Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Using a superconducting magnet operating at 0.35 T, the authors investigated the adrenal tissue characterization potential of magnetic resonance (MR) in 28 patients with 33 adrenal masses. There were 13 adrenal adenomas (12 non-hyperfunctioning, one aldosteronoma), nine adrenal metastases, four pheochromocytomas, two neuroblastomas, two adrenal lymphomas, two myelolipomas, and one adrenal cortical carcinoma. Spin-echo pulse sequences were obtained at TR 0.5, 2.0 sec and TE 28, 56 msec. Both qualitative (visual assessment) and quantitative (absolute signal intensity, intensity ratios, T1, T2) data were used for tissue characterization. The results suggest that non-hyperfunctioning adrenal adenomas can be distinguished from non-adenomas using both qualitative and quantitative data: 16/19 non-adenomas were visually hyperintense compared with liver at TR 2.0 sec, TE 56 msec, while none of the non-hyperfunctioning adenomas was relatively hyperintense at any pulse sequence used. Of the quantitative data, the intensity ratios of adrenal lesion/liver at TR 0.5 sec, TE 56 msec were most useful in diagnosis: all adenomas had ratios less than 0.83, while 19/20 non-adenomas had ratios exceeding this value. It is concluded that MR has considerable promise in adrenal tissue characterization.
 ...
PMID:Adrenal tissue characterization using MR imaging. 394 Apr 2

Differentiation between benign and malignant tumors of the adrenal cortex was studied by means of seven histologic parameters. Each separate criterion was significantly different in two groups, one consisting of patients without metastases within 10 years after operation and one of patients with metastatic tumors. Discrimination on the basis of single parameters in individual patients, however, was of little value. When a histologic index was calculated using the same parameters but after "weighing," a much better discrimination was obtained. The histologic index and, to a lesser degree, the mitotic activity seems to be related to the survival time of the patients with adrenal cortical carcinoma. The authors conclude that the calculation of a histologic index based on a summation of different parameters makes it possible to differentiate between malignant and benign adrenal cortical tumors. As single parameters, tumor weight and mitotic activity have the highest discriminating value.
 ...
PMID:Morphologic characteristics of benign and malignant adrenocortical tumors. 396 72

This report deals with the follow-up diagnostic evaluation of 18 patients previously treated for adrenal cortical carcinoma. The role of computed tomography is emphasized. Nine patients had adrenalectomy and the other 9 had adrenalectomy and ipsilateral nephrectomy. The left kidney and adrenal were removed in 8 patients. The patients were evaluated for 2-59 months with an average follow-up of 16 months. Of the 13 patients (72%) who had recurrent or metastatic disease, 8 experienced local recurrence in the adrenal fossa, 2 of whom had associated renal involvement. The recurrence was seen in 5 patients in the left and in 3 patients in the right side. Metastases occurred in the lung (7 patients), liver (3 patients), peritoneum (2 patients), paraaortic lymph nodes (3 patients), and bone (1 patient). At the time of the discovery of recurrence or metastases, 5 patients presented with lung metastases found on chest x-rays, 3 had recurrent Cushing's syndrome or hypertension, 3 had abdominal pain, 1 had weight loss, and 1 was asymptomatic.
 ...
PMID:Computed tomography after adrenalectomy in adrenal cortical carcinoma. 407 56

A case is presented of prolonged survival following multiple thoracotomies performed for metastatic adrenal cortical carcinoma that was refractory to other treatment modalities. In selected patients with isolated metastases to the lungs, repeated surgical resection may offer the only possibility for cure or extended palliation.
 ...
PMID:Prolonged survival following six pulmonary resections for metastatic adrenal cortical carcinoma: a case report. 620 79

Naturally-occurring hyperadrenocorticism was diagnosed in an 11-year-old female Dachshund with signs of polydipsia, polyuria, pendulous abdomen, weakness, depression and lethargy, and laboratory test abnormalities comprising lymphocytopaenia, eosinopaenia, hypercholesterolaemia and increased plasma alkaline phosphatase concentration. While awaiting hormonal test results, an adrenocorticolytic drug (o,p'-DDD) was administered for 14 days, during which the patient deteriorated. Hormonal assays suggested a functioning adrenocortical tumour, but the poor condition of the patient precluded adrenalectomy. An adrenocortical carcinoma with hepatic metastases was found at necropsy.
 ...
PMID:Functioning adrenocortical tumour in a dog. 628 91

This study concerns the history of a male patient with hormone-producing adrenal cortical carcinoma. Six months after resection of the primary tumor, lymph node metastases were detected and treatment with o,p'-DDD [1,1 dichloro-2-(o-chlorophenyl)-2-(p-chlorophenyl)ethane] (Lysodren/mitotane) was started. After 2 years, a complete histologically proven response was confirmed at laparotomy and is still sustained 2 years after the discontinuation of treatment. As a consequence of insufficient steroid replacement the patient suffered bouts of adrenal insufficiency. After 1 year of treatment, the measurement of the plasma levels of o,p'-DDD showed an accumulation of the drug. At that time, progressive major central nervous system toxicity occurred, which proved to be reversible on discontinuation of the treatment.
 ...
PMID:Complete response of metastasized adrenal cortical carcinoma with o,p'-DDD. Case report and literature review. 636 Mar 29

A virilizing adrenocortical carcinoma was treated by excision of the primary tumor and later lobectomy for metastases to the lung. Virilization was abolished, fertility restored, and the patient is without evidence of recurrent tumor 25 years later.
 ...
PMID:Pulmonary lobectomy for metastatic adrenocortical carcinoma: a 25-year survival. 648 3

Thirty-four patients with adrenocortical carcinoma were treated with o,p'-DDD. Twenty-eight patients presented with metastases at entry, and spillage of tumour cells occurred at surgery in 6 other patients. Eight patients had objective tumour regression, of whom 7 had serum levels over 14 micrograms/ml. The 3 patients with a lasting remission had levels of greater than 15, greater than 25, greater than 25 micrograms/ml respectively during prolonged periods. Increased survival times were found in the group of 14 patients with o,p'-DDD serum levels higher than 14 micrograms/ml when compared with patients not treated after discovery of metastases. In the patients with levels less than or equal to 10 micrograms/ml no therapeutic effect was seen. Levels of over 20 micrograms/ml are associated with symptoms of reversible neuromuscular toxicity. Monitoring of serum levels during treatment is mandatory. It is suggested that serum levels of about 25 micrograms/ml during longer periods may be curative.
 ...
PMID:The treatment of adrenocortical carcinoma with o,p'-DDD: prognostic implications of serum level monitoring. 653 15

The cytologic appearance of fine needle aspiration (FNA) specimens emanating from both symptomatic and incidental masses of the adrenal glands in 22 patients who attended a large cancer institution from 1976 to 1981 is described. Eligibility for the study required thorough clinical and radiologic follow-up for at least two years following the initial cytologic diagnosis. Histologic and ultrastructural correlations were performed when possible. Nine patients were found to have benign lesions, including five adrenal cysts, two adenomas, one nodular hyperplasia and one adrenal myelolipoma. Thirteen patients had malignant lesions, of which six were primary adrenal tumors, either neuroblastoma (two) or adrenocortical carcinoma (four). The overall sensitivity of FNA in detecting the presence of malignancy was 85%, while the number of patients correctly classified for all adrenal masses was 90%. The test was 100% specific for malignant lesions. It is concluded that FNA of adrenal masses is a safe and simple procedure with a high degree of accuracy. Its use appears to be especially justified in those patients with primary neoplasms of nonadrenal sites, in whom silent adrenal lesions are detected during radiologic surveys for metastatic disease. Fifteen of the patients fell into this category, yet over half (53%) of them were shown to have benign adrenal lesions, treatable with a conservative approach.
 ...
PMID:Fine needle aspiration cytology of the adrenal gland. 658 3

Seventy-seven patients with histologically proven adrenal cortical carcinoma seen at the University of Texas M. D. Anderson Hospital (1950-1981) were studied. Thirty-nine were women (mean age at diagnosis, 36.6 years), and 38 were men (mean age at diagnosis, 48.3 years). On presentation, 41 of 74 had abdominal symptoms (55.4%) and 25 of 74 had an abdominal mass (33.8%). Twenty-six patients (33.8%) were found to have clinically functional disease (18 women, 8 men). At diagnosis, 26 (33.8%) had clinical or radiologic signs of distant metastases. Preoperative radiologic studies yielded an abnormal intravenous pyelogram in 42 of 51 (82%), an abnormal abdominal ultrasound in eight of nine (88.9%), abnormal computerized tomography in 10 of 10 (100%), and abnormal arteriogram in 18 of 19 (94.7%). Surgery for localized or regional disease was associated with a disease-free interval of at least 2 years in 16 of 34 patients (47%). The use of op'DDD, abdominal radiotherapy, and systemic chemotherapy produced demonstrable effects in nine of 47 (19.1%), two of nine (22.2%), and three of 26 (11.5%), respectively. Distant metastases occurred in 60 patients, commonly in lung, liver, peritoneal and pleural surfaces, lymph nodes, and bone. Analysis of survival data showed a 5-year survival of approximately 30%. The authors concluded that early diagnosis and radical surgery offer the only prospects of long-term survival and the possibility of cure.
 ...
PMID:Adrenal cortical carcinoma. A study of 77 cases. 686 Nov 7


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>