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)

Serum values of alpha-fetoprotein (AFP) and human chorionic gonadotrophin (HCG) have been used to monitor disseminated testicular carcinoma. Serial measurements of these markers have been used to monitor the response to therapy, to follow the progress of disease, and to detect subclinical recurrences. With increasingly effective chemotherapy for systemic disease, central nervous system (CNS) metastases in testicular carcinoma are becoming increasingly important as a cause of treatment failure. Cerebrospinal fluid (CSF) values of AFP and HCG seem to be important ancillary acids in the neurosurgical management of CNS metastases from testicular cancer. Our preliminary experience with three cases suggests that these CSF markers (plus computerized tomograhic scanning) should be evaluated in patients with this disease.
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PMID:Cerebrospinal fluid markers in central nervous system metastases from testicular carcinoma. 8 23

The brain isoenzyme of creatine kinase (CK BB) occurs in trace amounts in normal serum and is moderately increased in only a small number of non-oncological conditions. Although many tissues and tumors contain CK BB, we observed serum elevations only in certain carcinomas. Eleven patients with tissue-proven small cell anaplastic carcinoma (SCAC) of the lung had striking elevations of serum CK BB and no evidence of central nervous system (CNS) metastases. Significant increases were also observed in three cases of prostatic carcinoma with no apparent CNS involvement, and in one case each of adenocarcinoma and SCAC of the lung with proven CNS metastases. Three patients with SCAC of lung without distant metastases, three with SCAC of the esophagus with distant metastases but no known CNS involvement, and 17 patients with oncological conditions other than SCAC of the lung or adenocarcinoma of the prostate have failed to show elevation in serum CK BB activity. Serum CK BB may be useful as a diagnostic marker or indicator of metastases for some carcinomas.
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PMID:Elevation of brain-type creatine kinase in serum from patients with carcinoma. 22 64

Central nervous system metastases are a common complication of disseminated germ cell tumors of the testis. They occurred in 16% of 242 patients treated and in 25% of the patients who died in our VAB chemotherapy series. Pulmonary metastases preceded or coincided with the development of brain metastases. The frequency of brain metastases differed with the histology of the primary tumor. They occurred in 13% of pure embryonal carcinomas, 18% of mixed tumors containing embryonal or choriocarcinoma elements, and 83% of pure choriocarcinomas. Embryonal carcinoma and choriocarcinoma were the principle histologies found in brain metastases. Characteristically, pure choriocarcinoma deposits in the brain were multiple (8/9) and cerebellar involvement was common (5/9). Pure embryonal carcinoma CNS metastases were typically single (6/8) or very few and cerebellar involvement was not observed. The interval from the diagnosis of malignancy to the diagnosis of brain metastases was longer for embryonal carcinoma than for pure choriocarcinoma (23 mos. vs. 6.5 mos.). Survival following the diagnosis of brain metastases was poor. There was a tendency toward longer survival for histologically pure embryonal carcinoma deposits in the brain than for the pure choriocarcinomas (6.5 mos. vs. 1 mo.).
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PMID:Neurological complications of malignant germ cell tumors of testis: biology of brain metastases (I). 22 44

A review of our experience using BCG immunotherapy as a postsurgical adjunct in the treatment of melanoma shows that the incidence of systemic metastases appears to have been reduced. However, central nervous system (CNS) metastases continue to develop in these patients and represent the single most frequent cause of death. Serial studies of immune competence in these patients reveal that those with CNS metastases usually retain normal immune responses, whereas those with metastases at other sites exhibit progressive immunosuppression with advancing disease.
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PMID:Failure of adjuvant immunotherapy to prevent central nervous system metastases in malignant melanoma patients. 32 99

Six patients with epithelial ovarian cancer had clinical diagnoses of central nervous system (CNS) metastases during a four-year period. A thorough review of the literature shows that involvement of the CNS by ovarian cancer is a rare phenomenon. Four of the six patients developed parenchymal brain metastases whereas carcinomatous meningitis was detected in the other two. These patients were younger and survived longer from initial diagnosis than the majority of women with ovarian cancer. Five of the six patients had previously received chemotherapy and had developed metastatic spread to extraperitoneal sites. Following extensive surgical resection, chemotherapy may provide intraperitoneal and systemic control, thereby extending survival and permitting occult CNS metastases to become apparent.
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PMID:Central nervous system involvement by ovarian carcinoma: a complication of prolonged survivial with metastatic disease. 63 May 51

Forty patients with disseminated malignant melanoma were treated with triple combination chemotherapy consisting of Imidazole Carboxamide, BCNU and Vincristine. Seventeen of 40 patients (42.5%) showed significant responses including three complete responses. Responses were seen in cutaneous, lymph node and pulmonary metastases. Nine instances of hepatic metastases were unaffected by therapy but 68% of the skin and nodal patients responded. The median response duration was only 4 months and the median survival of responders was 9.5 months compared to a 2 month median survival of non-responders. Half of the responders died of CNS metastases. The short duration of response, the resistance of hepatic metastasis and the high incidence of cerebral recurrence necessitate additional therapeutic approaches to this disease.
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PMID:Combination chemotherapy of malignant melanoma with imidazole carboxamide, BCNU and vincristine. 83 50

Measurements of human chorionic gonadotrophin (HCG) concentration in plasma and cerebrospinal fluid (CSF) have been made on patients with gonadotrophin-producing tumors. In the absence of brain metastases the spinal fluid concentration is, within wide limits, proportional to that in the plasma. In 73 patients with gestational choriocarcinoma the mean plasma/spinal fluid ratio was 286 with a lowest value of 64. In five patients with gonadotrophin-producing teratomas the mean ratio was 208 with a lowest value of 104. In 29/33 patients with brain metastases the plasma:CSF ratio was less than 60 at the time confirmatory evidence of brain metastases was obtained. One patient with a gonadotrophin-producing teratoma had a brain metastasis that apparently failed to produce HCG and this metastasis failed to show the histologic features of choriocarcinoma. Monitoring the plasma:CSF ratio provided evidence of brain metastases in 13/18 patients who were undergoing chemotherapy for extensive metastatic disease before confirmatory evidence was obtained by other methods. The lead-in time between assay diagnosis and diagnosis by other methods ranged from 1-20 weeks. Monitoring the plasma:CSF ratio provided a means of observing the response of cerebral metastases to therapy. In some patients the CSF HCG concentration exceeded the plasma concentration indicating that the higher CSF values in patients with CNS metastases cannot be attributed to impairment of the blood-brain barrier. Direct secretion of tumor products into CSF or indirect secretion into CSF via cerebral extracellular fluid evidently occurs. In contrast with radiographic and radionucleide detection methods, a chemical marker indicates the metabolic activity of tumor cells within the central nervous system and provides a basis for monitoring that activity.
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PMID:Immunodiagnosis and monitoring of gonadotrophin-producing metastases in the central nervous system. 98 35

119 patients with metastatic melanoma received fotemustine 100 mg/m2 on days 1 and 8 and dacarbazine 250 mg/m2 on days 15-18. After a 5-week rest, fotemustine 100 mg/m2 on day 1 and dacarbazine 250 mg/m2 on days 2-5 was given every 3-4 weeks. 12 complete responses (11.6%) and 16 partial responses were observed in 103 evaluable patients (response rate 27.2%). The median duration of response was 21.5+ weeks (8+ to 53+). The response rate was 26.3% in CNS, 18.2% in visceral sites and 37.5% in non-visceral sites. The toxicity was mainly haematological: grade III-IV leukopenia in 27.4% and thrombocytopenia in 23.4%. The response rate was lower than that in 63 patients previously reported. The present series had a higher median age (54 vs. 40 years) without any differences in other population variables. However, activity on CNS metastases and on non-visceral sites was confirmed. Haematological toxicity was about 50% lower than that with fotemustine alone. Hence, this is an active outpatient regimen for metastatic melanoma, especially against cerebral and non-visceral metastases.
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PMID:Fotemustine plus dacarbazine for malignant melanoma. 138 14

The Authors report the appearance of Central Nervous System lesions in three patients previously treated for ovarian carcinoma. In one case (Stage 1) the histological sample found a glioblastoma, in the others (Stage 3) the lesion was the metastases after systemic diffusion of the primary carcinoma. CNS metastases are rare and more frequently occur in advanced ovarian carcinoma. In patients at Stage 1, CNS isolated lesions may be primary tumors.
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PMID:[Cerebral lesions in patients with ovarian cancer]. 148 Mar 11

Choroid plexus carcinoma (CPC) arising in the infant poses several treatment dilemmas. The tumor is often not totally resectable at presentation given its large size and tendency to invade adjacent brain. Because of its predisposition to regrow and metastasize, some form of postoperative cytotoxic therapy is required. Chemotherapy (CHT), as opposed to radiotherapy (RT), has a more desirable risk/benefit role in infants, since it is relatively sparing of late neurologic sequelae. Three young male children presented with large intraventricular CPC at 9, 18, and 27 months of age. One child had subarachnoid metastases at diagnosis and the other two had localized disease. Subtotal resections were accomplished and all three required VP shunts. Initial CHT consisted of four monthly courses of cisplatin (20 mg/m2) and etoposide (100 mg/m2), both administered intravenously, daily, for five days. After four courses, two children had complete responses and one had stable disease. Additional CHT was given but one child developed a local recurrence and another diffuse CNS metastases. Both died with intratumoral hemorrhages at 5 and 57 months following diagnosis. The third child remains in continuous remission 46 months after diagnosis. None of the children received RT. Chemotherapy may permit long term deferral of RT. More aggressive CHT regimens should be explored in infants with CPC.
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PMID:Choroid plexus carcinoma--responses to chemotherapy alone in newly diagnosed young children. 154 80


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