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 51-year-old patient with severe back pain had undergone resection of a benign cerebellar tumour when aged 15 years. In addition, polycystic kidney disease was diagnosed 24 years ago, bilateral phaeochromocytoma 2 years ago, and for 4 months before the present admission he had been on haemodialysis. The family history indicated autosomal dominant inheritance of the polycystic renal disease. His general condition was found to have deteriorated, he had pain on pressure over the upper thoracic and lower lumbar vertebrae, and the kidneys were enlarged on palpation. There were increased concentrations of calcium (3.01 mmol/l), parathormone (2.0 ng/l), carcinoembryonic antigen (13.5 micrograms/l) and TPA (69 U/l). Computed tomography demonstrated cystic and solid parts of much enlarged kidneys. Biopsy revealed a poorly differentiated clear-cell renal carcinoma. Further information concerning the previously removed brain tumour showed this to have been an haemangioblastoma of the cerebellar tonsils indicating the diagnosis of v. Hippel-Lindau disease. Nine other family members had been affected, but none had the full-blown picture of the disease. The patient died 3 weeks later from the rapidly advancing tumour. Autopsy showed the bilateral renal carcinoma, bilateral phaeochromocytoma and metastases to the sternum, femurs, vertebrae and liver.
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PMID:[The von Hippel-Lindau syndrome. Its differential diagnosis from cystic kidneys in adulthood]. 778 10

A 71-year-old female presented with left back pain at our hospital. She had had the same symptom about 1 year previously, but she had been presumed to have undergone stone passage because her symptom had disappeared. At this time a urogram, either excretory or retrograde, showed narrowing of each caliceal infundibulum and dilatation of each calyx in the left kidney, but otherwise normal findings. A cytology of left ureteral urine was class V, and cystoscopy revealed no abnormality. Under the diagnosis of left renal pelvic tumor she underwent nephroureterectomy with resection of a bladder cuff and retroperitoneal lymphadenectomy. The resected specimen had no gross tumor throughout the renal pelvis and ureter, but histological examination revealed transitional cell carcinoma in situ (grade 2) in most of the renal pelvis and infiltration of inflammatory cells in the submucosa. The ureter did not have any cancerous lesion, and no lymph node metastases was found. Four months postoperatively she is thought to have no evidence of disease with negative urinary cytology.
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PMID:[Primary transitional cell carcinoma in situ of the renal pelvis: a case report]. 780 46

A 58-year-old male complaining of pollakisuria, miction pain and back pain visited us Dec. 26, 1979. Rectal examination revealed the prostate enlarged by 5 digital width, stony hard and irregular. Transrectal needle biopsy revealed moderately differentiated adenocarcinoma of the prostate. Bladder neck invasion, pelvic and mediastinal lymph node metastases and multiple bone metastases were found. The case was diagnosed with prostatic adenocarcinoma T3N2M1 (OSS, LYM) stage D2. Three courses of chemotherapy using ifosfamide applied from Feb. 2, 1980 showed no marked effect except for partial pain relief. Hormonal treatment with diethylstilbestrol diphosphate was started from May 28 and arterial infusion chemotherapy using CDDP and 5-FU was performed 2 months later, resulting in size reduction of the prostate and pelvic lymph node metastases and disappearance of mediastinal lymph node metastases. Needle biopsy of the prostate was negative for cancer cells. After 8 months, Tegafur was started, and 12 months later radiotherapy was added to the prostate and pelvic lymph nodes. The abnormal accumulation in bone scan began to decrease after 14 months and achieved complete remission 28 months after the initial therapy. We discontinued the hormonal therapy 31 months later because of his complaint of chest discomfort and palpitation. At the present time, 14 years after the initial therapy, the prostate was 35 x 29 x 19 mm in size on transrectal ultrasonography with undetectable serum PSA level and no tumor cells but only mass fibrosis has been seen by pathological examinations. We considered this patient to be with no evidence of disease.
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PMID:[A case of completely responding stage D2 prostatic cancer with no evidence of disease 14 years after diagnosis]. 780 48

A 63-year-old woman was in hospital for persistent backache. Four months prior to admission she had been pointed out as having hypertension for the first time. On admission, she had anemia (hemoglobin 7.0 g/dl) with reticulocytosis, and a blood smear showed fragmented erythrocytes. A bone marrow aspirate disclosed erythroid hyperplasia and invasion of cancer cells. The chest roentgenogram showed a coin-lesion of the right lung and left pleural effusion. A diagnosis of microangiopathic hemolytic anemia (MAHA) associated with carcinomatosis was made, but the primary site of the cancer was unknown. Respiratory failure developed and the patient died a month later. Surprisingly, the autopsy revealed a malignant pheochromocytoma arising from the right adrenal gland with massive metastases to the lungs, liver, lymph nodes and systemic bones, and also disseminated intravascular coagulation (DIC). The DIC would probably account for the MAHA in this case. To our knowledge, this is the first reported case of malignant pheochromocytoma accompanied by MAHA.
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PMID:Malignant pheochromocytoma accompanied by microangiopathic hemolytic anemia: a case report. 800 27

Two cases of primary extragonadal germ cell tumor of retroperitoneal origin are reported. One was a 26-year-old man complaining of back pain. He had a large retroperitoneal tumor with lung, liver and supraclavicular lymph node metastases. He was referred to us after being treated for malignant lymphoma. The serum AFP, beta-subunit of human chorionic gonadotropin (hCG-beta), CEA and CA-19-9 were elevated. The retroperitoneal disease was treated surgically and with radiotherapy. The pathological diagnosis was that of embryonal carcinoma and teratoma. The lung, liver and supraclavicular lymph node metastases disappeared completely after two courses of cisplatin-based chemotherapy. While further chemotherapy was postponed due to myelosuppression, the disease relapsed and was resistant to subsequent therapy. The patient died twelve months after he first saw us. The second case was that of a 36-year-old man complaining of edematous legs and external genitalia. He had an extensive retroperitoneal tumor with multiple pulmonary metastases. The serum AFP level was high. Suspected of having an extragonadal germ cell tumor, he was referred to us promptly. Cisplatin-based chemotherapy coupled with resection of residual retroperitoneal and pulmonary disease resulted in complete remission. The pathological diagnosis was that of possible embryonal carcinoma. Further chemotherapy was given as scheduled, using granulocyte colony-stimulating factor. The patient has been in complete remission for two years. The chemotherapeutic regimen and surgical policy in the treatment of the two patients were essentially same. Early diagnosis, adequate initial therapy and the use of granulocyte colony-stimulating factor may be relevant to the favorable prognosis in the latter case.
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PMID:Extragonadal germ cell tumor of retroperitoneal origin: report of two cases. 812 21

We presented a rare case of primary pulmonary artery sarcoma. A 27-year-old female was admitted with fever and back pain. Her chest X-ray showed right pleural effusion and infiltrate in the right lower lobe. Enhanced chest CT scan and pulmonary angiogram showed an intraluminal filling defect of the pulmonary trunk. She was operated on under cardiopulmonary bypass. Following the incision of the pulmonary trunk, a polypoid soft yellowing mass was exposed. The local tumor resection and the right pneumonectomy were performed. Histological and immunohistochemical studies of the tumor revealed malignant fibrous histiocytoma. She made a good recovery but died of distant metastases 10 months after surgery.
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PMID:[A case of malignant fibrous histiocytoma of the pulmonary artery]. 817 11

A 20-year-old caucasian woman with a 5-year history of right arm, neck, and back pain sought treatment when an automobile accident (4 months before admission) exacerbated her pain. Magnetic resonance imaging revealed an intra- and extradural mass compressing the spinal cord at the C5-C6 level. It also extended into and widened the neural foramen, mimicking a neurofibroma. A single cafe-au-lait spot was discovered in the inguinal region. A two-staged surgical resection was performed on an apparent hemorrhagic C6 nerve root mass. The mass exhibited diagnostic features of a malignant melanoma histologically, immunocytochemically, and ultrastructurally. A search for a primary lesion outside the nervous system or other metastases during an 8-year period from the onset of symptoms has been negative. The patient's chronic history, evidence of neural foraminal enlargement, and the absence of other malignant melanoma lesions or subsequent metastases indicates that this lesion may be a primary melanoma of the nerve root with a benign course.
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PMID:Melanoma arising in a cervical spinal nerve root: report of a case with a benign course and malignant features. 819 Feb 31

Back pain and low back pain can be caused by extravertebral diseases, functional disorders or morphologic changes of the spine. Diagnosis of back pain is mainly done by clinical examination. The examination of segmental mobility is necessary to make the diagnosis of functional disorders. X-ray and laboratory are mainly used to exclude morphologic changes of the spine. Functional disorders are best treated by chirotherapy completed by rehabilitation of the active motion apparatus. The most important morphologic diseases of the spine causing back pains are deformities, especially lumbar scoliosis, infectious diseases as pyogenous or specific spondylitis, rheumatic diseases as rheumatoid arthritis, mostly at the occipitocervical region, and Bechterew's disease, furthermore instability caused by spondylolisthesis or iatrogenic low back pain as the failed-backsyndrome and tumors, which are in the majority metastases. The role of degenerative changes as a cause of back pain is difficult to estimate. The operative treatment of spinal instability, which has changed in the last years is described, as modern treatment facilities of lumbar disc herniation as chemonucleolysis or percutaneous nucleotomy.
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PMID:[The spine in adulthood]. 837 59

Successful radiotherapy was performed for three post-operative hepatocellular carcinoma patients, two with bone metastases and one with lymph node metastasis. One patient had severe high back pain and paraplesia caused by spinal compression with bone metastasis on 5th thoracic vertebra. After a total of 45 Gy irradiations, the back pain was removed, and 9 months later the patient recovered from the paraplesia gradually and could start rehabilitation. A second patient with multiple bone metastases was very concerned about skull metastasis and severe headache. Radiation reduced the headache and the tumor vanished. A third patient with cervical lymph node metastasis was irradiated. The size of the lymph node was decreased but did not disappear. We concluded that radiotherapy for distant metastases (ie, bone, skin) in a hepatocellular carcinoma patient, can be an effective therapeutic procedure for patient complaints.
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PMID:[Evaluation of radiotherapy for bone and lymph node metastasis in post-operative hepatocellular carcinoma--three case reports]. 839 8

The authors categorized 125 spinal lesions in cancer patients and 127 lesions in patients with back pain according to their location in the vertebra on single photon emission computed tomographic (SPECT) images. Forty-four lesions were metastases, all in patients with known malignancy. Lesions in the apophyseal joints were all benign. Lesions manifesting as abnormal uptake projecting beyond the vertebral body surface were osteophytes. Thirty-seven percent of the lesions detected in cancer patients were categorized in either of these two benign categories. Lesions showing focal or diffuse uptake in the body were usually benign (96% and 87%, respectively). Lesions showing uptake in the body and pedicle were usually metastases (83%). When abnormal uptake was seen in both the body and posterior elements but with an intervening normal pedicle, benign disease was the most common cause (93%). It was concluded that the location of lesions on tomographic images provides useful information for differentiation between malignant and benign lesions in the vertebrae.
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PMID:Role of SPECT in differentiating malignant from benign lesions in the lower thoracic and lumbar vertebrae. 845 12


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