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)

Cerebral metastases are the most common intracranial tumors next to the malignant glioblastoma multiforme. The clinical aspects are described in summary with reference to 191 cases. At least 1/3 of the cerebral metastases are already multiple on diagnosis. The daughter tumors most frequently colonize in the cerebrum - in the centroparietal region in particular - and much more seldom in the cerebellum. Bronchial and mammary carcinomata are the most important primary tumors; melanomas and hypernephromas come next in frequency. The primary tumor escapes clinical detection relatively frequently. The first symptoms are most frequently signs of cerebral pressure. Of the local symptoms of cerebral metastases, the hemi-syndrome occupies first place.
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PMID:[Clinical aspects of cerebral metastases (author's transl)]. 80 34

A 3-year-old boy presented with multiple brain metastases 21 months after the resection of stage II Wilms' tumor. Metastasis to other organs was not found. He was treated by total removal of a large metastatic tumor in the left temporal lobe and post-operative radiotherapy and chemotherapy. He has been in complete remission for 20 months after surgery. Cerebral metastasis from Wilms' tumor without systemic metastases is very rare. It is speculated that brain metastases occurred in this patient because most of the anticancer agents used in the primary treatment for Wilms' tumor were not able to cross the blood brain barrier.
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PMID:[Brain metastases from Wilms' tumor without systemic involvement--a case report and review]. 133 62

A retrospective study was undertaken of factors affecting survival in 129 patients with cerebral metastases from malignant melanoma referred to the Department of Radiation Oncology from June 1982 to January 1990. Their ages ranged from 19 to 83 years and the time interval from diagnosis of the primary tumour to development of cerebral metastases ranged from one month to 17 years. Cerebral metastases were apparently solitary in 59 (46%) and multiple in 70 (54%) patients respectively. Craniotomy with resection of tumour was performed in 49 patients, of whom 24 had a solitary cerebral metastasis as the only evidence of disease. Most patients (94%) received a course of radiotherapy. Median survival of the whole group after detection of cerebral metastases was 5 months (range less than 1-87+). Univariate analysis indicated that a solitary cerebral metastasis, absence of extracranial disease and tumour resection predicted improved survival, but only surgical intervention was of independent prognostic significance in a multivariate analysis. The effect of cranial irradiation on survival could not be assessed, but the dose of radiation did not influence survival. Of the 10 patients who survived for more than 2 years, eight had total resection of a solitary cerebral metastasis.
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PMID:Cerebral metastases from malignant melanoma. 157 97

Cerebral metastasis is a common manifestation of lung cancer. Presenting signs and symptoms are often grave, and consequently often result in patients being debilitated for the rest of their lives. Radiotherapy has been used to treat a majority of these cases, and is considered as the treatment of choice. At Mackay Memorial Hospital, we collected from 1982 to 1985, the records of 42 lung cancer patients with brain metastasis. All the cases had a histological diagnosis of primary lung cancer; most of them were squamous cell carcinoma and adenocarcinoma; only two cases were small cell carcinoma. The diagnosis of brain metastasis was established by computed tomographic scans of the brain and radioisotopic brain scans. Of the 42 cases, 22 received palliative radiotherapy from a cobalt-60 teletherapy machine to the whole brain for a total dose of 30 Gray (Gy) in 10-15 fractions over a time span of 2 to 3 weeks, while the remaining patients only received medical treatment (e.g. cranial decompression with mannitol, steroids, etc.). Most of the patients have already died. In our study, those who received radiotherapy attained considerable palliation of their symptoms and signs, including improvement of their general performance status and neurological function. Although the treatment did not prolong the patient's survival, it did decrease considerably the disability caused by the metastatic disease.
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PMID:Palliative radiotherapy of cerebral metastasis from lung cancer. 169 12

Cerebral metastases of malignant melanoma are correlated with a very poor prognosis. Surgery of an isolated metastase can lead to a long survival but the brain lesions are frequently numerous and associated with an extracerebral diffusion. Dacarbazine (DTIC) gives a mean response rate of 21% on visceral localisations but doesn't cross the blood brain barrier (BBB). Neither do the biological response modifiers like Interleukin 2 (Il2) that leads to 25% response rate in disseminated melanoma. Nitrosoureas like carmustine (BCNU) and semustine (CCNU) have been investigated in different non randomised studies and the clinical results didn't illustrate their theorical ability to cross the BBB. Radiotherapy is also used as a palliative therapy with 7 to 16 weeks survival. Fotemustine (muphoran), a new amino acid linked nitrosourea, can give a response rate up to 28.2% in patients with cerebral metastases and the increased survival of responding patients is significant. The availability of this new drug may suggest associations with surgery and radiotherapy in the future to improve the survival of such patients.
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PMID:[Brain metastases of malignant melanomas]. 185 2

Radiosurgery is becoming more generally available and indications for its use continue to be defined. Cerebral metastases from malignant melanoma are often treated with whole-brain irradiation, but with limited benefit. Innovative treatments, such as radiosurgery, make possible the delivery of doses of radiation that are higher than usual. To determine how many patients might be candidates for radiosurgery, a retrospective analysis of computed tomographic brain scans performed on 41 patients with cerebral metastases from malignant melanoma was undertaken. One-third of these patients were found to have cerebral metastases amenable to a radiosurgical approach, as illustrated radiation dose-volume histograms. Patient and tumor characteristics suggest that this series is represent with cerebral metastases from malignant melanoma. The implications of radiosurgery for normal tissue radiation tolerance and its effects on melanoma are discussed.
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PMID:Disposition of cerebral metastases from malignant melanoma: implications for radiosurgery. 189 80

A woman aged 52 was treated with radioactive iodine for a papillary carcinoma of the thyroid. Four years later she developed signs and symptoms of an intracranial space occupying lesion. A computed tomographic scan showed a mass in the right posterior frontal region. Although she was suspected of having metastatic disease a definite diagnosis was not established until she died 6 months later when post-mortem examination confirmed that she had a cerebral metastasis from a papillary carcinoma of the thyroid. There was no evidence of metastatic disease elsewhere in the body. Cerebral metastases from papillary carcinoma of the thyroid are uncommon but may occur in patients who have metastases in bones or lungs. A search of the literature has revealed only two patients with solitary cerebral metastases.
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PMID:Solitary cerebral metastasis from a papillary carcinoma of the thyroid. 234 83

The records of 610 consecutive patients with small cell lung cancer, treated on a common protocol in a multicentre trial, were reviewed and 24 (4%) cases of spinal cord compression identified. Five hundred patients had isotope bone scans performed at presentation, and in 131 (26%) there was abnormal isotope uptake in the spinal column; only 7% of these patients developed spinal cord compression. However, of the 24 patients who presented with back pain and had a positive bone scan affecting the spine, 36% developed cord compression. Cerebral metastases occurred at some stage in 19.5% of all patients and in 45% of patients with cord compression. The combination of cerebral metastases and a positive bone scan gave a 25% chance of developing spinal cord compression. There were two distinct forms of clinical presentation. Six patients (group A) presented with cord compression: All had back pain and positive bone scans, five out of six had sphincter disturbance, and median survival from cord compression was 30 weeks. Eighteen patients (group B) developed cord compression while on treatment: 28% had positive initial bone scans, 44% back pain and 61% sphincter disturbance, and median survival from cord compression was 4 weeks. Spinal cord compression is an important cause of morbidity and mortality in small cell lung cancer. We suggest that it may be possible to select patients who should receive radiotherapy to the spine to try to prevent the development of this complication.
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PMID:Spinal cord compression in small cell lung cancer: a retrospective study of 610 patients. 254 Jul 90

Fifty-six patients presenting with symptomatic brain metastasis but undiagnosed primary neoplasm were retrospectively studied. Metastases were almost equally solitary (57%) as multiple (43%), and 30% were cerebellar. Cerebral metastases were most often parietal (67%). Underlying cancers were diagnosed in 84% of patients, usually before death, with the remainder having equivocal or unknown primary cancers. Lung cancer was most common (68%), especially adenocarcinoma or small ("oat")-cell types, followed by gastrointestinal primary cancers (9%), cancers of the bladder and thyroid (2% each), melanoma (2%), and lymphoma (2%). Breast cancer was remarkably absent, perhaps due to its greater systemic involvement prior to brain metastasis, or its earlier detection on physical examination. Overall group survival rates were 55% (6 months) and 13% (12 months), and cerebellar and noncerebellar metastases had the same survival rate at 12 months. The diagnostic evaluation of these patients, often extensive and costly, should be individually tailored, as 23% had complaints or findings indicative of their underlying primary cancer. Overall, chest roentgenograms and computed tomograms of the chest were the tests of greatest yield, followed by computed tomograms of the abdomen and pelvis. A rationale for evaluation is presented.
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PMID:Brain metastases from undiagnosed systemic neoplasms. 271 1

Cerebral metastases are considered an uncommon complication of ovarian carcinoma. In a series of 52 patients treated with platinum, Adriamycin, and cyclophosphamide combination chemotherapy, 6 patients developed cerebral metastases, an incidence (11.6%) higher than that reported by others. The median age of the patients with cerebral metastases was similar to that of patients without this complication. Cerebral metastases occurred as site of first relapse in three of six patients. Only one patient had extraperitoneal disease prior to chemotherapy and four of the six patients had attained a complete response following chemotherapy. Cerebral relapse occurred at 0, 21, 27, 30, 34, and 36 months from original diagnosis of ovarian carcinoma and 0, 9, 11, 19, 25 and 29 months following first treatment with combination chemotherapy. The median survival was 33 months from diagnosis and 28.5 months from first treatment with chemotherapy. This compares with a median survival from diagnosis for the entire series of 30 months (28 months from first treatment). The result of treatment of established metastases was poor. Survival from diagnosis of cerebral metastases was 2, 2, 3, 6, 10, and 41 + months. If other series confirm these findings consideration may need to be given to prophylactic central nervous system radiotherapy for patients achieving complete remission after systemic chemotherapy.
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PMID:Cerebral metastases in patients with ovarian cancer treated with chemotherapy. 272 52


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