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

A pretherapeutic evaluation of skeletal metastases should be carried out in all patients with proven mammary cancer including early stages. The scintigraphy is more reliable for detecting bone metastases than the conventional roentgenological survey. We recommend to employ complementally skeletall scintigraphy and conventional X-ray survey in the search for bone tumors. Negative scintigraphical results do not require any supplementary research. In case of a pathological scan or skeletal pain, a target roentgneological examination should be carried out to differentiate between benign diseases and neoplatic lesions.
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PMID:[Pretherapeutic evaluation of bone matastases in patients with potentially curable breast cancer (author's transl)]. 119 78

The results of combined treatment with 90 mg estradiol valerianate and 300 mg 17-alpha-hydroxy-19-norprogesterone-capronate (SH 834) (3 ml once a week i.m.) in 117 cases with disseminated or inoperable mammary carcinoma are reported. Objective remissions of 3 to 36 months were obtained in 48 patients. Soft tissue, lung and pleura metastases responded more favourably than bone metastases. Liver and brain metastases were unaffected.
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PMID:Hormonal treatment of mammary carcinoma with Progynon-Depot and Depostat. 120 23

Three types of involvement of the rectum and recto-sigmoid by carcinoma of the prostate are reviewed through an analysis of eight cases. A fourth type with subserosal metastatic implant of the proximal sigmoid may occasionally be encountered. The roentgenographic findings are not pathognomonic, but are characteristic of extrinsic involvement of the bowel wall. When clinical symptoms are predominantly related to the bowel, carcinoma of the prostate is usually advanced. All patients presented with bone metastases, uretero-hydronephorsis, lack of function of one kidney, or both bone metastases and urinary tract obstruction. Rectoscopy and biopsy are helpful. However, biopsy specimens often show non-diagnostic features in secondary malignancy. Correct diagnosis is important, since there is a difference in treatment of primary carcinoma and of secondary involvement of the rectum by prostatic carcinoma. A diagnostic challenge exists if the patient is evaluated by barium enema examination for primary bowel symptoms, in particular, large bowel obstruction. At this time intravenous pyelography and bone survey for metastases may not be available to suggest the correct diagnosis. More widespread use of barium enema examinations in the evaluation of advanced carcinoma of the prostate is suggested, since the type of rectal disease shown on barium enema study was not clinically suspected in five of eight patients. The prognosis is usually unfavorable because of advanced carcinoma. Survival often does not exceed several months to one year. However, one of our patients is still well after three years of hormonal therapy.
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PMID:Rectal and sigmoid involvement secondary to carcinoma of the prostate. 123 60

This contribution on the biology and management of bone metastases from prostatic cancer is divided into three parts. The first details a study conducted at Stanford University on the prevention of bone metastases in the lumbar spine, in patients in whom the lumbar spine has been irradiated coincidental to the radiation treatment of the paraaortic lymph nodes. The incidence of metastases was significantly reduced in 71 patients in whom the apparently normal lumbar spine was irradiated, as compared to the incidence of metastases in 65 patients who received no lumbar irradiation. The implications of these observations on developing strategies for early, or preemptive, irradiation for bone metastases are discussed. In the second part, the optimum radiation dose and fractionation scheme for the palliation of overt bone metastases is addressed. Drawing largely from the work of Arcangeli et al., a total dose of 40-50 Gy*, fractionated at 2 Gy per day, seems to be the regimen of choice for enduring pain relief for most patients with prostatic metastases to bone. Finally, the recent utilization of strontium-89 in the palliation of advanced bone metastases is addressed. *The Gy is the current international unit of radiation. 1Gy = 100 Rad; 1cGy (centigray) = 1 Rad.
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PMID:Radiation treatment of prostate bone metastases and the biological considerations. 128

Metastatic prostate carcinomas in autopsy cases from three populations 49 cases of indigenous Japanese, 29 cases of Japanese Americans and 14 from whites in Hawaii) were compared in terms of their clinicopathological, immunohistochemical (tenascin and ras p21) and lectin binding (Helix Pomatia antigen, HPA) properties. Only the clinicopathological features were analyzed in the cases of whites in Hawaii. The results indicate that poorly differentiated carcinoma is less common, whereas distant metastasis is more frequent, in indigenous Japanese. Some of the Japanese-American cases with poorly differentiated carcinomas did not show any distant metastases. HPA and ras p21 expression are more common, but tenascin is less common in indigenous Japanese. HPA expression is more common in cases with metastasis, especially with metastasis to the bone and other organs, than nonmetastatic cases. Prostatic cancer cases in indigenous Japanese were more aggressive biologically than those in Japanese Americans, but no phenotypic differences were seen relevant to the presence or absence of bone metastases.
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PMID:Comparative study of prostatic carcinoma bone metastasis among Japanese in Japan and Japanese Americans and whites in Hawaii. 128 3

During a 3-year period a consecutive series of 102 patients were treated for renal cell carcinoma at one urological unit. Thirty-three patients (32.4%) had metastatic spread, but bone metastases were found in six patients only, i.e. 5.9% of the whole series and 18.2% of the patients with metastases preoperatively. The bone metastases had in all six patients given local symptoms first indicating radiography, and thereafter radionuclide scintigraphy of the entire skeleton. Bone scintigraphy performed merely by routine in 70 patients did not reveal one single case of bone metastasis. Only one patient had a solitary bone metastasis, and this metastasis was considered inoperable because of its location and size and the patient's age. The decision about nephrectomy was not in any case altered by the finding of bone metastases. Solitary bone metastasis must be diagnosed early since they may be radically removed. Routine scintigraphy of the skeleton in symptomless patients, however, has a low yield. Screening for skeletal metastases may therefore be best performed by careful physical examination and history-taking.
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PMID:Skeletal metastases in 102 patients evaluated before surgery for renal cell carcinoma. 129 74

Six patients were treated for metastatic chemodectoma at Memorial Sloan-Kettering Cancer Center from 1971 through 1988. Four patients' primary tumors arose in the cervical region, and two arose in the retroperitoneum. Four patients received a total of eight different chemotherapeutic regimens, including cisplatin, doxorubicin, cyclophosphamide, and dacarbazine. Metastatic sites treated included bone, liver, lung, and retroperitoneum. No patient had a response to chemotherapy. Four patients received a total of nine courses of radiation therapy for palliation of bone metastases. Pain relief was complete in eight patients and partial in one. One patient was irradiated for a mass in the left psoas muscle, with stabilization of disease for 6 months after treatment. One patient was irradiated for epidural compression at T6, with resolution of neurologic symptoms and 50% clearing of the spinal block on follow-up myelogram. Recurrence or progression of disease in a previously irradiated site occurred in one patient 2 years after treatment. One patient was lost to follow-up 3 months after radiation therapy for epidural compression. The other five patients died of widespread metastatic disease 6 months to 9 years after initial treatment for their metastatic disease.
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PMID:Treatment of metastatic chemodectoma. 130 81

Combined Tc-99m MDP skeletal imaging and Tc-99m(V) DMSA whole body scans to detect metastases were performed during the follow-up of 30 patients who underwent surgery for breast carcinoma. Eight patients had normal Tc-99m MDP and Tc-99m(V) DMSA scans and were declared free of metastatic disease, further confirmed by no change in symptomatology over a 1-year follow-up period. Twenty-two patients had positive Tc-99m MDP scans with varied skeletal involvement. Tc-99m(V) DMSA scans showed matched areas of increased radiotracer concentration in bony metastases in 20 of these patients. Tc-99m(V) DMSA concentration was not seen in traumatic vertebral collapse or in coexistent osteoarthritic disease in vertebral metastatic involvement. Interestingly, Tc-99m(V) DMSA showed increased concentration in brain and liver metastases. Pentavalent Tc-99m(V) DMSA appears useful for detecting skeletal and soft-tissue metastases in breast carcinoma, and can improve the specificity of Tc-99m MDP bone scans in screening for bone metastases.
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PMID:Tc-99m(V) DMSA imaging. A new approach to studying metastases from breast carcinoma. 131 48

The first intention imaging modality for detecting bone metastases of non small cell (NSC) bronchogenic carcinoma is bone scintigraphy using technetium-99m pyrophosphate or diphosphonates. This test has a high sensitivity but equivocal images may lead to complementary tests including magnetic resonance imaging (MRI) or bone biopsy. Based on bone metastases prevalence, scintigraphy is recommended for patients entering a therapeutic trial, having bone pain, having a non characteristic bone abnormality on radiography or CT, having a non epidermoid histology or having associated pathologies increasing the risk of surgery. The utility of bone scan is questionable for patients having a Stage I or II epidermoid cancer, having already evidence of bone metastases or for whom the result of the bone scan will not change the therapeutic management. After a negative bone scan, there will be probably an indication for MRI at search of small infra-scintigraphic osteo-medullary metastases.
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PMID:[How can metastatic bone involvement be assessed?]. 133 74

A series of 38 patients with long bone metastases treated at the Birmingham Bone Tumour Treatment Service with resection of the metastatic lesion and replacement of the bone defect with an endoprosthesis was reviewed. The majority of cases had pathological fractures due to a massive destructive lesion. Two-thirds of the patients had a solitary metastasis. Metastases from hypernephroma and breast carcinoma accounted for the majority of cases. All the patients were independently mobile after the endoprosthetic replacement and were pain free. The average survival rate after the endoprosthetic replacement was 14.7 months and this varies with the primary tumour. The indications for endoprosthetic replacement for the treatment of long bone metastases are outlined and the results and complications are discussed. It is concluded that endoprosthetic replacement for bony metastases is an effective palliative procedure for a selected group of patients.
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PMID:Endoprosthetic replacement for bony metastases. 137 Oct 43


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