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)

From January 1969 through December 1989, 63 patients had 69 operations for pulmonary metastases. Patients ranged in age from 1 to 75 years; there were 36 men and 27 women. Metastasectomy was accomplished through a thoracotomy incision in 59 cases (5 staged, bilateral), and median sternotomy was used in 10 instances. Wedge resection was performed in 54 patients, with segmentectomy in 2, lobectomy in 12, and pneumonectomy in 1. There were no operative deaths. Multiple metastases were present in 29 patients, and a single metastasis in 34. Follow-up ranges from 2 to 204 months (mean = 42 months). Thirty-eight patients remain alive; thirty are free of disease and eight have developed other metastases. Actuarial survival at 5, 10, and 15 years is 40 (CL [confidence limits] 49,31), 36 (CL 44,26), and 24 (CL 35,13) per cent, respectively. Mean actuarial survival is 84 months, and median survival is 58 months. There is no difference in survival whether metastases were single or multiple. Survival is significantly less in groups with primary sarcoma and melanoma (P = .012). While pulmonary metastases may be a manifestation of terminal disease, metastasectomy has an important role in the multidisciplinary management of selected patients when metastatic disease is confined to the lung. Prolonged survival may be achieved in many patients.
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PMID:Twenty years' experience with pulmonary metastasectomy. 155 Feb 99

Childhood neuroblastoma is a neural crest-derived tumor that presents most commonly during this period of life. In disseminated form, it is resistant to cure by chemotherapy. The tumor tends to recur in diverse locations after an initial clinical response. The parenchyma of the central nervous system (CNS) is a rare location for metastatic disease and typically represents terminal disease spread. Therefore, effective therapy for CNS metastasis of neuroblastoma has not been reported. The authors describe the case of a child who had a large parenchymal CNS metastasis at the time of initial recurrence of Stage IV neuroblastoma. Chemotherapy with ifosfamide and etoposide resulted in complete resolution of this lesion.
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PMID:Combination chemotherapy with ifosfamide and etoposide is effective in the treatment of central nervous system metastasis of childhood neuroblastoma. 159 95

Hypercalcemia is one of the most serious metabolic disorders associated with cancer. The incidence and clinical circumstances associated with hypercalcemia vary in different types of cancer. Hypercalcemia is the most frequent metabolic complication of breast cancer and is usually related to widespread osteolytic metastases; however, local and systemic humoral factors mediating bone resorption have been described. In some patients with breast cancer, hypercalcemia results from treatment with estrogens, antiestrogens, androgens, or progestins. Coexisting primary hyperparathyroidism rarely confounds the diagnosis. In patients with lung cancer, the incidence of hypercalcemia varies with histology and is often unrelated to bone metastases. Hypercalcemia may occur either late or early in the disease but is seldom a presenting symptom. In patients with cancers of the head and neck region, hypercalcemia is most often associated with advanced recurrent and terminal disease, presumably humorally mediated. In renal cell carcinoma, hypercalcemia is also an adverse prognostic indicator, commonly mediated by humoral factors. On the other hand, almost all patients with multiple myeloma have extensive osteolytic bone destruction and hypercalcemia is frequently a presenting symptom. Hypercalcemia is uncommon in most lymphomas; however, it is usually a prominent feature of adult T-cell lymphomas and also occurs in some large cell, diffuse B-cell lymphomas. Awareness of the setting in which hypercalcemia of malignancy occurs will lead to its prompt diagnosis and institution of appropriate therapy.
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PMID:Overview of cancer-related hypercalcemia: epidemiology and etiology. 218 51

Spinal cord compression is a rare but serious complication of malignant diseases in children. Epidural cord compression was noted in 81 patients within the past 17 years at this center. The complication developed at different times during the course of the primary disease. For 29 of our patients, cord dysfunction was one of the initial signs of cancer--Ewing sarcoma, neuroblastoma, Hodgkin disease, and malignant lymphoma. By contrast, for most of the patients with osteosarcoma and rhabdomyosarcoma, it appeared later in their clinical course. The treatment outcome of patients who were paraplegia with complete loss of sensory function for greater than or equal to 48 hours was poor. Only four of 22 in this group became ambulatory. Ten patients with osteosarcoma did not undergo laminectomies because they all had multiple metastases and terminal disease. Paraplegia developed in all ten. There was no difference in ambulatory rates among other patients, with or without laminectomies.
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PMID:Metastatic epidural tumors in children. 695 58

A juxtaovarian tumor of probable mesonephric origin in an 18-year-old white woman recurred six years later with a pelvic mass and widespread peritoneal metastases. Chemotherapy with cyclophosphamide, Doxorubicin, and cis-platinum induced a partial response of approximately one year duration. The terminal disease course was associated with hypercalcemia and disseminated intravascular coagulation. At autopsy, there were extensive abdominopelvic tumor masses with pleural deposits.
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PMID:Metastasizing malignant juxtaovarian tumor with terminal hypercalcemia: a case report. 724 14

Overexpression of the proto-oncogene c-myc has been associated with neoplastic transformation in a variety of tumors. For human melanoma high c-myc expression has been found in the vertical growth phase and higher positivity reported in metastases than primary tumors. The principle aim of this study was to determine, whether c-Myc expression influences the metastatic behavior of human melanoma in the absence of lymphocyte-mediated immune phenomena. The growth characteristics and tumor biology of two c-myc transfectants of the human melanoma cell line IGR39D, expressing c-Myc 1.7 and three times over baseline and the respective vector control were analyzed both in vitro and in a severe combined immunodeficient mouse model in vivo. Both c-myc transfectants showed increased growth rates, anchorage independent growth and directed cell movement in culture. Subcutaneously implanted IGR39D melanomas highly overexpressing c-Myc spontaneously formed macroscopic metastases (lymph nodes and lung) in severe combined immunodeficient mice in all cases (n = 7 per group), whereas less prominent c-Myc overexpression caused the development of only lung micrometastases. During the time period leading to terminal disease in animals injected with c-myc transfected human melanoma cells, melanoma development was not seen in vector controls. These findings suggest that constitutive high c-Myc expression in human melanoma results in a more aggressive growth behavior both in vitro and in vivo and favors metastasis in severe combined immunodeficient mice by factors unrelated to immune phenomena such as class I human leukocyte antigen downregulation known to be associated with c-Myc expression.
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PMID:Influence of increased c-Myc expression on the growth characteristics of human melanoma. 1008 11

Facial metastasis from colorectal carcinoma is extremely rare. Only two cases have been reported in the literature. This is the first reported case of malar metastasis from colon carcinoma. The patient was a 64-year-old, white woman who underwent a low anterior resection for a nearly obstructive carcinoma at 20 cm. Her chest X-ray revealed lung metastases. Postoperatively she was treated with fluorouracil and leucovorin. Twenty months later, she presented with left facial edema, which progressively increased in size. CT scan and magnetic resonance imaging with gadolinium showed a large soft tissue mass centered about the left anterior zygomatic arch. The platysma muscle was displaced laterally, and the masseter muscle was involved. There was extension into the masticator space and bony involvement of the zygomatic arch. True-cut biopsy of the left cheek revealed metastatic adenocarcinoma. Histology was similar to that of the primary rectal adenocarcinoma. Metastasis to the malar region is extremely rare. It is a grave prognostic sign, as it is associated with advanced terminal disease. Because of the widespread metastases, only palliative treatment can be provided.
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PMID:Malar metastasis from rectal carcinoma: a case report. 1059 63

During embryonic development, epithelial cells must escape the structural constraints imposed by tissue architecture and adopt a phenotype more amenable to cell movement, a process known as the epithelial-mesenchymal transition (EMT). The progression of carcinomas to invasive and metastatic disease may also involve localized occurrences of EMT. However, data that support the actual occurrence of EMT in specific carcinomas and the relevance of this process to the progression of these tumors had been scant. This review highlights recent studies that substantiate the importance of the EMT to colorectal carcinoma. Specifically, a novel model for studying the EMT of colorectal carcinoma has been used to gain insight into the nature of the EMT itself and to identify molecular events that contribute to disease progression. Although loss of E-cadherin function is a primal event for the EMT, the expression of specific integrins such as alpha(v)beta6 as a consequence of the EMT enables invasive cells to interact with interstitial matrices and to sustain activation of TGF-beta. Of note, alpha(v)beta6 expression in tumors is a marker of cells that have undergone an EMT and it is prognostic for tumors that will progress more rapidly to terminal disease. The EMT also induces autocrine signaling involving VEGF and Flt-1 that enable invasive cells to become 'self-sufficient' for survival. Thus, the EMT appears to be an integral component of colorectal cancer progression and its analysis can yield novel targets for prognosis and therapy.
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PMID:The epithelial-mesenchymal transition (EMT) and colorectal cancer progression. 1584 61

Up to a few years ago peritoneal carcinomatosis was considered as an "incurable" disease. The aim of this paper is to review the surgical approach with curative intent to carcinomatosis: it consists of complete resection of macroscopic disease (R1), associated with hyperthermic intraperitoneal chemotherapy (HIPEC) to treat residual microscopic disease, and to evaluate its indications. Overall 5-year survival of patients with peritoneal carcinomatosis treated by HIPEC is similar to that of patients with hepatic metastases treated with curative intent. Those patients should no longer be considered as patients with a terminal disease but as patients with a potentially treatable localized disease.
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PMID:Hyperthermic intraperitoneal chemotherapy in the treatment of peritoneal carcinomatosis of digestive and peritoneal origin: rationale. 1691 1

Small bowel metastases from primary carcinoma of the lung are very uncommon and occur usually in patients with terminal stage disease. These metastases are usually asymptomatic, but may present as perforation, obstruction, malabsorption, or hemorrhage. Hemorrhage as a first presentation of small bowel metastases is extremely rare and is related to very poor patient survival. We describe a case of a 61- year old patient with primary adenocarcinoma of the lung, presenting with melena as the first manifestation of small bowel metastasis. Both primary tumor and metastatic lesions were diagnosed almost simultaneously. Upper gastrointestinal endoscopy performed with a colonoscope revealed active bleeding from a metastatic tumor involving the duodenum and the proximal jejunum. Histological examination and immunohistochemical staining of the biopsy specimen strongly supported the diagnosis of metastatic lung adenocarcinoma, suggesting that small bowel metastases from primary carcinoma of the lung occur usually in patients with terminal disease and rarely produce symptoms. Gastrointestinal bleeding from metastatic small intestinal lesions should be included in the differential diagnosis of gastrointestinal blood loss in a patient with a known bronchogenic tumor.
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PMID:Melena: a rare complication of duodenal metastases from primary carcinoma of the lung. 1745 Dec 16


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