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)

The 24 h-whole-body retention (WBR), determined by a whole-body counter, may be used to quantify exactly bone seeking properties of a radiopharmaceutical. The 24h-WBR of 99mTc-methylene-diphosphonate was determined in 200 patients and was found to be independent of kidney function if this function was normal or only slightly diminished. The 24h-WBR was slightly dependent on age since it decreased up to 20 years of age, reaching a minimum at 20-25 years, and then increased with increasing age. Normal values of 24h-WBR for individuals of more than 20 years of age were 31.8 +/- 5% of injected dose. Not more than two focal accumulations, i.e. skeletal metastases, failed to elevate the 24h-WBR significantly (p less than 0.1). However, a highly significant (p less than 0.001) difference to normals was found in patients with multiple metastases (24h-WBR: 38.2 +/- 7%), with diffuse osseous involvement as in primary hyperparathyroidism (24h-WBR: 49 +/- 11.7%, p less than 0.001) or with osteoporosis (24h-WBR: 45%). The 24h-WBR was found to be very sensitive in grading diffuse osseous involvement. This was shown in single-tumor patients by follow-up as the 24h-WBR in addition to bone scans was useful to describe progression or remission. Moreover, the 24h-WBR correlated closely with results of bone marrow biopsies in a small group of patients with malignancies of the lymphoreticular system.
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PMID:[Whole-body retention of 99mTc-methylene diphosphonate in skeletal diseases]. 622 77

In 32 patients with primary liver tumors incidence and etiology of hypercalcemia were evaluated. Two patients revealed hypercalcemia from osteolytic metastases, one had coexistent primary hyperparathyroidism and in one patient hypercalcemia was paraneoplastic. The last two patients are presented in detail by case reports. Differential diagnostic problems appear often in patients in bad general condition, since invasive diagnostic methods are limited. The most potent substance to treat acute hypercalcemic syndrome is mithramycin. In those cases where surgical treatment is possible, complete resection of the primary liver tumor or the adenoma of the parathyroid gland is recommended.
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PMID:[Hypercalcemia in liver tumors (author's transl)]. 625 29

Hypercalcemia accompanies often malignant diseases. The majority of cases of malignancy complicated by hypercalcemia is induced by metastases involving bone, hypercalcemia may also accompany localised tumors. Various hormones have been implicated in the genesis of malignant hypercalcemia: ectopic secretion of parathyroid hormone by tumor or orthotopic secretion by concomitant primary hyperparathyroidism, prostaglandin activating osteoclasts, production of hypercalcemic factor other than these hormones. This review summarizes current knowledge about endocrine-mediated mechanisms which produce hypercalcemia and about its frequency and mechanism in different types of tumors.
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PMID:[Hypocalcemia in malignant diseases]. 635 39

Hypercalcemia secondary to malignancies can be divided into two groups according to their calcium elevating mechanism: solid tumors with bony metastases, most frequently originating from the breast or the bronchi, and solid tumors without bony metastases, associated with secretion by the tumor of a substance which increases the calcium level. This substance resembles parathormone in pseudo-hyperparathyroidism, prostaglandins, or other substances not yet identified. The most common tumors involved are bronchial or renal cancers. Diagnostic problems vary depending on whether the cancer has been identified or not, and if bony metastases have or have not been discovered. Primary hyperparathyroidism must also be considered since it is frequently associated with cancer. Hypercalcemia from blood dyscrasias (myeloma and lymphoma) originates from the same mechanisms. It may or may not be associated with bony lesions. The hypercalcemia could be due to a "parathormone like" substance, to prostaglandins, to a substance that stimulates osteoclasts (OAF), or to calcitriol (1,25-dihydroxycholecalciferol). The treatment of hypercalcemia due to malignancies is primarily through the use of antiosteoclastic agents: calcitonin, mithramycin, and more recently diphosphonates. Corticosteroids and the prostaglandin inhibitors can have an additional calcium lowering effect.
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PMID:[Hypercalcemia of cancer and myeloma]. 639 3

We have experienced 186 patients with proven primary hyperparathyroidism operated on during past 16 years. In this series, 147 patients (79%) had adenoma, 24 patients (12.9%) had carcinoma and only 15 (8.1%) had hyperplasia. Because of a 92% of single gland involvement, the removal of an enlarged gland is adequate, if the remaining gland are grossly normal. Besides, interestingly enough, an incidence of parathyroid carcinoma is rather high in Japan, so that surgeons should be alert to recognize the parathyroid carcinoma on the basis of clinical and operative findings. In an effort to minimize recurrence, en bloc resection of the parathyroid carcinoma is important. When a patient with parathyroid carcinoma has a local recurrence or distant metastases, an aggressive surgical approach is recommended to alleviate hypercalcemic symptoms. The majority of patients with hyperplasia belong to multiple endocrine neoplasia, type 1. Recent development of the non-invasive diagnostic methods is remarkable. The last consecutive 31 patients underwent preoperative localization study by 201Thallium (201TI-CI) scanning and ultrasonography. 201TI-CI scanning gave the most accurate results and 100% correct localization was obtained when the parathyroid tumor was more than 1 g. However, it is noteworthy that the parathyroid tumor was less than 1 g in 64% of patients who had no evidence of generalized fibrous osteitis.
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PMID:[Surgical management of primary hyperparathyroidism]. 650 56

The true incidence of carcinoma of the parathyroid gland is probably about 1 percent of cases of primary hyperparathyroidism. Overreporting may occur if the diagnosis is based on histologic appearances alone because the histologic criteria are less than definitive. Carcinoma of the parathyroid gland, if diagnosed early and treated with adequate surgical excision, is associated with a satisfactory long-term prognosis. However, the possibility of distant metastases or locally recurrent disease is not necessarily excluded by a prolonged interval of disease-free status, and the physician should continue to follow the patient on a regular basis by physical examination and routine serum calcium analysis.
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PMID:Carcinoma of the parathyroid gland: is it overdiagnosed? A report of three cases. 669 6

Squamous cell cancer of the pancreas is a rare variant of pancreatic ductal cell carcinoma. This tumor has not been reported to be associated with hypercalcemia in the absence of primary hyperparathyroidism or bone metastases. We present a patient with pancreatic squamous cell carcinoma who presented with intractable hypercalcemia, had normal parathormone levels, and was found at autopsy to have normal parathyroid glands and no evidence of bony metastases. A review of squamous cell carcinoma of the pancreas and pancreatic neoplasms associated with hypercalcemia is presented.
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PMID:Squamous cell carcinoma of the pancreas associated with hypercalcemia. 712 33

Breast cancer is the malignant neoplasm most commonly associated with hypercalcemia. At the University of Texas M. D. Anderson Hospital, Houston, during the fiscal year 1977 to 1978, of 16,887 patients having calcium determinations, 7.8% had hypercalcemia. From 1969 to 1979, 13 patients had proved and three had presumed primary hyperparathyroidism associated with breast cancer. Two other patients had pseudohyperparathyroidism. Selective neck vein catheterization was used in 17 of the 18 patients and helped localize and confirm the diagnosis of primary hyperparathyroidism. Chloride-phosphate ratios were elevated in 13 of the 14 patients with proved or presumed primary hyperparathyroidism. This condition may mimic osseous metastases by producing brown tumors or compression fractures. In patients with breast cancer and hypercalcemia, particularly without osseous metastases, a careful diagnostic evaluation is warranted to rule out primary hyperparathyroidism.
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PMID:Hypercalcemia in patients with breast cancer. Osseous metastases, hyperplastic parathyroid tissue, or pseudohyperparathyroidism? 723 46

Over a period of 6 1/2 years hypercalcemia has been diagnosed in 86 patients. In 55.8% of cases a malignant tumor was the cause of the elevated calcium levels, and in 22.1% of cases primary hyperparathyroidism (p.Hp.) was diagnosed. In the remaining 19 patients hypercalcemia was related to renal insufficiency (5 patients), vitamin-D intoxication (4) and thiazide therapy (3), while other, rarer causes were identified in 7 cases. As expected, bronchial and breast carcinomas were most frequent (52%) in the malignancy group. In patients below age 40 malignancy was never responsible for the hypercalcemia, but in patients over 50 malignancy was present in 65%. Of the patients with solid tumors 54.8% had skeletal metastases, while other organ metastases were found in 33.3% of these. The occurrence of a hypercalcemia in patients with malignancy is associated with a poor prognosis since over 60% of the patients died within as little as one month and over 90% within a year after the occurrence of hypercalcemia. Renal function impairment in hypercalcemia was significantly more marked in the patients with malignancy than in patients with p.Hp. and was closely related to the calcium levels. Pharmacological reduction of the blood calcium level produced a distinct improvement in renal function in 70% of the patients treated. The current hypothesis on the pathogenesis of hypercalcemia among carcinoma patients is briefly discussed.
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PMID:[Hypercalcemia in hospitalized patients. Diagnostic and prognostic aspects]. 731 56

We collected 60 cases of parathyroid carcinoma, which was a rare disease of primary hyperparathyroidism, from 1980 to 1989, at several institutes in Japan by a questionnaire. The incidence of parathyroid carcinoma among the cases of the primary hyperparathyroidism in Japan was 4.8%, which was a little higher than that in the western countries. Most of the patients with parathyroid carcinoma show bone disease, high level of serum calcium and palpable anterior neck mass. Echogram is useful for the diagnosis of parathyroid carcinoma and its localization. Cure of the disease depends on the initial operation methods. En bloc resection of the tumor should be performed in each suspected case of a parathyroid carcinoma. The incidence of distant metastasis was 24%, and local recurrence 20% in Japan. Compared with the western countries, the lower incidence of local recurrence in Japan may be due to the operation method. The resection of local recurrence or distant metastases is effective for the control of recurrent hypercalcemia. We should always consider parathyroid carcinoma at the time of diagnosis and treatment of the patients with primary hyperparathyroidism.
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PMID:[Parathyroid carcinoma]. 775 83


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