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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

By the term reticulum cell sarcoma we denote any tumor composed predominantly of undifferentiated cells, some of which have the qualities of histiocytes. The origin of such CNS tumors may be traced to circulating monocytes, perithelial ro meningeal histiocytes or microgliocytes. The ubiquity of cells of the monocyte-histiocyte series allows six possibilities of CNS involvement: a) primary in the brain: b) secondarily involve the brain or spinal cord by extending from a cranial bone or vertebra to the epidural space c) rarely to involve intraneuronal tissues (lymph nodes, bone, viscera) and then later to localize to the brain substance d) to spread from brain outside the nervous system e) to evoke any one or several of the paraneoplastic diseases (polymyositis, polyneuritis, cerebellar degeneration, f) to permit widespread infections of the nervous system such as multifocal leucoencephalitis. Clinical attributes to be emphasized are the relative rarity of hematogenous metastases (2 of 121 cases), the relatively high incidence of such tumors in immunologically suppressed individuals (12 of 5000 cases), the frequency of primary tumors of CNS (23 of 144 cases), the high incidence of epidural and dural involvement from osseous lesions (13 of 121 cases); the rapid evolution of clinical phenomena; the rarity of paraneoplastic syndromes; the occasional spontaneous and frequent therapeutic regression upon x-radiation. The common invasion of pia and ependyma by the tumor cells and their natural tendency to phagocytosis opens unrealized possibilities of clinical diagnosis by cytological examination and culture of CSF. Early diagnosis by these methods permits avoidance of surgery and the use of radiation and possibly chemotherapy, which may be rewarded by symptomatic regression and potential cure.
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PMID:Certain notable clinical attributes of the histiocytic sarcomas of the central nervous system. 109 70

Primary brain tumors invade and metastasize within the central nervous system (CNS), but rarely extraaxially. A model explaining this behavior is presented. In non-CNS tumors metastases occur since subpopulations of cells capable of invasion and metastases are selected by the tissular environment, and in particular by the connective stroma, which opposes invasion. The CNS lacks a connective stroma, therefore a primary tumor can grow easily in it, but subpopulations capable of metastasization are not selected. Implications of the explanation are: 1) metastasization is largely based on the ability to invade the connective stroma, 2) paradoxically, a less favourable host tissue environment can result in a more aggressive tumoral behavior.
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PMID:An explanation for the rarity of extraaxial metastases in brain tumors. 143 99

Of 29 consecutive children treated for malignant primary tumors of the central nervous system (CNS) at this institution, postoperative examination showed radiographic or cytologic evidence of neuraxis dissemination in 10 (34%). Given the historically poor results in disseminated CNS tumors treated with surgery and radiation therapy alone, these ten patients were treated prospectively with an investigational Phase II protocol consisting of preirradiation cisplatin (90 mg/m2 on day 1) and etoposide (150 mg/m2 on days 3 and 4). The diagnoses included medulloblastoma (n = 4), malignant glioma (n = 3), cerebral primitive neuroectodermal tumor (n = 1), pineoblastoma (n = 1), and mixed glioma of the brainstem (n = 1). Postoperative neuraxis scanning with computed tomography, magnetic resonance imaging, or spinal myelography showed measurable intracranial or spinal metastases in all children. The cerebrospinal fluid (CSF) cytologic examination was positive for tumor cells in five. The best responses, based on serial imaging of neuraxis metastases, included two complete responses, four partial responses, and three stable disease states. One patient had progressive disease at the primary site despite stable disease in the spine; progressive neuraxis disease was documented in only one patient during chemotherapy. Clearance of tumor cells from the CSF was documented in three patients. The adverse effects of chemotherapy, consisting of transient myelosuppression and mild ototoxicity, were minimal. Reversible neurologic deterioration occurred in two patients; one patient became acutely quadriplegic after a prolonged convulsive seizure without radiographic evidence of tumor progression.
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PMID:Neuraxis dissemination in pediatric brain tumors. Response to preirradiation chemotherapy. 173 73

Intermediate filament keratin is regarded as a good marker for epithelial and mesothelial tumors. In the intracranial and intraspinal spaces keratin has been demonstrated only in the endocrine cells of the adenohypophysis, squamous epithelial islands in the pars tuberalis of the hypophysis and in the choroid plexus epithelium. Since gliomas and meningiomas do not express keratin, this marker provides an additional help for differentiating between primary and secondary CNS tumors. Indirect immunofluorescence using an anti-keratin serum was used in a retrospective search for keratin in 80 tumors of the cranium and intraspinal space. Of the primary CNS tumors keratin positivity occurred in craniopharyngiomas, epidermoid tumors, pituitary adenomas, chordomas, a plexus papilloma as well as in the majority of germ cell tumors. Only 3 renal cell carcinoma metastases of 21 metastatic epithelial cell tumors (7 bronchial carcinomas, 6 breast cancers, 6 renal carcinomas, 1 rectum carcinoma, 1 cervix carcinoma) were keratin-negative. Similar findings were made in two melanoma metastases which we examined, whereas in a seminoma metastasis a few keratin expressing cells were found. Primary CNS tumors such as myxopapillary ependymomas, medulloepitheliomas, malignant meningiomas and paragangliomas which are often difficult to distinguish from these metastases proved to be keratin negative.
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PMID:[Significance of immunohistochemistry in neuro-oncology. V. Keratin as a marker for epithelial differentiation of primary and secondary intracranial and intraspinal tumors]. 244 Feb

We present an immunohistochemical study of 16 meningiomas and 19 CNS tumors including gliomas, neurinomas and metastatic carcinomas, in order to establish a histopathologic differential diagnosis, using formalin-fixed and paraffin-embedded material. The antibodies analysed included vimentin, GFA-protein, cytokeratin, S-100 protein and epithelial membrane antigen. Meningiomas always express vimentin as marker, and occasionally cytokeratin and EMA. The most constant antigens demonstrated in astrocytomas were GFA-protein and vimentin, and occasionally we were able to detect S-100 protein. Neurinomas proved positive to S-100 protein, and metastases presented cytokeratin and EMA reactivity. Our results confirm the existence of diverse immunohistochemical patterns within CNS tumors, a fact that can be useful in routine differential diagnosis.
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PMID:[Differential immunohistochemical characteristics of meningiomas and other neoplasms of the central nervous system]. 263 47

Osseous metastases from primary central nervous system (CNS) tumors are rare. The CNS tumors that most frequently metastasize to bone are the glioblastoma multiforme and the medulloblastoma. In this report, a 22-year-old woman sought treatment for a lytic lesion in her right proximal femur 18 months after a craniotomy to remove a pinealoblastoma, a rare primitive neuroectodermal tumor of the pineal gland. An extensive evaluation demonstrated no other primary tumors. A biopsy of the femoral lesion revealed that it was morphologically identical to the pinealoblastoma, and special immunohistochemical stains were performed that verified neuronal differentiation. This may be the first report of a pinealoblastoma associated with an extracranial skeletal metastasis.
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PMID:Extracranial skeletal metastasis from a pinealoblastoma. A case report and review of the literature. 267 97

This study compares the CT characteristics in a consecutive sample of supratentorial metastases (n = 31) with primary tumors of the same location (n = 49) in childhood. Postcontrast CT was performed in all but one of the metastases cases. In all but one of these children the location and type of primary tumor was known at time of occurrence of cerebral metastasis. Primary CNS tumors (n = 12) had a higher incidense of supratentorial metastatic spread than tumor originating elsewhere. Three children had diffuse subarachnoid seeding, while 28 had solid tumors (21 solitary, 7 multiple). The predilection location for the solid metastases was the gray-white matter junction (n = 12). The following CT findings were significantly less frequent in metastases than in primary tumors (P less than 0.05): Midline location, calcification and cyst formation. On the other hand bleeding, pronounced contrast enhancement and location in the gray-white matter junction were more frequent in the metastatic group (P less than 0.05).
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PMID:Computed tomography in intracranial, supratentorial metastases in children. 271 99

While the embryonal central neuroepithelial tumors present complex conceptual and clinical problems, advances in cell type identification by special neurohistological, immunohisto- and immunocytochemical techniques have permitted discrimination of distinct cytomorphogenetic entities. These are based in part on their resemblance to the normal phases of neurocytogenesis. Four of these tumors, medulloepithelioma, desmoplastic infantile ganglioglioma, pineoblastoma and medulloblastoma, are designated as multipotential in light of their capacity to undergo divergent differentiation. Cytomorphogenetic, clinical and experimental data implicate fetal neural cell targets for transformation and raise the possibility that aberrant developmental regulatory mechanisms may contribute to the biologic behavior of these tumors. Growth factors and some neuroregulatory neurotransmitters (such as serotonin) are known to act as modulators of normal neuromorphogenesis. They could play a regulatory role in central neuroepithelial tumors on the hypothesis that the aberrant behavior of the embryonal neoplasms could either be modified by functional receptor responses or result from abnormal receptor responses to these substances. Future challenges include the definition of new cytomorphogenetic entities and subgroups of the currently defined forms of embryonal CNS tumors based on the presence of specific growth factors and neuroregulatory neurotransmitters, or their receptors, the characterization of neoplastic receptor responses mediating any modulatory role of the presently known growth factors or neuroregulatory neurotransmitters on the growth and maturation potential of the embryonal central neuroepithelial tumors and the further definition of developmental, stage-specific modulators that might be operative in these tumors.
Cancer Metastasis Rev 1987
PMID:Embryonal central neuroepithelial tumors: current concepts and future challenges. 288 64

Since December 1979, 14 patients with progressive metastatic brain lesions have been treated with temporary implantation of high-activity iodine 125 sources using stereotaxic techniques. Four patients had prior surgical resections, and 13 had been treated with external whole-brain radiotherapy. Nine patients had brachytherapy performed at recurrence 4 to 16 months after conventional radiation therapy; the other four had implants as an adjuvant "boost" to the tumor area from 2 to 4 weeks after external radiation. Six patients have since died: two with stable brain lesions at 4 and 22 weeks, respectively; three with progressive systemic and CNS tumors at 23, 24, and 29 weeks, respectively; and one with progressive CNS disease 116 weeks postimplant. The remaining eight patients are alive with a median follow-up of 63 weeks (range, 52-239+ weeks). Median survival for the entire group is 80 weeks. Brain tumor brachytherapy may be useful for palliation and possible long-term survival in selected patients with solitary metastatic disease.
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PMID:Interstitial brachytherapy for metastatic brain tumors. 291 71

Eight patients with intraocular lymphoma were studied; all were middle-aged or elderly, usually presenting with a unilateral visual deficit. All patients also had an extraocular lymphoma with either systemic (2) or isolated central nervous system (CNS) involvement (6). When ocular symptoms preceded CNS symptoms, they presented from 11 months to 10 years earlier. Intraocular lymphoma tended to affect the eye ipsilateral to the CNS tumor either exclusively or initially, and to the greatest degree histologically. Histologic examination of intervening optic pathways revealed extension of intraocular tumor across the optic nerve into orbital leptomeninges in 3 cases. Corresponding CNS tumors showed prominent leptomeningeal involvement. All intraocular and extraocular tumors showed diffuse growth patterns with histiocytic (large cell), poorly differentiated lymphocytic or mixed lymphocytic-histiocytic subtypes. CNS tumors were detected only after onset of neurologic symptoms, and were almost always fatal, although CNS irradiation prolonged survival for years in some cases. Our data suggest that the peculiar link between intraocular and CNS lymphomas may reflect both multicentric and metastatic disease processes. The prompt recognition of intraocular lymphomas as a harbinger of extraocular tumor may prove valuable in earlier recognition and treatment of the disease.
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PMID:Intraocular lymphomas. Natural history based on a clinicopathologic study of eight cases and review of the literature. 634 57


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