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

The liver is the most frequent site of metastases in colon cancer. No good animal model has been available to help improve the treatment of liver metastases or their prevention after resection of a primary colon cancer. The aim of this study was to develop a model of colon cancer induced by azoxymethane in the rat and to study the outcome after surgical resection alone or in association with intraperitoneal chemotherapy (5-fluorouracil (5-FU). Three hundred male Wistar rats received subcutaneous azoxymethane (10 mg/kg body weight/week) for 12 weeks. Eighty-three rats with isolated colon cancer underwent total colectomy; 40 of these rats with no metastases were randomized into two groups: surgery alone or surgery plus 5-FU (5 mg/kg body weight/day) for 5 days after surgery. Thirty rats were able to be evaluated. At autopsy, peritoneal carcinomatosis and liver metastases were more frequent in the control group than after adjuvant treatment with 5-FU (27.7 percent vs. 0, P less than 0.05; and 22.2 percent vs. 0, P less than 0.05, respectively). The rates of peritoneal and hepatic recurrence after resection of the primary cancer indicate that the model mimics the natural history of human colon cancer. In this model, 5-FU reduced the rate of peritoneal carcinomatosis and liver metastases but did not influence survival.
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PMID:Experimental model of colon cancer: recurrences after surgery alone or associated with intraperitoneal 5-fluorouracil chemotherapy. 185 22

Colon carcinoma is one of the most frequent causes of cancer death in industrialized countries. The patients generally die of the metastases. In a colon cancer rat model, the authors have shown that lipopolysaccharides from Escherichia coli induced the regression of carcinomatosis and cured 20%-30% of the rats. Some synthetic derivatives of lipid A, which are less toxic than lipopolysaccharides, were injected 14 days after the tumor cells. They induced the complete regression of peritoneal carcinomatosis consisting of numerous nodules measuring 1-5 mm in 20%-30% of rats. Only compounds with three or more hydroxymyristic acid residues were effective. In vivo effects were correlated with the capacity to induce the production of interleukin 1 and tumor necrosis factor but not with the capacity to induce macrophage-mediated cytolysis. It is therefore possible to synthesize weakly toxic derivatives of lipopolysaccharides retaining their antitumoral property in vivo.
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PMID:Antitumor effect of synthetic derivatives of lipid A in an experimental model of colon cancer in the rat. 186 Jun 36

Patients with locoregional gastric carcinoma often die because of the low rates of curative resection and frequent appearance of distant metastases (mainly peritoneal and hepatic). To evaluate the feasibility of preoperative and postoperative chemotherapy, 25 consecutive previously untreated patients with potentially resectable locoregional gastric carcinoma received two preoperative and three postoperative courses of etoposide, 5-fluorouracil, and cisplatin (EFP). Ninety-eight courses (median, five courses; range, two to five courses) were administered. Six patients had major responses to EFP. Eighteen patients (72%) had curative resections, and three specimens (12%) contained only microscopic carcinoma. At a median follow-up of 25 months, the median survival of 25 patients was 15 months (range, 4 to 32+ months). Peritoneal carcinomatosis was the most common indication of failure. One patient died of postoperative complications, but there were no deaths due to chemotherapy. EFP-induced toxic reactions were moderate. Preoperative and postoperative chemotherapy for locoregional gastric carcinoma is feasible, and additional studies to develop regimens that could result in 5% to 10% complete pathologic responses may be warranted.
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PMID:Resectable gastric carcinoma. An evaluation of preoperative and postoperative chemotherapy. 189 49

Metastatic involvement of the temporal bone by malignant tumors is considered to be rare. The actual incidence of metastatic temporal bone tumors, however, is probably much higher than suggested by reports in the literature. The reason for this is that histologic studies are rarely performed on temporal bones in routine postmortem examinations of patients with possible metastatic disease. Also, in patients with multiple metastatic lesions, otologic complaints and signs may often be overshadowed by other more disabling symptoms. Twelve temporal bones were histopathologically examined from 6 patients who had metastatic temporal bone disease from various primaries and the results obtained in our present series of 6 cases were: 3 cases of hematogenous dissemination from a distant primary (a hepatic cell carcinoma, a bronchogenic squamous cell carcinoma, and an adenocarcinoma of unknown primary); 2 cases of direct invasion from adjacent head and neck tumors (squamous cell carcinomas of the eyelid and hypopharynx); and one case of diffuse metastatic leptomeningeal carcinomatosis (a transitional cell carcinoma of the renal pelvis). Among these, to our knowledge either hepatic cell carcinoma or renal pelvis carcinoma metastatic to the temporal bone has not been reported previously in the world literature. We reviewed the previously published reports of metastatic temporal bone tumors and found that there were 212 reported cases cited in the literature and that the most common sites of origin in order of frequency were breast, lung, pharynx, kidney, and prostate. Our temporal bone study and literature survey reveal that there are three distinct routes of tumor spread from the primaries to the temporal bone: 1) hematogenous dissemination from a distant primary, 2) direct neoplastic extension from adjacent areas, and 3) diffuse metastatic leptomeningeal carcinomatosis (DMLC). Our study also indicates that in most cases temporal bone symptoms appeared late in the course of disease, but in some cases the otologic symptoms were an initial sign of tumor, which was particularly conspicuous in the cases of DMLC. In the cases of hematogenous dissemination, the metastatic lesion tends to be overlooked or undiagnosed because occult metastases are relatively common or, when symptomatic, the otologic symptoms often resemble the features characterized by a severe form of mastoiditis. In the cases of direct neoplastic invasion, on the other hand, recognition of temporal bone involvement is usually simple since the primary disease is quite evident. Although metastatic temporal bone malignancies are rare, otologist should always be aware of existence of this disease entity in clinical practice.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Secondary malignant tumors of the temporal bone. A histopathologic study and review of the world literature]. 191 60

There is an important need for clinically relevant animal models for human cancers. Toward this goal, histologically intact human colon-cancer specimens derived surgically from patients were implanted orthotopically to the colon or cecum of nude mice. We have observed extensive orthotopic growth in 13 of 20 cases of implanted patient colon tumors. These showed various growth patterns with subsequent regional, lymph-node, and liver metastasis, as well as general abdominal carcinomatosis. Thus, models for human colon cancer have been developed that show (i) local growth, (ii) abdominal metastasis, (iii) general abdominal carcinomatosis with extensive peritoneal seeding, (iv) lymph-node metastasis, (v) liver metastasis, and (vi) colonic obstruction. These models permit the passage of the tumors to form large cohorts. They will facilitate research into the biology of colon cancer metastatic capability and the development of new drugs active against metastatic cancer. These models may also predict the clinical course and the in vivo response to drugs of the cancer of individual patients.
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PMID:Models of human metastatic colon cancer in nude mice orthotopically constructed by using histologically intact patient specimens. 192 98

To determine the frequency and distribution of extrahepatic and extraskeletal metastases in patients with breast carcinoma, the abdominal CT scans of 260 consecutive patients were systematically evaluated. Extrahepatic and extraskeletal metastases were demonstrated in 26 patients (10%). Confirmation of findings was made by biopsy, autopsy, or by demonstration of progression or regression of disease. Twelve patients (4.6%) demonstrated metastases to the stomach, eleven of whom presented with a linitis plastica pattern. Retroperitoneal and/or mesenteric adenopathy was noted in 10 patients (3.8%), of whom three demonstrated associated hydronephrosis and one demonstrated associated biliary obstruction. Ascites was seen in 14 (5.4%) and peritoneal carcinomatosis in 7 (2.6%). Genitourinary involvement included metastases to the kidney (one case), ureter (one), and uterus (one). Direct invasion of the diaphragm by adjacent pleural metastases (two cases) as well as a soft tissue metastasis (one case) was also demonstrated. Metastases to the ovaries, adrenals, or pancreas could not be identified. Although lesions to the liver and skeleton account for the largest group of metastases from breast carcinoma seen in the abdomen, one should be aware of the potential for other locations of metastatic disease.
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PMID:Distribution of metastases in breast carcinoma: CT evaluation of the abdomen. 193 43

We analyzed the autopsy records of 261 patients with breast carcinoma, who died at The Institute of Oncology, Ljubljana, Yugoslavia, for the presence of metastases to the central nervous system, particularly for the presence of leptomeningeal carcinomatosis. Metastases to the central nervous system were found in 41 (18.1%) of 226 patients who had metastatic cancer. In 24 cases (10.6%), metastases were seen in brain parenchyma; in 11 cases (4.9%), only dura mater was involved, and in six cases (2.6%), leptomeningeal carcinomatosis was found. All patients with leptomeningeal carcinomatosis showed some symptoms of central nervous system involvement while alive. The patients died between 2 weeks and 2 months after the onset of central nervous system symptoms. Four of six patients with such a complication presented with locally advanced or disseminated carcinoma on the first admission. With regard to histologic findings, three patients had infiltrating lobular carcinoma, two had infiltrating ductal carcinoma, and one had mixed infiltrating lobular and ductal carcinoma, with a metastasizing lobular component. Metastases to the brain parenchyma were found exclusively in infiltrating ductal carcinoma. We stress that infiltrating lobular carcinoma represents a distinctive type of breast cancer with an unusual propensity to disseminate into leptomeninges, as this occurred in almost 14% of all cases of infiltrating lobular carcinoma in our series in contrast to a 1% incidence in cases of infiltrating ductal carcinoma.
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PMID:Association of leptomeningeal carcinomatosis in carcinoma of the breast with infiltrating lobular carcinoma. An autopsy study. 202 20

Tissue polypeptide antigen (TPpA) in the cerebrospinal fluid (CSF) was measured in 59 consecutive breast cancer patients with suspected central nervous system (CNS) metastases. Subsequently, we determined that 13 patients had parenchymal brain metastases, 10 had leptomeningeal carcinomatosis, and 36 had no CNS involvement. The concentration of TPpA, which is a nonspecific marker for cell proliferation, was significantly higher in patients with CNS metastases than in those without it (P less than .0001; Mann-Whitney test). A tentative cutoff value for CNS metastases was set at 95 U/L TPpA; the upper limit of values indicating absence of CNS metastases was 89 U/L. Given these cutoff points, the sensitivity of TPpA as a marker for CNS metastases was 74% and the specificity was 100%; the predictive values of positive and negative tests were 100% and 86%, respectively. In 16 patients with CNS metastases, no correlation was found between TPpA activity in corresponding CSF and blood samples (correlation coefficient, Spearman's rho = .4; P greater than .1). In three patients treated for leptomeningeal carcinomatosis, the measurements of CSF TPpA showed correlation between the presence of tumor cells in the CSF and neurological clinical function. TPpA concentrations decreased in parallel with the clinical response and increased prior to CNS disease progression. As a marker for CNS metastases, the level of TPpA in the CSF in breast cancer patients appears to be superior to the level of protein, lactate dehydrogenase, or glucose, which showed very low sensitivity (41%, 47%, and 8%, respectively). For quantitative evaluation of treatment for leptomeningeal carcinomatosis, the TPpA level appears to be valuable and superior to CSF cytology, because tumor cells are not always present in CSF samples from patients with this condition.
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PMID:Tissue polypeptide antigen activity in cerebrospinal fluid: a marker of central nervous system metastases of breast cancer. 204 Oct 52

Computed tomography (CT) is clearly more sensitive than chest radiography or conventional linear tomography in the detection of pulmonary metastases. Routine chest CT scans may reveal peripheral nodules as small as 2-3 mm, and high-resolution CT may demonstrate lymphangitic carcinomatosis. Specificity remains a problem, but attention to clinical factors, such as the type of extrathoracic malignancy (ETM), epidemiology, patient age, and prior treatment, should be of assistance. CT is useful in the evaluation of an apparent solitary pulmonary nodule or an equivocal radiographic finding. For single or multiple nodules, CT is essential for planning invasive procedures such as biopsy or surgical resection. Routine CT scanning to screen for occult metastases is indicated only for patients with ETMs that have a high propensity for metastasizing to the lungs and for which detection of pulmonary metastases would influence therapy--bone and soft-tissue sarcomas, most pediatric tumors, choriocarcinoma, nonseminomatous testicular carcinoma, and possibly advanced melanoma. Future large prospective studies evaluating individual malignancies are needed to assess the impact on long-term survival of early detection of pulmonary metastases with CT.
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PMID:CT evaluation for pulmonary metastases in patients with extrathoracic malignancy. 205 72

Abdominal CT of 230 patients (310 CT examinations) with a diagnosis of malignant melanoma was retrospectively reviewed for the evaluation of small bowel and mesenteric involvement. Seventeen (7.4%) patients had evidence of small bowel and mesenteric involvement on CT. There were four distinct patterns of disease: (a) intraluminal masses in 3 patients; (b) ulcerating lesions in 2; (c) diffuse infiltration in 6; (d) implants in 10. Four patients had more than two patterns of involvement. Of the 10 patients with tumor implants, carcinomatosis was noted in 2. Two patients had intussusception and 4 had extensive mesenteric nodal involvement. Of the 17 patients, 12 (71%) had at least one symptom referable to the gastrointestinal tract, while 5 (29%) were clinically asymptomatic. Fourteen of the 17 patients (82%) had additional intraabdominal metastases to sites other than small bowel and mesentery.
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PMID:CT of malignant melanoma: patterns of small bowel and mesenteric involvement. 206 69


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