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)

Extracranial metastasis of primary central nervous system neoplasms is uncommon and has not been described in the dog. We report the clincopathologic features of intracranial meningioma with pulmonary metastasis in three dogs (case No. 1: 13-year-old castrated male Boxer dog; case No. 2: 14-year-old spayed female Dachshund; case No. 3: 6-year-old spayed female German Shepherd Dog). Case No. 1 presented with ataxia, lethargy, vomiting, and leaning and falling to the right, and had a transient remission following radiation and corticosteroid therapy; case No. 2 had a history of seizures that were unresponsive to primidone, left-sided postural reaction deficits, ataxia, and circling to the right; case No. 3 had only intermittent episodes of vomiting Computed tomography of case Nos. 1 and 2 revealed peripherally located homogeneous contrast-enhancing intracranial masses. Postmortem examination revealed intracranial masses with single or multiple pulmonary nodules in all three cases. Histologically, the intracranial and pulmonary masses were meningotheliomatous meningiomas with atypical features including brain infiltration, necrosis, nuclear atypia, prominent nucleoli, and moderate cell density. All of the primary meningiomas had low mitotic rates. The current interest in early diagnosis and aggressive clinical/surgical management of canine patients with meningioma and other primary central nervous system neoplasms will likely result in an increased detection of extracranial metastases.
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PMID:Intracranial meningioma with pulmonary metastasis in three dogs. 162 30

A cerebral demyelinating disease developed in 3 patients during adjuvant therapy with 5-fluorouracil and levamisole for adenocarcinoma of the colon. None of the patients had evidence of metastatic disease or prior neurological disease. The duration of chemotherapy before onset of neurological symptoms ranged from 15 to 19 weeks. The total dose of 5-fluorouracil was 9.7 to 15.7 gm. The total dose of levamisole was 2.7 to 3.75 gm. Two patients presented with a subacute (2-3 weeks) progressive decline in mental status and ataxia. The third patient had two unexplained episodes of loss of consciousness. In each, magnetic resonance imaging with gadolinium demonstrated prominent multifocal enhancing white matter lesions. Cerebral biopsy was performed stereotaxically in 2 patients. The morphological features were those of active demyelinating disease. The myelin loss was associated with numerous dispersed as well as vasocentric macrophages, sparing of axons, and perivascular lymphocytic inflammation. Electron microscopy confirmed the light microscopic findings. All 3 patients improved after cessation of chemotherapy and a short course of corticosteroid therapy. Our patients represent the first reported examples of an inflammatory leukoencephalopathy associated with the administration of 5-fluorouracil and levamisole. This syndrome may represent the pathological basis for 5-fluorouracil neurotoxicity, although we cannot completely exclude the role of levamisole.
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PMID:Multifocal inflammatory leukoencephalopathy with 5-fluorouracil and levamisole. 163 34

A case of malignant ependymoma with extracranial metastases is reported. A 59-year-old male was admitted to our hospital with vomiting and ataxia. Following computed tomographic (CT) scanning indicating a ring-like enhanced mass in the cerebellum, the tumor was subtotally removed in December, 1985. Histological diagnosis was malignant ependymoma. A second operation was performed in February, 1987, due to recurrence of the tumor in the fourth ventricle. Postoperative radiation therapy at a total dose of 7780 rads was given over 2 years. Eleven months after radiation therapy was completed, he reported cough and multiple skin metastases. Chest x-rays showed metastases at the right hilus. Repeated CT scans revealed separate frontal cerebral metastatic tumors. He died of respiratory insufficiency. Extracranial metastases of infratentorial ependymoma to the skin and lung are rare pathological entities.
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PMID:Extracranial metastases of malignant ependymoma--case report. 169 51

We have studied an unusual, spontaneous, intradural extramedullary spinal cord tumor in 12 dogs. Animals presented with paraparesis and ataxia early in life (11/12 ranged from 6 to 38 months of age) suggesting that these tumors may be congenital. Various breeds of dogs were represented with four cases in German Shepherds and three in retrievers; there was no sex predisposition. Post-mortem examinations revealed a single intradural mass consistently located between T10 and L2, which produced extensive compression of the spinal cord. Metastasis was never observed and significant pathological changes in other organs were lacking. Microscopic examination revealed solid sheets of ovoid to fusiform cells interspersed with areas of acinar and tubular differentiation. Some areas were rarified and focal squamous metaplasia was observed. Ultrastructural features included the presence of a continuous basal lamina, junctional complexes, microvilli and occasional cilia at the apices of acinar complexes. Immunocytochemical studies did not support a neurectodermal origin. At least 13 case reports of this entity have been previously published and have been designated ependymomas, medulloepitheliomas and neuroepitheliomas. A recent case was diagnosed as a nephroblastoma and we feel that this is an interesting and provocative diagnosis. These tumors could result from remnants of renal primordium which becomes trapped between the dura and the developing spinal cord. However, firm evidence of such a histogenesis is not yet at hand.
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PMID:A novel intradural extramedullary spinal cord tumor in young dogs. 245 49

The association of opsoclonus and malignant neoplasia is infrequent. The clinical and neuropathological data of two patients in whom opsoclonus and ataxia developed 7 and 11 months before the detection of a bronchial carcinoma are reported. Loss of Purkinje cells, edema of dentate nucleus and peridental demyelination were the most important neuropathological findings; neither carcinomatous metastases nor inflammatory signs were found in the brain. From the review of the pathological reports of paraneoplastic opsoclonus, the following conclusions can be drawn: the changes in the cerebellum are produced by the paraneoplastic cerebellar degeneration and are unrelated to the origin of opsoclonus, which has other anatomic substrates; paraneoplastic opsoclonus is a "remote effect" of cancer with an inflammatory basis, for which neurotoxic and immunological mechanisms have been hypothesized.
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PMID:Paraneoplastic opsoclonus: a neuropathologic study of two cases. 255 25

Low-dose continuous infusion 5-fluorouracil (LDCI-FU) was administered to 28 women with advanced breast carcinoma. Daily doses ranged from 175 to 250 mg/m2. The LDCI-FU was delivered continuously until the appearance of toxicity and was reinstituted at a 20% dose reduction after toxicity completely resolved. Patients with a median age of 56 years and a median performance status of 60% (Karnofsky) had been previously treated with combination chemotherapy. Complete responses were observed in two patients with soft tissue metastases. Thirteen patients experienced partial responses with a median duration of response of 4+ months. Partial responses were predominantly observed in soft tissue disease; however, five patients with visceral metastases experienced partial tumor regression. Median survival for the study group was 4+ months. Hormonal receptor status did not predict response to LDCI-FU. Toxicities included stomatitis, ten patients; hand-foot syndrome, eight patients; mild leukopenia, two patients; moderate thrombocytopenia, two patients; diarrhea, three patients; ataxia, three patients. Catheter-related toxicities of sepsis and/or thrombosis occurred in six patients. Because of the demonstrated activity in previously treated patients (53% response rate), LDCI-FU should be investigated in combination chemotherapy regimens in untreated breast cancer patients.
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PMID:Low-dose continuous infusion 5-fluorouracil. Evaluation in advanced breast carcinoma. 291 20

A 66-year-old man with hepatic metastases from gastric adenocarcinoma was treated on two occasions with 5-fluoro-2-deoxyuridine (FUdR) via hepatic artery infusion (HAI). The patient developed neurologic signs and symptoms including disorientation, oculomotor defects, ataxia and multifocal myoclonus during both attempts at HAI. Systemic drug toxicity is unusual when FUdR is given via HAI, and neurologic toxicity has not previously been reported. We postulate individual hypersensitivity to FUdR or selective concentration of FUdR in brainstem structures to explain the toxicity in this case.
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PMID:Neurologic toxicity associated with hepatic artery infusion HAI of FUdR. 294 26

A 41 year old male presented with headache, lethargy, and ataxia and found to have a left temporal lobe mass and a leukoerythroblastic peripheral blood smear. The latter prompted an iliac crest bone marrow biopsy on which a diagnosis of metastatic glioma was made and verified by immunohistologic characterization. The patient was treated with cranial irradiation and simultaneous systemic BCNU (bis-dichloroethylnitrosurea) with complete response. This case with diffuse bone marrow involvement demonstrates that a glioblastoma is capable of extracranial metastases without previous intervention. From a review of reported cases of gliomas of extraneural metastasis, it is concluded that untreated gliomas are capable of vascular spread although less frequently than previously manipulated tumors.
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PMID:Intracranial astrocytoma with diffuse bone marrow metastasis: a case report and review of the literature. 329 52

We analyze a series of 44 medulloblastomas in patients aged 20 and older, listed in the Connecticut Tumor Registry. Average age was 34.1 years. Incidence was 0.058 per 100,000 per year. Headache and ataxia were the most frequent presenting complaints. Findings at diagnosis most often were papilloedema, cranial nerve palsies, and cerebellar dysfunction. Treatments included operation (15%), radiation (7%), and operation plus radiation (60%). Probability of survival at one year was 0.62; at five years, 0.26. Survival with operation and radiation was superior to survival with other courses of treatment. Extracranial metastases to the spinal cord, the bones, and the pleura occurred in 27% of cases. For the first two years from diagnosis, survival in this series was significantly better than survival in the contemporary series of children with medulloblastoma. At five years and ten years, survival in adults and children was comparable.
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PMID:Adult occurrence of medulloblastoma. 361

To characterize the neurological complications of cancer patients admitted to a community hospital, the charts of all cancer patients evaluated by a neurologist during a single year were reviewed. Nine percent (N = 93) of cancer patients received neurological consultation compared to 3.6% of other patients. The neurologic problem preceded the diagnosis of cancer in 11% of patients. Complications were most common with known metastases. Neurologists frequently discovered signs not noted by the referring physician: 52 patients were paretic, with weakness reported in only 31; cranial nerve complaints were described in 3, but found in 20; sensory abnormalities were noted in 8, but found in 26. A change in mental status was confirmed in 33% and ataxia in 10%. After consultation, distant metastasis was diagnosed in 40% of patients, direct extension in 8%, metabolic encephalopathy in 14% and remote effects of cancer and side effects of cancer therapy in 4% each. Other patients had unrelated diagnoses. In most cases, the neurologic consultation let to a change in treatment, with radiotherapy directed to a symptomatic tumor mass the most common beneficial outcome.
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PMID:Neurological consultation in the management of patients with systemic cancer admitted to a community hospital. 376 59


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