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)

Visceral pleural lesions in primary lung cancer were studied histopathologically in 102 autopsy cases. Pleural carcinomatosis was defined as the presence of cancer cells in the visceral pleura and/or pleural space. Ipsilateral and contralateral pleural carcinomatosis in the primary lung cancer were compared. They were found to be similar in that both were closely related with cancer cell infiltration of blood vessels in the lung parenchyma, lymphangiosis carcinomatosa in the lung parenchyma and multiple extrathoracic organ metastases. However, differences were observed. In the ipsilateral visceral pleura, cancer cells were thought to infiltrate the interstitium in the vascular layer of the visceral pleura from lymphatic vessels in the vascular layer of the visceral pleura with the following frequency; 3.6:8.52:6.52:1. In the contralateral visceral pleura, however, cancer cells were thought to infiltrate the interstitium in the vascular layer of the visceral pleura from lymphatic vessels in the vascular layer of the visceral pleura, the pleural space, the subpleural lung parenchyma and blood vessels in the vascular layer of the visceral pleura with the following frequency; 4:1.9:12.25:1. Disruption of the elastic layer of the visceral pleura was also studied. Twenty-eight of 66 pleural carcinomatosis cases showed no disruption of the elastic layer, and greater than 1-mm disruption was found in only 7 cases. The author thought that the disruption in these few cases was related to the manner of cancer-cell infiltration of the visceral pleura. When cancer cells spread to the visceral pleura from the lung parenchyma, they lost intercellular adhesiveness in four adenocarcinoma cases. Thus we suspected that cancer cells lost intercellular adhesiveness and became single cells or small cancer nests when infiltrating the visceral pleural from the lung parenchyma, and single cells or small cancer nests entered through the elastic layer of the visceral pleura. Therefore only small disruptions are found in the visceral pleura of pleural carcinomatosis cases.
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PMID:[A histopathological study of 102 autopsy cases of primary lung cancer with respect to pleural carcinomatosis]. 261 67

Leptomeningeal carcinomatosis (LC) is commonly observed in malignant lymphoproliferative diseases (leukemias and lymphomas), and it can rarely be the presenting feature of a solid tumour. The types of tumour most commonly associated with that condition are breast, lung and gastrointestinal carcinomas and malignant melanoma. We report a patient with a carcinoma of probable renal origin who presented with meningeal carcinomatosis, without any symptom attributable to the initial tumour. We review and discuss the diagnostic criteria, the pathophysiology and the therapeutic outlook of this relatively uncommon type of metastatic disease.
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PMID:[Leptomeningeal carcinomatosis as the primary manifestation of a carcinoma of probable renal origin]. 262 76

To determine whether creatine kinase-BB isoenzyme would be useful in detecting central nervous system metastases secondary to breast cancer, we measured the cerebrospinal fluid (CSF) activity of creatine kinase (CK) and its BB isoenzyme (CK-BB) in 65 consecutive patients suspected of having CNS involvement. All patients underwent neurological evaluation, computer tomography (CT) scan and/or radionuclide scintigraphy and lumbar puncture with CSF examination. Thirty patients had CNS metastases, of whom 18 had parenchymal brain metastases (MET). Twelve had leptomeningeal carcinomatosis (MC), of whom four also had parenchymal brain metastases. Thirty-four patients were concluded not to have CNS involvement, whereas one was considered equivocal. CK-BB activity was significantly higher in patients with CNS metastases than in those without (P less than 0.05). This difference was primarily related to the fact that patients with MC had a significantly higher CK-BB activity than patients without CNS metastases or patients with parenchymal brain metastases only (P less than 0.01 and P less than 0.05, respectively). Taking 0.20 U/l as a tentative cut-off value (the upper limit range of patients without CNS metastases being 0.19 U/l), 10 out of 12 patients with MC had activities above this level. The sensitivity and specificity for having MC were 83% and 87%, and the positive and negative predictive values 60% and 96%, respectively. The sensitivity and negative predictive value for having any CNS metastases were 57% and 72%. Specificity and positive predictive value: 100%. The CSF activity of CK-BB appears to be a contribution in the diagnosis of MC secondary to breast cancer and seems superior to protein and LDH.
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PMID:Creatine kinase-BB in the cerebrospinal fluid as a marker of CNS metastases and leptomeningeal carcinomatosis in patients with breast cancer. 263 53

1. Widespread visceral and intestinal wall metastases are present in women dying with ovarian cancer. Intestinal wall invasion is commonly found at autopsy and is associated with bowel obstruction. Liver parenchymal replacement by metastases in more extensive than that in the lung, where most metastases have a subpleural location. Multifocality characterizes metastases in both of these organs. 2. Neoplastic lymphatic invasion is common. Lymphatic and blood vascular invasion are associated with an increased incidence of metastases in lymph nodes, small bowel wall, pancreas, lungs, ureter, and liver. 3. The mean survival time from diagnosis to death is less than 2 years. Both increasing neoplastic histological grade and clinical stage at diagnosis are associated with decreased survival time. 4. The most common causes of death are carcinomatosis, infection, or a combination of these processes. Sepsis, pneumonia, or both of these account for most of the fatal infections. 5. Bowel and ureteral obstruction constitute the most common forms of tumor-induced morbidity. The former process tends to be multifocal, involving the small and large intestines, and it is found during the disease course as well as at autopsy. Ureteral involvement is usually associated with hydronephrosis and is bilateral in approximately one fourth of the cases.
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PMID:The pathology and biologic behavior of ovarian cancer. An autopsy review. 265 34

In this phase II multicenter trial, 67 evaluable patients with advanced measurable gastric carcinoma were treated with a combination of etoposide, Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH), and cisplatin (EAP). The overall response rate was 64%, including 21% complete responses (CRs). In 55 patients with metastatic disease, 31 responses (51%) including eight CRs (15%) were achieved. Responses were seen in all metastatic sites, but the response rate was lower in patients with peritoneal carcinomatosis. In 12 patients with locoregional disease, six CRs and six partial responses (PRs) were observed. Eight CRs (three and five in patients with metastatic and locoregional disease, respectively) were pathologically confirmed. The overall median response duration was 7 months; it was 16 months for patients achieving CR (22 months for pathologically confirmed CR [pCR]), and 6 months for PR. The median survival time for all patients was 9 months, for the patients who achieved CR 17 months, for pCR 23 months, and for PR 9.5 months. Median survival time for all patients with metastatic disease was 8 months, and for locoregional disease 12.5 months. Six patients (9%) (four local, two metastatic disease) were alive at 2 years, and four patients are alive and disease free at 35+ to 56+ months. Main toxicities were leukopenia and thrombocytopenia, with 64% of patients developing grade 3 to 4 myelosuppression and 12% severe infections. Nonhematologic toxicities of World Health Organization (WHO) grade 4 were not observed.
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PMID:Phase II study with the combination etoposide, doxorubicin, and cisplatin in advanced measurable gastric cancer. 267 Dec 87

MR imaging was used to investigate normal and abnormal meningeal enhancement, with an emphasis on meningeal carcinomatosis. Three groups of patients were studied on a 1.5-T system. In group 1, the normal meninges were examined in 20 patients and were found to show fine linear enhancement in short segments, especially in a parasagittal distribution. In group 2, all gadolinium-enhanced head scans were reviewed retrospectively. Abnormal meningeal enhancement was detected in 52 patients. In some of these, the enhancement was associated with pathologic conditions of the meninges, including leptomeningeal tumor and meningeal infections and other inflammatory conditions; in others the enhancement was adjacent to subdural hematomas, subacute infarcts, and skull lesions, such as metastases or postoperative defects. In group 3, 30 cases of meningeal carcinomatosis were studied prospectively. Enhancement was seen in approximately two-thirds of cases and usually was quite diffuse and applied to the inner table of the skull. Frank nodules were seen less often. Contrast-enhanced CT was equal to MR in the detection of nodules but was nearly always unable to show diffuse meningeal enhancement against the inner table of the skull. Contrast-enhanced MR was more sensitive than contrast-enhanced CT in the examination of normal and abnormal meninges. Abnormal findings, such as meningeal carcinomatosis, were demonstrated more often by MR than by CT.
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PMID:MR imaging of the cranial meninges with emphasis on contrast enhancement and meningeal carcinomatosis. 280 23

Despite the frequency of cerebral metastases from melanoma, there have been very few papers on this subject in the radiological literature. We report one such case, original by its disseminated carcinomatosis appearance and by the disassociation between computed tomography and magnetic resonance imaging, illustrating the greater sensitivity of the latter examination. In view of the fact that 11 to 13% of patients with a cerebral metastasis from melanoma are asymptomatic, there may be a place for screening of these patients by MR imaging. The association of neurological lesions and cutaneous naevi raises the problem of neurocutaneous melanosis (degenerating phakomatosis).
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PMID:[The value of MRI in a case of cerebro-meningeal miliary carcinomatosis of melanotic origin]. 281 27

An autopsy case of genital Paget's disease with a widespread metastases is reported. A 69-year-old man with redness, itching and swelling of the scrotum obtained dermatological consultation and underwent tumor resection for Paget's disease. At 8 months after discharge, he suffered from a costal fracture because of carcinomatosis of the bone marrow. In laboratory data the serum level of alkaline phosphatase and carcinoembryonic antigen was shown to be high. Four months later, he died of severe congestive edema of the lung with diffuse micrometastases. An autopsy revealed a widespread metastases in various organs and lymph nodes. The Paget cells were positive in carcinoembryonic antigen.
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PMID:[An autopsy case of Paget's disease of the scrotum with general metastasis]. 282 77

In a series of 641 patients with small cell lung cancer, 189 (29.5%) had at least one neurologic disorder either at the time of presentation or during the subsequent clinical course of the cancer. The total number of neurologic disorders was 210, which included brain metastases (75.7%), meningeal carcinomatosis (6.7%), intramedullary metastases (2.4%), epidural metastases (11.0%), hyponatremia producing CNS symptoms (3.3%), and Eaton-Lambert syndrome (1.0%). The most common signs and symptoms were motor dysfunction and confusion. The overall survival of patients with any neurologic disorder was compared to that of patients without neurologic problems. There was no difference between the survival curves for the first year and a half, but patients without neurologic complications had a greater probability of long-term survival (log-rank P = 0.03). There were no statistically significant differences when this comparison was made according to stage of disease. When a neurologic disorder related to cancer occurred, the survival time from the date of that diagnosis was usually short. The neurologic disorder was the immediate cause of death in the majority of cases. In patients who achieved a complete remission, the administration of prophylactic cranial irradiation (PCI) significantly reduced the risk of developing brain metastases as the initial site of the relapse (log-rank P = 0.0034). After adjustment for performance status and extent of disease, the survival of complete responders treated with and without PCI was not significantly different. We conclude that neurologic complications are a frequent and serious problem in patients with SCLC.
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PMID:Neurologic disorders in patients with small cell lung cancer. 283 Sep 55

Vasopressin (ADH) was measured in CSF and plasma in 75 evaluable patients with known or suspected CNS metastases from small-cell bronchogenic carcinoma (SCBC), and in 66 control patients having neither malignant disease nor organic CNS disease. The presence of CNS metastases was confirmed or excluded on the basis of computed tomographic scans, neurologic examination, and autopsy. Twenty-four of the 75 patients had no CNS metastases. Ten of the 51 patients with CNS metastases had leptomeningeal carcinomatosis (MC). CSF-ADH was significantly increased in patients with MC (P less than .05), but not in patients having exclusively parenchymatous CNS metastases. Taking 2 pg/mL (95th percentile of control patients) as the upper limit of normal, 15 SCBC patients had elevated CSF-ADH, including 12 patients with CNS metastases and six patients with MC. The CSF-ADH to plasma ADH ratio was significantly increased in patients with CNS metastases (P less than .05). Patients without CNS metastases had a ratio less than or equal to 0.8 whereas the ratio was greater than 0.8, in 21 of the 51 patients with CNS metastases. The positive and negative predictive values with 95% confidence limits were 84% to 100% and 31% to 59%, respectively. Patients with inappropriate secretion of ADH (SIADH) constituted a significantly greater proportion of patients with elevated CSF-ADH than of patients with normal CSF-ADH levels (P less than .05). In addition, patients with SIADH constituted a significantly greater proportion of patients with MC than of patients with parenchymatous metastases (P less than .05). The diagnostic application of these findings is limited because of the large number of false-negative results, but it may prove to be of value in conjunction with the measurement of other tumor markers.
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PMID:Cerebrospinal fluid vasopressin as a marker of central nervous system metastases from small-cell bronchogenic carcinoma. 298 Dec 91


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