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 imaging findings in a group of 33 patients who developed thoracic metastases following prior therapy for nasopharyngeal carcinoma (NPC) were reviewed. Four (12.1%) patients had scintigraphic or radiographic evidence of hypertrophic pulmonary osteoarthropathy (HPOA) on presentation. In one case this developed prior to radiographic or CT evidence of pulmonary metastatic disease. Evidence of hilar or mediastinal metastatic involvement was seen in three of four patient, and a pulmonary metastasis alone in one. Similarity in appearance of the hilar or mediastinal deposits to primary bronchial carcinoma and the presence of HPOA necessitated biopsy confirmation of NPC metastasis in all four cases. The scintigraphic and CT appearances of this unusual radiological association are discussed.
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PMID:Thoracic metastases from nasopharyngeal carcinoma presenting as hypertrophic pulmonary osteoarthropathy: scintigraphic and CT findings. 765 21

Bone scintigraphy is very sensitive in detecting metastases in an early stage, when changes in osteoblast function precede morphologic changes. In many oncologic situations, however, osteoarticular abnormal changes seen on the bone scan are not caused by tumor infiltration. They may be due to tumor associated conditions, such as carcinoma polyarthritis and hypertrophic pulmonary osteoarthropathy. They also may be due to therapy-associated conditions, such as the flare effect on metastases due to hormonal treatment, chemotherapy or radiotherapy, and osteonecrosis as a complication of radiotherapy or the use of corticosteroids. The introduction of Colony Stimulating Factors (CSF) to reduce myelotoxicity have allowed higher doses of chemotherapeutic agents to be administered. Currently, there is research being performed on the clinical effects of CSF in phase-II studies. In addition to the flare response of metastases, increased uptake in the axial skeleton and/or juxta-articular areas on bone scintigraphy in five patients receiving CSF has been observed. This new phenomenon could be explained by a reaction to a very cellular marrow caused by the use of CSF. The clinical relevance of this finding remains to be established. The authors present an overview of these old and new phenomena seen on the bone scan with clinical and roentgenologic correlation.
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PMID:Tumor and therapy associated abnormal changes on bone scintigraphy. Old and new phenomena. 769 20

Cutaneous paraneoplastic syndromes are a large group of dermatoses that may be associated with an internal malignancy. Among these dermatoses are acanthosis nigricans, tripe palms, dermatitis herpetiformis, dermatomyositis, extramammary Paget's disease, hypertrophic pulmonary osteoarthropathy, pemphigus vulgaris, pruritus, pyoderma gangrenosum, Sweet's syndrome and reactive erythemas. Once the diagnosis of the dermatosis has been confirmed, an appropriate work-up should be undertaken to search for an underlying asymptomatic neoplasm in a patient without known cancer or to detect recurrent or metastatic disease in a patient with an established history of malignancy.
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PMID:Cutaneous paraneoplastic syndromes. 794 26

A patient with florid hypertrophic pulmonary osteoarthropathy (HPOA) associated with metastatic nasopharyngeal carcinoma is presented. Despite the presence of metastatic disease in the thorax and in bone, the patient's main symptom was severe pain from the HPOA, which was temporarily relieved by chemotherapy. Her disease subsequently progressed during chemotherapy and the pain became resistant to conventional treatment, including high dose morphine, non-steriodal anti-inflammatory agents and steriods. It was only with local radiation to the involved joints that the pain could be controlled. Our patient demonstrates that local radiotherapy is an option for the palliation of extreme HPOA.
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PMID:Radiotherapy for extreme hypertrophic pulmonary osteoarthropathy associated with malignancy. 881 77

A 15-year-old crossbred dog was presented with a severe cough of acute onset and an enlarged right testis. Symptomatic treatment for presumed 'kennel cough' failed to produce any improvement and at re-examination the dog had developed a swollen right forelimb. Radiographic examination suggested a diagnosis of hypertrophic pulmonary osteoarthropathy (Marie's disease) associated with pulmonary metastases from a testicular tumour. The dog was re-presented five days later with acute-onset severe vomiting and the owner elected for euthanasia. Necropsy was performed and histopathological assessment confirmed the presence of a Sertoli cell tumour in the right testis with multiple pulmonary and renal metastases. Hypertrophic pulmonary osteoarthropathy is a rare complication of metastatic canine Sertoli cell tumour. The authors know of no previously reported cases.
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PMID:Canine hypertrophic osteoarthropathy associated with a malignant Sertoli cell tumour. 1130 57

We describe an extremely rare case of a woman with pulmonary metastatic disease from breast cancer, who presented with features of hypertrophic pulmonary osteoarthropathy (HPOA). Pain associated with HPOA may be extremely disabling and resistant to treatment. Treatment with pamidronate, an inhibitor of osteoclastic bone resorption, given every 2 weeks by i.v. drip infusion, led to rapid disappearance of uncontrolled pain caused by HPOA.
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PMID:Pamidronate-induced remission of pain associated with hypertrophic pulmonary osteoarthropathy in chemoendocrine therapy-refractory inoperable metastatic breast carcinoma. 1159 54

A 51-year-old man with a known history of hepatic cirrhosis and a right lung mass presented with hemoptysis and widespread bone pain. Sputum cytology demonstrated atypical cells. A CT scan of the chest demonstrated a 3-cm spiculating mass in the right lower lobe, in addition to nodules in both upper lobes and lymphadenopathy within the mediastinum and both hila. Skeletal scintigraphy was performed to assess for metastatic bone disease, and demonstrated increased tracer uptake along the cortex of the distal femurs bilaterally. There was also low-grade cortical uptake in the mid femur and tibia bilaterally on planar imaging. SPECT/CT was able to improve the specificity of the planar scintigraphic findings, by confirming tracer uptake was localized to the periosteum as expected for hypertrophic pulmonary osteoarthropathy, thereby excluding the presence of skeletal metastases.
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PMID:Hypertrophic pulmonary osteoarthropathy demonstrated on SPECT/CT. 1969 32


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