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)

Serum thyroxine was significantly higher in 59 patients with hepatocellular carcinoma than in normal subjects, patients with uncomplicated cirrhosis (48), or other primary tumours with or without hepatic metastases (50). Elevated thyroxine levels appeared attributable to high levels of thyroxine binding globulin which showed a positive linear correlation with serum thyroxine in all groups studied. Despite this hyperthyroxinaemia all patients appeared clinically euthyroid and, consistent with this, T3 was elevated in only one patient and the free thyroxine index was normal in all. Amongst a group of 25 cirrhotic patients who were followed-up for between 12 and 72 months, there was a striking dissociation between the TBG values of those destined to develop HCC and those who did not. In the former group TBG rose steadily with time whereas in the latter group levels remained stable, or, more often, fell. The rises in TBG occurred prior to any clinical signs of tumour development and may be one of the earliest serological changes to occur during carcinogenesis in the cirrhotic liver.
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PMID:Hyperthyroxinaemia in hepatocellular carcinoma: relation to thyroid binding globulin in the clinical and preclinical stages of the disease. 283 1

Proton therapy was developed as one of the most promising radiation therapy techniques and it has shown remarkable improvement of the local cure rate of cancer lesions and decrease of late injury. However, cooperation with chemotherapy is to be considered as a reasonable way to further improve the radical cure rate, because the indication of proton therapy is limited to a single primary lesion. Thereupon, combined chemotherapy before or after completion of the proton therapy of the primary lesion to control latent metastases of lung cancer, esophageal cancer, to control multicentric lesions of liver cancer, urinary bladder cancer, or to diminish the size of the lesions with too much volume, could well contribute to improved clinical results.
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PMID:[Cooperation of proton therapy and chemotherapy]. 283 99

Ultrasonographic features of tumor nodules in 64 patients with hepatocellular carcinoma and 87 with metastatic liver cancer were analyzed for differential diagnosis. Sonographic characteristics of hepatocellular carcinoma were the mosaic, posterior echo enhancement, and lateral shadow patterns, which were rarely observed in metastatic liver cancers. Small hepatocellular carcinomas, less than 3 cm in diameter, showed a hypoechoic pattern. Metastatic liver cancers originating from the gastrointestinal tract were frequently hyperechoic irrespective of their size and the bull's-eye-like pattern was specific for metastases from the lung. These results indicate that ultrasonography is useful for the differential diagnosis of hepatocellular carcinoma and metastatic liver cancer.
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PMID:Ultrasonographic differentiation of hepatocellular carcinoma from metastatic liver cancer. 283 56

Between 1977 and 1986, 172 patients with primary hepatic cancer were treated at the Department of Surgery I, University of Vienna Medical School. In 76 cases (80%) males, 20% females), cirrhosis of the liver was also present. Ninety patients underwent curative surgery (hepatic resection in 64, and liver transplantation in 26 cases). There were no early tumor stages. Forty-five large tumors were confined to one lobe, 42 involved both lobes, 3 even invaded adjacent structures, the majority (74%) being hepatocellular carcinomas. Forty-four of the 64 liver resections were performed in patients with otherwise normal livers (mortality 18%), while 20 patients had associated liver cirrhosis. In view of the extremely high mortality rates after extended liver resection, only limited local resections have been performed in cirrhotic malignancies since 1982 (mortality 25%). Perioperative mortality (25% overall) was due mainly to hepatic failure and sepsis; non-fatal complications occurred in 12 patients (26%). Seventeen of the 26 liver transplants were cirrhotic hepatomas. Nine deaths (34%) were caused by technical problems (graft failure, clotting disorder after massive transfusion) and systemic infections. The outcome for the patient after the immediate postoperative period was determined by tumor regrowth (residual liver tissue, graft, distant metastases) in both groups (median life expectancy 18.4 months after radical liver resection and 18.6 months after liver transplantation). Surgery is the only alternative for these patients (50% survival of untreated hepatoma: 2.6 months), improving both their quality of life and survival. We believe that in carefully selected candidates with non-resectable tumors liver replacement may be a useful alternative.
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PMID:Primary hepatic cancer--the role of limited resection and total hepatectomy with orthotopic liver replacement. 285 Sep 84

Metastasis of the cervical spine or pathological fracture respectively presents a demanding therapeutical task. Pain and threatening, neurological deficit require an active action, even if curative treatment is unlikely. The remaining survival time after appearance of osseous metastasis is on the average nine to twelve months and justifies an operation, especially in view of psychosocial consequences for the patient. We are describing the unique case of cervical spinal manifestation after liver transplantation because of primary hepatic cancer.
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PMID:[Occipitocervical fusion in metastasis to the dens]. 285 Dec 3

Serum concentrations of lipids and apolipoprotein A-I, A-II and B were determined in patients with hepatic metastases of colorectal cancer, with primary liver cancer and with cirrhosis. In all three liver diseases, the HDL fraction and apolipoproteins A-I and A-II showed significantly low values, while apolipoprotein B was only increased in hepatic metastases. The decrease of apolipoprotein A-II levels was more prominent in cirrhosis, thereby enhancing the A-I/A-II ratio. This ratio is decreased in metastasis and normal in hepatomas. In patients with hepatic metastases a correlation was observed between alkaline phosphatase and apolipoprotein A-II (p less than 0.05), and between gamma-glutamyltransferase and the A-I/A-II ratio (p less than 0.05). The present work suggests that determination of apolipoproteins and lipids of the HDL fraction offers a new approach to the study of liver diseases.
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PMID:Serum apolipoproteins A-I, A-II and B in hepatic metastases. Comparison with other liver diseases: hepatomas and cirrhosis. 287 62

Twenty-one patients with hepatic hemangioma, five with hepatic cysts, and 25 with primary or metastatic cancer involving the liver were studied by magnetic resonance imaging (MRI). Benign lesions (hemangiomas, cysts) were diagnosed noninvasively by CT, radionuclide studies, and/or sonography and confirmed by follow-up examinations more than 1 year later. Malignant lesions were confirmed by liver biopsy in every case. Identical multisection/multiecho techniques were used in all patients to obtain T1-and T2-weighted spin-echo (SE) and inversion-recovery (IR) images. MRI detected more hemangiomas than any other imaging technique. Of 30 hemangiomas, 25 were spherical or ovoid with a homogeneous appearance and smooth, well defined margins. Cancer tended to have a heterogeneous appearance and poorly defined margins. On T2-weighted SE images obtained with 2000 msec TR and 60, 120, or 180 msec TE, hemangiomas had significantly greater contrast-to-noise ratios (C/N) than liver cancer (p less than 0.001). The SE 2000/120 sequence provided the single most useful image for distinguishing hemangiomas from cancers. When morphologic criteria are used in conjunction with measured C/N, MRI correctly distinguished cavernous hemangiomas from liver cancer with 90% sensitivity, 92% specificity, and an overall accuracy of 90%. Cysts had a low signal intensity on SE 500/30 images and could often be distinguished from hemangiomas and cancers that were nearly isointense relative to liver. IR images were sensitive for lesion detection but provided no tissue-specific information. The data indicate that T2-weighted SE imaging may become the procedure of choice for distinguishing cavernous hemangioma from liver cancer.
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PMID:Magnetic resonance imaging of cavernous hemangioma of the liver: tissue-specific characterization. 299 50

Four hepatocellular cancer patients and 11 metastatic liver cancer patients were treated with intra-hepato-arterial infusions of cis-diamminedichloroplatinum (II) plus 5-fluorouracil. Cis-diamminedichloroplatinum (II) (25-35 mg/m2) was given once a week, 5-fluorouracil (150-180 mg/m2) was infused daily. A partial response was obtained in 3 of 4 patients with primary cancer and in 5 of 9 evaluable metastatic cancer patients; the mean response durations were 27+ weeks in the former and 47+ weeks in the latter. However, severe bone marrow suppression occurred in 4 patients; 3 died of septicemia (2 cases) and massive intra-tracheal bleeding, respectively. This combined intra-hepato-arterial chemotherapy exerts a synergistic anticancer effect on malignant liver tumors, however, the related bone marrow suppression remains to be overcome.
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PMID:Intra-hepato-arterial infusions of cis-diamminedichloroplatinum (II) and 5-fluorouracil clinically effective for malignant liver tumors. 299 30

Seven cases of hepatocellular carcinoma (hepatoma) (HCC) presenting as primary extrahepatic masses on CT are reported. All cases were diagnosed at the time of percutaneous biopsy, surgical resection, or autopsy. In none of the cases was the final diagnosis of HCC prospectively suspected on the basis of clinical and radiologic findings. Although three of the patients were at higher risk for development of HCC because of their medical histories, the absence of an elevated serum alpha-fetoprotein level and the extrahepatic location of the masses by CT suggested other disease. This variable pattern of radiologic presentation of HCC should be kept in mind during the evaluation of patients with suspected HCC, or when the findings on abdominal/pelvic CT of mass and presumed hepatic metastases are at variance with the clinical presentation.
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PMID:Hepatocellular carcinoma presenting as primary extrahepatic mass on CT. 300 40

The liver is a segmental organ that allows resection through anatomically defined planes. The surgical management of an intrahepatic lesion, discovered either during investigation of hepatological symptoms or coincidentally, must involve an approach to investigation that carries a minimum risk and does not compromise subsequent excision of the lesion. Biopsy of an intrahepatic lesion found at laparotomy is essential, but attempts at early tissue diagnosis by percutaneous biopsy of operable tumours may lead to unnecessary morbidity and tumour spread. Preoperative studies often allow a firm pathological diagnosis to be made and ultrasonography, CT scanning and arteriography can be used to fully assess operability. Hepatocellular carcinoma (HCC) is the commonest primary liver cancer and is often found in association with cirrhosis and in patients with inadequate functional hepatic reserve. Surgical excision represents the only hope of cure for these patients and a 35% 5-year survival can be achieved by resection in the non-cirrhotic patient. Fibrolamellar HCC is less often associated with cirrhosis and is more often resectable with a better prognosis. Secondary tumours are often diffuse but about 5% of colorectal metastases are either solitary or confined to a resectable area of the liver. These tumours and secondary deposits from gastrointestinal endocrine tumours represent a small group of patients with potentially curable metastatic disease. Morbidity and mortality of operation depends on the extent of resection and the functional reserve of the liver. Local resections and resection for benign disease should carry no operative mortality. Major hepatic resection has a mortality of 3-5% and resection involving the structures at the hilus of the liver has an operative mortality of 10-12%. Liver transplantation in the management of neoplastic disease in the liver has yet to show any benefit over resectional surgery except where tumours have been discovered incidentally in the removed liver after transplantation for cirrhosis.
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PMID:Surgery of liver tumours. 303 56


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