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)

Sensitivity and specificity of plain T2-WI and Gd-DTPA enhanced T1-WI were compared by evaluating MR exams of 30 patients with brain metastases. Large lesions with high signal on T2-WI always enhanced (43/43) when a structure (perifocal edema, tumor tissue, central necrosis) was found. Large lesions nearly always enhanced (53/55) even if no such structure was found. 65% of small unstructured white matter lesions with high signal on T2-WI, which are generally considered vascular, did not enhance. Surprisingly, 35% did enhance. Demonstration of blood brain barrier disturbance in these lesions suggested a metastatic origin. In 3 patients with multiple metastases, Gd-DTPA enhanced T1-WI disclosed more than 140 lesions not seen on T2-WI. All of them were located in or adjacent to grey matter. Our results indicate that enhanced T1-WI should be obtained even if T1-WI are normal or show only small white matter lesions.
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PMID:[MRT of brain metastases. (I) What is the place of screening with T2-weighted sequences?]. 217 Oct 67

An autopsy case of malignant fibrous histiocytoma (MFH) of the mediastinum in a 25-year-old Japanese man is described. He initially complained of general fatigue and intermittent tarry stool, and was radiographically revealed to have a huge mass within the mediastinum as well as multiple nodules within the abdominal cavity, respectively. The mediastinal tumor could not be resected because of direct tumor invasion into surrounding tissues. Within the abdominal cavity, three distinct tumor nodules were discovered in the jejunum, which could be resected surgically. Histopathologically, the components of both lesions were very similar, and the present case was interpreted as multiple metastases of mediastinal MFH to the intestinal wall. In spite of various kinds of treatment, the mediastinal tumor rapidly enlarged, causing SVC syndrome. Brain CT findings suggested multiple metastases which were considered to be the cause of death. Autopsy confirmed that the main tumor nodule was located within the mediastinum, with brain metastases. The present case of mediastinal MFH is considered to be the youngest case as well as the first case presenting intestinal metastases.
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PMID:An autopsy case of malignant fibrous histiocytoma of the mediastinum, presenting multiple metastases to the small intestine and to the brain--a rare case report with a review of the literature. 217 6

Between May 1986 and August 1989, we treated 18 patients with 21 recurrent or persistent brain metastases with stereotactic radiosurgery using a modified linear accelerator. To be eligible for radiosurgery, patients had to have a performance status of greater than or equal to 70% and have no evidence of (or stable) systemic disease. All but one patient had received prior radiotherapy, and were treated with stereotactic radiosurgery at the time of recurrence. Polar lesions were treated only if the patient had undergone and failed previous complete surgical resection (10 patients). Single doses of radiation (900 to 2,500 cGy) were delivered to limited volumes (less than 27 cm3) using a modified 6MV linear accelerator. The most common histology of the metastatic lesion was carcinoma of the lung (seven patients), followed by carcinoma of the breast (four patients), and melanoma (four patients). With median follow-up of 9 months (range, 1 to 39), all tumors have been controlled in the radiosurgery field. Two patients failed in the immediate margin of the treated volume and were subsequently treated with surgery and implantation of 125I to control the disease. Radiographic response was dramatic and rapid in the patients with adenocarcinoma, while slight reduction and stabilization occurred in those patients with melanoma, renal cell carcinoma, and sarcoma. The majority of patients improved neurologically following treatment, and were able to be withdrawn from corticosteroid therapy. Complications were limited and transient in nature and no cases of symptomatic radiation necrosis occurred in any patient despite previous exposure to radiotherapy. Stereotactic radiosurgery is an effective and relatively safe treatment for recurrent solitary metastases and is an appealing technique for the initial management of deep-seated lesions as a boost to whole brain radiotherapy.
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PMID:The treatment of recurrent brain metastases with stereotactic radiosurgery. 217 75

Athymic nude mice have been used in recent years to study the biology of human tumors and to assess therapeutic responses in vivo rather than just in vitro. Some human tumors metastasize in nude mice, providing model systems for analyzing various aspects of the metastatic phenotype of human neoplasms. For breast carcinomas, however, the tumor-take rate of surgical specimens is low, and only a limited number of cell lines proliferate in nude mice. The site of injection of the breast carcinoma cells is important; tumors grow at a lower inoculum dose and with shorter latent intervals after implantation in the mammary fatpad of nude mice than after injection in the subcutis. One breast carcinoma cell line, MDA-MB-435, metastasizes from mammary fatpad tumors to lymph nodes, lungs, and other visceral organs. In contrast, two other cell lines show lower metastatic ability. Intravenous injection and injection of tumor cells into the internal carotid artery of nude mice produces lung and brain metastases, respectively, thus simulating the arrest and organ colonizing steps of the metastatic cascade. These different techniques demonstrate the potential of experimental studies of human breast cancer growth and metastasis using nude mice.
Cancer Metastasis Rev 1990 Feb
PMID:Studies of human breast cancer metastasis using nude mice. 218 9

In assessing the value of systematic evaluation of extrathoracic extension for potentially resectable, non-small-cell bronchogenic carcinoma, a prospective study was conducted in 146 patients. The study protocol included computed tomographic (CT) scan of the brain and upper abdomen, abdominal ultrasonography, and whole-body bone scanning. The findings were matched with the clinical presentation, histologic features, and TN staging, having found out that non-small cell bronchogenic carcinoma does not follow a set pattern to metastasize. The rate of metastasis for adenocarcinoma is not only significantly larger (p less than 0.05) but it does not correlate with the TN staging, in contrast to what happens with the squamous cell carcinoma (p less than 0.01). None of the squamous cell carcinomas in intrathoracic stage I was found to metastasize. Twenty-one percent (4/19) of brain metastases were asymptomatic (three adenocarcinomas and one squamous cell carcinoma with multiorgan metastasis). Bone scanning detected metastasis in 3.4 percent (4/116) of the asymptomatic patients, and three of the four patients with asymptomatic metastasis had nonskeletal foci. In 61 percent (11/18) of patients with hepatic metastasis, we did not find organ-specific indicators to suspect it. The series showed a 7.5 percent incidence of adrenal metastasis. Our findings suggest the convenience of performing an upper abdominal CT scan and/or ultrasonography in all patients, except for those with asymptomatic stage I squamous cell carcinoma; we also suggest brain CT scanning for all patients with adenocarcinomas and large-cell carcinomas as well as for those with squamous cell carcinoma with neurologic symptoms, and whole-body bone scanning only in those patients with clinical and laboratory indication of possible bone involvement by metastatic disease.
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PMID:Extrathoracic staging of bronchogenic carcinoma. 218 92

Fotemustine is a new chloronitrosourea recently developed by the French company Servier. It is chemically characterized by the graft of an aminophosphonic acid on the chloronitrosourea radical, which makes it highly lipophil. The preclinical studies revealed a lower mutagenicity and hepatotoxicity when compared to BCNU. The pharmacokinetic studies showed a high body clearance and a short half-life. The phase I study enabled us to determine the definitive treatment schedule: 100 mg/m2/week during 3-4 consecutive weeks followed by 5 weeks' rest and a maintenance therapy of 100 mg/m2 every 3 weeks for stabilized or responding patients. Fotemustine should be given as a 1-h intravenous infusion, protected from daylight. There was no life-threatening toxicity and positive activity was observed in different tumors and especially melanomas. This indication was thus chosen for the phase II study. Among the 153 evaluable patients, the response rate reached 24.2%. It depended on the location of the metastatic sites, with 25% brain metastases, 19.2% visceral metastases, 8.8% liver metastases and 31.8% skin and lymph node metastases. The median duration of response was 22 weeks. The median overall survival of responding patients reached 85 weeks, while it dropped to 52 weeks in case of minor response or stabilization and 17 weeks in case of progression. The hematological toxicity was moderate (WHO grade III and IV: 46.3% leukopenia and 40.3% thrombopenia) and delayed as for other nitrosoureas (nadir: white blood cells: day 44 and thrombocytes: day 35).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Fotemustine, a new nitrosourea derivative. Current status of development]. 218 26

The cases of two patients with epithelial ovarian carcinoma who had been treated with surgery and cisplatin-containing combination chemotherapy and had developed brain metastases are described. Modern protocols for management of advanced-stage epithelial ovarian carcinoma have resulted in prolonging the lives of the patients sufficiently for central nervous system metastases to become apparent and possible resistence of the 'blood brain' barrier to the currently used chemotherapeutic agents may have left the CNS 'unprotected' from metastases.
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PMID:Brain metastases in epithelial ovarian carcinoma; two case reports. 219 64

Eleven patients, three males and eight females, developed brain metastases from well-differentiated thyroid carcinoma 1 to 20 years after their original diagnosis. Two had brain metastases only and nine had metastases to the lungs and bones as well. Most patients died within a year of diagnosis of brain metastases. We conclude that brain metastasis from thyroid carcinoma carries a poor prognosis and that newer modalities of therapy may be needed.
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PMID:Brain metastases in patients with well-differentiated thyroid carcinoma: study of 11 cases. 220 41

Computerized tomographic (CT) scans of 271 patients with histologically proven bronchial carcinoma accomplished for initial tumor staging were retrospectively evaluated for signs of cerebral metastasis. The results for the histologic subtypes were quite different. In 13.8% of patients with small cell carcinoma and limited disease the authors found signs of brain metastasis. However, routine cerebral staging in these patients did not seem to be useful because of lack of therapeutic consequences. On the other hand, no patient with non-small cell carcinoma (N-SCC) and tumor Stage I or II had brain metastases. All patients with brain metastasis from N-SCC had been classified as tumor Stage III before cerebral imaging. Among these patients, however, the authors found brain metastasis in 17.5% of those without known distant metastatic disease (III/M0), especially in large cell carcinoma and in adenocarcinoma. Stage III/M0 patients should undergo routine cerebral imaging if their tumor is surgically resectable and thoracotomy is planned.
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PMID:Cerebral tumor staging in patients with bronchial carcinoma by computed tomography. 222 99

During the years 1973-1987, 75 patients were irradiated for brain metastases of unknown origin at the Institute of Oncology in Ljubljana. Of these, 35 (47%) were previously treated by surgery: Metastases were completely removed in 22 patients and partially in 7, whereas biopsy alone was performed in 6 patients. Based on the examinations carried out during radiation therapy and at the time of follow-up, the primary sites of tumor were established as follows: The lung in 40 patients, the breast in 2, melanoma in 2, and the esophagus, kidney, and parotid gland in one patient, respectively. Primary tumor could not be detected in 28 (37%) patients. Metastases were microscopically verified in 48 cases in which anaplastic carcinoma and adenocarcinoma were most frequent. All the patients were irradiated on a cobalt unit, generally with doses of 10 x 300 cGy in 2 weeks. Median survival of the 22 patients with total removal of brain metastases was 9.5 months, one-year survival being achieved in 41% of cases. In the remaining patients median survival was 3 months, whereas only 12% of the patients survived one year. The cause of death were most frequently, i.e. in 45 patients, brain metastases.
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PMID:Management of patients with brain metastases of unknown origin. 223 20


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