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 purpose of this study was to compare the diagnostic significance of serum tumor markers in metastatic breast cancer and to evaluate their usefulness in monitoring palliative treatment. One hundred sixty-two breast cancer patients with various disease involvement have been followed-up by serum beta-human chorionic gonadotrophin (beta-HCG), alkaline phosphatase (AP), phosphohexose isomerase (PHI), carcinoembryonic antigen (CEA), and tissue polypeptide antigen (TPA) analysis for 6 to 29 months. In metastatic disease, rates of elevated tumor marker levels ranging between 44% and 91% were found except for beta-HCG (13%). The low rate of positive beta-HCG values did not suggest that routine estimation may be useful. For the other markers, differences in positive rates were seen when site of metastasis, tumor burden, tumor activity, and stage of disease were taken into account. CEA and TPA were shown to be more sensitive indicators for metastatic disease than AP and PHI. TPA was more sensitive but less specific than CEA; both provided almost identical discrimination. In monitoring palliative treatment, a close correlation was found between the clinical course and changes of CEA. AP and PHI frequently became elevated only in very advanced disease, their elevation supported the clinical evidence of progression.
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PMID:Serum tumor markers in metastatic breast cancer and course of disease. 619 67

A comparison between primary and metastatic germ cell tumours from 38 male patients showed that 19 of 24 metastases with residual differentiated teratoma after adequate therapy came from tumours with teratoma as a component of the primary. The correlation between the presence of teratoma in the primary and the metastases is statistically significant (P less than 0.01) and supports the view that the so called 'maturation' of germ cell tumours is due to selective destruction of anaplastic components in tumours which have already shown an inherent capacity for differentiation. Elevation of the serum concentrations of HCG and AFP on presentation with disseminated disease was significantly related to the presence of morphologically identifiable trophoblast and yolk sac elements respectively in the primary tumours (P less than 0.001). Histological identification and specific mention of teratomatous, trophoblastic and yolk sac elements in reporting germ cell tumours is therefore useful since their presence in the primary correlates with the morphology in the metastases.
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PMID:Significance of the 'maturation' of metastases from germ cell tumours after intensive chemotherapy. 620 25

The most common type of testicular tumor is the germ cell tumor, which shows peculiar histological and biological features. The histopathology of germ cell tumors of the testis is illustrated here according to the WHO classification except for extremely rare polyembryoma and teratoma with malignant transformation. The tumors are divided roughly into 2 groups, one histological type including seminoma, spermatocytic seminoma, embryonal carcinoma, yolk sac tumor, choriocarcinoma and teratoma, and more than one histological type including many possible combinations of one histological type. Seminoma and spermatocytic seminoma show some similar features to the germ cell line, while embryonal carcinoma, yolk sac tumor, choriocarcinoma, and teratoma show differentiation toward a variety of structures appearing at any stage of embryogenesis instead of the original testicular tissue. The histology of the metastatic disease may or may not be the same as that of the primary lesion. The reasons for the occurrence of histological differences between primary and metastatic tumors is discussed. Two major tumor markers of the germ cell tumor, HCG and AFP, are analyzed using immunohistochemical procedure, and the significance of immunostaining for these markers in clinicopathological study is stressed.
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PMID:[Histopathology of testicular germ cell tumors]. 621 48

The clinico-pathological features of four patients with placental-site trophoblastic tumour (trophoblastic pseudotumour) are presented. One patient had the nephrotic syndrome associated with evidence of disseminated intravascular coagulation, with complete resolution after hysterectomy. In two patients the tumour extended beyond the uterus, and one of them died with many metastases in spite of intensive post-operative chemotherapy and 'second look' laparotomy. In three patients the tumour behaved as an actively infiltrative neoplasm resistant to chemotherapeutic regimes usually effective for choriocarcinoma. Serum HCG levels were relatively low compared with those of choriocarcinoma. Histologically the tumours were predominantly composed of mononuclear cells supported by a variable amount of vascular stroma and lacked the bilaminar structure characteristic of choriocarcinoma. Scattered cells stained positively with anti-beta HCG and anti-alpha HCG antisera. Prior curettage was diagnostic in two of three cases. We did not find a clear correlation between mitotic activity and subsequent behaviour. Inflammatory cell infiltration and evidence of organisation around the tumour may be favourable prognostic indicators. We agree with a recent publication stressing the variable behaviour of this tumour, and emphasize the importance of serum HCG monitoring. Total surgical excision is usually feasible and in aggressive cases offers the best chance of eradication. We support the recent suggestion that 'trophoblastic pseudotumour' is an unsuitable name for a potentially lethal disease.
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PMID:Placental site trophoblastic tumour (trophoblastic pseudotumour): a study of four cases requiring hysterectomy including one fatal case. 628 Nov 56

The authors report a series of 97 germinal tumours of the testis in the adult, studied first in terms of conventional histological data. Of 33 seminomas, 2 secreted HCG. The 5-year actuarial survival at stage I was 93%, and at stage II 75%. Stage II deaths revealed the existence of not purely seminomatous tumours. Amongst dysembryomas, half secreted HCG, with 3 histological groups: predominant choriocarcinomas, tumours with a trophoblastic component and "apparently pure" dysembryomas. The 3-year actuarial survival for dysembryomas was 90% at stage I and 58% at stage II. 51 patients of the series were studied retrospectively by sections with HCG peroxidase, a technique which reveals the intracytoplasmic synthesis of the hormone. Two types of cells have proved capable of such synthesis: syncytial cells, of syncytial-trophoblastic type, and small mononuclear cells. One third of seminomas and 90% of dysembryomas proved to have a trophoblastic component as demonstrated by HCG immunoperoxidases. All patients secreting HCG were HCG peroxidase positive. This equally applied to all patients with syncytial cells. Furthermore, all the indications are that HCG secretion is above all by the syncytial cells. From a diagnostic standpoint, any rise in beta HCG is synonymous with an HCG immunoperoxidase trophoblastic component. Detection of such a component using immunoperoxidase would seem to be essential for non-secreting tumours. From a prognostic standpoint, seminomas with a trophoblastic component are in fact dysembryomas and lymph node dissection should be performed, this being the only way of not missing a non-seminomatous metastasis. Therapeutically, pure seminomas are distinguished by the possibility of cure by radiotherapy. For all other tumours, orchidectomy must be followed by lymph node dissection. Subsequent treatment is decided on the basis of the results of the latter, with the exception of tumours with visceral metastases where chemotherapy must come first.
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PMID:[Diagnosis, prevalence, prognosis and treatment of the trophoblastic component in germinal tumours of the testis in the adult]. 629 86

Alpha HCG, estimated after evacuation of hydatidiform mole, was found to follow the decline of beta-HCG. In patients with low-risk non-metastatic gestational disease the alpha-subunit values also followed the beta-HCG values. This indicates no additional value in following alpha-HCG in such patients. Whether alpha-HCG elevation may portend recurrence in treated high-risk cases of metastatic disease in remission with non-detectable beta-HCG remains unresolved by this study.
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PMID:Alpha subunit in gestational trophoblastic disease. 630 44

A 41-year-old woman who 5 years earlier had a hysterectomy for a placental site trophoblastic tumor (formerly called trophoblastic pseudotumor) was readmitted to the hospital with pelvic recurrence and multiple lung metastases. Despite an initial decrease in the size of the lung metastases and concomitant lowering of the serum values of human chorionic gonadotropin (beta-HCG) from 2,200 to 40 ng/ml, combined chemotherapy became ineffective. The patient died 4 months later with widespread metastases. The clinical course and the autopsy findings of this case are reported and compared with the two similar cases reported in the literature.
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PMID:Placental site trophoblastic tumor (trophoblastic pseudotumor) of the uterus with metastases and fatal outcome. Clinical and autopsy observations of a case. 631 Oct 36

Serum levels of chorionic gonadotropin (HCG), testosterone, luteinizing hormone (LH) and prolactin were evaluated with the radioimmunoassay in 59 patients with lung cancer, 10 patients with benign lung disease, and 37 normal controls. HCG was present in 6.8% of the lung cancer patients but in none of the subjects of the other two groups. Prolactin and LH levels were significantly higher than normal in lung cancer patients (respectively p less than 0.001 and p less than 0.01) as well as in patients with benign lung disease (p less than 0.01 for both the hormones). Testosterone levels were significantly lower than normal in patients with lung cancer (p less than 0.05) but not in those with benign lung disease. When the patients were analyzed according to histologic type and clinical stage of disease, significantly lower than normal values of testosterone were found in patients with small cell carcinoma or squamous cell carcinoma. In the squamous cell carcinoma group, the patients with lymph node metastases had significantly lower testosterone levels than those without lymph node metastases. From these results, we may hypothesize that the raised levels of prolactin and LH are related to a pulmonary pathology, not necessarily neoplastic, whereas the low levels of testosterone are related to the presence of the tumor.
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PMID:Abnormal serum hormone levels in lung cancer. 631 49

From 1972 to June 1980, 138 patients were admitted into the University Gynaecological Unit, Queen Mary Hospital for persistent gestational trophoblastic tumours. Forty had pulmonary metastases, all were treated by chemotherapy and 5 died shortly after commencement of treatment. The remaining 35 patients went into biochemical remission. Five of these patients had persistent chest shadows and 2 had evidence of active disease. Thoracotomy is of doubtful value both in therapy and in predicting prognosis. These patients have an increased risk of relapse. Close and long-term follow-up HCG assay is advocated.
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PMID:Persistent chest opacity in trophoblastic disease: is thoracotomy justified? 632 36

A rare case of a malignant Leydig-cell tumour of the testis in a 26-year-old patient, with radical orchiectomy from an inguinal incision is described. Although the results of AFP, HCG, biochemical, X-ray, lymphographic and scintigraphic examinations were negative, the first metastases into the lungs appeared one year after the operation. Combined cytostatic treatment, polychemotherapy and X-ray therapy proved ineffective. The patient died of multiple metastases 28 months after the surgical intervention.
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PMID:Malignant Leydig-cell tumour of testis. 648 Feb 83


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