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)

A 39-year-old man had pain and swelling of the terminal phalanx of a finger. Radiograph was interpreted as osteomyelitis, and amputation through the mid-phalanx was performed. Histology revealed Ewing sarcoma. Lung metastases rapidly developed. Right lung irradiation and systemic chemotherapy, including doxorubicin, were instituted. He developed progressive severe right ventricular failure which was attributed to effects of large pulmonary metastases. Autopsy showed massive right ventricular metastases, the primary pathological cause of the heart failure, without evidence of doxorubicin cardiomyopathy.
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PMID:Ewing sarcoma: phalangeal primary with fatal cardiac metastases. 54 62

Two cases of occlusion of the inferior vena cava by leiomyosarcoma are reported. This localisation is extremely rare for mesenchymal tumors. The neoplasm originated from the wall of the vena cava, expanded forward into the lumen of the vessel, in one case up to the right atrium. Collateral circulation, anasarca edema and varices develop by this occlusionsyndrome. The fatal outcome of the disease is usually determined by right heart failure and not by metastases directly. In most cases diagnosis is made by autopsy. In cavography the differential diagnosis of thrombosis might include the rare possibility of leiomyosarcoma of the caval vein. Only early diagnosis makes succesful surgical therapy possible.
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PMID:[Vena cava occlusion-syndrom by leiomyosarcoma. Two case reports (author's transl)]. 89 50

In contrast to pulmonary parenchyma metastases or lymphangitic carcinomatosis, neoplastic emboli of small pulmonary arteries and capillaries frequently go unrecognized and are only discovered at autopsy. Five patients (48 +/- 12 years old) were admitted to 3 intensive care units for severe acute respiratory failure and died between the first and the tenth day following hospitalization. Each patient had a history of rapidly progressive dyspnea, and physical examination showed clinical evidence of right ventricular failure. The lungs were clear on chest X-rays and the ECG revealed sinus tachycardia with a right QRS axis. The mean partial pressures of oxygen (PaO2) and carbon dioxide (PaCO2) were, respectively, 50.8 +/- 9.1 mm Hg and 22.2 +/- 2.4 mm Hg. A swan-Ganz catheter, inserted into 4 patients, revealed pulmonary arterial hypertension (55, 43, 37, 28) with capillary wedge pressure within the normal limits and cardiac output normal or low (3.0, 3.8, 4.4, 5.0 l/min). Pulmonary angiograms from each patient showed decreased distal lung perfusion without any proximal defects suggestive of pulmonary embolism. The inferior vena cava always appeared clear. Malignant cells were found upon autopsy (4 cases) in the lumina of the pulmonary arterioles and the primary site of the cancer was determined in 3 patients (2 hepatomas and 1 pancreatic carcinoma). The last patient had a known breast cancer with bone marrow metastases and clinical, hemodynamic and angiographic evidence of neoplastic emboli. The clinical course of neoplastic emboli can suggest acute pulmonary embolism, but the diagnosis can only be advanced after pulmonary angiography, especially if the patient is to have a cancer.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Acute respiratory distress caused by distal neoplastic pulmonary emboli]. 209 8

A 70 year old woman was admitted for right ventricular failure and cyanosis of recent onset. Echocardiography showed a very large, homogenous, immobile, smooth-contoured mass filling the right atrium. Right atrial pressures were raised but the other intracardiac pressures were normal at catheterisation. Right heart angiography confirmed the voluminous right atrial mass and dilatation of the hepatic veins and showed early opacification of the left heart chambers. A right-to-left shunt was confirmed by oximetry which showed significant desaturation of the blood in the left atrium and ventricle (saturation 78% in the left ventricle). The tumour was also documented by a thoracic CT scan. At surgery, a very large, malignant right atrial tumour was resected which histological examination showed to be an angiosarcoma. The interatrial septum seemed to be intact: there was no true atrial septal defect but a persistent foramen ovale was found. After resection of the tumour the right atrium was reconstructed. The initial postoperative period was uncomplicated but the patient died nine months later of metastatic disease particularly affecting the liver and brain. The clinical presentation of malignant cardiac tumour is very variable but a right-to-left interatrial shunt through a patent foramen ovale has only been reported previously in 2 cases of primary malignant tumours (a rhabdomyosarcoma and an angiosarcoma) and in 1 case of a secondary cardiac metastasis.
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PMID:[Right-left shunt caused by sarcoma of the right atrium]. 211 45

A case of adult neuroblastoma of the right adrenal with tumor thrombus extending into the right atrium is reported. Because of right heart failure, the tumor thrombus in the right atrium was removed under the cardiopulmonary bypass. The histopathological examination of the tumor thrombus revealed neuroblastoma. Fourteen days after the first operation, the adrenal tumor, right kidney and tumor thrombus remaining in the vena cava were removed to prevent the recurrence of right heart failure. Two courses of chemotherapy and radiation were given postoperatively and the patient was doing well. Eight months after the second operation, however, the patient died of multiple metastases of the bone and liver.
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PMID:[Adult neuroblastoma of the adrenal with intraatrial tumor thrombus: report of a case]. 317 42

A report is made of a rare case of Wilms' tumour which simulated clinically a syndrome of ;right heart failure', as found in some cases of Ebstein's disease. The clinical, radiological, and electrocardiographic study led to the suspicion of this type of malformation. The cine-angiographic study revealed two important facts: the impossibility of approaching the inferior vena cava with opaque material injected into the azygos vein and a filling defect of the right atrium. The post-mortem study revealed the presence of a Wilms' tumour of the right kidney which extended into the inferior vena cava and into the right atrium without producing metastases. This seems to be the first case of this peculiar course of a Wilm's tumour which has grown into the right atrium, resulting in this bizarre clinical picture.
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PMID:Wilms' tumour propagated through the inferior vena cava into the right heart cavities. 431 67

A case, unique in the literature, is reported in which a primary carcinoma of the liver presented a right-sided heart failure and pulmonary hypertension. The diagnosis of hepatocarcinoma was established by needle biopsy of the liver. Later, postmortem examination demonstrated that the pulmonary arterial tree was severely compromised by multiple tumor microemboli, despite the persistent lack of characteristic roentgenographic abnormality in our patient. In reviewing the literature, we found rare cases of occult renal cell carcinoma, choriocarcinoma and one of occult hepatocarcinoma, which presented as pulmonary embolism. These were diagnosed by pulmonary embolectomy, human chorionic gonadotrophin levels or autopsy, respectively. In another small group of reported cases of known carcinoma (gastric, breast, colonic) the patients had a clinical picture of "idiopathic" pulmonary hypertension or of pulmonary hypertension with pulmonary metastases. Pulmonary hypertension in these cases resulted from carcinomatous lymphangitis and/or tumor microembolization, as in our case. We report this case to emphasize the necessity of including occult carcinoma in the differential diagnosis of pulmonary hypertension and right ventricular failure.
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PMID:Pulmonary hypertension as a presentation of hepatocarcinoma. Report of a case and brief review of the literature. 624 34

A case of focal defects seen on liver scintigraphy on the basis of right ventricular failure is presented. The pattern bore a striking similarity to that seen in hepatic metastases.
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PMID:Focal defects on liver scintigraphy due to right ventricular failure. 672 69

From December 1978 to February 1981 91 regional hyperthermic perfusions with melphalan (1.0 or 1.5 mg/kg body weight) were performed in 87 patients with malignant melanoma of the extremities. During a one-hour perfusion with whole blood at an intramuscular temperature of 42 degrees C the flow rate was 264 +/- 62 ml/min in the upper and 495 +/- 42 ml/min in the lower limb. Apart from one intima dissection there were no serious intraoperative complications. Postoperatively one female patient died on the 19th day from acute right heart failure with severe bone marrow suppression. In six patients intransigent metastases appeared after an average of six months. One patient developed lung metastases 7 months postoperatively from which he died. Seventy-nine patients remained free of tumour during the observation period.
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PMID:[Regional hyperthermic perfusion with cytostatic agents in malignant melanoma of the extremities (author's transl)]. 730

A patient with squamous cell carcinoma of the cervix with cardiac metastases causing a massive right ventricular and right atrial tumor embolus is presented. The patient presented with right heart failure due to the right ventricular outflow tract obstruction. The electrocardiogram showed low QRS voltage. Echocardiogram showed the right atrial and ventricular mass. The patient expired 3 days later. Involvement of the heart by metastatic carcinoma of the cervix is rare. The different modes of metastatic involvement of the heart by carcinoma of the cervix are discussed.
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PMID:Carcinoma of the cervix causing massive intracardiac embolus. 789 1


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