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)

Twenty-four patients with bronchial adenoma seen over a 20-year period are reviewed. Follow-up data was available in all patients. They included 19 with carcinoid, 2 with adenoid-cystic carcinoma, and 3 with muco-epidermoid carcinoma. Recurrent pulmonary infection, cough and hemoptysis were the most common clinical manifestations. Surgical resection was performed in all but one patient, who was treated by irradiation; bronchoplastic and conservative resectional procedures were used in 5 patients with carcinoid adenoma. Carcinoid tumors are considered to be very slowly-growing malignant neoplasms that sometimes give rise to metastases to regional lymph nodes. Such metastases were present in only one patient. All patients are alive and well. Adenoid-cystic carcinoma is a more aggressive tumor with a tendency to recur. Much of the difficulty in its treatment is due to its close proximity to the bifurcation of the trachea. One patient was operated upon three times for local recurrences and ultimately died from respiratory failure after the third operation. The other patient received radiation therapy with cobalt and is well, without recurrence, 3 years after the treatment. The 3 muco-epidermoid carcinomas were histologically similar to such tumors of salivary glands but behaved clinically like highly malignant tumors, no patients surviving 8 months after resection. The term bronchial adenoma is a misnomer. The neoplasms grouped under this heading should be called carcinoid adenoma, adenoid-cystic carcinoma, and muco-epidermoid carcinoma and considered as separate entities, since the ultimate course and prognosis is definitely different.
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PMID:[Bronchial adenoma]. 19 6

Patterns of failure after treatment for carcinoma of the lung were analyzed by the major WHO cell types. Only diagnoses of the review panel of the Veterans Administration Lung Group were used. First sites of progression were analyzed for 185 patients in a clinical trial, and cause of death was evaluated in 300 consecutive autopsies from VALG studies. Clinical progression was similar for all cell types--20% failed locally and 30% developed metastases. Carcinomatosis or brain metastasis caused death in only 27% of patients with squamous, in over half with large cell and adenocarcinoma, and in 70% of patients with small cell carcinoma. Complications of the local tumor (infection, hemorrhage, and respiratory failure) caused death in 50% of patients with squamous, in 1/3 with large cell and adenocacrinoma, and in 21% of those with small cell carcinoma. These clinical and autopsy data suggest the need for aggressive treatment of the local tumor in all cell types, and systemic therapy for small cell carcinoma. Both local and systemic approaches are needed for large cell and adenocarcinoma.
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PMID:Influence of cell type on failure pattern after irradiation for locally advanced carcinoma of the lung. 22 35

A 61-year-old male was admitted because of hemoptysis. He had a 9 year history of liver cirrhosis associated with HB viral chronic hepatitis. Physical examination revealed no abnormalities. Laboratory investigations revealed positive HBs antigen with normal alpha-fetoprotein. Chest X-ray film showed large mediastinal lymph nodes and an endobronchial polypoid mass in the distal end of the right main bronchus. The right main PA was narrowed due to compression by the mediastinal mass. Bronchoscopic examination revealed a polypoid mass in the right main bronchus. The biopsy specimen was histologically diagnosed as undifferentiated large cell carcinoma. The patient developed respiratory failure, and died 3 weeks after admission. Autopsy revealed a small liver cancer of 1.3 cm diameter within the cirrhotic liver, associated with a small abdominal lymph node metastasis and large mediastinal lymph node swellings. Thromboembolism in the bilateral main pulmonary arteries was concluded to be the cause of death. The mediastinal mass which directly invaded into the right main bronchus had a close histological similarity with the liver cancer, showing undifferentiated carcinoma cells with bizarre nuclei and abundant cytoplasm. An immunohistological study revealed cells positive for alpha-fetoprotein in the mediastinal lymph nodes. The patient was diagnosed as having small liver cancer with mediastinal lymph node metastases. A survey of the literature revealed only a few cases of advanced hepatoma associated with prominent mediastinal metastases. This is the first reported case of small liver cancer presenting with large mediastinal lymph node metastases.
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PMID:[A case of small liver cancer presenting as a huge mediastinal mass]. 132 37

17 cases with bronchial carcinoid were reported. 16 cases of them were proved pathologically after pulmonary resection, and the remaining one was confirmed histopathologically through bronchoscopic biopsy. 64.7% was under 40 years of age. The main clinical manifestations were cough, hemoptysis, fever and repeated pneumonitis. In one patient, the carcinoid was associated with Cushing's syndrome. Chest roentgenograms showed lesions centrally located in 12 cases, and peripherally located in 5 cases. Histological examination revealed 15 typical and 2 atypical carcinoid tumors. This disease was usually misdiagnosed as lung cancer, tuberculoma and benign tumors. Chest X-ray examination and fiberoptic bronchoscopic biopsy are helpful to the diagnosis of the disease. Pulmonary resection was performed in 16 cases. Two patients had hilar lymph node metastases, one of them had also involvement of pericardium. There was no operative mortality. In the follow-up study, the disease-free actuarial survival following pulmonary resection was 92.9% at 5 years. 2 patients died. One died of respiratory failure 4 months after pneumonectomy, the other died of pericardium involvement of carcinoid 8 months after operation. Resection is the only effective treatment for bronchial carcinoid.
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PMID:[Bronchial carcinoid. A clinical, roentgenological and pathological study of 17 cases]. 147 26

From february 1965 to march 1990, 70 squamous cell carcinomas, 3 adenocarcinomas and 2 undifferentiated lung cancer were operated by lobectomy extended to the main bronchus: 44 right upper lobectomies, 22 left upper lobectomies, 5 left lower lobectomies, 2 right lower lobectomies, 1 middle lobectomy and one lower and middle bilobectomy. Respiratory function prevented pneumonectomy in 1 out of 3 patients. The postoperative mortality related to surgery (2.7%) has been eliminated since the introduction of systematic protection of the pulmonary artery from the bronchial suture (1976). The sutures are performed with very fine suture material. Endoscopic follow-up is essential: 11 cases of suture granuloma (1 laser) and 4 cases of fibrotic stenoses, including 1 post-irradiation stenosis (2 lasers). Fifty-three patients were N0 (28 T1, 22 T2, 3 T3) and 22 were T+ (including 4 N2). The actuarial survival for the N0 was 91% at 1 year and 60% at 5 years and decreased to 63% and 40% for N+. Eighty-three percent of the late cancer-related deaths had metastatic disease. Lobectomies extended to the main bronchus do not appear to compromise the oncological value of the resection and they offer the possibility of resection in some respiratory failure patients.
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PMID:[Lobectomies enlarged to the main bronchus in the conservative treatment of lung carcinoma. Apropos of 75 cases]. 160 36

A 65-year-old man who died of respiratory failure due to malignant hemangioendothelioma is reported. He was admitted to our hospital because of intractable hemoptysis. Chest roentgenogram revealed multiple patchy shadows in both lungs, but we could not make a diagnosis by usual clinical examinations including transbronchial lung biopsy. Since the patient's condition became critical, oxygen therapy, anticoagulants and antibiotics were started. In addition, corticosteroid therapy and double filtration plasmapheresis were performed since immunological disorder was suspected because of positive immunological examinations such as antinuclear antibodies and an increase in circulatory immune complexes. There was little response to the treatments and the patient finally died of respiratory failure. At autopsy, multiple tumor nodules were found throughout the lungs and the liver. Metastasis to mediastinal lymph nodes was also discovered. These findings made it impossible to confirm the primary lesion. Microscopy showed proliferation of anastomosing capillaries encasing tumor cells of unknown origin. Silver staining demonstrated capillaries encompassing the atypical cells, suggesting a vascular origin of the tumor. Furthermore, factor VIII related-antigen in the tumor cells was confirmed by the peroxidase-antiperoxidase (PAP) method. The final diagnosis of malignant hemangioendothelioma was made from these histological findings. Malignant hemangioendothelioma is rare, but is an important cause of intractable hemoptysis.
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PMID:[A case of intractable hemoptysis due to malignant hemangioendothelioma]. 162 87

Treatment of choriocarcinoma is mostly successful but there is still appreciable mortality from early respiratory failure. A series of 135 patients with choriocarcinoma presenting with dyspnea between 1960 and 1988 was studied to find prognostic factors for early respiratory death and to identify how mortality may be further reduced. Mortality with respect to early respiratory death (ERD) was 11% and was significantly associated with WHO prognostic score, chest X-ray appearance, central cyanosis, tachycardia, anemia, and clinical evidence of pulmonary hypertension. Indicators on chest X ray of high risk of ERD were the presence of more than 10 opacities, extensive opacification of lung fields, size of metastases, and hazy background obscuring the vascular pattern. Intensity of initial treatment was not correlated with this outcome. A set of criteria has been derived which will predict ERD with 100% sensitivity and 38% positive predictive value. These are opacification of lung fields on chest X ray of more than 50%, OR initial plasma hCG level greater than 10(5) when there is anemia and a history of chest pain. Patients presenting with choriocarcinoma and dyspnea who fulfill these criteria should be considered for extracorporeal perfusion techniques. As respiratory failure in this condition is characterized by hypoxemia and right-to-left shunting, extracorporeal perfusion should be effective. Ventilation should be avoided as no patient survived mechanical ventilation.
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PMID:Respiratory failure due to choriocarcinoma: a study of 103 dyspneic patients. 169 17

Between 1977 and 1986, 23 patients with pulmonary metastases were operated upon in a thoracic and cardiovascular surgery department, totalling 26 thoracotomies. The time elapsed between treatment of the primary tumour and that of the metastasis (single or multiple) ranged from 11 to 89 months. The metastases were discovered on follow-up x-ray films of the chest in 15 cases. All patients underwent preoperative lung function assessment, pulmonary radiotomography or thoracic computerized tomography and bronchial fibroscopy. Surgery consisted of tumorectomy (12 cases), lobectomy (5 cases), pneumonectomy (3 cases), segmentectomy (1 case) and tumorectomy combined with lobectomy (1 case). In 2 patients only exploratory thoracotomy could be performed. The operative mortality was nil. The mean survival counted from the date of the last thoracotomy was 17 months (range 1 to 51 months). The mean absolute survival was 24 months (range 13 to 51 months). The actuarial survival rate was 60 percent at 1 year, 47 percent at 2 years and 26 percent at 3 years. Terminal respiratory failure was the main cause of death. Surgery within a multidisclinary approach of lung cancer must therefore spare as much lunch parenchyma as possible to preserve the patient's future.
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PMID:[Surgical treatment of pulmonary metastases]. 182 13

Male lung cancer patients with poor performance status [Eastern Cooperative Oncology Group (ECOG) index 3-4] have an endocrinological dysfunction as assessed by serum testosterone and sex hormone-binding globulin (SHBG) levels. Patients who respond to therapy regain normal free testosterone levels within 12 weeks post chemotherapy, whereas non-responders continue to exhibit subnormal levels. The perturbations of endocrinological variables in patients with lung cancer is not due to development of hypoxia, as patients with respiratory failure maintain a significantly lower testosterone level compared to cancer patients. The development of a deficiency in total testosterone concentrations in lung cancer patients is correlated to their performance status, and not to the presence of metastatic disease. The mechanisms responsible for the endocrinological dysfunction in patients with lung cancer remain unknown.
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PMID:Gonadal endocrine dysfunction in patients with lung cancer: relation to responsiveness to chemotherapy, respiratory function and performance status. 191 28

A forty-seven-year-old woman visited our hospital in March 1987 suffering from the local recurrence of the tumor. Her right 7th and 8th rib had been resected 2 years and 11 months before because of the malignant fibrous histiocytoma (MFH) originated from the right 7th rib. In May 1987, wide resection of the right lateral chest wall and partial resection of the right diaphragm were done. Dacron meshed silicon plate (Silastic) and musculocutaneous flap of the right latissimus dorsi were used to reconstruct the chest wall. Seven months after the second operation, local recurrence occurred again on the anterior chest wall, involving the right diaphragm and right lower lobe of the lung. In March 1988, extensive resection of the anterior chest wall with partial resection of the right diaphragm and the right lower lobe was followed by reconstruction of the chest wall by Silastic. The patient recovered uneventfully without any respiratory disturbances after both operations which included wide resection of the chest wall. Multiple pulmonary metastases were found 4 months after the operation, and she died of respiratory failure 7 months after the final operation. Although MFH was one of the most common sarcomas of the soft tissues, only one case of the MFH originated from the rib had been reported previously in this country. Silastic was proved to be a useful prosthesis for the reconstruction of widely resected chest wall.
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PMID:[Malignant fibrous histiocytoma of the rib: a case report of repetitive extensive resections and reconstruction of the chest wall]. 215 18


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