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)

We report our experience with the management of 7 primary nonrenal parenchymal malignancies with vena caval tumor thrombus. Included are 3 cases of adrenal cortical carcinoma and 1 each of transitional cell carcinoma, embryonal cell testicular carcinoma, pheochromocytoma and primary small cell carcinoma of the lung with metastases to the kidney. Surgical treatment and followup are presented, as well as a review of the literature. An aggressive surgical approach is warranted because prolonged survivals free of disease are possible.
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PMID:Management of primary nonrenal parenchymal malignancies with vena caval thrombus. 198 10

At the time of initial diagnosis, testicular malignancy is usually limited to the testicle and infradiaphragmatic lymph nodes. Metastases initially follow the retroperitoneal lymph channels and subsequently extend to the supradiphragmatic lymph nodes in the mediastinum and supraclavicular fossa. Testicular metastases to the pericardium are rare and usually asymptomatic. These lesions are most commonly identified at autopsy; therefore, the actual incidence is unknown. The authors report a 32-year-old man with testicular carcinoma, who developed asymptomatic pericardial metastases without concomitant supradiaphragmatic nodal or pulmonary metastases. They review the efficacy of echocardiography in diagnosis and follow up or pericardial metastasis.
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PMID:Pericardial metastasis from testicular seminoma: appearance and disappearance by echocardiography. 200 Aug 90

Computed tomography (CT) is clearly more sensitive than chest radiography or conventional linear tomography in the detection of pulmonary metastases. Routine chest CT scans may reveal peripheral nodules as small as 2-3 mm, and high-resolution CT may demonstrate lymphangitic carcinomatosis. Specificity remains a problem, but attention to clinical factors, such as the type of extrathoracic malignancy (ETM), epidemiology, patient age, and prior treatment, should be of assistance. CT is useful in the evaluation of an apparent solitary pulmonary nodule or an equivocal radiographic finding. For single or multiple nodules, CT is essential for planning invasive procedures such as biopsy or surgical resection. Routine CT scanning to screen for occult metastases is indicated only for patients with ETMs that have a high propensity for metastasizing to the lungs and for which detection of pulmonary metastases would influence therapy--bone and soft-tissue sarcomas, most pediatric tumors, choriocarcinoma, nonseminomatous testicular carcinoma, and possibly advanced melanoma. Future large prospective studies evaluating individual malignancies are needed to assess the impact on long-term survival of early detection of pulmonary metastases with CT.
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PMID:CT evaluation for pulmonary metastases in patients with extrathoracic malignancy. 205 72

Improvements in operative technique and perioperative management have expanded the application of hepatic resection for metastatic cancer. Although a policy of aggressive surgical resection of residual pulmonary and retroperitoneal disease following chemotherapy and normalization of serum tumor markers has been adopted for disseminated germ cell carcinoma, resection of residual hepatic disease in these cases has not been addressed. This report concerns a series of prospectively randomized patients who received systemic cisplatin-based chemotherapy for testis cancer during the past 13 years. Twenty-eight patients underwent resection of residual hepatic disease after serologic remission. Most (23 of 28 patients) of these procedures were performed concomitantly with other cytoreductive procedures. There were no operative deaths, although 28% of the patients developed complications. The 2-year survival rate was 54%, with an average follow-up of 34 months. Patients were stratified into three groups based on the most aggressive histology noted in the resected specimen. Survival is predicted by this histologic classification system. Hepatic resection can be performed safely and is an important component in the treatment of disseminated testicular carcinoma.
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PMID:Hepatic resection for disseminated germ cell carcinoma. 216 94

During the period from 1. 1. 1980-31. 12. 1989 71 patients underwent lung resection for pulmonary metastases. In 21 cases, the primary tumours were sarcoma, in 19 cases carcinoma of the kidney, and 14 cases of melanoma. There were 9 cases of testicular carcinoma, 5 of colorectal carcinoma, and in 1 case each larynx-, oesophagus-, and oral cavity-carcinoma. In 51 patients we could perform an atypical wedge resection, lobectomy was carried out in 19 patients. 1 patient underwent segmental resection. Hospital lethality counted with 0.7%. For all patients, the cumulative survivals revealed an one-year actuarial about 60%, a 3-year actuarial survival of 40%, and a 5-year actuarial survival rate of 38%.
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PMID:[Results of surgical treatment of pulmonary metastases]. 227 8

Since June 1979, the authors have had the opportunity to treat a renal homograph recipient who developed primary embryonal cell testicular carcinoma with retroperitoneal and pulmonary metastases. This patient was treated with an induction chemotherapy protocol of vinblastine sulfate, bleomycin, and cisplatin and has remained free of disease through June 1985, without loss of his renal homograph. Cisplatin-based cytoxic drug therapy can be delivered safely to a renal transplant recipient without causing kidney damage, and, in this case, achieved a cure of metastatic testicular cancer.
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PMID:Curative, platinum-based cytoxic drug therapy in a renal transplant recipient with metastatic testicular cancer. 242 86

We reviewed the records of 11 patients with yolk sac carcinoma of the testis seen at the Children's Hospital of Philadelphia from 1971 through 1983. Each child was less than 2 years old at diagnosis, and each had stage I disease (localized to the testicle). Initial management consisted of radical inguinal orchiectomy in all 11 patients. Four patients then underwent retroperitoneal node dissection and none had pathological evidence of retroperitoneal tumor spread. After primary surgical management 5 patients received no further initial treatment. Of these 5 patients 3 are alive with no evidence of disease at 1.5, 2.7 and 4.5 years after diagnosis. The tumor recurred in 2 patients, 1 of whom was salvaged with pulmonary radiation therapy and chemotherapy. The other 6 patients received chemotherapy postoperatively and only 1 has suffered relapse. Over-all, of 3 patients in whom pulmonary metastases developed 1 died of tumor and 1 died of treatment-related pneumonopathy. Our experience and that of others have led us to conclude that patients with localized disease and normal postoperative serum alpha-fetoprotein levels do not benefit from retroperitoneal node dissection, postoperative abdominal irradiation or chemotherapy. Patients with retroperitoneal nodal involvement, widely metastatic disease or recurrent disease can be treated successfully with chemotherapy and in some cases with radiation therapy.
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PMID:Yolk sac carcinoma of the testis in children. 243 36

From 1981 to 1984, 86 consecutive patients with previously untreated nonseminomatous testicular carcinoma were classified as clinical radiological stage I and treated with orchiectomy alone. The follow-up program included chest x-ray and lymphangiography (LAG) every month and abdominal computed tomography (CT) bimonthly. All patients were followed for 15 to 63 months after orchiectomy (median 32 mo.). Metastases developed in 23 patients (26.7%) and in 13/23 there was retroperitoneal lymphadenopathy. Time of relapse after orchiectomy ranged from 2 to 36 months (median 7 mo.) with a shorter interval for chest (4 mo.) compared with retroperitoneal metastases (7 mo.). Lung metastases were readily identified at an early stage (less than 2 cm) whereas more than one-third of retroperitoneal nodal metastases were greater than 5 cm at time of diagnosis. LAG detected metastases in 8/11 patients (72.7%), abdominal CT in 8/10 (80%), and both together (LAG and CT) 7/8 (87.5%). In clinical stage I nonseminomatous testicular carcinoma, the high incidence of concomitant but often asymptomatic regional and distant metastases and the relatively high cost and inconvenience of follow-up using abdominal CT imaging, LAG and chest x-ray suggest that orchiectomy is best combined with retroperitoneal node dissection at time of initial presentation to insure more accurate and safe staging of tumor dissemination.
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PMID:Reliability of diagnostic imaging after orchiectomy alone in follow-up of clinical stage I testicular carcinoma: excessive cost with potential risk. 368 40

The authors describe two cases of germinal carcinoma of the testis. The two patients were brothers, but not twins. The evolution of the disease was the same in both cases, with cerebral metastases. The etiology was not discovered but the localization of the metastases in the brain would seem due to the fact the antimitotic drugs used in therapy failed to cross the brain blood barrier.
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PMID:[Similar evolution, with cerebral metastases, of testicular cancers in 2 non-twin brothers]. 372 2

We report 2 cases of diffuse intraperitoneal metastases from testicular carcinoma following transabdominal retroperitoneal lymphadenectomy. This is an unusual pattern of metastasis for nonseminomatous germ cell tumors and it is believed to be the result of direct seeding from lymphatic leakage secondary to surgery. The value of computerized tomography in diagnosing this entity is emphasized.
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PMID:Computerized tomography diagnosis of diffuse intraperitoneal metastases after retroperitoneal lymphadenectomy for testicular carcinoma. 373 49


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