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 values of alpha-fetoprotein (AFP) and human chorionic gonadotrophin (HCG) have been used to monitor disseminated testicular carcinoma. Serial measurements of these markers have been used to monitor the response to therapy, to follow the progress of disease, and to detect subclinical recurrences. With increasingly effective chemotherapy for systemic disease, central nervous system (CNS) metastases in testicular carcinoma are becoming increasingly important as a cause of treatment failure. Cerebrospinal fluid (CSF) values of AFP and HCG seem to be important ancillary acids in the neurosurgical management of CNS metastases from testicular cancer. Our preliminary experience with three cases suggests that these CSF markers (plus computerized tomograhic scanning) should be evaluated in patients with this disease.
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PMID:Cerebrospinal fluid markers in central nervous system metastases from testicular carcinoma. 8 23

The value of lymphography and CT in the diagnosis of abdominal lymph node metastases was compared in 82 patients with various types of malignant disease. In the presence of systemic disease or testicular tumours, CT increased the recognition of lymph node metastases and their extent, particularly of high para-aortic deposits which were frequently underestimated by lymphography. Lymph nodes in the pelvis are more easily identified. CT is the first choice for the investigation of systemic disease and testicular tumours. This will, in addition, also demonstrate abnormalities of the organs and assist in radiation planning. CT is a simple procedure which is also very valuable in following the effect of treatment. For metastases from other origins, lymphography is often more valuable since CT is unable to identify metastases in lymph nodes if these are not enlarged. The two methods complement each other and their combination provides improved diagnostic information.
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PMID:[Lymph node metastases--diagnosis by lymphography and CT (author's transl)]. 15 75

Periosteal reaction is frequently the first sign of systemic disease affecting the skeleton, including generalized osteopathia. It can be generalized, focal, monostotic or polyostotic and shows solid, lamellary or interrrupted spiculae-like reaction. A reliable diagnosis is possible from the interpretation of these changes, as for instance with spiculae: Very dense and evenly arranged spiculae are only seen in hemolytic anemias and metastases of neurogenic tumors. Onionskin like periosteal reaction with simultaneous transformation of the diaphyseal cortex are difficult to interpret. However, in case of hyperparathyreoidism, subperiosteal resorption and transformation of the diaphyseal cortex permit precise diagnosis. Follow-up examinations have prognostic and therapeutic value. The knowledge of the different morphology of periosteal reaction associated with systemic disease (including generalized osteopathias) is important in diagnostic radiology.
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PMID:[Radiographic findings of periosteal reactions in systemic bone disorders (author's transl)]. 22 45

Eighty-seven patients with recurrent breast cancer after mastectomy were analyzed for patterns of recurrence and methods of detection. After an average disease-free interval of 30 months, 38% developed osseous metastases, 16% recurred locally, 10% had local plus systemic disease, 10% showed pulmonary metastases and the remainder were distributed among liver, brain, and remaining breast disease. In 79 patients recurrence was heralded by symptoms. Physical examination in five asymptomatic patients revealed local or supraclavicular recurrence. In only three asymptomatic patients was recurrence documented by "routine" chest x-rays (in two), or liver enzymes/liver scan (in one). No asymptomatic disease was found by bone scan. It is concluded that periodic history, physical examination, and chest x-rays are the most important components in the follow-up of breast cancer patients. Radioisotope scans and other radiographs are valuable in confirming symptomatic disease and detecting additional diseases, but cannot be recommended routinely in the asymptomatic patient because of low yield and cost.
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PMID:Symptomatology as an indicator of recurrent or metastatic breast cancer. 42 36

Four patients with primary reticulum-cell sarcoma of the cervix were described. One patient was treated with radical hysterectomy and lymphadenectomy. The pelvic lymph nodes contained metastatic cancer and the patient died shortly after disseminating disease. The other three patients were treated with external radiation and vaginal and intrauterine radium application. The complete work-up failed to reveal cancer outside the pelvis or evidence of systemic disease. Two of these patients had an exploratory laparotomy with biopsies of pelvis and para-aortic lymph nodes and of the liver. One of these patients had a splenectomy, with no evidence of disease. Both patients are alive with no evidence of disease 3 and 10 years after their treatment. The third patient treated by radiation therapy died 2 years later with no evidence of disease. The importance of complete staging work-up and the advantage of radiation therapy in the treatment of reticulum-cell sarcoma of the cervix is emphasized.
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PMID:Reticulum-cell sarcoma of the cervix. 77 75

Epidermoid carcinoma of the cervix was treated in 120 patients by means of exploratory celiotomy (with semitherapeutic excision of involved lymph nodes) followed by irradiation. The size of the field used for irradiation was determined by the presence and site of lymph involvement. Of 64 patients, metastatic cancer in pelvic nodes was found in 40, and in common iliac or aortic nodes in 24. Of the 2 groups, 8 and 3 patients, respectively, survived for 2 years or more. Irradiation to extended fields (using 5500 rads at 850 rads per week) controlled the cancer satisfactorily within the treated area, but the incidence of bowel complications was high. Recurrent carcinoma usually appeared as distant metastases outside the treatment area which suggests that patients with bulky primary lesions and positive nodes actually already have systemic disease as treatment is started. A safe yet effective dosage level for radiation therapy to extended fields has not yet been established.
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PMID:Preirradiation celiotomy and extended field irradiation for invasive carcinoma of the cervix. 84 Apr 62

From 1969-1974 1000 unselected enucleated globes have been examined histopathologically. 277 derive from the University Eye Hospital in Hamburg, 723 from various Eye Hospitals in northern and southern Germany. They originate from 589 men and 408 women, three times the sex was unknown. 86 globes had to be removed from children less than 15 years old. 6 groups of etiologies have been distinguished: trauma (308), histologically confirmed neoplastic disease (281), ocular manifestations of systemic diseases (diabetes mellitus, occlusions of central retinal vessels presumably following generalized vascular disease etc.: 128), "operative ocular disease" (164), primary inflammatory disease (71), miscellaneous (malformations, high myopia, pseudo-glioma and pseudo-melanoma: 48). The etiology "operative ocular disease" consists of 67 primary glaucomas (57 adults, 10 buphthalmus), 41 idiopathic cataracts (7 of these congenital) and 3 primary corneal dystrophies, as well as 53 cases of primary retinal detachment. Among the 281 neoplastic diseases, there are 238 primary intraocular malignant melanomas of the uvea, 18 retinoblastomas, 4 primary reticulumcellsarcomas of the retina, 2 choroidal nevi, 10 intraocular metastases and 9 orbital tumors. 16 enucleations among the 1000 enucleations have been performed for pseudo-gliomas (5 x Coats disease, 5 x persistent primary hyperplastic vitreous, 2 x retrolental fibroplasia, others 4 x). The manifestations of systemic disease are consisting of 68 central retinal vein-occlusions, 30 complications of diabetes mellitus and 10 central retinal artery occlusions as well as 20 other generalized diseases. A primary inflammatory disease led to enucleation 50 times due to an intraocular process, 5 times due to scleritis and 18 times as a consequence of keratitis (including 13 times herpes simplex). As the final clinical cause for enucleation the following categories have been elaborated: secondary glaucomas (416), clinical diagnosis of "tumor" (275), atrophy and phthisis bulbi (118), inflammation (112), acute trauma to 4 weeks after the accident (72), others (7). In conclusion the central role of rubeosis iridis leading to secondary angle closure glaucoma is emphasized. This process presents a challenge to ophthalmologic research. Finally the significance of early surgery for primary angle closure glaucomas and for complete restoration of the anterior chamber after trauma and any intraocular procedure is stressed.
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PMID:[Etiology and final clinical cause for 1000 enucleations. (A clinico-pathologic study) (author's transl)]. 95 59

Splenic metastasis is a late manifestation of disseminated disease. Focal metastatic splenic involvement, however, without evidence of additional systemic disease, is unique. Review of the literature yielded only one case of isolated splenic metastasis incidental to rectal carcinoma. We have reported an additional case of isolated solitary splenic metastasis from primary adenocarcinoma of the rectum. Theoretically, certain anatomic, histologic, and functional splenic attributes may limit splenic involvement from metastatic disease.
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PMID:Isolated splenic metastasis from rectal carcinoma. 141 16

Ependymomas, glial neoplasms usually arising in the posterior fossa or spinal cord, rarely metastasize outside the central nervous system. We have reviewed all 81 ependymomas evaluated at MSKCC between 1956-1989. Five (6.2%) had extraneural metastases (ENM). The primary tumor was in spinal cord in 3 patients and the cerebral hemisphere in 2. Two tumors were histologically anaplastic; 3 were histologically benign. The 5 patients were 3, 3, 3.5, 16 and 37 years old. Time from initial diagnosis to development of ENM was 0, 15, 35, 40, and 288 months. At the time of ENM the primary tumor was progressing in 4/5 patients. Prior therapy had included resection plus radiation therapy (RT) (1), RT plus chemotherapy (1), resection plus RT plus chemotherapy (2). One patient had not received prior therapy because ENM were present at diagnosis. The sites of ENM included lung and thoracic lymph nodes (2), pleura and peritoneum (2), and liver (1). Both patients with peritoneal ENM had had ventriculoperitoneal shunts. ENM did not correlate with histologic grade, age, or degree of surgical resection. When patients with ependymoma develop signs or symptoms of systemic disease such as abdominal pain, cough, or adenopathy, ENM should be considered.
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PMID:Extraneural metastases in ependymoma. 143 36

Recent literature has confirmed patient age, Karnofsky status, and the extent of extracerebral tumor as independent prognostic variables in patients with cerebral metastases. In a good-risk population, surgery followed by radiation therapy is superior to radiation alone for treatment of patients with solitary metastases. Stereotactic radiosurgery is feasible in the same select patient population, but questions regarding the extent of delayed toxicity, tumor response, and the impact on quality of life and longevity remain to be answered. Studies of external beam radiation therapy for patients with brain metastases have shown that 1) misonidazole does not improve the response rate, quality of life, or duration of survival, 2) 5 Gy for six fractions and 3 Gy for 10 fractions produce similar results, and 3) reirradiation at doses of 25 Gy for tumors progressing after initial radiation may be feasible in a selected population of patients. Chemotherapy can affect regression of brain metastases in patients with small cell lung and breast carcinoma, as well as melanoma, but the overall contribution to the quality and duration of the patient's life compared with radiation alone is unknown. Intracarotid chemotherapy is feasible for patients with brain metastases, but substantial toxicity precludes its use outside of an investigational setting. Brain metastases remain an important cause of morbidity and mortality for patients with cancer, but the majority of patients still succumb to widespread systemic disease. The goal of treatment of brain metastases should be palliation with minimal infringement upon the patient's quality of life.
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PMID:Surgery, radiation therapy, and chemotherapy for metastatic tumors to the brain. 149 61


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