Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A patient with metastatic osteogenic sarcoma involving the left atrium is described who presented with features of bacterial endocarditis. The source of infection was the adjacent esophagus into which the tumor had eroded. This case demonstrates that sarcomas metastasizing to the heart may result in a clinical condition indistinguishable from infective endocarditis. At post-mortem, careful dissection of cardiac metastases should be undertaken to check for possible esophageal involvement.
 ...
PMID:Metastatic osteogenic sarcoma to the heart presenting as bacterial endocarditis. 836 2

Nineteen patients who had a giant-cell tumor of the pelvis were managed from 1944 through 1989. Thirteen of the patients were in the third or fourth decade of life. The ileum was involved in thirteen patients; the pubis, in two; the ischium, in three; and the pubis and ischium, in one. Five patients who had an initial Stage-II (active) lesion were managed with curettage; in one of the five, a local recurrence developed at twelve months, and the other four had no evidence of disease from nine to forty-six years after the curettage. Eight patients who had a Stage-III (aggressive) lesion were managed with resection of most of the lesion followed by curettage of any remaining positive margins; four of the eight also received adjuvant irradiation. None of the eight had a local recurrence; six had no evidence of disease from eight to twenty-seven years after the operation, one died because of a metastatic post-radiation sarcoma thirteen years after the operation, and one was asymptomatic but had pulmonary metastases three years after the operation. Four patients who had a Stage-III recurrent local tumor when they were first seen were managed with hemipelvectomy, wide resection, resection and curettage, and curettage and arthroplasty (one procedure each). Three had no evidence of disease seven to twenty years after the operation and one had died because of a post-radiation metastatic osteosarcoma eight years after the operation. Two patients who had Stage-III disease were managed with external beam radiation alone. One had no evidence of disease twenty-six years later. The other had a recurrence one year later, which was treated with additional irradiation; a second recurrence was treated with curettage and bone-grafting. Twenty-eight years after the initial radiation treatment, this patient had no evidence of disease. External beam irradiation was used for a total of eight patients; a post-radiation sarcoma developed in two.
 ...
PMID:Treatment of giant-cell tumor of the pelvis. 840 35

A study was undertaken to determine the effect chemotherapy had when used to treat 45 dogs with measurable metastatic osteosarcoma. The primary tumor was histologically confirmed as an osteosarcoma in each case. Thirty-nine dogs had the primary tumor surgically removed. Twenty-four of these dogs were treated adjunctively with cisplatin (70 mg/m2 of body surface, IV, q 3 weeks; median 2 doses, range 1 to 6 doses) prior to the onset of metastasis. The remaining 6 dogs from which the primary tumor was not surgically removed were diagnosed as having metastatic osteosarcoma in addition to the primary tumor on initial examination. The median time from initial examination until the development of metastatic disease was 115 days (range, 27 to 1,199 days). The location of the metastatic disease was lungs (31 dogs), bone (3 dogs), soft tissue (1 dog), and multiple sites including lungs, bone, and soft tissue sites (10 dogs). The metastatic lesions were confirmed by pretreatment biopsy (n = 8) or cytologic evaluation (n = 2) in 10 cases and at necropsy in 27 cases. The remaining 8 cases were diagnosed radiographically as multiple metastatic lesions in the lungs consistent with metastatic osteosarcoma. The metastatic disease was treated with cisplatin in 31 dogs (70 mg/m2, IV, q 3 weeks; median 2 doses, range 1 to 4 doses), doxorubicin in 11 dogs (30 mg/m2, IV, q 3 weeks; median 2 doses, range 1 to 3 doses), and mitoxantrone in 3 dogs (5 mg/m2, IV, q 3 weeks; median 2 doses, range 1 to 3 doses).(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Evaluation of single-agent chemotherapy for treatment of clinically evident osteosarcoma metastases in dogs: 45 cases (1987-1991). 842 42

From September 1986 to September 1990 35 patients affected by osteosarcoma of the extremities with synchronous metastasis were treated with two cycles of high-dose methotrexate IV, cisplatin IA and adriamycin IV followed, in 22, by simultaneous resection of the primary and metastatic tumor. Six patients progressed and were not operated on, 7 patients with complete response of pulmonary nodules underwent surgical resection of the primary lesion. A complete histological examination of the resected specimens was always performed to evaluate the percentage of necrosis produced by chemotherapy on both the primary and metastatic tumor. After surgery the patients received 3 more cycles of the same drugs as used preoperatively plus ifosfamide. The histological response of the primary tumour was "good" (90% or more tumour necrosis) in 8 patients (27%) and "poor" (less than 90% of tumour necrosis) in 21 (73%) while in the 75 metastatic nodules the resulting necrosis was good in 18 (24%) and poor in 57 (74%). A good correlation between the histological response in the primary and metastatic tumour was observed. At an average follow-up of 30 months (R 12-60), 13 patients are alive, 10 disease-free, and 3 with uncontrolled disease. This data suggest that prognosis of osteosarcoma of the extremities with synchronous metastases remains poor even with a very aggressive treatment. Our results also seem to confirm the validity of the present strategy in the treatment of non metastatic osteosarcoma: to introduce new drugs postoperatively in patients poor responder can allows a better treatment of microscopic disease and can improve the prognosis for these patients.
 ...
PMID:[Osteosarcoma of the extremities metastatic at presentation. Results obtained with primary chemotherapy followed by simultaneous resection of the primary and metastatic lesion]. 846 55

The diagnosis of pulmonary intravascular tumor emboli is difficult to establish both clinically and on conventional radiographic studies. Between 1985 and 1991, four cases of pulmonary intravascular metastases were demonstrated on computed tomographic (CT) scans from among 14,000 CT scans of the chest. A retrospective study of these cases was performed, including a review of chest radiographs. All four patients had invasive tumors, including an atrial myxoma, a renal cell carcinoma, an osteosarcoma, and a chondrosarcoma of the pelvis. Three cases had histopathologic documentation of pulmonary artery tumor emboli. At CT, all the patients demonstrated multifocal dilatation and beading of peripheral pulmonary arteries, primarily in a subsegmental distribution involving multiple lobes. Ossification of the pulmonary arteries occurred in one case of metastatic osteosarcoma. In two cases, small, peripheral wedge-shaped opacities distal to some abnormal pulmonary arteries suggested pulmonary infarcts. The finding of dilated and beaded peripheral pulmonary arteries at CT is highly suggestive of metastatic intravascular tumor emboli.
 ...
PMID:Pulmonary intravascular tumor emboli: dilated and beaded peripheral pulmonary arteries at CT. 775 28

To investigate the chance of discovery of metastatic lung tumors and the five-year survival rates of patients undergoing surgical resection, we followed 99 patients who underwent initial surgical treatment at our hospital between 1979 and 1996. With regard to primary organs or sites, 32 patients had rectal cancer, 27 patients had breast cancer, 19 patients had colon cancer and 21 patients had osteosarcoma. For 22 of 99 patients (22%), discovery was due to subjective symptoms such as cough and sputum (n = 12), chest (or back) pain (n = 7) or hemosputum (n = 5). Ten of 19 patients (53%) with colon cancer experienced subjective symptoms which led to the discovery of metastases. In 76 of 99 patients (78%), metastatic lung lesions were not discovered through subjective symptoms. In 63 of those 76 patients, such lesions were initially found by plain chest roentgenography or CT. In 20 of 21 patients (95%) who had osteosarcoma, metastatic lung tumors were discovered by chest roentgenography or CT. In 14 of 76 patients, all of whom had metastatic lung carcinomas, the lesions were discovered through elevated levels of tumor markers. Therefore the importance of periodic chest roentgenography and tumor marker testing was demonstrated. Disease-free interval (DFI) was over six years in five of 32 patients (16%) with rectal cancer and 13 of 27 (48%) with breast cancer. DFI was less than five years for 15 of 19 patients (79%) with colon cancer, and less than two years for 16 of 21 (75%) with osteosarcoma. Thus, DFI differed according to the sites of the tumors. The five-year survival rates of 97 patients were examined. Patients were divided according to the sites of their primary tumors, and then subdivided according to the type of surgery they received. Patients were thus divided into five categories: I) those who underwent incomplete resection of metastatic lung lesions, II) those who underwent complete resection of both pulmonary lesions and involved mediastinal lymph nodes, III) those who had undergone previous treatment for tumors in organs other than the lung, IV) those who underwent complete resection of multiple lung lesions, and V) those who underwent complete resection of solitary lung lesions. For all primary sites, none of the patients in group I) survived for more than two years. Therefore complete resection seems very important for the treatment of metastatic lung tumors. With regard to the other groups, several facts were noted. For rectal cancer, the five-year survival rate of groups V) and III) was 55.6% in either case. Therefore complete resection of rectal cancer metastatic to the lung may improve the five-year survival rate even for patients who have previously been treated for cancers in organs other than the lung. For colon cancer, the five-year survival rate of group V) was 51.4%. Complete resection of only a solitary lung lesion may improve the five-year survival rate for colon cancer. For breast cancer, the five-year survival rate of group V) was 37.5% and that of group II) was 60.0%. This may indicate that for patients who have both pulmonary lesions and mediastinal lymph node involvement, complete resection of both is important. For osteosarcoma the five-year survival rate of group IV) was 26.0%. Thus, osteosarcoma patients have a chance of survival if they undergo complete resection of lung metastases.
 ...
PMID:[Diagnosis and surgical treatment of metastatic lung tumors]. 883 35

A 23-year-old black woman presented with abdominal pain of sudden onset, high fever, chills, and an elevated serum alkaline phosphatase level. Examination revealed a tender abdominopelvic mass consistent with an ovarian mass. Her medical history was significant for an osteosarcoma of the left humerus removed 7 years earlier and excision of multiple pulmonary and chest wall metastases 2 years earlier. Exploratory laparotomy revealed a solid hemorrhagic left ovarian mass and ascites. There was no other evidence of disease. A left salpingo-oophorectomy was performed. Pathological examination of the mass showed metastatic osteosarcoma. Four months later, the patient died of widespread osteosarcoma. The clinicopathologic features of ovarian osteogenic sarcomas reported in the literature are reviewed. Pain, fever, and elevated serum alkaline phosphatase levels may be the presenting clinical features of this rare ovarian tumor.
 ...
PMID:Osteosarcoma metastatic to the ovary: a case report and review of the literature. 898 36

Sarcomas seldom metastasize to the skin. This report describes a rare instance of this phenomenon. A 24-year-old patient with a history of osteosarcoma (osteoblastic type) of the right humerus was seen with a cutaneous nodule on the left temple. Histologic examination of the skin showed the lesion to be a metastatic osteosarcoma. On histologic examination, a proliferation of bizarre mononucleated or multinucleated osteoblastic cells was noted in the dermis and subcutis. Although osteoid formation and calcification were not recognized, as they had been in contrast to the primary lesion, basic structures and components of the skin lesion were identical to those of the primary tumor tissue. Cutaneous metastasis from on osteosarcoma of bone is an extraordinarily rare event and, as far as we can determine, has only been reported three times.
 ...
PMID:Cutaneous metastasis of an osteosarcoma. A case report. 898 39

There are several reports of osteosarcoma metastases to the heart. A rare case of a metastatic osteosarcoma to the endocardium of the left atrium in a 17 year old patient is described. The radiological features are discussed in detail.
 ...
PMID:Metastatic cardiac osteosarcoma--imaging features. 961 48

We investigated predictive factors for local recurrence in 540 patients with non-metastatic osteosarcoma of the extremity treated with surgery and neoadjuvant chemotherapy, between March 1983 and October 1994. The median follow-up was 7.5 (2.5-15) years. Local recurrences developed in 31 (6%) patients after a median time of 2 (0.5-7) years. Local recurrence did not correlate with patients' age and sex, histologic subtype, site and tumor volume, presence of pathologic fracture, chemotherapy regimen and type of surgery. Local recurrence-free survival (LRFS) correlated with the quality of surgical margins and response to chemotherapy: the 7-year LRFS was 97% after adequate surgical margins and 71% after inadequate surgical margins (p < 0.0001), and was 95% in good responders and 90% in poor responders (p = 0.001). Only 1 of 31 patients with local recurrence was free of disease 15 months after the last treatment, 3 were alive with uncontrolled disease and 27 died. This post-relapse outcome is significantly worse than in patients who relapsed with metastases only (25% free of disease, 0.5-9 years after the last treatment). We conclude that, in osteosarcoma of the extremity, limb-salvage procedures should be planned only when the preoperative staging indicates that it is possible to achieve adequate surgical margins. If the pathologic examination of the surgical specimen shows inadequate surgical margins, an immediate amputation should be considered, especially if the histologic response to preoperative chemotherapy was poor.
 ...
PMID:Predictive factors for local recurrence in osteosarcoma: 540 patients with extremity tumors followed for minimum 2.5 years after neoadjuvant chemotherapy. 970 94


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>