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)

A retrospective study is presented of 19 patients with pleural mesothelioma diagnosed over an 18-year period (1964-1981). Two patients are alive after observation for 12 and 16 months. In 16 fatal cases the post-diagnosis survival time was 1-113 (median 17) months. One patient was lost to follow-up after 6 months. The male: female ratio was 5.3:1. The disease was most commonly detected in persons in their sixties and seventies. Pain and dyspnoea, the most common of the presenting symptoms, occurred in half of the patients. Weight loss and malaise were reported by six patients. Mesothelioma was most common on the right side, but often spread to the left, infiltrating the pericardium and the diaphragm. Metastases to abdominal organs were found in five of the eight autopsies, and in three other patients there were clinical signs of abdominal spread. Thoracotomy was performed in 12 patients, in one of whom radical removal of the tumor was attempted, but the patient died of recurrent tumor. Radiotherapy and cytostatic medication had no demonstrable effect on survival. Pleural effusion developed in all cases and all had roentgenologically demonstrated changes. Exposure to asbestos was documented in 6 of the 19 cases. In three asymptomatic patients the mesothelioma was incidentally revealed by routine X-ray examination, and these patients had significantly longer survival than the others. One of these tumors, however, had a relatively benign histologic appearance. Frequent X-ray examination of risk groups seems to offer the only prospect of improving management by earlier diagnosis.
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PMID:Malignant pleural mesothelioma. A clinical review of 19 patients. 671 76

Mesothelioma is a rare, asbestos-associated tumor that infrequently metastasizes. We reviewed 22 autopsies (from February 1989 through July 1994) showing mesothelioma. We determined distribution of metastases and staining characteristics of primary mesotheliomas compared to tissue involved by metastases and/or direct extension. Mean patient age was 68 years (range, 38 to 88 years); black:white patient ratio, 4:18; and male:female patient ratio, 2:1. All patients had a history of asbestos exposure. Fifteen autopsies were complete and 7 were limited to the thoracic cavity. Multiple sites were involved by direct extension. Metastases were in multiple sites, including omentum, stomach, intestine, mesentery, adrenal glands, ovary, pancreas, kidneys, liver, spleen, and vertebrae. Results of immunohistochemical staining of primary mesotheliomas and metastases were similar; both were positive for low-molecular-weight keratin and negative for carcinoembryonic antigen, Leu-M1, Ber-EP4, and periodic acid-Schiff reagent with diastase. Results of testing for high-molecular-weight keratin were variable.
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PMID:Mesothelioma: a study of 22 gases. 904 71

Tumours metastasizing to the heart are one of the least investigated subjects in clinical oncology. Nevertheless, this problem holds great practical significance in relation to the operability and type of treatment of neoplastic patients. Of 4769 patients autopsied at the Institute of Pathological Anatomy of Trieste from 1994 through 1995, 1148 males (42%) and 780 females (38%) had a primary tumour. Among them, 162 subjects had cardiac metastases (8.4%) of all cancers), with a significant decrease in frequency in elderly patients. Mesothelioma, melanoma and lung cancer showed the highest frequency of heart involvement in males (100, 50 and 31%, respectively). Melanoma, lung tumours and renal neoplasms had the highest percentages of secondary heart lesions in females (45, 26 and 20%, respectively). In lung cancer, anaplastic small-cell carcinoma (37%) and adenocarcinoma (33%) showed the most frequent heart involvement in males, while squamous carcinoma (43%) and anaplastic small-cell carcinoma (29%) had the highest frequency of heart metastases in females. Adenocarcinoma (82%) and anaplastic small-cell carcinoma (74%) of the lung, mesothelioma (100%) and breast tumours (73%) had the highest frequency of metastases to the pericardium. A particularly high frequency of myocardial involvement was observed in squamous cell carcinoma of the lung (62%), urinary tract tumours (60%) and melanoma (45%).
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PMID:Metastases of the heart and pericardium. 947 58

Platelet-derived growth factor BB (PDGF BB) and the PDGF receptor beta are expressed on mesothelioma cells, but their biological function has not yet been defined. In the present study we used Boyden chambers fitted with filters coated with the adhesive matrix proteins fibronectin, laminin, collagen type IV or the nonmatrix adhesive molecule poly-L-lysine (PLL). Mesothelioma cells migrated towards PDGF BB at concentrations ranging from 0.78 to 12.5 ng/ml if matrix proteins were present as adhesive substrates. This migration was integrin dependent since the same cells failed to migrate if the adhesive interactions necessary for migration were provided by molecules other than integrins. Migration of mesothelioma cells on fibronectin, laminin or collagen-type IV in response to PDGF BB was inhibited if the cells were pretreated with blocking antibodies to alpha3beta1 integrin. These findings describe for the first time PDGF BB as a chemoattractant for malignant mesothelioma cells and that collaboration between PDGF receptor beta and integrin alpha3beta1 is necessary for the motile response of these cells to PDGF BB.
Clin Exp Metastasis 1998 Aug
PMID:Platelet-derived growth factor (PDGF) BB acts as a chemoattractant for human malignant mesothelioma cells via PDGF receptor beta-integrin alpha3beta1 interaction. 987

Mesothelioma is a disease mostly involving the pleura, peritoneum, and pericardium. Hematogenously disseminated metastases involving the liver, adrenal glands, kidneys, and contralateral lung have been documented in some patients, but central nervous system (CNS) involvement, especially as leptomeningeal infiltration, is very rare. A 44-yr-old mesothelioma patient admitted to hospital with convulsions and diffuse leptomeningeal infiltration was shown with magnetic resonance imaging. She had a positive history for environmental asbestos exposure. Pleural and axillary lymph node biopsies were consistent with mesothelioma. Diffuse leptomeningeal infiltration is the only constant radiological finding reported as a diagnostic criteria for CNS involvement and histopathological confirmation is usually possible only at autopsy, so clinical and radiological diagnosis is essential after exclusion of other possible causes.
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PMID:Leptomeningeal infiltration of malignant mesothelioma. 1248 27

This review highlights the different imaging modalities for the detection of malignant pleural mesothelioma. The chest film is the initial diagnostic tool of choice because it is easy to perform, inexpensive, and widely available. Unfortunately, it demonstrates malignant pleural mesothelioma in later stages of disease and is not suitable for an early sensitive and specific diagnosis. Computed tomography is capable of distinguishing the different forms of pleural abnormalities. The knowledge of computed tomography findings is important for differentiation of malignant pleural diseases from benign diseases. Contrast-enhanced magnetic resonance imaging in three planes can be clinically useful to differentiate pleural mesothelioma from other malignancies or from benign pleural diseases. Furthermore, magnetic resonance imaging offers the possibility to differentiate invasion of the diaphragm from transdiaphragmatic tumor growth, and, in patients who are surgical candidates and who have questionable areas of local tumor extension on computed tomography, magnetic resonance imaging may provide additional information to plan or avoid surgery. Improvements in the detection of regional and distant metastases are needed to identify patients most likely to benefit from aggressive combined modality treatment regimes. In this context, positron emission tomography is a metabolic imaging technique that offers the possibility to evaluate active malignant cells. Drawbacks to this technique include false-positive findings, which may occur at sides of inflammation, and lesser anatomic detail information. A complete and accurate staging of malignant pleural mesothelioma is essential to evaluate the efficacy of new therapeutic strategies. This implies the need to be familiar with the most recently developed staging system from the International Mesothelioma Interest Group.
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PMID:The role of new imaging techniques in diagnosis and staging of malignant pleural mesothelioma. 1260 Dec 77

Mesothelioma is a rare neoplasm of the serosal membranes. Signs and symptoms of a pleural effusion typically herald discovery of the tumor. We report a case of miliary metastatic mesothelioma involving both lungs in a 54-year-old man who presented with right-sided chest discomfort, numerous pulmonary nodules detected by computed tomography of the chest, and absent pleural effusion. Immunohistochemical and electron microscopy studies performed on wedge biopsies of parenchymal pulmonary nodules led to the diagnosis of metastatic mesothelioma. Subsequent pleural evaluation and biopsy of pleural thickening noted at a site of prior chest wall trauma identified the primary neoplasm and confirmed the diagnosis as malignant epithelioid mesothelioma. The histologic appearance of discohesive epithelioid cells in a distinctly myxoid background was the clue in this case leading to the consideration of metastatic mesothelioma and a thorough immunohistochemical evaluation of the tumor. This case shows that mesothelioma may metastasize throughout the lungs in a miliary pattern and the metastases may be clinically detected before the primary pleural tumor. Metastatic mesothelioma is a consideration for metastatic pulmonary tumors of unknown origin.
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PMID:Miliary pulmonary metastases from a clinically occult pleural mesothelioma. 1291 49

Malignant pleural mesothelioma (MPM) is an aggressive cancer of the pleura that is usually caused by exposure to asbestos. The incidence of MPM has risen for some decades and is expected to peak between 2010 and 2020. Current surgical treatment involves in a multimodality regimen with radiation and multiple-drug chemotherapy. All currently proposed therapeutic strategies are in total agreement with the international Mesothelioma Interest Group TNM staging system. Schematically: for stage Ia (early stage disease), the therapeutic approach is generally neo-adjuvant intrapleural treatment using cytikines followed by surgical pleurectomy; for more advanced disease (stage Ib, II and III), a multimodal treatment combining extra-pleural pneumonectomy, radiotherapy and multiple-drug chemotherapy, including in all cases cisplatin, is proposed. Recently, results using this multiple modality approach have been favorable especially for patients with epithelial histology, negative resection margins and no metastases to extrapleural lymph nodes; for stage IV (unresectable tumor), palliative treatment is indicated. Early results have been encouraging and the use of recent drugs should allow more optimal treatment.
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PMID:[Surgery for malignant pleural mesothelioma]. 1513 42

Malignant pleural mesothelioma (MPM) is an uncommon neoplasm arising from mesothelial cells of the pleura. The prognosis is poor with a median survival of 8 to 18 months after diagnosis. Multimodality regimens combining chemotherapy, radiotherapy, immunotherapy, and surgery are being used more frequently in patient management. Extrapleural pneumonectomy is the surgical treatment of choice in 10% to 15% of patients who present with resectable disease and is reported to prolong survival. Accurate staging is important to distinguish patients who are resectable from those requiring palliative therapy. Integrated computed tomography-positron emission tomography (CT-PET) increases the accuracy of overall staging in patients with MPM and significantly improves the selection of patients for curative surgical resection. Specifically, CT-PET detects more extensive disease involvement than that shown by other imaging modalities and is particularly useful in identifying occult distant metastases. This article reviews aspects of imaging performed in the initial staging of patients with MPM according to the International Mesothelioma Interest Group staging system and will emphasize the appropriate role of CT-PET imaging in determining the T, N, and M descriptors.
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PMID:Preoperative evaluation of patients with malignant pleural mesothelioma: role of integrated CT-PET imaging. 1677 Feb 31

Mesothelioma is a rare malignant neoplasm of the serosal membranes, which can give distant metastases in various organs in advanced stages of its course. Subcutaneous tissue is an unusual metastatic site. In the literature, only one case of metastatic mesothelioma to the skin of the face has been reported. We present a case of a 60-year-old female with a prior history of peritoneal malignant mesothelioma, who 6 months after the initial diagnosis presented with a subcutaneous nodule in the lateral chest wall. Cytological examination of the material obtained by FNA from the nodule revealed metastatic mesothelioma. Although subcutaneous metastasis of malignant mesothelioma is a rare entity, one must always keep this possibility in mind and proceed to further investigation of such lesions. In these cases, FNA is a simple diagnostic procedure for the identification of metastatic disease in patients with a prior history of malignancy.
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PMID:Subcutaneous metastasis of peritoneal mesothelioma diagnosed by fine-needle aspiration. 1718 90


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