localisation of enzyme activity (ILEA) assay to evaluate placental-like alkaline phosphatase (PLAP) as a serum marker of testicular germ cell tumours. Single or repeated assays were performed on 213 normal blood donor and a smaller number of term pregnancy and testicular cancer sera. The detection limit of PLAP by this system was 0.14 O.D. units equivalent to 0.04iul-1. Of 50 patients with established metastatic disease tested before treatment, 88% of 16 with seminoma, 54% of 13 with mixed seminoma and malignant teratoma and 33% of 21 with malignant teratoma had serum PLAP greater than 0.2 O.D. units. This compared to an incidence of 2% in non-smokers and of 29% in smokers who had been free of disease for more than 12 months. In 15 of 22 successfully treated patients, pre-treatment serum PLAP exceeded 0.2 O.D. units (mean 0.69 O.D.) and varying (53-97%) reductions in the initial levels occurred with treatment. These results with monoclonal antibody ILEA assay suggest that measurement of PLAP levels will be useful in the management of patients with germ cell tumours, particularly seminoma.
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PMID:Serum marker potential of placental alkaline phosphatase-like activity in testicular germ cell tumours evaluated by H17E2 monoclonal antibody assay. 298 64

We reviewed the autopsy, clinical, and radiographic records of 39 patients with metastatic skeletal disease (age range 18 months-20 years). There were 11 different primary tumors responsible for skeletal metastases, of which neuroblastoma was the most common (16 patients). Other commonly occurring tumors giving rise to secondary skeletal deposits were rhabdomyosarcoma (seven), teratoma-teratocarcinoma (four), and Wilms tumor (three). Overall patient survival ranged from 2 weeks to 72 months, with an average of 10.2 months. Those patients presenting without skeletal metastases at the time of diagnosis of the primary tumor had a survival time averaging 16.2 months (range 3-72 months), whereas those patients presenting initially with skeletal metastases at the time of diagnosis of the primary tumor had a survival time of 8.5 months (range 0.5-23 months).
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PMID:Metastatic skeletal disease in the pediatric population. 298 4

Twenty-one patients aged 16 years or less had been treated for a primary mediastinal germ cell tumor at the Children's Hospital, Boston Massachusetts, during the last 54 years. There were 13 boys and eight girls with the average age at diagnosis being 7 years (range 2 weeks to 16 years). Twelve mediastinal germ cell tumors were classified as pure teratoma, five contained embryonal carcinoma admixed with other germ cell components, and four were pure embryonal carcinoma. Of 12 patients with pure teratoma, 10 underwent complete surgical resection and were alive and well 1 to 13 years later; two children left untreated died of complications related to local tumor growth. Complete surgical resection was possible for only two of nine patients with embryonal carcinoma; both received adjuvant therapy and were alive and well 3 and 20 years later. Seven patients received radiation and/or chemotherapy but died of residual or metastatic disease. Successful treatment for children with embryonal carcinoma requires an operation aimed at either debulking or complete resection (if possible) coupled with early and aggressive combination chemotherapy. The role of radiation in primary therapy remains undefined with regard to curative intent.
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PMID:Mediastinal germ cell tumors in childhood. A clinical and pathological study of 21 cases. 298 18

To assess the hypothesis that local extent of the primary lesion in patients with nonseminomatous germ cell tumors of the testicle can predict disseminated disease, clinicopathological correlations of the primary tumor and metastases were determined in a retrospective review of 120 patients treated at our institution from 1970 to 1982. Pathological staging was available for all 93 patients with subdiaphragmatic disease and the primary tumor was examined by routine histological techniques in all cases. Increased primary tumor stage, as evidenced by invasion into the tunica vasculosa or extension into the rete testis, epididymis and/or lower or upper spermatic cord, was associated with metastatic disease in 91, 96, 97 and 97 per cent of the patients, respectively. Only 9 per cent of the patients with pathological stage A disease had vascular invasion compared to 45 and 67 per cent of those with stages B and C disease, respectively (p less than 0.01). Furthermore, metastases and/or eventual dissemination occurred in 84 per cent of the patients with clinical stage A disease and vascular invasion, and in only 23 per cent of those without vascular invasion (p less than 0.01). Size of the primary tumor was not of predictive value. Local extension of the primary lesion was common with embryonal carcinoma but it was not demonstrated when the predominant histological type was teratoma or teratocarcinoma, although metastases were present in 37 and 46 per cent of the latter cases, respectively. The implications of these findings, especially with regard to expectant management for clinical stage A nonseminomatous germ cell testis tumors, are discussed.
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PMID:Nonseminomatous germ cell tumor of the testicle: does extensive staging of the primary tumor predict the likelihood of metastatic disease? 301 46

Thirty-three patients with a non-seminomatous germ cell tumor of the testis in clinical stage I were treated only by orchidectomy. The very careful follow-up--with tumor marker assays every 3 weeks, chest X-rays every 6 weeks and CT-scans of the lungs and retroperitoneum every 3 months--revealed metastases in 7 of the patients (21%). All these relapses were diagnosed within 6 months of the orchidectomy. Para-aortic node metastases were found in 5 of the 7 patients, with additional inguinal node metastases in 1 and additional lung metastases in 1; 2 patients had only lung metastases. Six of the 7 patients with a relapse were given chemotherapy (PVB); 1 patient refused chemotherapy. In view of residual disease a surgical excision was performed; it revealed necrosis as well as mature teratoma. All 33 patients are still alive, the post-orchidectomy follow-up period being 12-38 months.
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PMID:Wait-and-see policy in clinical stage I non-seminomatous germ cell tumors of the testis. 301 79

The completely resected teratomatous metastases of 55 patients who had been treated with cisplatin-based combination chemotherapy for non-seminomatous germ cell tumors were reviewed to see if cellular atypia had an effect with respect to recurrent disease. The degree of atypia of the epithelial and mesenchymal elements was assessed on the basis of the cytologic features and mitotic activity. Twenty-three percent of the cases contained high-grade epithelial elements, whereas high-grade mesenchymal elements occurred in 18% of the cases; in addition there were nine cases classified as showing frankly malignant teratomatous elements. The presence of cytologically disturbing epithelial and mesenchymal elements (which, however, lacked an invasive malignant pattern) correlated with an increased incidence of recurrent teratoma compared to less atypical teratomatous elements (23% vs. 6% for epithelial elements, and 18% vs. 9% for mesenchymal elements, respectively). This difference, however, was not statistically significant (P greater than 0.05). There was no correlation between teratomatous atypia and recurrent, non-teratomatous germ cell tumor. The presence of an invasive malignant pattern did identify patients at significantly increased risk for recurrent teratoma-derived tumor. The authors conclude that cytologic atypia in the absence of invasion is not sufficient justification for altering the usual therapeutic strategies for patients with teratomatous metastases.
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PMID:The significance of atypia within teratomatous metastases after chemotherapy for malignant germ cell tumors. 302 6

The orchiectomy specimens and the respective lymphadenectomies of 33 teratocarcinomas (teratoma and embryonal carcinoma) and 30 embryonal carcinomas were identified in a series of 457 consecutive germ cell tumors of the testis. Although teratocarcinomas were larger tumors the retroperitoneal lymphadenectomies revealed metastases in only 10 of 33 (30%) teratocarcinomas as compared to 19 of 30 (63%) embryonal carcinomas. Even after subtracting the teratoma component and stratifying for size of the embryonal carcinoma component, the teratocarcinomas were still less likely to metastasize than comparably sized pure embryonal carcinomas. Statistical significance was found between the differences in size and the differences in the rates of metastases, before and after stratifying for size of the embryonal carcinoma component of the teratocarcinomas. Further, all embryonal carcinomas metastasized as embryonal carcinoma while only 5 teratocarcinomas metastasized as embryonal carcinoma. This study supports experimental evidence that the embryonal carcinoma cells in teratocarcinomas are not necessarily identical to embryonal carcinoma cells in embryonal carcinomas.
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PMID:The characteristics of embryonal carcinoma cells in teratocarcinomas. 303 99

At the department of neurosurgery and pediatrics of the University Hospital of Hamburg 18 children with pineal region tumors were treated by surgical removal and craniospinal axis radiation. Total or nearly total removal was achieved in 13 cases. In case of astrocytoma and pineocytoma no further treatment was performed. Children with germinoma, pinealoblastoma and teratoma underwent craniospinal axis radiation postoperatively. All children thus treated, except one with a highly malignant pinealoblastoma, are so far relapse-free. Two patients with germinoma and two patients with malignant mixed teratoma, which showed extensive growth and/or primary metastases already at admission died. Subject of this report is an assessment of quality of live and a comprehensive follow-up of neurological, endocrinological and psychointellectual conditions of the surviving children. Parent assessment of quality of life indicate for all but two children life quality as excellent or reasonable. One child was disabled by severe motor dysfunction, visual defects and convulsions. In two children minor neurological handicap was found. Minor oculomotor dysfunction was the most frequent neurological finding. Four children showed endocrinopathies. In three cases tumor associated panhypopituitarism persisted after treatment. Only one child developed growth hormone and ADH deficit succeeding surgery and craniospinal axis radiation. The children were examined with a neuropsychological test-battery. In four children severe neuropsychological deterioration was found. Three children showed no remarkable deterioration, five only minor or moderate psychological deficits. Generally verbal intelligence seemed to be on average, non-verbal intelligence and ability for concentration showed decreased scores.
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PMID:[Prognosis and quality of life following tumors in the pineal region in childhood]. 312 66

A case is reported in which a testicular cancer presented as a metastatic deposit in the eyelid. The histological appearances of both the metastasis and the subsequently detected primary were diagnostic of malignant teratoma trophoblastic (MTT). After comments on the testicular tumour, metastases occurring in the eye and adnexa are discussed.
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PMID:Testicular cancer presenting as a red swollen lid. 320 64


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