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 gained with the observation and treatment of malignant testicular tumors, retro-peritoneal seminomas and malignant germinal tumors of the mediastinum. In particular we describe one patient operated for a pure seminoma of the thymic space followed by radiation therapy. Three years later he developed a texticular tumor of an entirely different origin; an embryonal cell carcinoma. An unilateral orchidectomy was performed. Subsequent generalized pulmonary metastases were treated with poly-chemotherapy followed by temporary radiological regression of the metastases. The patient expired & years after the mediastinal--and 3 years after the scrotal intervention with generalized liver, spleen, brain and pulmonary metastases originating from the testicular embryonal cell carcinoma. The origin, however controversial of these germinal gonadal and extra-gonadal tumors is discussed. In the above mentioned case, we do think that 2 autonomous germinal tumors developed on a (hormonal ?) predisposed terrain. Nevertheless it is not possible to prove beyond any doubt that it was not a single primary tumor with early large mediastinal metastases which disclosed the disease. Careful periodical examination of the testis during 3 years preceding the development of the embryonal cell carcinoma of the testis did not reveal anything abnormal.
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PMID:[Double germinal tumor of the mediastinum and testis]. 740 76

Late recurrence of nonseminomatous germ cell tumours of the testis is rare. The authors report on a 35-year-old man treated initially for embryonal cell carcinoma of the testis with metastases, who presented 12 years later with an increasing serum alpha-fetoprotein level and a biopsy-proven embryonal cell cancer in the hilus of the left lung. Because the tumour was highly resistant to two separate courses of cis-platinum-based chemotherapy and one course of radiotherapy, surgical resection for salvage was carried out. The patient was free of disease 3.5 years after the second operation. The possible reasons for the occurrence of this highly resistant metastatic testicular cancer are discussed. They include a second primary tumour and malignant degeneration of the original tumour. In this patient the latter cause was the most plausible.
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PMID:Late recurrence of testicular cancer. 815 73

The clinical course of a patient who presented with a massive left renal metastasis from testicular carcinoma is described. Treatment with cisplatin-based chemotherapy produced a dramatic response. Symptomatic renal metastases from testicular cancer are rare and may be reflective of a high tumor burden or refractory disease.
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PMID:Symptomatic renal metastasis from testicular cancer. 838 57

Between 1988 and 1994, 24 patients underwent 32 procedures for pulmonary metastases. Primary tumours were gastrointestinal, malignant melanoma, osteogenic sarcoma, renal cell carcinoma, head and neck cancer and finally testicular carcinoma. Age ranged from 16 to 78 years, with a female/male ratio of 7/17. Pulmonary metastasectomy was performed in 9 cases through median sternotomy, in 21 cases through thoracotomy and in 2 cases by thoracoscopy. In 9 cases repeated resection was necessary. Overall mortality was 0% (95% confidence limits are 0.00 +/- 14.25). Computed tomography of the chest in combination with tumour markers, were most important during follow-up to detect recurrent disease. The overall 5-year actuarial survival and disease-free survival were 0.56 +/- 0.17 and 0.30 +/- 0.14 respectively. With regard to testicular carcinoma 5-year actuarial survival was 100%. Pulmonary metastasectomy is a recommended procedure in the treatment of selected patients with metastatic pulmonary disease. Resections should be as conservative as possible and if necessary, repeated. In our study this procedure proved especially effective in case of testicular carcinoma.
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PMID:Pulmonary metastasectomy. 857 21

Positron-emission tomography (PET) employing 18F-labeled deoxyglucose (FDG) has been found to be a highly sensitive and rather specific tool in the detection of a variety of malignant carcinomas. Due to high resolution and outstanding image quality its complementary and supplementary role as compared to morphological methods has increasingly been acknowledged. Urinary-tract malignancies, with the exception of prostate carcinoma, have a rather low incidence and thus experience with FDG-PET is limited. We have compared the diagnostic accuracy of FDG-PET mainly in the primary staging of malignant testicular carcinoma, prostate and renal cell carcinoma. Our data indicate, that FDG-PET is more accurate in the detection of lymph node metastases in malignant testicular cancer as compared to CT, but also fails to detect micrometastases and highly differentiated teratoma. Its role in prostate carcinoma is questionable due to the low metabolic activity of this type of cancer. In all other urinary tract malignancies no final conclusions can be drawn, due to limited experience.
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PMID:Possible role of FDG-PET in the evaluation of urologic malignancies. 917 13

Secondary leukemia following chemotherapy or radiotherapy for mediastinal germ cell tumors is a well-described entity. It also may occur in patients with testicular germ cell tumors. We report a case of acute monocytic leukemia occurring in a 44-year-old man who received etoposide-based chemotherapy and radiotherapy for a recurrent, metastatic testicular germ cell tumor. The patient received 14 cycles of systemic chemotherapy for pulmonary and para-aortic lymph node metastases following his initial orchiectomy. The total amount of etoposide this patient received was 6,400 mg/m2. Leukemia occurred 11 years after orchiectomy. A literature review revealed 25 other reported cases of secondary leukemias after treatment for testicular carcinoma. It is not clear whether chemotherapy, radiotherapy or both are responsible for the secondary leukemias seen in these patients.
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PMID:Secondary acute monocytic leukemia occurring during the treatment of a testicular germ cell tumor. A case report and review of the literature. 925 26

Aim of this review article was to critically analyse the recently described zytogenetic and molecular markers for testicular germ cell tumors with regard to their clinical utility. The isochromosome i(12p) represents the most common and characteristic cytogenetic finding which already appears in testicular carcinoma in situ. A number of proto-oncogenes (Cyclin D and PTHLH) as well as putative tumor suppressor genes are localized on 12p; however, their role in pathogenesis and prognosis of testicular germ cell tumors has not been defined yet. Clinical characteristics of patients with familial testicular germ cell tumors indicate a genetic background for the development of testicular tumors. Although a number of chromsomal loci encoding potential testicular tumor susceptibility genes have been identified, the genetic basis of testicular cancer pathogenesis is still unknown. With regard to molecular prognostic risk factors most of the reported data on proliferation markers, tumor suppressor genes, proteases and adhesion molecules have to be confirmed in prospective randomized trials prior to their widespread clinical use. Based on the available data on prospective studies percentage of embryonal carcinoma and vascular invasion appear to be the most significant prognosticators. Investigation and identification of those factors determining the aggressive biologic behavior of embryonal carcinoma compared to all other histological components appear to be most promising in research for prognosticators of metastatic disease. In conclusion, the increasing knowledge of molecular genetic events involved in pathogenesis and prognosis of testicular germ cell tumors will not only help to better understand development and progression of testicular cancer, but it also will define new approaches to classification and management of germ cell tumors.
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PMID:[Molecular pathogenesis and prognostic factors in testicular tumor]. 988 88

Aim of this review article was to critically analyze the recently described cytogenetic and molecular markers for testicular germ cell tumors with regard to their clinical utility. The isochromosme i(12p) represents the most common and characteristic cytogenetic finding which already appears in testicular carcinoma in situ. A number of proto-oncogenes (cyclin D and PTHLH) as well as putative tumor suppressor genes are localized on 12p; however, their role in pathogenesis and prognosis of testicular germ cell tumors has not been defined yet. Clinical characteristics of patients with familial testicular germ cell tumors indicate a genetic background for the development of testicular tumors. Although a number of chromosomal loci encoding potential testicular tumor susceptibility genes have been identified, the genetic basis of testicular cancer pathogenesis is still unknown. With regard to molecular prognostic risk factors most of the reported data on proliferation markers, tumor suppressor genes, proteases and adhesion molecules have to be confirmed in prospective randomized trials prior to their widespread clinical use. Based on the available data on prospective studies the percentage of embryonal carcinoma and vascular invasion appear to be the most significant prognosticators. Investigation and identification of those factors determining the aggressive biologic behavior of embryonal carcinoma compared to all other histological components appear to be most promising in the research for prgnosticators of metastatic disease. In conclusion, the increasing knowledge of molecular genetic events involved in pathogenesis and prognosis of testicular germ cell tumors will not only help to better understand development and progression of testicular cancer, but it will also define new approaches to classification and management of germ cell tumors
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PMID:Molecular genetic parameters in pathogenesis and prognosis of testicular germ cell tumors. 1070 88

Testicular cancer is a rare tumour with the potential for cure at diagnosis. It is important, however, to identify those patients with metastases at presentation so as to ensure that the optimum treatment strategy is employed. Many criteria have been used to try to place patients into high- or low-risk groups, with variable success. Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) has the potential to identify active disease and thereby influence further management. Here we report on a retrospective study of the use of FDG-PET in the detection of metastatic testicular carcinoma at diagnosis. Thirty-one patients [13 with seminoma and 18 with non-seminomatous germ cell tumours (13 teratomas, 5 mixed)] were staged by FDG-PET scanning. The imaging was performed using a Siemens ECAT 951 scanner. All results were assessed on the basis of histology or clinical follow-up. FDG-PET scan identified metastatic disease in ten and was negative in 16; there were no false-positives and five false-negatives. There were six patients in whom FDG-PET was negative and computed tomography was regarded as suspicious but follow-up was inconclusive. The positive predictive value was 100%. The negative predictive value was 76% or 91%, depending on whether the aforementioned six cases were regarded as true-negatives or false-negatives. It may be concluded that FDG-PET is capable of detecting metastatic disease at diagnosis that is not identified by other imaging techniques. These preliminary results are sufficient to suggest that a large prospective study should be performed to evaluate the role of FDG-PET in primary staging of disease.
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PMID:Fluorodeoxyglucose PET in the initial staging of germ cell tumours. 1085 16

A 20-year-old man with Stage II nonseminomatous germ cell tumor underwent chemotherapy and multiple surgical resections of recurrent abdominal and supradiaphragmatic mature teratomas. Evaluation of a new heart murmur led to the diagnosis of tricuspid valve teratoma, which required complete valve excision and replacement. We present our experience with the first discrete tricuspid valve metastasis from testicular carcinoma and review the literature regarding cardiac metastases from germ cell neoplasms.
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PMID:Tricuspid valve metastasis from testicular carcinoma: a case report and review of the literature. 1092 10


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