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 present report is that of a 40-year-old woman admitted with hematemesis and epigastric pain. Endoscopy revealed a fungating mass in the lower esophagus. Esophageal brushing revealed clustered and single malignant cells with ample cytoplasm, large bizarre nuclei and prominent, irregular nucleoli; the chromatin was irregular with clumping at the nuclear borders. Giant multinucleated malignant cells were numerous. These cells had nuclear molding and abundant acidophilic cytoplasm. Autopsy findings included a large tumor in the lower esophagus and metastases to lung, liver and kidneys. Microscopically, the fungating esophageal tumor and metastases were composed of cyto- and syncytiotrophoblastic elements. Choriocarcinoma of the esophagus is a rarity, and only two cases were found in the literature. The diagnosis, however, can be achieved by brush biopsy since the characteristic cyto- and syncytiotrophoblastic cells can be readily identified, provided that the possibility of this ectopic occurrence is recognized.
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PMID:Choriocarcinoma of the esophagus: histologic and cytologic findings. A case report. 28 54

A 28-year old woman with ovarian choriocarcinoma developed a uveitis in her left eye. Subsequently, a mass was observed in the anterior segment of that eye together with a subconjunctival mass that appeared to extend from it. Biopsy of the subconjunctival nodule showed two different cell types consistent with the cytotrophoblastic and syncytiotrophoblastic elements typical and choriocarcinoma. No abnormalities of the posterior segment were found on careful examination. Treatment consisted of systemic chemotherapy with a variety of therapeutic agents, argon laser photocoagulation of tumor seedings in the anterior chamber angle, radiation to the eye, and finally, subconjunctival injections of methotrexate. The eye became blind and painful and was enucleated. Histopathologic examination revealed residual tumor cells in the anterior segment indicating treatment changes, but there were no abnormalities posteriorly. Choriocarcinoma metastatic to the eye has been reported infrequently, and this is the first case in which anterior segment metastases have been observed and the effects of treatment thoroughly documented.
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PMID:Anterior segment metastases from an ovarian choriocarcinoma. 57 42

Fifty-two cases of choriocarcinoma were recorded in the Jamaica Cancer Registry for the parishes of Kingston and St. Andrew, giving an incidence of 1:7,384 live births. This is intermediate between figures reported for Western metropolitan populations and for Far Eastern countries. Clinicopathological studies on 26 cases treated at the University Hospital in Jamaica revealed that 65% followed either normal pregnancy or abortion. Choriocarcinoma following a normal pregnancy or occurring without a previous history of pregnancy carried a poorer prognosis than those with a preceding hydatidiform mole. Many patients had primary neurological manifestations. The overall prognosis was poor due to late presentation with disseminated metastases. Of the 26 patients, 15 died of the disease within two years and only six appeared for a six-year follow-up.
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PMID:Choriocarcinoma in Jamaica. 84 72

Choriocarcinoma of the nonmolar placenta is presumptively a rare entity and is usually associated with widespread maternal metastases at the time of diagnosis. Nonmetastatic disease goes unrecognized and undiagnosed because placental carcinoma can be limited to a few villi, and grossly evident disease is often misinterpreted as a placental infarct. The optimal treatment for patients with choriocarcinoma of the placenta is not known but aggressive combination chemotherapy is suggested for patients with metastatic disease. Historically, the prognosis for both mother and infant has been poor.
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PMID:Choriocarcinoma in a term placenta with maternal metastases. 150 30

Choriocarcinoma is a malignant germ cell tumor that usually arises from a previous gestation, but may also arise from germ cells anywhere along their known migratory pathway during fetal development. Gestational choriocarcinoma is highly sensitive to chemotherapy. This malignancy is known to undergo spontaneous regression of the primary tumor, which, in the face of metastases, may obscure the primary tumor site. The authors report the case of a patient with choriocarcinoma who was seen with pulmonary metastases and a single large lesion in the kidney 5 years posthysterectomy. The problems in resolving the primary site and the importance of a tissue diagnosis before nephrectomy are discussed.
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PMID:Choriocarcinoma of the kidney. 161 47

Choriocarcinoma is a rare malignancy in Scandinavia. We present a case of a young primigravida who experienced an uneventful pregnancy and gave birth to a healthy baby. Six days after delivery she underwent neurosurgery for intracranial hemorrhage. Pathological examination of the evacuated hematoma revealed metastatic choriocarcinoma. Further work-up exposed additional metastases in the lungs and liver. The initial serum level of human chorionic gonadotropin (beta-HCG) was 350,000 IU/I. Chemotherapy was given both intravenously and intrathecally. At 10 weeks, beta-HCG had returned to normal. Treatment was continued for another 10 weeks. Two years after cessation of therapy the patient is still in complete remission. In the discussion we review a scoring system to be used in selecting the mode of treatment, and briefly mention diagnosis and prognosis.
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PMID:Choriocarcinoma presenting with cerebral metastases after full-term pregnancy. 170 21

A case of choriocarcinoma of the urinary bladder is presented. A 57-year-old man underwent a cystectomy for transitional cell carcinoma, grade II. Choriocarcinoma was found, in addition to the transitional cell carcinoma, in the removed urinary bladder. After the operation, metastases appeared in both lungs, evolving rapidly despite chemotherapy. The patient died five months after admission. Immunohistochemically, staining for human placental lactogen was strongly positive, and both alpha and beta subunits of human chorionic gonadotropin were weakly positive in the primary site of the removed urinary bladder and in the metastatic foci.
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PMID:Primary choriocarcinoma of the urinary bladder. 245 Oct 42

The development of metastases represents the lethal event in the clinical course of most neoplastic diseases. The complex mechanism responsible for the spread of cancer are governed by interactions between tumour cells and the host tissues. Choriocarcinoma cells and cultured blood vessels were used to study the interaction between tumour and endothelial cells. Seeding of tumour cells onto blood vessel wall caused retraction of endothelial cells leading to the exposure of underlying tissue. Subsequently, the tumour cells penetrated the sub-endothelial connective tissue and the internal elastic lamina.
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PMID:In vitro studies on the invasion of blood vessel wall by choriocarcinoma cells. 270 42

Choriocarcinoma is the rarest testicular germ cell tumor, occurring in less than 1% of cases. Gastrointestinal bleeding is not uncommon in cases of testicular choriocarcinoma and reflects metastatic disease. Typically, the patient presents with marked upper or lower gastrointestinal tract bleeding. A young adult male with metastatic testicular choriocarcinoma presented as a near-syncopal episode, with a hematocrit of 22% and hemoccult-positive stool. Endoscopy revealed a solitary bleeding lesion along the greater curvature of the stomach. His presentation suggested chronic, rather than acute, gastrointestinal blood loss. This case may represent the first case of testicular choriocarcinoma in which chronic gastrointestinal blood loss was the presenting manifestation of metastatic disease.
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PMID:Testicular choriocarcinoma. An unusual presentation as occult gastrointestinal blood loss. 278 29

There seems to be no higher incidence of primary brain tumor in pregnancy. There are no extracranial tumors that are likely to metastasize that are uniquely related to the specific pregnancy. Choriocarcinoma during the index pregnancy is rare. Although pregnancy-related choriocarcinoma has a high propensity for brain metastasis, it is in the postpartum period or later that such tumors and their metastases present. The fetus seems to be spared from any complications resulting from maternal tumor, provided that it is safely delivered. There is a rich literature on the immunology and steroid receptor pharmacology of brain tumor but alterations in immunity or in receptor sites seem to have little impact on the incidence of tumors during pregnancy. There may be modification of the behavior of brain tumors by pregnancy and hence possibly by steroid hormones. The principle governing management of the mother is primarily common sense. As the ability to manage brain tumors in general improves, the necessity of interfering with either the pregnancy or mode of delivery evaporates.
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PMID:Brain tumors in pregnancy. 305 52


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