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)

We report the case of a 42 year old man in whom orthotopic liver transplantation was performed successfully for unresectable hepatic metastases of a bronchial carcinoid tumor. Prior to transplantation, somatostatin therapy, pulmonary lobectomy, and systemic chemotherapy (streptozotocin and fluorouracil) were performed. After 9 months there were no signs of clinical or biological recurrence. Orthotopic liver transplantation might be indicated for unresectable and limited liver metastases of neuroendocrine tumor.
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PMID:[Orthotopic liver transplantation for metastases of bronchial carcinoid tumor]. 134 69

We report the fine needle aspiration cytology findings in six cases of neuroendocrine tumor of the pancreas. Three cases were from the pancreas, two from hepatic metastases and one from a peripancreatic lymph node metastasis. The cytologic features that permitted a preoperative diagnosis of pancreatic neuroendocrine tumor were: a cellular aspirate; numerous isolated cells and irregular, loose, dyshesive cellular aggregates; minimal nuclear pleomorphism; infrequent mitoses; fine, evenly dispersed nuclear chromatin with occasional inconspicuous nucleoli; a scant-moderate amount of granular, amphophilic, well-defined cytoplasm; clustering of tumor cells around segments of capillaries; and rosette formation. The differential diagnosis includes cells derived from normal pancreatic acini, islet cell hyperplasia, acinic cell carcinoma, well-differentiated pancreatic adenocarcinoma, metastatic small cell undifferentiated carcinoma of the lung, pancreatic small cell anaplastic carcinoma and malignant lymphoma. The application of immunocytochemistry to cytologic smears can be easily and reliably performed to confirm the neuroendocrine nature of the tumor and identify the specific type of polypeptide hormone or hormones produced by these tumors. Four aspirates showed immunoreactivity for chromogranin, and one was positive for gastrin. Cells of a lipid-rich neuroendocrine tumor were negative for chromogranin; however, the tissue section contained neuron specific enolase, and neurosecretory granules were demonstrated by electron microscopy.
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PMID:Fine needle aspiration cytology of neuroendocrine tumors of the pancreas. A cytologic, immunocytochemical and electron microscopic study. 152 21

Neuroendocrine cell carcinoma of the cervix is a virulent tumor associated with an extremely poor prognosis. Even in clinical Stage I disease, there may be subclinical hematogenous and lymphatic metastases with frequent recurrences. Adjuvant postoperative external pelvic radiotherapy has been reported to offer some degree of local control; however, most patients succumb to distant disease. Following radical abdominal hysterectomy and pelvic lymphadenectomy, with confirmation of the neuroendocrine tumor by electron microscopy and immunohistochemical staining, two patients were given adjuvant systemic chemotherapy with concurrent pelvic radiotherapy, employing regimens with documented activity against small cell carcinoma of the lung of neuroendocrine origin. Despite severe myelotoxicity and persistent neuropathy, both patients are alive without clinical evidence of disease at 28+ and 47+ months.
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PMID:Adjuvant therapy for neuroendocrine small cell carcinoma of the cervix: review of the literature. 166 Apr 33

In a retrospective study of cancer patients seen between 1980 and 1990, 7 cases of metastases to skeletal muscles were found: 2 primary bronchial carcinomas, 1 spindle cell sarcoma, 1 malignant melanoma, 1 ovarian adenocarcinoma, 1 squamous cell laryngeal carcinoma and 1 malignant neuroendocrine tumor from an unknown primary site. Despite their rich blood supply, skeletal muscles are rarely secondary metastatic sites (less than 1% of all malignant metastases of hematogenous origin); only 242 cases have previously been reported in 82 publications. Primary cancers of the lung, blood, gastrointestinal tract and genitourinary tract were the most frequently involved. Although skeletal muscle metastatic sites were rarely observed, the possibility of such a colonization should be known to physicians, as their detection requires specific tests. Furthermore, the localization of such sites clearly illustrates the recent progress made in the biology of metastases, especially the organ--or tissue--specificity of the site.
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PMID:[Muscle metastases of cancers]. 177 83

Determination of plasma levels of vasoactive intestinal polypeptide (VIP) has been used for screening patients with chronic diarrhea to identify potential neuroendocrine tumors. This 6-year blinded study from 1981 to 1986 examines the causes of elevated VIP levels in patients. In healthy volunteers ( n = 144), VIP concentrations ranged from 14 to 76 pg/mL (mean +/- SE, 28 +/- 12), whereas in chronic renal failure, 4 of 34 patients or 12% [serum creatinine 4.5 - 9.0 mg/dL (397-795 mumols/L)] had an elevation to greater than 100 pg/mL. No patient with idiopathic hepatic cirrhosis (n = 12) had elevation of serum concentration of this peptide. Among 588 consecutive unselected patients undergoing evaluation for chronic diarrhea (n = 362; 62%) or possible neuroendocrine tumor (n = 214; 36%), 23 patients (3.9%) had concentrations greater than 76 pg/mL. In this group, 5 patients had functioning (VIP, 160-5975 pg/mL) and 5 had nonfunctioning (VIP, 80-120 pg/mL) pancreatic islet cell carcinomas: all 10 patients had hepatic metastases. Other known cases of elevated levels of VIP, ranging from 80 to 340 pg/mL, included other neurogenic tumors (n = 3), small- bowel resection (n = 2), inflammatory bowel disease (n = 2), chronic renal failure (n = 1), and prolonged fasting (n = 1). Patients with diarrhea in which VIP-secreting tumors were identified had plasma vasoactive intestinal peptide concentrations greater than 140 pg/mL. In patients with chronic diarrhea, determination of plasma vasoactive intestinal peptide levels did identify tumors secreting this peptide, but the results from this referral institution did not show identification of these tumors early in their clinical course.
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PMID:Plasma vasoactive intestinal polypeptide concentration determination in patients with diarrhea. 198 54

A female patient suffering from a bronchial neuroendocrine tumor with unilateral left-sided carcinoid heart disease is reported. Repeated x-ray films of the chest showed a slowly growing lung tumor in the left lower lobe. The patient refused any diagnostic or therapeutic procedure to define the type of the tumor. During the follow-up of 24 years she developed severe mitral and moderate to severe aortic insufficiency, both invasively quantified by thermodilution techniques. During surgery for double valve replacement the patient died from left ventricular heart failure. Necropsy revealed the typical pattern of a bronchial neuroendocrine tumor without metastases. Examination of the heart disclosed the characteristic deposits of fibrous tissue on the cusps of both the mitral and the aortic valves whereas the right heart showed no abnormalities. Review of the literature suggests the unilateral left-sided carcinoid heart disease to be a very rare finding, its pathogenesis remains to be elucidated.
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PMID:Bronchial neuroendocrine (carcinoid) tumor causing unilateral left-sided carcinoid heart disease. 201 74

Partial or complete obliteration of the fat surrounding the celiac axis and superior mesenteric artery on CT is considered so characteristic of pancreatic carcinoma that many consider it diagnostic. However, this finding may be present on CT scans of some treatable tumors. During a 2-year period, we retrospectively collected 10 cases of nonpancreatic tumors that obliterated the fat surrounding the celiac axis and/or superior mesenteric artery. Four patients had metastatic disease, three had lymphoma, two had primary small-bowel adenocarcinoma, and one had a diffuse retroperitoneal endocrine tumor. The scans were analyzed for presence, location, and morphology of the mass and biliary and/or pancreatic ductal dilatation. Of the patients with metastatic disease, three had focal, retropancreatic, periceliac masses without ductal dilatation. One had an infiltrative retroperitoneal process enveloping the pancreas and causing biliary dilatation. Of the patients with lymphoma, two had focal masses in the mesenteric root without ductal dilatation, and one had an infiltrative retroperitoneal process. Of the two patients with primary carcinoma of the small bowel, one had a mesenteric mass without ductal dilatation and the other had an infiltrative retroperitoneal process enveloping the pancreatic head and obstructing the ducts. The patient with the neuroendocrine tumor had an infiltrative retroperitoneal process enveloping the pancreas without ductal dilatation. Obliteration of the fat surrounding the celiac axis and superior mesenteric artery is not a specific CT finding of carcinoma of the pancreas. One cannot rely solely on its presence for the diagnosis of pancreatic carcinoma but should use other important findings such as a focal pancreatic mass and ductal dilatation.
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PMID:Obliteration of the fat surrounding the celiac axis and superior mesenteric artery is not a specific CT finding of carcinoma of the pancreas. 212 Sep 70

The clinical and pathologic findings of Merkel cell carcinoma of the vulva were reported. The light microscopic findings of sheets of small, uniform cells were consistent with a diagnosis of neuroendocrine tumor. The electron microscopic characteristics revealed membrane-bound secretory granules, confirmed the diagnosis of Merkel cell carcinoma. Regional lymphnode metastases were present at the time of initial surgery and the adjunctive radiotherapy was also given. This case was unusual because Merkel cell carcinoma was usually found on the face, extremities and buttocks.
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PMID:Merkel cell carcinoma of the vulva: a case report. 259 89

Twenty-nine patients with poorly differentiated neuroendocrine tumors of unknown primary site were seen at Vanderbilt Medical Center between May 1977 and February 1987. All patients had pathologic findings typical of neuroendocrine tumors by electron microscopy (22 patients), light microscopy (6 patients), or immunochemical staining (1 patient). Patient age ranged from 18 to 77 years; 21 were men and 8 were women; and 12 had no history of tobacco use. Seventeen patients had metastatic tumor at two or more locations. Common metastatic sites included the retroperitoneum, lymph nodes (particularly cervical), and mediastinum. In most patients, these neoplasms showed an aggressive biology, with rapid onset of symptoms and rapid growth of metastases. Major responses were seen in 18 of 25 patients who received combination chemotherapy; 6 patients achieved a complete response. Three patients remain disease-free more than 24 months after completing therapy. Four patients with single sites of disease received local therapy only; all remain disease-free 1 to 10 years after completion of therapy. In 4 patients, specific tumor types were eventually recognized: small cell lung cancer, 1; gastrointestinal carcinoid tumor, 2; and extragonadal germinal tumor with predominant neuroendocrine differentiation, 1. In the remaining 25 patients, no well-recognized type of neuroendocrine tumor was identified. Recognition of these tumors broadens the spectrum of neuroendocrine neoplasia, and also identifies a distinct subset of patients with poorly differentiated carcinoma of unknown primary site. Although optimal therapy remains undefined, these patients are usually responsive to combination chemotherapy, and long-term survival is attainable in a minority.
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PMID:Poorly differentiated neuroendocrine carcinoma of unknown primary site. A newly recognized clinicopathologic entity. 284 95

The clinical and pathologic features of a vulvar neuroendocrine (Merkel cell) neoplasm are presented. Cytologic studies of material obtained from needle aspiration suggested that the tumor was a small cell neoplasm possibly of neuroendocrine derivation. The light-microscopic findings of sheets of small, uniform cells were consistent with a diagnosis of neuroendocrine tumor. The electron-microscopic characteristics, including the presence of neurosecretory granules, confirmed the diagnosis of a neuroendocrine (Merkel cell) carcinoma. Regional lymph node metastases were present at the time of initial surgery, and both local and distant metastases developed 8 months later. A comprehensive pretreatment metastatic evaluation is recommended. The role of chemotherapy for primary therapy is considered.
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PMID:Neuroendocrine (Merkel cell) carcinoma of the vulva: a case report and review of the literature. 299 60


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