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

The clinical and pathologic features of 14 children with rhabdoid tumors are presented. Eight patients had primary renal neoplasms and six had extrarenal tumors. The eight renal rhabdoid tumors were identified among 514 primary renal neoplasms collected at four pediatric institutions. Six patients were under 1 year of age; five children died of tumor-related causes, four of them within 4 months of diagnosis and one 17 months postnephrectomy. Another patient died of sepsis 12 days postnephrectomy. One is alive 13 months postnephrectomy, and one was lost to follow-up evaluation. The most common sites of metastasis were the lymph nodes (seven children) and the lungs (three patients). Three infants with renal rhabdoid tumors had, in addition, intracranial masses, two of which manifested clinically before the detection of the renal tumors, in one confirmed to be a primitive neuroectodermal tumor. Five of the 6 extrarenal tumors were identified among 155,926 surgical pathology specimens examined in the same children's hospitals over the same period of time; the remaining extrarenal rhabdoid tumor was received in consultation from a community hospital. The extrarenal rhabdoid tumors occurred in the dorsum of the right foot, liver, soft tissue of the right chest wall, left temporal lobe, left leg, and left thoracic paraspinal region. The ages ranged from 6 weeks to 15 years and two months. Three patients died of tumor-related causes within 4 months of diagnosis; one was a term stillborn. Two are alive, 1 month and 70 months postdiagnosis. Common sites for metastases included the lungs (three patients), and liver and lymph nodes (two children each). Patients with renal and extrarenal rhabdoid tumors are of similar age, have a similar clinical course, with early metastases and poor response to therapy. Primitive neuroectodermal intracranial tumors have been identified in several reported patients with renal rhabdoid tumors; similar brain tumors have not been documented in patients with extrarenal rhabdoid tumors. The histogenesis of this tumor remains unknown.
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PMID:Renal and extrarenal rhabdoid tumors in children: a clinicopathologic study of 14 patients. 361 19

A prospective, blinded comparison of three methods of hepatic contrast enhancement in computed tomography (CT) was conducted in 15 patients with colorectal carcinoma metastatic to the liver. Arterial portography (AP-CT) was performed with injection of contrast material into the superior mesenteric artery during CT. Delayed scanning (DS-CT) was performed 4 hours after intravascular administration of contrast material (mean dose, 280 mL). CT with an ethiodized oil emulsion (EOE-CT) was performed 1 hour after slow intravenous infusion of the emulsion. All patients underwent laparotomy following imaging studies. A lesion-by-lesion analysis of 56 metastases showed no significant differences in sensitivity (AP-CT, 77%; DS-CT, 83%; EOE-CT, 82%), but the false-positive rate for AP-CT was significantly higher than that for DS-CT (P less than .001) or EOE-CT (P less than .01). False-positive rates for EOE-CT and DS-CT were not significantly different. The predictive value of a positive test was 63% for AP-CT, 90% for DS-CT, and 81% for EOE-CT. AP-CT does not appear to be clinically useful for detection of hepatic metastases because of the high false-positive rate. No difference could be demonstrated between DS-CT and EOE-CT. DS-CT is a valuable method for hepatic contrast enhancement.
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PMID:Hepatic metastasis detection: comparison of three CT contrast enhancement methods. 368 61

Twenty patients with known liver metastases were evaluated by unenhanced computed tomography (CT), scans enhanced with ethiodized oil emulsion-13 (EOE-13), and magnetic resonance (MR) imaging with three pulse sequences. Spin-echo (SE) 300/26 (repetition time/echo time, in msec) images prospectively demonstrated 95.4% of the detectable liver metastases; inversion recovery (IR) 1,500/100 (repetition time/inversion time, in msec) images revealed 90.8%; and EOE-13-enhanced CT scans showed 87.1%. SE 2,000/80 images showed 51.4%, and unenhanced CT scans 49.6%, of the metastases. The relationship of vascular anatomy to metastatic foci was best seen on SE 300/26 images and EOE-CT scans. SE 300/26, IR 1,500/100, and EOE-CT studies particularly improved detection of lesions in the 1-2-cm range compared with SE 2,000/80 imaging or unenhanced CT scanning. SE 300/26 and IR 1,500/100 sequences appear comparable to EOE-CT scans in demonstrating liver metastases and significantly superior to conventional CT scans. Because EOE-13 is generally not available, these MR sequences should be the procedure of choice for the diagnosis of liver metastases.
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PMID:Liver metastasis detection: comparative sensitivities of MR imaging and CT scanning. 378 86

Twelve consecutive children with primitive neuroectodermal tumors of the posterior fossa (PNET-PF) were evaluated for spinal metastases with CT metrizamide myelography (CTMM) in the early postoperative period. Metastases were identified in 5 children (42%) and all were noted to have deposits in the thoracic region. All children with metastases were less than 3 years old and had differentiated PNET-PF.
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PMID:Spinal metastasis in primitive neuroectodermal tumors (medulloblastoma) of the posterior fossa: evaluation with CT myelography and correlation with patient age and tumor differentiation. 384 59

Cerebrospinal fluid (CSF) polyamine levels were analyzed retrospectively in 21 pediatric patients with different types of intracranial malignant tumors to determine the benefit of following these markers during the clinical management of brain tumors. The tumors included 16 medulloblastomas and 1 each of germinoma, ependymoma, primitive neuroectodermal tumor, astrocytoma, and malignant teratoma. The clinical course of each patient was followed by neurologic examination, cranial computed tomography, CSF cell count, and cytology after cytocentrifugation. The correlation of CSF putrescine and spermidine levels with the clinical course of the brain tumors was analyzed. The following results were obtained: (1) A significant increase in CSF putrescine levels was observed in children with medulloblastoma when there was recurrent or metastatic disease in the sites close to the CSF pathway compared with the children whose disease status was stable after successful treatment (P less than 0.005). (2) The increase of CSF putrescine levels was the earliest predictor of recurrence or metastasis near the CSF pathway. (3) In tumors other than medulloblastoma, the levels of polyamines were not predictive of disease activity with the possible exception of germinoma. (4) Spermidine levels in the CSF were of limited clinical importance for patients with brain tumors. CSF putrescine levels may be the earliest and most sensitive quantitative marker of the progression of medulloblastoma, and their evaluation should be included in the diagnostic work-up and follow-up examination of children with medulloblastoma.
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PMID:Evaluation of polyamine levels in cerebrospinal fluid of children with brain tumors. 395 78

A prospective study of computerized tomography (CT) of the liver using a liver contrast agent compared to conventional CT was undertaken. CT scanning without contrast agents (NC-CT), CT with water-soluble contrast (WSC-CT), and CT with ethiodized oil emulsion (EOE-CT) were performed on patients with possible or probable hepatic metastases. The findings on these three examinations were compared to the objective findings at surgery in 53 patients. Accuracy of these examinations was 80.7% for NC-CT, 77.1% for WSC-CT, and 84.9% for EOE-CT. The true-positive percentage for 129 hepatic lesions was 40.6% for the NC-CT, 33.6% for WSC-CT, and 76.7% for the EOE-CT. Eighty-three percent (44/53) of 1- to 2-cm liver lesions were detected by EOE-CT, whereas only 26.4% (14/53) lesions of this size were detected by the NC-CT and 20.4% (10/49) shown by WSC-CT. The likelihood that a lesion seen by CT scan was malignant was 84.6% for NC-CT, 89.4% for WSC-CT, and 81.8% for EOE-CT. The EOE contrast agent improves the sensitivity of liver CT for detecting hepatic metastases. The improvement occurs with lesions 1 cm and greater in diameter, but is particularly striking for lesions of 1 to 2 cm in diameter.
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PMID:Improved detection of focal lesions with computerized tomographic examination of the liver using ethiodized oil emulsion (EOE-13) liver contrast. 608 90

More specific therapy can be achieved for brain tumors by identifying morphologic markers like primitive neuroectodermal tumor cells that tend to be radioresponsive and spread diffusely through the cerebrospinal fluid (CSF). Utilizing clinical manifestations to suspect and then localize the brain tumor, morphologic markers, that can be appreciated with computerized tomography and cerebral angiography as well as at operation, provide a basis for more aggressive extirpation and the usefulness of radiation and chemotherapy. Metastatic neoplasms possess such markers as tumor hemorrhage and meningeal involvement suggesting specific extraneural sources. In almost half of these patients, cytologic examination of the CSF should help to identify the malignant cells. Although most gliomas do not metastasize either within or outside the central nervous system, the occurrence of primitive neuroectodermal tumor cells (undifferentiated malignant small cells) in about 20% of all glioblastomas implies spread throughout the CSF and some radioresponsiveness. With thorough clinicomorphologic evaluations of all patients with brain tumors in concert with liberal clinical consultations, the aggressive, newer therapeutic modalities can be used more effectively.
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PMID:Clinicomorphologic markers for predicting behavior and guiding therapy for brain tumors. 624 79

Primitive neuroectodermal tumors are rare cerebral neoplasms previously described only in children and young adults. This report describes such a tumor arising in the left frontal lobe of a 57-year-old man. After surgical resection and radiation therapy to the primary site, the patient developed extensive central nervous system metastases that led to his death. The histopathologic, radiographic, and clinical features of this case suggest that future therapeutic protocols for primitive neuroectodermal tumor should be similar to those for childhood medulloblastoma or neuroblastoma.
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PMID:Primitive neuroectodermal tumor in a 57-year-old man. 630 52

The neuroradiological findings in four cases of primitive neuroectodermal tumor of the cerebrum are described. These highly malignant neoplasms of childhood present as large, enhancing cerebral masses with extensive neovascularity. Cerebrospinal fluid seeding is common and distant extraneural metastases may occur.
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PMID:Neuroradiology of primitive neuroectodermal tumors. 630 99

Accurate detection of hepatic metastases is necessary to properly stage and follow many malignancies. Nineteen patients underwent computed tomographic (CT) examination with ethiodized oil emulsion 13 (EOE-CT) and liver scintigraphy within 1 month of an exploratory laparotomy. The sensitivity, specificity, and accuracy of these two imaging procedures were evaluated statistically. No differences were seen when the patients were scored as positive or negative for metastases. However, in a lesion-by-lesion analysis of 58 hepatic lesions, the sensitivity of EOE-CT was 69.0% and the sensitivity of scintigraphy was 32.8% (p less than 0.001). All lesions detected scintigraphy were also detected by EOE-CT. EOE-CT had a size threshold of 1.0-1.5 cm, while liver scintigraphy had a threshold of 2.5-3.0 cm. EOE-CT is a more sensitive examination for detection of small hepatic metastases than liver scintigraphy.
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PMID:Detection of hepatic metastases: comparison of EOE-13 computed tomography and scintigraphy. 631 88


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