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)

Patients with pain syndromes resulting from recurrent or metastatic cancer should be evaluated carefully to determine the cause of their pain and the need for appropriate antitumor treatment. Currently, opioid analgesics are the mainstay of pain control, but side effects limit their use in some patients. When pharmacologic pain control is inadequate or associated with intolerable side effects, neurosurgery should be considered. Currently the implantation of a pump for the intraspinal infusion of opioid analgesics is the most popular procedure, but its usefulness may be limited by the development of opioid tolerance. The most effective ablative pain control procedure at the current time is cordotomy, which is indicated in patients with unilateral pain. Although the place of neurostimulatory procedures in controlling cancer pain is not well established, they are attractive because of their nondestructive nature and potential usefulness in the treatment of bilateral pain syndromes. Specific antitumor surgical procedures should be considered in patients with certain spinal and plexopathy syndromes, because such intervention offers the prospect of both pain relief and tumor control. In this article, the neurosurgical procedures used in the management of cancer pain are reviewed.
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PMID:Neurosurgery in the treatment of cancer pain. 256 73

The authors reviewed the records of 2261 patients with histologically proven cervical cancer. Among the 1042 patients with carcinoma in situ, four neurologic complications occurred (0.4%), including three strokes and one seizure. None of the neurologic complications were related to cervical cancer. Among the 1219 patients with International Federation of Gynecology and Obstetrics (FIGO) Stage I or greater disease, 99 neurologic complications occurred (8%). Metastatic neurologic complications were twice as common as nonmetastatic neurologic complications and included lumbosacral plexopathy (50 patients), peripheral nerve compressions (eight patients), spinal cord compressions (two patients), and brain metastases (six patients). Nonmetastatic neurologic complications were less frequent and included stroke (11 patients), encephalopathies (three patients), infectious complications (two patients), effects of therapy (six patients), and seizures (11 patients). In conclusion, neurologic complications are rare in cervical cancer and virtually nonexistent in Stage 0 disease. Metastatic neurologic complications were more common than nonmetastatic complications and lumbosacral plexopathy caused by retroperitoneal lymph node metastases was the most common neurologic complication.
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PMID:Neurologic complications of cervical cancer. A review of 2261 cases. 266 51

Eleven patients were diagnosed as having lumbosacral plexopathy at M. D. Anderson Hospital, Houston, from August 1981 through July 1982. Four causes were documented: plexopathy secondary to metastatic disease (six cases); radiation-induced plexopathy (two cases); plexopathy secondary to intra-arterial chemotherapy (two cases); and plexopathy as the result of a second primary tumor (one case). Patients with plexopathies secondary to tumor or irradiation complained of pain in the ipsilateral lower extremity. Computed tomography of the pelvis was the most accurate method of documenting tumor in the region of the lumbosacral plexus. Radiation therapy records of patients with cervical carcinoma were reviewed with respect to positioning of intracavitary radium, which was thought to be responsible for the development of radiation-induced plexopathies. Radiation therapy and/or systemic chemotherapy provided relief of pain and improvement of neurologic deficits in three patients with metastatic involvement.
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PMID:Diagnosis and treatment of lumbosacral plexopathies in patients with cancer. 609 50

Five cases with metastatic and 40 with metastatic and/or postradiation plexopathy are presented. Metastases and radiation seem to affect equally mostly the lower plexus. Neurolysis with free or pedicled omentoplasty has a positive effect in about 20 percent of cases. Pain relief is more frequently obtained.
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PMID:Operative treatment for radiation-induced and metastatic brachial plexopathy in 45 cases, 15 having an omentoplasty. 609 80

Data from 133 patients with cancer and suspected compression of the spinal cord or cauda equina was reviewed. Although there were differences in presenting symptoms and signs between the group of 62 patients with compression and the 71 without, no single symptom or sign discriminated adequately between the two groups. Multiple logistic regression was used to try to develop an index of signs and symptoms which could identify those without compression, thereby sparing them a myelogram. Eight characteristics, in combination, proved most effective as an index, but they were not perfect predictors of patients with block. Final diagnoses in the group without compression were: vertebral metastases 35%, carcinomatous meningitis 24%, plexopathy and/or neuropathy 21%, other 30% (10% had two diagnoses). Sixty-six percent of those with compression and 50% of those without compression died within six months, although patients rarely survived for much longer.
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PMID:Suspected epidural compression of the spinal cord and cauda equina by metastatic carcinoma. Clinical diagnosis and survival. 683 60

Two patients, a woman aged 65 years and a man aged 56 years, with cancer, presented with pain in one leg as the first manifestation of metastases. The woman had tumour plexopathy of the lumbosacral plexus caused by an os sacrum metastasis of a thyroid carcinoma; she received radiotherapy but died a short time later. The man had lumbosacral epidural metastases of a colon carcinoma, compressing lumbosacral roots; with radiotherapy he survived the first year. Back pain with radiating pain is a frequent symptom in patients with cancer. Spinal epidural metastases, spinal and paraspinal metastases without epidural extension, tumour plexopathy and leptomeningeal metastases are the commonest causes. Early diagnosis (by MRI or spinal fluid examination) is important; with progressive weakness or sphincter disturbances the prognosis worsens.
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PMID:[Pain in one leg in patients with cancer]. 1009 55

Neoplastic lumbosacral plexopathy occurs with some abdominal and pelvic malignancies. Patients present with severe pain radiating from the low back down to the lower extremities, and this progresses to weakness. Neoplastic lumbosacral plexopathy is virtually always associated with known malignancy or obvious pelvic metastatic disease. Uncommonly, prostate cancer can present as a lumbosacral plexopathy occurring through direct pelvic spread. We describe two cases of lumbosacral radiculoplexopathy from infiltrative prostate cancer without evidence of other pelvic or extraprostatic spread. The probable etiology of tumor spreading along prostatic nerves into the lumbosacral plexus (i.e., perineural spread) is discussed as are the potential mechanisms for this unusual mode of cancer dissemination.
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PMID:Neoplastic lumbosacral radiculoplexopathy in prostate cancer by direct perineural spread: an unusual entity. 1681 Jun 82

Many etiologies may cause sciatica, and intra-abdominal masses usually affect the lumbosacral plexus by local invasion or distal metastases. Lumbosacral plexopathy caused by compression of intra-abdominal tumors instead of invasion is rarely seen. A 67-year-old woman had a 3-month history of progressive neurogenic claudication, lumbago and left L5 radiculopathy with foot drop. Nocturia and progressive abdominal distension with voiding dysfunction were also noted. Imaging studies showed a huge pelvic mass with severe compression of the left lumbosacral trunk. There was no direct invasion of the lumbosacral plexus by the pelvic mass noted in the preoperative imaging studies or intraoperative findings. Bilateral ovarian borderline mucinous cystic tumor with pseudomyxoma peritonei (PMP) was diagnosed, and the sciatica was improved dramatically after subsequent abdominal debulking surgery. Although rare, neural compression caused by PMP and intra-abdominal masses needs to be considered in the differential diagnosis of sciatica.
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PMID:Sciatica caused by pseudomyxoma peritonei. 1918 96

Brachial plexopathy (BP) in breast cancer patients is a rare event, attributed mainly to radiation damage or tumor infiltration of the plexus. Differentiation between these etiologies is a diagnostic challenge. We have studied retrospectively eight female patients with breast cancer who developed a clinical syndrome of brachial plexopathy following the treatment of the primary disease, out of more than 900 during the last 10 years. None of the available ancillary tests such as plain films, CT or MRI studies, EMG or tumor markers, provided reliable data regarding the cause of the plexopathy. Biopsy, on the other hand, was not always feasible. In our series, all the patients who developed BP did not have any blood-borne metastases before developing the syndrome. In 3 of the patients BP was the first sign of recurrence. In the other 5, only local or locoregional relapse preceded. In 7 of the 8 patients the left side was affected. Treatment should be tailored in each case according to course of the disease. The optimal treatment has not yet been defined.
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PMID:Breast-cancer associated brachial plexopathy - still a diagnostic and treatment challenge. 2159 16

Endometrial stromal sarcoma (ESS) is typically associated with metastasis to the abdomen, pelvis, and lung. We found three case reports of ESS metastasis to the bone (two to the thoracic spine, and one to the parietal bone). Our objective is to review the literature on ESS spinal and intracranial metastases and, report the first case of ESS metastatic to the lumbar paraspinal region and sphenoid bone. A 53-year-old female with ESS status-post radiation, chemotherapy, and pelvic exenteration surgery presented with right hip weakness, back pain, and radicular leg pain that were explained by chemotherapy-induced neuropathy, radiation-induced lumbosacral plexopathy, and femoral nerve and obturator nerve injury during pelvic exenteration surgery. During routine positron emission tomography, we found metastasis to the L3 lumbar spinal region. L3 laminectomy and subtotal resection of the mass was performed with tumor residual in the neuroforamina and pedicles. One month later, magnetic resonance imaging (MRI) performed for persistent headaches revealed a large lesion in the sphenoid bone that was biopsied transsphenoidally with the same diagnosis, but no further surgery was performed. She is intolerant of chemotherapy and currently undergoing whole brain radiation. Delay in the diagnosis and management of lumbar paraspinal and sphenoid bone metastasis of ESS likely occurred because of the uniqueness of the location and aggressiveness of ESS metastasis. Health care providers should be aware of potentially aggressive metastasis of ESS to bone, in particular the unusual locations of the lumbar paraspinal region and sphenoid bone.
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PMID:Endometrial stromal sarcoma metastasis to the lumbar spine and sphenoid bone. 2206 34


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