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)

The skeleton is the most common organ to be affected by metastatic cancer, and tumors arising from the breast, prostate, thyroid, lung, and kidney possess a special propensity to spread to bone. Breast carcinoma, the most prevalent malignancy, causes the greatest morbidity. Of great clinical importance is the observation that metastatic bone disease may remain confined to the skeleton. In these patients, the decline in quality of life and eventual death is due almost entirely to skeletal complications and their subsequent treatment. Bone pain is the most common complication of metastatic bone disease, resulting from structural damage, periosteal irritation, and nerve entrapment. Recent evidence suggests that pain caused by bone metastasis may also be related to the rate of bone resorption. Hypercalcemia occurs in 5-10% of all patients with advanced cancer but is most common in patients with breast carcinoma, multiple myeloma, and squamous carcinomas of the lung and other primary sites. Pathologic fractures are a relatively late complication of bone involvement. The clinical courses of breast and prostate carcinoma are relatively long, with a median survival of 2-3 years. For patients with breast carcinoma, good prognostic factors for survival after the development of bone metastases are good histologic grade, positive estrogen receptor status, bone disease at initial presentation, a long disease free interval, and increasing age. In addition, patients with disease that remains confined to the skeleton have a better prognosis than those with subsequent visceral involvement. For patients with prostate carcinoma, adverse prognostic features include poor performance status, involvement of the appendicular skeleton and visceral involvement, whereas for patients with multiple myeloma, the levels of serum beta2-microglobulin and lactate dehydrogenase and the immunologic phenotype are the most important factors. These prognostic factors may be useful in planning the rational use of bisphosphonates in the treatment of advanced cancer.
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PMID:Skeletal complications of malignancy. 936 26

Breast carcinoma metastases to the eye occur more frequently than is clinically recognized. The prevalence of this lesion is not appreciated because of the dominant clinical picture of metastases occurring in other organs or because a number of eye lesions are small and asymptomatic. With the increasing length of survival, more breast cancer patients will require care for ocular metastases. A thorough ophthalmic evaluation, aided by computed tomography or magnetic resonance imaging, usually confirms the diagnosis. Rapid progression of a lesion demands emergency therapy since the dysfunction produced by progressive disease may not otherwise be corrected. Early diagnosis of ocular metastases in patients with breast cancer is important because timely treatment may improve vision and quality of life in the time remaining to patients. Experience with two cases of metastases to the eye from breast cancer are presented, with a review of the literature.
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PMID:Ocular metastases from breast carcinoma: a report of two cases. 961 81

Metastatic tumors in ovaries from breast carcinoma are well known. Breast carcinoma metastases in primary ovarian tumors are much more uncommon. The authors present a case of a primary breast carcinoma, with a lobular component (signet ring cells), which metastasized into a mature cystic teratoma of the ovary. The problem of differential diagnosis with other primary ovarian tumors or metastatic tumors and the problem of particular behavior of metastatic lobular components are discussed.
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PMID:Metastasis of a breast carcinoma in a mature teratoma of the ovary. 1041 Aug 92

Breast carcinoma is a rare cause of ectopic ACTH syndrome. There are only two previously reported cases in which ACTH secretion is documented. We describe the case of a 56-year-old woman who presented with clinical and biochemical features of ectopic ACTH syndrome in the setting of metastatic breast carcinoma. Despite aggressive management of her ectopic ACTH syndrome, her course was complicated by opportunistic infection, respiratory failure and death. Immunostaining of the breast metastases for ACTH was positive and in situ hybridization revealed proopiomelanocortin gene expression. This is the first reported case of ectopic ACTH syndrome associated with metastatic breast cancer in which the technique of in situ hybridization has been used to confirm the breast cancer metastases as the source of ectopic ACTH secretion.
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PMID:Cushing's syndrome secondary to ectopic ACTH secretion from metastatic breast carcinoma. 1046 35

Breast carcinoma is the most common primary tumor producing intraocular metastasis. Metastases to the iris and ciliary body are relatively rare. The authors report a case of a 61-year-old lady, operated for carcinoma of the left breast 3 years back, who presented with symptoms and signs of acute narrow-angle glaucoma in the right eye. A diffuse whitish plaque-like mass in the upper nasal quadrant of the iris with an episcleral nodule on the limbus in the corresponding area and all the signs of acute narrow-angle glaucoma were present in the right eye. Intraocular pressure was controlled medically. Fine-needle aspiration cytology from the episcleral nodule showed malignant cells. Histopathology of the excised nodule showed metastatic poorly differentiated carcinoma, and the cellular pattern was similar to the carcinoma of the breast. There was no other metastasis anywhere in the body. Fine-needle aspiration cytology from an external lesion of the eye is a less invasive and easier procedure than paracentesis to diagnose the metastatic nature of the lesions. The rare features in our case are the clinical presentation as acute glaucoma and the ocular structures being the first and only site of metastasis.
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PMID:Anterior uveal and episcleral metastases from carcinoma of the breast. 1096 54

Metastatic eyelid tumors are uncommon. Their presentation may vary markedly. We describe a 61-year-old female who presented with a tender nodule in her right upper eyelid shortly after chemotherapy for metastatic disease. She had undergone right mastectomy and radiotherapy because of an adenocarcinoma 16 years ago. Histopathologic findings were consistent with metastatic carcinoma. Knowledge of the diverse clinical and histopathologic features of metastatic breast carcinoma to the eyelids is essential for the appropriate management of these patients. Breast carcinoma metastatic to the eyelid represented in this patient the only sign of insufficient chemotherapy.
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PMID:Breast carcinoma metastatic to the eyelid presenting as the first sign of insufficient chemotherapy. 1124 46

Serum carbohydrate antigen 15.3 (CA 15.3) and carcinoembryonic antigen (CEA) are currently employed in clinical practice as markers for breast cancer, particularly in the follow-up and therapy monitoring. However, the American Society for Clinical Oncology (ASCO) stated in its clinical practice guidelines for the use of tumour markers in breast carcinoma that neither CA 15.3 nor CEA are recommended for routine use in screening, diagnosis and surveillance after primary treatment, or in monitoring response to treatment, because current literature data are insufficient. Cytokeratin fragment 21.1 (CYFRA 21.1) assay detects a serum fragment of cytokeratin 19 (CK19) and is employed in the diagnosis and management of lung cancer, particularly of squamous cell histotype. Breast carcinoma has been demonstrated to express CK19 fragments in the primary and metastatic lesions and CK19 mRNA is detectable in peripheral blood from patients affected by breast cancer. We measured serum markers CYFRA 21.1, CEA and CA 15.3 in the sera from 212 females affected by histologically proven breast carcinoma. Patients comprised 96 individuals with untreated primary disease (54 stage I-II, 18 stage III and 24 stage IV), 30 regional (chest-wall and/or lymph-nodes) relapsing disease and 68 metastatic (haematogenous metastases) relapsing disease. Forty-eight patients previously treated by surgery and without any evidence of disease were enrolled to evaluate the role of serum markers in the monitoring for recurrence of the disease. One hundred healthy age-matched females and 65 patients affected by benign mammary gland disease (including 38 patients with mastopathy and 27 with fibroadenoma) were enrolled as controls. Serum levels of all markers increased from controls to patients affected by breast cancer, from stage I-II to stage IV of the breast cancer and from local to advanced recurrence. The comparison of diagnostic accuracy in the detection of primary and relapsing breast cancer showed no significant differences between markers. Univariate and multivariate survival analysis showed a significant statistically prognostic value for CA 15.3 and CYFRA 21.1 but not for CEA. However, the factors N and M were confirmed to be very strong predictors of the patients' survival. Finally, CEA and CYFRA 21.1 detected less recurrences than CA 15.3. In conclusion, our data show no significant improvement in the diagnosis, prognostic evaluationand follow-up of breast cancer by CYFRA 21.1 and CEA assays compared to CA 15.3 assay. Considering the ASCO statement on tumour markers in breast cancer, the CYFRA 21.1 assay should not be employed in clinical practice.
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PMID:Serum cytokeratin fragment 21.1 (CYFRA 21.1) as tumour marker for breast cancer: comparison with carbohydrate antigen 15.3 (CA 15.3) and carcinoembryonic antigen (CEA). 1200 21

Osteolytic and osteoblastic metastases are often the cause of considerable morbidity in patients with advanced prostate and breast carcinoma. Breast carcinoma metastasis to bone occurs because bone provides a favorable site for aggressive behavior of metastatic cancer cells. A vicious cycle arises between cancer cells and the bone microenvironment, which is mediated by the production of growth factors such as transforming growth factor beta and insulin growth factor from bone and parathyroid hormone-related protein (PTHrP) produced by tumor cells. Osteolysis and tumor cell accumulation can be interrupted by inhibiting any of these limbs of the vicious cycle. For example, bisphosphonates (e.g., pamidronate, ibandronate, risedronate, clodronate, and zoledronate) inhibit both bone lesions and tumor cell burden in bone in experimental models of breast carcinomametastasis. Neutralizing antibodies to PTHrP, which inhibit PTHrP effects on osteoclastic bone resorption, also reduce osteolytic bone lesions and tumor burden in bone. Other pharmacologic approaches to inhibit PTHrP produced by breast carcinoma cells in the bone microenvironment also produce similar beneficial effects. Identification of the molecular mechanisms responsible for osteolytic metastases is crucial in designing effective therapy for this devastating complication.
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PMID:Mechanisms of osteolytic bone metastases in breast carcinoma. 1254 83

Breast carcinoma has a high predisposition to metastasize to the brain parenchyma. An association between carcinoma of the breast and intracranial meningioma has been reported. The available published articles regarding patients with intracranial meningioma and breast carcinoma have been reviewed. To the best of our knowledge, 86 cases including our 4 cases have so far been reported. All cases were female, and the mean age was 62.4 years when intracranial meningioma was diagnosed. The mean interval of the 2 tumours was 4.5 years. Twenty-five cases of breast tumour were infiltrating duct carcinomas. The location of intracranial meningioma and pathologic subtype showed no specific predominance. Hormone receptor study was performed in 28 cases. In meningioma, the positive rate of progesterone receptor (32.1%) is higher than oestrogen receptor (7.1%); while the positive rate of oestrogen receptor (53.6%) is higher than the progesterone receptor (42.9%) in breast cancer. A review of this study is presented with emphasis on the existence of intracranial meningioma and breast cancer in one patient at different periods. Lesions of the central nervous system in patients with breast cancer should not be immediately labeled as metastases. Intracranial meningioma should be excluded. Likewise, patients with meningioma should have periodic physical examinations and mammographies whereby disease may be diagnosed and treated at an early stage
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PMID:Intracranial meningioma and breast cancer. 1294 58

Bladder metastases from solid tumors are rare. Breast carcinoma cells seldom spread to the urinary bladder. We report the case of a patient with invasive breast carcinoma who developed a breast recurrence followed by bone and urinary bladder metastases. Starting from this clinical case we review the available literature on this issue. Only few cases of urinary bladder metastases from primary breast cancer have been reported, although the case reports have increased in recent years. Patients with breast cancer presenting with urinary symptoms should be examined for possible bladder metastases.
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PMID:Urinary bladder metastases from breast carcinoma: review of the literature starting from a clinical case. 1620 59


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