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)

Osteosarcoma is a rare malignant tumor of bone that produces osteoid. Most tumors arise in the metaphyses of long bones. At least 80 per cent of patients have subclinical metastases at diagnosis. Successful management of osteosarcoma requires surgical control of the primary tumor and chemotherapeutic control of systemic metastases. Wide resection of primary tumor is often compatible with limb-sparing surgery. Multiagent chemotherapy has significantly enhanced disease-free survival. Osteosarcoma metastasizes to lung and other bones. Aggressive surgical resection can sometimes control pulmonary metastases; bony metastases are almost always followed by death.
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PMID:Malignant bone tumors in children: osteosarcoma. 332 77

Osteosarcoma is known to metastasize rather early, and even after surgical resection of the primary metastases may occur predominantly in the lung. Administration of polychemotherapy for destruction of micrometastases has served to improve prognosis. Preoperative chemotherapy facilitates the evaluation of regression, another factor of high prognostic relevance. Morphologic analysis of pulmonary metastases developing during chemotherapy is of considerable interest on account of the potential therapy resistance of certain histologic subtypes of osteosarcoma. In the present study pulmonary metastases resected in 20 thoracotomies of 15 osteosarcoma patients were investigated by light microscopy and compared, if possible, to the respective primaries. All patients had received chemotherapy, predominantly according to the COSS 80 and COSS 82 protocols. The histologic picture of a tumor was found to change from the primary to the pulmonary metastasis, a pattern also verified in the lung metastases collected in consecutive thoracotomies from the same patient. Several different subtypes were regularly found side by side in the metastases, but generally no special sensitivity or resistance to chemotherapy could be attributed to any of these subtypes. Our results nevertheless do indicate an increased resistance of anaplastic tumor tissue. The response to chemotherapy agreed in 9 of 10 primaries with that of their metastases.
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PMID:Morphology of pulmonary metastases from osteosarcoma during chemotherapy. 347 66

In 19 unselected subsequently entered non-metastatic patients with a normal osteogenic sarcoma two different just tolerable chemotherapy combinations were applied pre- and postoperatively. The median follow-up time after discontinuation of chemotherapy is 26+ months. Nine patients have failed, all showing pulmonary metastases, six have died despite several heavy salvage regimens. So the disease free survival rate is 53%. Longer follow-up in this group and the European Osteosarcoma Intergroup Study will be needed to clarify the value of neoadjuvant chemotherapy in this disease.
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PMID:Combination chemotherapy preceding surgery in osteogenic sarcoma. 386 3

Osteosarcoma associated with a skip metastasis (SM) is a rare occurrence. The impact of modern chemotherapy on this entity has not been previously reported. This paper presents three cases treated by primary amputation and postoperative chemotherapy. All patients developed typical pulmonary and subsequent bony metastases. The average disease-free interval was 6.7 months. None appeared to benefit either from intensive chemotherapy or thoracotomy. The disease disseminated extensively in all three patients without radiologic or clinical response to the varied chemotherapeutic or additional surgical procedures. We conclude that a SM is a grave prognostic sign despite modern adjuvant modalities and suggest that a different therapeutic strategy is required.
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PMID:Skip metastases in osteosarcoma: recent experience. 657 71

Osteosarcoma very rarely metastasizes to the heart. Thirteen cases have been reported in the literature so far. Diagnosis in some of these cases was made during investigation for severe cardiac failure and in most of them at autopsy. Our patient, a 13-year-old girl, showed right pulmonary metastases on chest x-ray 1 year after above knee amputation for osteosarcoma of the distal femur. Routine preoperative computerized axial tomography (CT Scan) revealed a calcified lesion in the heart in addition to the pulmonary metastases. She was very active and completely asymptomatic. Two-dimensional echocardiography, angiography, and right and left heart catheterizations were done. This revealed a large mobile metastatic lesion in the right ventricle. The intraventricular tumor was successfully removed, and 12 days later she had a second thoracotomy for removal of pulmonary metastases. Nine months after her intraventricular metastasis was removed she developed a solitary right pulmonary metastasis. This was successfully resected. Now, 10 months later, she is disease free and completely asymptomatic.
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PMID:Asymptomatic intracardiac metastasis from osteosarcoma: a case report with literature review. 657 7

An osteosarcoma of the talus occurred in a 21-year-old man. The tumor had been mistaken for a fibrosarcoma, but its osteogenic nature was demonstrated by multiple sectioning of the entire talus. Nineteen months after amputation the patient died from pulmonary metastases. Osteosarcoma in the talus seems not to have been previously reported.
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PMID:An unusual case of primary osteosarcoma of the talus. 693 30

Osteosarcoma usually spreads via the blood stream, resulting in pulmonary and skeletal metastases. The value of bone imaging in the management of these patients is widely accepted. Less commonly, the disease spreads via the lymphatics. Such a case is reported to show that bone imaging will detect progressive involvement of the lymph nodes.
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PMID:The lymphatic spread of osteosarcoma shown by Tc-99m-MDP scintigraphy. 693 56

An analysis was made of 17 cases of microscopically proven rib neoplasms, with the objective of evaluating the variability of clinical and radiographic findings, the neoplastic cell types, the occurrence of metastases, and the survival time following the diagnosis. In 15 dogs with primary rib neoplasms and in 2 dogs with secondary (presumably metastatic) rib neoplasms, the clinical signs commonly included dyspnea and a localized swelling on the thoracic wall. For the dogs with primary rib neoplasms, the mean age was 4.5 years, with a range of 1.3 to 16 years. On radiography, rib osteolysis, extra and/or intrathoracic soft tissue masses often containing areas of mineralization, and pleural effusion were commonly identified. Ribs 5 through 9 were the most commonly affected and the right side was involved twice as often as the left side. Osteosarcoma was the most frequently diagnosed tumor, but chondrosarcomas and hemangiosarcoma were also found. At necropsy, over 50% of the dogs with primary rib neoplasms had metastases in the lungs. Less than 10% of the dogs with primary rib osteosarcomas survived more than 4 months after the diagnosis.
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PMID:Malignant neoplasia of canine ribs: clinical, radiographic, and pathologic findings. 695 63

The successful treatment of metastases will have to include modalities that can overcome the obstacles presented by the heterogeneous nature of malignant neoplasms and the continuous evolution of variant cells. Macrophages activated to become tumoricidal by interaction with L-MTP-PE may be able to accomplish this. Osteosarcoma appears to be an ideal disease in which to employ L-MTP-PE as an additional adjuvant to present chemotherapy regimens. The lung is the most frequent site of metastases, and pulmonary micrometastases are considered to be present in the majority of patients at diagnosis. Approximately 40% of patients with osteosarcoma develop pulmonary metastases despite the administration of adjuvant chemotherapy. The 2-year disease-free interval has not improved over the past 10 years, despite multiple changes in adjuvant regimens. These data argue that there is a subpopulation of patients who harbor tumor cells that are relatively resistant to all chemotherapy. Unfortunately, this group of patients cannot be identified at the time of initial diagnosis. This necessitates the incorporation of new forms of therapy into the adjuvant chemotherapy protocols for all patients in the hope of eradicating the resistant cells harbored in the 40%. Based on the data summarized previously, L-MTP-PE may improve the clinical outcome of patients with osteosarcoma by activating pulmonary macrophages to destroy residual tumor cells that are not eliminated by chemotherapy. Monocytes from osteosarcoma patients can be rendered cytotoxic to tumor cells by in-vitro incubation with L-MTP-PE and following the intravenous administration of this agent. L-MTP-PE can be given safely to both adults and children with minimal side effects. The whole-body distribution of 99mTc-labeled liposomes containing MTP-PE confirms that the agent is taken up by the lungs. Biologic activity in osteosarcoma patients is revealed by the elevations in plasma levels of several cytokines plus stimulation of monocyte-mediated cytotoxicity following L-MTP-PE infusion and by histologic changes in the pulmonary lesions. Ifosfamide therapy given in combination with L-MTP-PE does not suppress this immune response, as judged by both plasma cytokine levels and tumor histology. Finally, L-MTP-PE has been shown to be effective as a single agent against relapsed osteosarcoma. It is unlikely that the addition of other chemotherapeutic agents to the adjuvant chemotherapy protocols will alter the 65% to 70% 2-year disease-free survival rate associated with osteosarcoma. The preceding data indicate that L-MTP-PE is an active agent against this disease and deserves further investigation. Therefore, the inclusion of L-MTP-PE with chemotherapy is a reasonable alternative to consider to improve the response rate of this disease.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Biologic therapy for osteosarcoma using liposome-encapsulated muramyl tripeptide. 749 Feb 49

Osteosarcoma of the thoracic spine developed in a 15-year-old Japanese boy. After his first admission with paralysis, multiple skeletal metastases were demonstrated in the absence of pulmonary metastasis. This rare condition may possibly be considered as a unicentric osteosarcoma with bone metastases, since there were no precursor lesions or history of exposure to radioactive materials or chemical agents. These multiple lesions may be an example of so-called "organ-specific metastasis," although this "nonstochastic" process is rare.
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PMID:Osteosarcoma with multiple skeletal metastases. A case of "nonstochastic" metastasis. 751 Jan 14


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