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)

An 83-year-old male presented in October, 1988, with pigmented tumor lesions on the penis. The main tumor mass accompanied with necrotic bleeding, measuring 5 cm in diameter was located on the fore skin and glans penis. On the proximal shaft of the penis, there were three other black tumors, measuring from 0.5 to 3 cm in diameter. The distal urethra of the penis was clinically involved in the tumor mass and bilateral inguinal lymph nodes were palpable. Chest X-ray and liver scan both revealed multiple metastases. Tumor biopsy confirmed malignant melanoma. Phallectomy and bilateral inguinal lymph node biopsies were performed in October, 1988. Pathological findings revealed that a malignant melanoma had developed from the fore skin and glans penis, extended into the penile urethra and metastasized to bilateral inguinal lymph nodes. The patient gradually deteriorated in general condition and died of cancer 28 days later. The prognosis of malignant melanoma of the penis seems to be extremely poor.
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PMID:[A case of malignant melanoma of the penis]. 189 14

A case of primary malignant melanoma of the male urethra is reported. Treatment included partial urethrectomy, bilateral inguinal and iliac lymphadenectomy, and post-surgical systemic chemotherapy. After thirty-six months, the patient is alive with cutaneous, pelvic lymph node, and gastric metastases.
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PMID:Primary malignant melanoma of male urethra. 201 4

Thirteen patients with Stage Tis, Ta, or T1 transitional cell carcinoma (TCC) of the bladder treated by transurethral resections and intravesical chemotherapy developed TCC of the prostate. Among the 13 cases, cytology specimens were obtained from 10 at the time prostatic disease was diagnosed; 9 demonstrated TCC. One was treated successfully by transurethral resection of a Ta lesion involving the prostatic urethra only. One of 2 patients declining radical surgery is alive with residual disease at twenty-four months, and the other died of progressive disease at nineteen months. Of the 10 patients who underwent radical cystoprostatectomy, 7 are alive with no evidence of disease eight to forty-two months postoperatively, with 2 of these 7 having received 4 courses of systemic methotrexate, vincristine, Adriamycin, and cisplatinum (MVAC) for metastatic disease. Two of the 10 died of metastatic disease six and thirteen months postoperatively, and one frail patient died of surgical complications. When treating patients with intravesical chemotherapy for superficial TCC, biopsy of the prostate should be done during follow-up examinations, especially in the presence of cytologic or palpable prostatic abnormalities.
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PMID:Prostatic occurrence of transitional cell carcinoma after intravesical chemotherapy. 202 89

We studied 15 patients with histologically proved multifocal carcinoma in situ of the bladder who were in remission at a mean followup of 21 months after induction intravesical chemotherapy with mitomycin C. These patients have been followed for a further 28 months, for a total mean duration of 49 months. Of the 15 patients 4 suffered new areas of carcinoma in situ, including 3 who subsequently required cystectomy (2 after unsuccessful intravesical bacillus Calmette-Guerin therapy and 1 with a simultaneous invasive tumor). One patient underwent transurethral resection of the prostate for carcinoma in situ of the prostatic urethra, which subsequently was shown to be limited to mucosa and not involving the deeper ducts nor the stroma. Of the remaining 11 patients 1 died of unrelated disease and 2 suffered recurrent papillary transitional cell carcinoma treated successfully with a combination of intravesical bacillus Calmette-Guerin therapy and resection. The other 8 patients have remained free of tumor. None of the 15 patients had metastatic cancer. We believe that these results support the durability of response after induction mitomycin C therapy. We stress the necessity for prolonged close followup to detect recurrent tumor and to avoid metastatic disease.
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PMID:Topical mitomycin C therapy for carcinoma in situ of the bladder: a followup. 210 37

Mitomycin C was given intravesically over periods of 2-32 months to 34 patients with carcinoma in situ of the urinary bladder. Initial complete response was obtained in 17 patients, 14 of whom remained without evidence of disease during follow-up averaging 28 months from cessation of mitomycin therapy. In three responding patients malignant cells reappeared in the urine during follow-up, although no recurrence of carcinoma could be proven in bladder biopsy specimens. In eight of the 17 non-responders, muscle invasion and/or metastatic disease developed during or after mitomycin treatment. The prostatic urethra was involved in five cases. Chemotherapy had to be discontinued because of chemical cystitis in three cases. Mitomycin C appears to be effective for intravesical treatment of carcinoma in situ of the urinary bladder. Close surveillance of these patients is mandatory, however, and must include monitoring not only of the bladder, but also of the prostatic urethra and the upper urinary tract.
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PMID:Intravesical mitomycin C for carcinoma in situ of the urinary bladder. 210 91

To evaluate the relative efficacy of cisplatin, cyclophosphamide, and Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH) (CISCA) versus methotrexate, vinblastine, Adriamycin, and cisplatin (MVAC), a prospective randomized trial was performed in patients with advanced metastatic urothelial tumors. Patients were stratified by histologic disease type and degree of tumor dissemination. Equal distribution of the clinical characteristics was achieved. One hundred ten patients with metastatic disease of the urinary tract (86 bladder, 16 renal pelvis, seven ureter, one prostatic urethra) met eligibility criteria and were enrolled on study. These represented 82% of the total patients seen during the study period in the Section of Genitourinary Oncology who met the eligibility criteria. The combined complete and partial response rate was significantly higher for patients treated with MVAC than for those treated with CISCA (65% v 46%; P less than .05). The survival duration of MVAC-treated patients was significantly longer than that of CISCA-treated patients (mean, 62.6 weeks; median, 48.3; range, 5.0+ to 162.3+ v mean, 40.4 weeks; median, 36.1; range, 7+ to 147.1+). We conclude that MVAC chemotherapy is superior to CISCA chemotherapy, achieving a higher response rate and a longer survival for equivalent patients with metastatic urothelial tumors.
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PMID:A prospective randomized trial comparing MVAC and CISCA chemotherapy for patients with metastatic urothelial tumors. 1118 90

The primary manifestation of a malignant melanoma is rarely found in the female urethra and considerably less in urinary bladder. This article is based on a case report of a female patient who had to undergo numerous transurethral resections and died of such an escalating tumor. Malignant melanoma in the form of metastases are relevant to the urologist, because they are discovered frequently in the genitourinary tract. The symptoms and diagnostic procedures correspond to those of other urological carcinomas. Radical surgery is of major importance as therapy.
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PMID:[Primary malignant melanoma of the distal urogenital tract. Case report and review of the literature]. 220 Jan 93

Six men with either recurrent (n = 4) or unresectable (n = 2) squamous cell carcinoma of the penis (n = 5) and urethra (n = 1) received chemotherapy with cisplatin intravenously at a dose of 100 mg/m2. This was followed 24 hours later by a continuous intravenous infusion of 5-fluorouracil (5-FU) at a dose of 960 mg/m2/d for five days every 3 to 4 weeks. There was universal alopecia. The other toxicities were mild and consisted of mucositis, nausea, vomiting, reversible creatininemia, and transient azotemia. After chemotherapy, five patients had a clinical partial response and one had a complete response. Of the five patients with no metastases, three had residual unresectable tumors. These three patients received radiation and survived for 6, 8, and 20 months after the start of chemotherapy. The other two patients were rendered disease-free by surgery. The first patient, who was a partial responder to chemotherapy, survived for 26 months. The second patient, who was a clinical complete responder, had excision of microscopic disease and is disease-free at 32+ months after the start of chemotherapy. This is the first article to report that the combination of cisplatin and 5-FU is active in penile and urethral carcinomas. After chemotherapy, surgery may be useful in selected patients to accurately assess response and excise localized residual tumors. Patients rendered tumor-free may achieve long-term survival.
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PMID:Chemotherapy with cisplatin and 5-fluorouracil for penile and urethral squamous cell carcinomas. 229 33

In seven patients with undifferentiated carcinoma of the prostate, the immunohistochemical stain for prostate-specific antigen was negative. The stain for prostatic acid phosphatase done on the same tissue samples was diffusely positive in three, focally positive in three, and negative in one. Only the three with diffusely positive immunostaining had elevated serum acid phosphatase levels, although five had evidence of metastatic disease. All seven neoplasms were histologically similar, being composed of large cells with large nuclei, a moderate amount of cytoplasm, and indistinct cell borders. All tumors grew as broad sheets within the prostatic stroma as well as in the prostatic urethra; in six cases. Thus, prostatic carcinoma with this histologic pattern frequently loses prostate-specific antigen immunoreactivity. Awareness of this occurrence should prevent a misdiagnosis of urothelial carcinoma in such cases. The prostatic origin of these neoplasms can usually be verified by prostatic acid phosphatase immunostaining, which proves to be more sensitive in this particular setting.
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PMID:Carcinoma of the prostate with atypical immunohistological features. Clinical and histologic correlates. 243 Apr 76

A case of male urethral melanoma is reported. A 85-year-old male with a 2-month history of progressive, severe obstructive urinary symptoms and bloody urethral discharge was referred to us after an unsuccessful management at a local doctor. Physical examination revealed an ill looking old man with no evidence of nevi or other cutaneous pigmentation looking like malignant melanoma. Neither palpable periurethral mass nor inguinal lymphadenopathy was noted. RUG showed an irregular shadow defect in bulbous urethral regions. In cystourethroscopy, a raised nodular reddish black lesion in the urethra without adjacent satellite lesions was found. Histologic examination revealed that the tumor was made up of closely spaced, anaplastic, spheroidal or polyhedal cells. Intracellular brown pigment was richly present, gave a negative reaction for iron, but stained black with Masson-Fontana's method. Further examination for evaluating metastases including bone scintigraphy, computer tomographic scan, chest X-ray film were negative. Due to his poor risk, radical operation such as cystourethrectomy might be undesirable. We performed TUR to relieve urethral obstruction, because the patient refused cystostomy. He died of wide spread metastases at 6 months after the operation. This case seems to be the second report in the Japanese literature.
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PMID:[Malignant melanoma of male urethra: a case report]. 265 6


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