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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A prospective study was done to assess the effect of embolization on the technical ease of nephrectomy, change in the immunological status of the patient and subsequent behavior of tumors and/or metastases in 55 patients with renal cell carcinoma. We found that embolization makes the operation easier technically. No changes in responses to delayed hypersensitivity skin tests were found after embolization with or without nephrectomy. There may be a response following embolization and adjuvant radical nephrectomy in some patients with limited lung metastases. No significant regression of renal cell carcinoma and/or metastases after embolization alone or with nephrectomy and hormonal/chemotherapeutic treatment was demonstrated. Survival of patients with metastatic renal cell carcinoma was longer for those who underwent embolization and nephrectomy than for those who underwent embolization alone.
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PMID:The role of preoperative embolization in renal cell carcinoma. 670 75

We treated 100 patients with metastatic renal cell carcinoma by angioinfarction of the primary tumor followed by radical nephrectomy. Of the patients 88 also received postoperative parenteral progesterones. We achieved an over-all response rate of 28 per cent (complete regression of all metastatic lesions in 7 patients, regression greater than 50 per cent in 8 and stabilization for at least 1 year in 13). Patients with parenchymal pulmonary metastases only have the best survival rate (64 per cent at 1 year) and are most likely to benefit from angioinfarction and nephrectomy. The presence of hilar or mediastinal adenopathy, pleural effusion or nonpulmonary metastases confers a worse prognosis. These patients do not appear to survive longer with preoperative angioinfarction than if treated by nephrectomy alone. Our data demonstrate that it is critically important to stratify patients by site and volume of disease when results are reported and compared for any patient undergoing treatment for metastatic renal cell carcinoma.
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PMID:Angioinfarction plus nephrectomy for metastatic renal cell carcinoma--an update. 688 54

This is a clinicopathologic study of 17 cases of alveolar soft-part sarcoma of the orbit. The mean age of patients was 23 and the median was 18 (range, 11 months to 69 years); 13 patients (76.5 per cent) were women and four were men (ratio, 3.25:1). The right and left orbits were equally involved (eight patients each), and in one the laterality was not specified. Histologically, the tumors had a distinctive organoid pattern outlined by thin-walled capillaries and were composed of nests of large polyhedral cells with abundant, finely granular, acidophilic cytoplasm. Approximately two thirds of the tumors had diagnostic PAS-positive diastase-resistant crystalline structures. Histologically, the differential diagnosis included nonchromaffin paraganglioma, granular cell tumor, metastatic renal cell carcinoma, vascular tumor, alveolar rhabdomyosarcoma, and amelanotic malignant melanoma. Electron microscopic studies of one tumor disclosed mitochondria with abnormal cristae, increased amounts of glycogen, and cytoplasmic crystalline structures with a periodicity of 8 to 10 nm. Smaller membrane-bound electron-dense granules appeared to be precursors of the crystals. Follow-up studies showed that eight patients were alive and well (median follow-up period, 11.4 years). Six of the eight patients at the time of diagnosis were 20 years of age or younger. A ninth patient was alive and well 13 years after excision of the orbital mass and four years after bilateral thoracotomy with resection of nine pulmonary nodules. Two patients died as a result of metastatic disease, one 14 years and the other 21 years after initial orbital surgery. Two patients died of other causes, one of whom had pulmonary metastases at autopsy. The follow-up period on two recent cases was less than three years, and two patients were lost to follow-up. The disease pursued an indolent clinical course. Surgery offers the best chance to control the disease.
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PMID:Alveolar soft-part sarcoma of the orbit: a clinicopathologic analysis of seventeen cases and a review of the literature. 707 38

At our institution, 3 patients with pulsatile sternal tumor have been seen. Although ascending aortic aneurysm frequently is high on the list of differential diagnoses, the likelihood that this tumor is metastatic from either a primary renal or thyroid neoplasm is overwhelming. Of the 15 patients reported, 11 had metastases from a primary renal cell carcinoma, including all 3 of our patients. There were 2 patients with primary myeloma, the only histologically proved primary pulsatile sternal tumor. From the surgical standpoint, only the patient with metastatic renal cell carcinoma has a chance of cure. With the recent report of 2 5-year survivors and our own experience of 1 patient with a long asymptomatic interval following resection of the primary kidney tumor and the secondary sternal metastasis, the attitude of hopelessness for these patients should be challenged and an aggressive approach considered.
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PMID:Pulsatile sternal tumor: report of three cases and a review of the literature. 721 19

Three cases of metastatic renal cell carcinoma to the ocular structures are presented. Each of these tumors clinically simulated a more common ocular entity, thus causing diagnostic difficulty. The first patient had a metastatic tumor to the eyelid that clinically simulated a large chalazion. The second patient had a choroidal tumor with clinical features and ancillary studies strongly suggestive of a primary choroidal melanoma. The third patient presented with unilateral proptosis secondary to an orbital mass that was clinically believed to be a cavernous hemangioma of the orbit. In each case, there was a long interval between the ocular metastasis, which represented the first sign of metastatic disease.
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PMID:Metastatic renal cell carcinoma to the eye and adnexae: a report of three cases and review of the literature. 732 86

Twenty-five patients with metastatic renal cell carcinoma and ten patients with minimum residual disease, but at high risk of recurrence after surgery, received weekly intradermal injections of purified RNA extracted from lymphoid organs of sheep immunized with human renal cell carcinoma. A retrospective control group consisted of 86 consecutive patients with metastatic renal cell carcinoma from the same institution. Group survival was notable in RNA-treated patients who had multiple metastases limited to the lungs when compared with matched controls. Therapy did not influence the survival of patients with metastases to other sites or with multiple organ involvement. Eight of ten patients with minimum residual disease remained free of recurrence from 16 to 36 months after the initiation of therapy. Toxicity of RNA therapy was minimal. Changes in skin test response to dinitrochlorobenzene and common antigens, and levels of lymphocyte-mediated cytotoxicity and complement-fixing antibody, were primarily related to changes in tumor burden. Immune RNA therapy may be of value in selected patients with metastatic renal cell carcinoma and as adjunctive therapy after definitive surgery.
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PMID:The therapy of renal adenocarcinoma with immune RNA. 735 1

Hundred nine unselected patients with metastatic renal cell carcinoma have been stratified into 3 groups according to their type of metastasis: 17 patients with sceletal involvement only, 67 patients with visceral metastases, and 21 patients with a mixed type of metastasis. Four patients with a locoregional pattern of recurrence were not included in the analysis. The survival data (evaluated by life table analysis and a modified Wilcoxon-Rang-test) revealed a better prognosis for patients presenting exclusively with osseous metastases compared to the group with visceral metastases. The patients with osseous metastases showed a median survival time from diagnosis of 29.9 months compared to 11.6 months in patients with visceral involvement. Considering only patients whose metastases have been detected after a period of latency post nephrectomy, there is a further increase in the survival in favour of the patients with sceletal metastases and the difference to the group with visceral metastases becomes statistically highly significant.
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PMID:[Prognosis of metastatic renal cell carcinoma related to the pattern of metastasis (author's transl)]. 735 67

Although metastatic renal cell carcinoma (RCC) is not uncommon, dissemination to the gallbladder or prostate is very rare. We present 1 case of RCC with synchronous metastasis to the gallbladder and 1 case of RCC with metachronous metastasis to the prostate. These cases illustrate the propensity of RCC for unpredictable presentation and unusual sites of metastases. The first case also illustrates the benefit of adjuvant nephrectomy with excision of a solitary metastasis. Patterns of RCC metastases and flow cytometric analysis of RCC are discussed.
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PMID:Renal cell carcinoma metastatic to the gallbladder or prostate: two case reports. 749 30

A 15-year old male with chronic renal failure secondary to obstructive uropathy received an adult cadaveric donor kidney. Evaluation for painless macroscopic hematuria occurring 2 years after transplantation disclosed a metastatic renal cell carcinoma, which by the use of restriction fragment length polymorphism analysis was shown to be of the donor's origin. Transplant nephrectomy and cessation of immunosuppressive therapy resulted in complete regression of multiple pulmonary metastases.
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PMID:Metastatic renal carcinoma in a pediatric recipient of an adult cadaveric donor kidney. 750 73

Cytokine therapy of metastatic renal cell carcinoma reveals a remission rate of about 25% regarding to the different patients selection criteria, i.e. age, performance status, site of metastasis, tumour load. Remission is not correlated to patient's survival. Adjuvant or neoadjuvant immunotherapy is not a treatment option. Nephrectomy has no influence on distant metastases and should be limited to symptomatic primary tumours. In conclusion, cytokine therapy is not a standard treatment. Its value has to be evaluated in randomized trials.
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PMID:[Cytokine therapy of metastatic renal cell carcinoma]. 761 May 12


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