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

Ten patients with inoperable renal carcinoma underwent embolization of the renal artery. As embolic material homogenized autologous muscle was used. Besides conventional catheters introduced by the Seldinger technique also flow-directed balloon catheters were employed. The merely palliative purposes of embolization were staunching of otherwise untreatable hematuria in eight and reduction of tumor bulk in two cases. Bleeding could be stopped in all, tumor mass reduced in 6 patients as shown by control angiographies. There was always a recanalization of the renal arteries, the vascular tree, however, being much rarefied. Five patients died of the metastatic cancer within the first seven months after embolization, one patient three days after embolization due to phlegmonous retroperitoneal infection. Further complications consisted in flank pain, reversible rises of body temperature, blood pressure and serum creatinine levels. Thrombotic occlusion of deep veins occurred in two patients. The only true benefit of embolization for the patient consists in a relatively simple, fast and safe way to control an otherwise untreatable hemorrhage from inoperable renal carcinoma. Whether prolongation of survival can be reached remains doubtful in spite of a reduction of the tumor mass.
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PMID:[Transfemoral catheter embolization of inoperable kidney cancer]. 7 51

A case was reported concerning a successful removal of tumor thrombus extending into the right atrium through the left brachiocephalic vein and the superior vena cava. The patient was a 34-year-old man who underwent a left inguinal orchiectomy for immature teratoma of testis in June 1987. The operation was followed by another three operations for excision of lymph node metastases and five courses of cisplatin based combination chemotherapy. In December 1988, the chest CT scan film revealed filling defect in the superior vena cava and the right atrium. Thrombus was detected using echocardiography and angiography. He had no symptom, but multiple pulmonary infarcts were also detected. In February 1989, the operation was performed by means of cardio-pulmonary bypass. A soft yellowish thrombus attached to the left venous angle was removed with resection of the left brachiocephalic vein. Microscopic findings revealed that the thrombus was metastatic testicular teratoma. With further treatment after the operation, he has been disease-free for 14 months now. We conclude that in this case aggressive surgical management following chemotherapy had great value to control the disseminated testicular tumor.
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PMID:[A case of tumor thrombus in the right atrium after multimodal treatment of testicular tumor]. 196 Apr 46

During a 5-year period, 32 patients with colorectal carcinoma underwent a Hartmann procedure. Twenty operations were performed as emergencies for obstruction or peritonitis, and 12 for the elective treatment of colorectal malignancies. Of 22 surviving patients with potentially curable resections, 17 had restoration of colorectal continuity without complication. Five patients refused this option. Of the nine palliative procedures, seven patients developed a pelvic recurrence, one developed metastatic disease, and the remaining patient died after surgery. The median hospital stay was 17 days (range 8-48 days). There were two postoperative deaths (6%), both from pulmonary emboli. Thrombotic events occurred in three further patients, and wound sepsis in four. Other complications inherent to this procedure were individual cases of pelvic sepsis, anastomotic stricture, and a failed initial attempt at 'reversal'. These findings confirm that this operation is safe and effective in dealing with rectal and distal sigmoid colon malignancies with potential for local recurrence, and in those presenting as an emergency with obstruction or peritonitis, particularly when the operator is a surgical trainee.
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PMID:Hartmann's procedure for carcinoma of rectum and distal sigmoid colon: 5-year audit. 203 11

Between 1979 and 1985, 10 patients were treated for renal carcinoma with extension into the inferior vena cava but without evidence of disseminated disease. Two of these had tumour thrombus extension up to the level of the hepatic veins and in four the extension was above the level of the diaphragm, two of which entered the atrium. Thrombus was removed en bloc at radical nephrectomy. Six patients are still alive, with a mean survival of 22 months. There was no correlation between the level of tumour thrombus and perinephric extension or indeed any correlation between tumour thrombus level and overall survival. It is suggested that tumour thrombus in the inferior vena cava, in the absence of metastatic disease, should be managed by radical surgery.
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PMID:Surgical approach to inferior vena caval extension of renal carcinoma. 342 30

Most metastases in patients occur as a result of hematogenous dissemination of tumor cells. This process of metastasis is complex and consists of several steps, foremost of which is the arrest of circulating emboli in capillary beds and the formation of a thrombus at that site. Thrombus formation in the metastasis of human cancer was described first by Billroth in 1878. It was reported that the organization of tumor cell emboli, and the subsequent penetration of tumor cells into the capillary wall, was the first stage of metastasis. Since then, many investigations and observations have been made clinically as well as experimentally to clarify the process (or mechanisms) of tumor cell arrest and how to inhibit it. Coagulative and fibrinolytic pathways were believed to have a main role in thrombus formation. However, other factors responsible for the relationship between tumor cells and the host must be also considered. Elegant and extensive studies by Fidler and Kripke demonstrated that development of metastasis is not a random process, but a selection process of specialized subpopulations of highly metastatic cells within the primary tumors. Biochemical constituents and ionic properties on cell surfaces, deformability or locomotive activities of tumor cells, as well as thrombo-plastic-fibrinolytic activities, are also important factors determining the arrest patterns of circulating tumor cells. On the other hand, host defense factors against tumor cells in the bloodstream have been attracting much attention recently in tumor immunology. Host defense factors relating the arrest of tumor cells to the establishment of metastatic foci seemed difficult to define, since many studies showed contradictory data concerning the influence of immune response on tumor cell arrest. Hemodynamic abnormality may also influence the arrest of tumor cells in the circulation. Hypercoagulability induced from host tissues is greatly associated with the arrest patterns. Platelet activities might affect thrombus formation. Nevertheless, exact explanations of the process or mechanisms inhibiting or enhancing the arrest of tumor cells after hematogenous dissemination have not been obtained. In any event, for cancer treatment, it is important to determine which substances inhibit the arrest of circulating tumor cells and how to prevent hematogenous metastasis. In this review, we will focus upon coagulative and fibrinolytic processes and then upon substances that inhibit the arrest of circulating tumor cells. Furthermore, some comments on the possible clinical applications of inhibitory substances for prevention of cancer metastasis are added.
Cancer Metastasis Rev 1983
PMID:Inhibition of the arrest of hematogenously disseminated tumor cells. 636 67

Most all the thoracic structures are visible with magnetic resonance imaging: the mediastin, the myocardium including the endocardium and the pericardium, the pulmonary parenchyma and hile and the pleural walls. In cases of mediastrinal masses, T1 images clearly delimit their relations with neighbouring organs and vessels. The intensity of the signal is compared with that of the muscles on T1 weighted images of the preceding sections and T2 weighted images of fat. Images of aneurysms and chronic dissections can be synchronized with the ECG allowing three-dimensional measurement of the size and thickness of the vessel walls. Thrombi or extension to other vessels can also be recognized. Small hilar tumours can be differentiated from vessels but the scanner is better for analyzing systematization and bronchial lesions. For lung tissue itself, magnetic resonance imaging can detect nodules greater than one centimeter in diameter, but the low proton density and respiratory movements hinder spatial resolution. MRI is indicated for localizing tumours situated anteriorly or posteriorly or at the apex and to identify parietal extension of peripheral cancers. Spinal, vascular, pericardial, diaphragmatic and lymph node metastases can be recognized. MRI is the noninvasive method of choice for evaluating left ventricular masse, intra and paracardiac mass studies and for investigating congenital and acquired cardiomyopathies. Technical advances have made it possible to evaluate myocardial perfusion and heart function.
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PMID:[Magnetic resonance imaging in thoracic diseases]. 798 43

Studies on catheter-related central venous thrombosis (CRCVT) have been focused mainly on clinically evident CRCVT due to occlusive thrombi, underestimating therefore the actual thrombosis prevalence. This prospective study was aimed at evaluating prevalence, timing and evolution of thrombosis, and identifying involved veins and risk factors in cancer patients (pts) undergoing percutaneous subclavian central venous catheterization (CVC) for chemotherapy, parenteral nutrition or both. We enrolled 127 consecutive pts requiring partially or totally implanted central venous silastic catheters. The study protocol included peripheral phlebography (P) at day 8, 30 and every two months following CVC and/or when clinically indicated, along with peripheral and pullout P on catheter withdrawal. A quantitative scale was developed to evaluate thrombus grading in subclavian, innominate and cava veins. Age, sex, coagulation profile tumor histotype, metastases, therapy, catheter type, and catheter insertion side were also investigated. Only pts who underwent at least two P were evaluated, and chi 2 test was adopted for statistical analysis. Altogether, 95 pts were evaluable. CRCVT was observed in 63/95 (66%) pts. At day 8, 30 and 105 (representing the median days in which first, second and last P were performed) CRCVT was evidenced in 64%, 65% and 66% of the pts, respectively. Thrombus grading did not differ among first, second and last P. CRCVT was symptomatic in 4/63 (6%) pts. Thrombosis prevalence was higher in subclavian (97%) with respect to innominate (60%) or cava (13%) veins (p < 0.001). Thrombosis was higher in left subclavian catheters (14/16; 87.5%) than in right ones (49/79; 62%), p < 0.01. No associations were established between CRCVT and other investigated parameters. Our data show a very high actual frequency of CRCVT in cancer pts, and emphasize that first days following CVC are at the highest risk for CRCVT development. Based on our results, a study on short-term antithrombotic prophylaxis in cancer pts requiring CVC is warranted. Finally, our data indicate that left subclavian vein catheterization represents a risk factor for CRCVT.
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PMID:Central venous thrombosis: an early and frequent complication in cancer patients bearing long-term silastic catheter. A prospective study. 917 32

The purpose of the present work is to show a possibility of simultaneous implantation of Russian-made cava filters into the vena cava inferior (VCI) and vena cava superior in thrombosis of the respective venous beds. Thrombotic processes (usually seen in oncological patients) requiring insertion of filters into the both above-mentioned veins have not at all been described in Russian medical literature, with only few such cases being sporadically reported in foreign literature. The authors present herein the clinical pattern, findings of examination and treatment of a patient with an inoperable tumour of the pancreatic head with hepatic metastases, who, on postoperative day 9, was diagnosed with thrombosis of veins of the left lower limb and thrombosis of the right upper extremity veins with a floating thrombus in the VCS. The patient was therefore subjected to simultaneous implantation of Russian-made cava filters "Zontik" (umbrella) and "Yolka" (fir) into the VCI and VCS, respectively. The postoperative period included but was not limited to comprehensive anticoagulation and disaggregant therapy. The patient was discharged two weeks after implantation of the cava filters, with manifestations of partial re-canalization of thrombus-affected venous beds.
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PMID:[Simultaneous implantation of cava filters]. 1562 5

The nature and rate of endogenous autorosette formation were investigated in peripheral blood from cancer patients. Both neutrophils, monocytes and platelets were involved. The latter lysed red blood cells. Thrombotic autorosette levels rose as the number of lymphocytes was falling and metastases appeared.
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PMID:[Specific features of endogenous autorosette formation in the peripheral blood of cancer patients]. 1841 60

Cardiac magnetic resonance imaging (MRI) is an important tool for the diagnosis of cardiac masses. Various cardiac tumors are predisposed to occurring in atrial structures. The aim of this review article is the description of atrial tumors and their morphological features in MRI. In general, cardiac tumors are rare: approximately 0.001 - 0.03 % in autopsy studies. About 75 % of them are benign. The most common cardiac tumor is the myxoma. They are predisposed to occur in the atria and show a characteristically strong hyperintense signal on T 2-wieghted images in MRI. In other sequences a heterogeneous pattern reflects its variable histological appearance. Lipomas exhibit a signal behavior identical to fatty tissue with a typical passive movement in cine imaging. Fibroelastomas are the most common tumors of the cardiac valves. Consisting of avascular fibrous tissue, they often present with hypointense signal intensities. Thrombi attached to their surface can cause severe emboli even in small tumors. Amongst primary cardiac malignancies, sarcomas are most common and favor the atria. Secondary malignancies of the heart are far more common than primary ones (20 - 40 times). In case of known malignancies, approximately 10 % of patients develop cardiac metastasis at the end of their disease. Lymphogenic metastases favor the pericardium, while hematogenic spread prefers the myocardium. Since they are not real atrial tumors, thrombi and anatomical structures of the atria have to be differentiated from other pathologies.
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PMID:[Atrial tumors in cardiac MRI]. 1983 Jun 42


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