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)

An extremely rare case of esophageal metastasis from prostate cancer is reported. A 65-year-old man presented with anorexia and back pain. Upper gastrointestinal X-ray fluoroscopy and endoscopy revealed a shallow longitudinal ulcer, with converging mucosal folds, approximately 5 cm above the esophagogastric junction. The histological diagnosis of the biopsied specimen was adenocarcinoma. Blood biochemistry revealed elevated serum prostate-specific antigen (PSA) and gamma-seminoprotein levels. Ultrasonography of the prostate disclosed a hypoechoic lesion in the left lobe, and needle biopsy led to the diagnosis of prostatic adenocarcinoma. Since there was no finding suggestive of a primary lesion, apart from that in the prostate, we conducted reverse transcriptase-polymerase chain reaction (RT-PCR) for PSA. PSA-positive mRNA was demonstrated in the tissue of the esophageal tumor. There are three reports on metastasis to the esophagus from prostate cancer, but this is the first case of esophageal metastasis from prostate cancer without any evidence of metastasis to other organs. The importance of RT-PCR for the diagnosis of primary lesions of metastatic cancer is discussed.
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PMID:Esophageal metastasis from prostate cancer: diagnostic use of reverse transcriptase-polymerase chain reaction for prostate-specific antigen. 908 74

There are many radionuclides currently used in oncologic imaging including technetium 99m diphosphonates, gallium 67, thallium 201, technetium 99m sestamibi, and others. The specific interactions of each of these agents with computed tomography (CT) and magnetic resonance imaging (MRI) are extensive. The radionuclide bone scan using 99mTc diphosphonate is the most frequently performed nuclear medicine examination in oncologic imaging. The bone scan can be used as a model to generalize the interactions of nuclear medicine with CT and MRI. The applications for the bone scan and many other nuclear medicine procedures in oncologic imaging include evaluating for metastases, assessing the response to therapy, and guiding radiation therapy planning. Bone scan findings that are equivocal for metastases can be evaluated with other imaging modalities. Areas of abnormal uptake in the axial skeleton can be evaluated with CT or MRI, whereas those in the appendicular skeleton can be evaluated with plain radiographs, followed by CT or MRI if necessary. The bone scan is valuable in oncologic imaging because of its high sensitivity for lesion detection, its ease in whole body imaging, and its low cost. The major disadvantage of the bone scan is that it lacks fine anatomic detail, which is of particular importance in the cancer patient with local back pain, radiculopathy, or myelopathy. Because local back pain with or without radiculopathy is the earliest symptom of spinal cord compression in 90% of patients, an MRI is the study of choice because of its exquisite depiction of anatomy. A myelogram followed by a postmyelogram CT can be performed if there are contraindications to an MRI. The basic principle of high sensitivity for lesion detection and ease in whole body imaging provided by nuclear medicine and fine anatomic detail provided by CT and MRI can be applied also to the use of other radionuclides in oncologic imaging.
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PMID:Oncologic imaging: interactions of nuclear medicine with CT and MRI using the bone scan as a model. 914 56

A 30-year-old female presented with a three month history of back pain. Radiographs and computed tomography indicated an aggressive haemangioma of T12 which was confirmed on red cell scintigraphy. The varying imaging appearances of non-aggressive and aggressive vertebral haemangiomas are described, emphasizing the ability of aggressive haemangiomas to mimic metastases on magnetic resonance imaging. The therapeutic role of embolisation as an adjunct ro surgery is stressed.
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PMID:Clinics in diagnostic imaging (25). Aggressive vertebral haemangioma. 925 6

The authors report 64 renal cell carcinomas observed in 64 patients over a period of 14 years (1982-1995). The mean age was 58 years (range: 20 to 80 years). Male involvement was observed in 34 cases (53%). The clinical symptoms were nonspecific, consisting of haematuria (26 cases), back pain (33 cases) and tumour (8 cases). Twenty patients presented with paraneoplastic syndromes and 4 presented with metastases. The tumour was an incidental finding in 6 cases. Fifty two patients were treated by radical nephrectomy and two by partial nephrectomy. The tumour was associated with venous involvement in 2 cases, lymphatic involvement in 4 cases and distant metastases in 2 cases. The overall 5-year survival was 37% with a poor prognosis in the case of lymph node involvement or metastases and in the case of secondary local recurrence (4 cases) or distant metastases (2 cases).
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PMID:[Renal cell adenocarcinomas. Report of 64 cases]. 927 41

Two patients with hypochromic microcystic anemia received intravenous iron therapy (Blutal, Yuham Co., An Yang, Korea). These patients demonstrated diffuse hepatic uptake of Tc-99m MDP on bone scintigraphy, which was performed for evaluation of lower back pain in one patient and to rule out skeletal metastases from gastric cancer in the other patient. Blutal is an iron colloid chondroitin sulfate complex and is used to treat iron deficiency anemia in Korea. Phagocytized iron colloid within the hepatic reticuloendothelial system is responsible for the hepatic uptake of Tc-99m phosphate in the two presented cases.
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PMID:Hepatic uptake of Tc-99m MDP on bone scintigraphy from intravenous iron therapy (Blutal). 936 85

Bone scan has long been considered to be an important diagnostic test in searching for bone metastases. However, considerable difficulty is encountered in the vertebral region due to the complexity of structures and the fact that other benign lesions, especially degenerative changes, are very common there. Single-photon emission tomography (SPET) has been reported to be useful in the differentiation of benign from malignant conditions. Here we report our experience with bone SPET in the diagnosis of vertebral metastases. This is a retrospective study of technetium-99m methylene diphosphonate (MDP) bone scans in 174 consecutive patients who were referred for the investigation of back pain in our department. MDP planar and SPET images were obtained. Of teh 174 patients, 98 had a known history of malignant tumours. The diagnosis of vertebral metastasis was made on the basis of the patients' clinical histories and the findings with other imaging techniques such as magnetic resonance imaging, computed tomography or follow-up bone scan. We found that the presence of pedicle involvement as seen on SPET was an accurate diagnostic criterion of vertebral metastasis. SPET had a sensitivity of 87%, a specificity of 91%, a positive predictive value of 82%, a negative predictive value of 94% and an accuracy of 90%. On the other hand, planar study had a sensitivity of 74%, a specificity of 81%, a positive predictive value of 64%, a negative predictive value of 88% and an accuracy of 79% in diagnosing vertebral metastasis. Except with regard to the negative predictive value, SPET performed statistically better than planar imaging. Only 9/147 (6.4%) lesions involving the vertebral body alone and 3/49 (6.1%) lesions involving facet joints alone were subsequently found to be metastases. We conclude that bone SPET is an accurate diagnostic test for the detection of vertebral metastases and is superior to planar imaging in this respect.
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PMID:Comparison of bone single-photon emission tomography and planar imaging in the detection of vertebral metastases in patients with back pain. 961 79

Individuals who have severe back pain have trouble bending, may not be able to put on their shoes, have difficulty in ambulation, and may not be able to clean their own houses. What distinguishes these individuals with low back pain from those afflicted with other conditions (i.e., congestive heart failure, metastatic cancer, symptomatic acquired immune deficiency syndrome) is prognosis. Back pain essentially never shortens life. Acute back pain has a very benign prognosis, with more than 90% of the individuals returning to functional status equivalent to their baseline status within 3 months of the onset of pain. Patients who have chronic back pain have a significantly worse prognosis, but most cohort studies show that substantial numbers of chronic back pain patients improve over time with supportive therapy.
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PMID:Disability: how successful are we in determining disability? 985 77

Two patients, a woman aged 65 years and a man aged 56 years, with cancer, presented with pain in one leg as the first manifestation of metastases. The woman had tumour plexopathy of the lumbosacral plexus caused by an os sacrum metastasis of a thyroid carcinoma; she received radiotherapy but died a short time later. The man had lumbosacral epidural metastases of a colon carcinoma, compressing lumbosacral roots; with radiotherapy he survived the first year. Back pain with radiating pain is a frequent symptom in patients with cancer. Spinal epidural metastases, spinal and paraspinal metastases without epidural extension, tumour plexopathy and leptomeningeal metastases are the commonest causes. Early diagnosis (by MRI or spinal fluid examination) is important; with progressive weakness or sphincter disturbances the prognosis worsens.
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PMID:[Pain in one leg in patients with cancer]. 1009 55

This case describes what may become an increasingly common clinical problem in Australia as the proportion of our population originally derived from South East Asia, ages. Our patient was of Chinese origin and presented with back pain which was eventually found to be due to metastatic disease from an otherwise silent hepatoma, in association with unrecognised chronic hepatitis B infection.
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PMID:An unusual cause of back pain. 1033 Jul 60

The authors present the case of a patient in whom intradural metastasis from renal cell carcinoma spread to the cauda equina. To the authors' knowledge, this is only the second report of its kind. This male patient had undergone nephrectomy for the treatment of renal cell carcinoma for 5 years and was diagnosed as having metastatic lung disease 1 year prior to admission. The patient presented with lower back pain that radiated to both legs, but he exhibited no sensorimotor deficits. The majority of cauda equina tumors are primary tumors, and metastases are very rare. The literature is reviewed with reference to current molecular genetic paradigms of metastatic renal cell carcinoma.
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PMID:Renal cell carcinoma: a rare source of cauda equina metastasis. Case report. 1041 38


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