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)

Four cases are presented of primary anterior mediastinal tumors in young adults that were characterized by solid, infiltrative lesions showing histologic and immunohistochemical features of rhabdomyoblastic differentiation. The patients were three men and one woman between 19 and 27 years of age (mean age, 23 years). All patients presented with symptoms referable to their tumors, including cough, chest pain, dyspnea, and left-sided pleural effusion. Grossly and radiographically, the lesions were characterized by their solid, infiltrative appearance. Histologically, two cases corresponded to the solid variant of alveolar rhabdomyosarcoma, one case was an embryonal rhabdomyosarcoma with a predominant spindle cell component, and the remaining case showed the features of a pleomorphic rhabdomyosarcoma. No glandular, epithelial, or other component could be identified in any of the tumors on extensive sampling. Immunohistochemical studies showed positive staining of the tumor cells with actin, desmin, and vimentin antibodies, with focal positivity for myoglobin in three cases and focal positive staining with S-100 protein in one case. Stains for low and high molecular weight keratin, carcinoembryonic antigen, alpha-fetoprotein, human chorionic gonadotropin, placental alkaline phosphatase, leukocyte-common antigen, and neuron-specific enolase were negative. All patients experienced rapid recurrence and metastases within the first 6 months after diagnosis. Three patients died within this period due to their tumors; the fourth patient has been lost to follow-up. Pure primary rhabdomyosarcomas of the anterior mediastinum are highly aggressive neoplasms that should be distinguished from germ cell, teratomatous, or carcinosarcomatous tumors with a focal rhabdomyoblastic component.
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PMID:Rhabdomyosarcomas of the anterior mediastinum: report of four cases unassociated with germ cell, teratomatous, or thymic carcinomatous components. 816 67

A 73-year-old man presented to our hospital complaining of dysuria and nocturia. The examination revealed prostatic cancer. Metastatic cancer was not revealed by the examination. He underwent total prostatectomy and iliac lymphadenectomy. Pathological examination of the surgical specimen revealed moderately differentiated adenocarcinoma of the prostate with right iliac lymph node metastasis. On the 33rd postoperative day, he suddenly developed chest pain, dyspnea, tachycardia, and tachypnea. Arterial PO2 was 62 mmHg, and chest X-ray showed right ventricular hypertrophy. Pulmonary perfusion scan revealed multiple cold areas throughout both lung fields. The diagnosis was pulmonary embolism and anti-coagulant therapy was immediately successful in resolving his symptoms. We suggest that pulmonary embolism should be considered as one of the postoperative complications of urological operations.
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PMID:[A case of pulmonary embolism following total prostatectomy]. 817 46

A 67 year old male with non-resectable hepatocellular carcinoma (HCC) in both lobes and liver cirrhosis was treated with transcatheter arterial embolization and regional chemotherapy. He was doing well for 18 months. He was readmitted for fever, chest pain and multiple pulmonary metastases. During interleukin-2 therapy, he suddenly developed dyspnoea and palpitation, and was in shock. Left-sided haemothorax was confirmed by draining 3 L of fresh blood. In spite of intensive care, he died within 36 h. Autopsy showed that the haemothorax was caused by rupture of one of the metastases in the upper lobe of the left lung, and that the primary HCC was totally necrotic. Survey of the literature failed to find a report of fatal bleeding from a lung metastasis of HCC.
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PMID:A rupture of lung metastasis of hepatocellular carcinoma causing haemothorax. 828 Aug 50

To determine the clinical presentation of patients with malignancies metastatic to the lung, the diagnostic utility of fiberoptic bronchoscopy (FB), and the primary site of malignancies metastasizing endobronchially, we retrospectively reviewed 1,853 FB records (1987 to 1991) and selected 111 cases for review. Cases were divided on the basis of FB findings into abnormal (44 patients) and normal (67 patients). Pulmonary symptoms (cough, hemoptysis, and chest pain) prompted referral significantly more often in the abnormal FB group (34/44) than in the normal FB group (24/67). The finding of atelectasis on chest radiograph occurred more frequently in patients with endobronchial abnormalities. The spectrum of extrapulmonary malignancies that metastasize endobronchially has changed during the AIDS epidemic. Our study shows the most frequent causes of endobronchial mass lesions were Kaposi's sarcoma and the lymphoma group (Hodgkin's disease, nonHodgkin's lymphoma, chronic lymphocytic leukemia) and the most common malignancies causing submucosal metastases were breast and the lymphoma group. In summary, the highest yield from FB can be expected in patients experiencing symptoms of cough or hemoptysis and/or having radiographic evidence of atelectasis. We propose a new mnemonic "KLAS" (Kaposi's sarcoma, Lymphoma, Adenocarcinoma, Sarcoma) to describe the malignancies most likely to metastasize endobronchially in the 1990s.
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PMID:Fiberoptic bronchoscopy in the evaluation of carcinoma metastatic to the lung. 830 46

Angiosarcoma involving the lung is a rare disorder and its clinical features are not well known. We conducted a retrospective analysis of 15 patients seen at our institution from 1950 to 1990 in an attempt to better characterize the spectrum of clinical and radiographic findings of angiosarcoma in the lung. No documented case of primary angiosarcoma of the lung was seen. The diagnosis of metastatic angiosarcoma to the lung was made antemortem in 12 of 15 cases, either by lung biopsy specimen (5 patients), biopsy evidence of metastatic disease elsewhere with abnormal chest radiograph (4 patients), or a compatible clinical picture in a patient with previously documented angiosarcoma arising in an extrapulmonary site (3 patients). The median age at the time of diagnosis was 45 years with the most common presenting symptom being hemoptysis (7 of 15 patients). Other presenting complaints included weight loss (6 of 15), cough (4 of 15), and chest pain (4 of 15) occurring 6 weeks to 1 year prior to diagnosis. Chest radiographs frequently disclosed multiple pulmonary nodules (11 of 15). Primary origins of the angiosarcoma most commonly included the heart and breast. Metastatic sites other than the lung included the pericardium, liver, spleen, kidney, adrenal gland, bone, and brain. The prognosis is generally poor, with our study population surviving an average of 9 months after diagnosis.
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PMID:Angiosarcoma in the lung. 848 39

A 43-year-old man was admitted to Nara Medical University Hospital because of right-sided chest pain. Computed tomographic examination revealed a right pleural effusion and diffuse pleural thickening. Malignant mesothelioma was diagnosed from the results of a percutaneous pleural biopsy, and the patient then underwent right pleuro-pneumonectomy. The resected specimen was examined by light and electron microscopy, which revealed scattered sarcoma-like malignant cells with some epithelial differentiation, in abundant extracellular collagen with storiform derangement. Therefore, desmoplastic malignant mesothelioma (mixed type) was diagnosed. This is a rare histological subgroup of malignant mesotheliomas. The patient died 2 months after the operation, due to multiple and rapidly growing metastases. After lung tissue was dissolved, ferruginous (asbestos) bodies were counted, and the results were consistent with occupational exposure to asbestos (413 asbestos bodies per 5 g of lung tissue).
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PMID:[A case of desmoplastic malignant mesothelioma]. 858 23

The treatment of choice for advanced inoperable non-small cell lung cancer (NSCLC) is radiation therapy. Palliative radiotherapy schedules vary considerably in different centers, but a 30-Gy dose given in ten fractions over two weeks is a typical standard schedule. Our study was aimed at investigating whether a shorter course of only one 10-Gy fraction allows good palliation in the treatment of inoperable NSCLC patients whose main symptoms are related to an intrathoracic lesion. Patients of both sexes and any age, untreated with radiotherapy, with inoperable and histologically or cytologically proved NSCLC were examined. Seventeen patients, too advanced for radical "curative" radiotherapy and whose main symptoms were related to primary intrathoracic lesions, entered the study even though they had metastases. On admission, 76% (13/17) of patients had cough 76% (13/17) dyspnea, 70.7% (12/17) chest pain and 23.6% (4/17) hemoptysis. They received a single dose of 10 Gy, delivered with an 18-Mv linear accelerator via anteroposteriorly opposing portals without spinal cord shielding. Treatment volume usually included the macroscopically detected lesion identified with a CT simulator. Palliation of symptoms was achieved in high rates of patients: 46% for cough, 69% for dyspnea, 83% for pain and 75% for hemoptysis. These results were obtained within one month of treatment. Unfortunately, palliation of symptoms did not last long, decreasing to 42% within two months of the end of treatment and to 32% at three months. Four patients were retreated, one patient three months and three patients two months after the end of radiotherapy. Ten Gy to the target volume were administered as retreatment with spinal cord shielding. Side-effects were mild: nausea in 3 patients (17%), vomiting in one patient (5%) and grade-II dysphagia in two patients were observed and classified according to WHO criteria. Pain increased 24 hours after radiotherapy in five patients. We can conclude that single dose radiotherapy yields good, but short, palliation of symptoms with acceptable side-effects.
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PMID:[Single-dose palliative radiotherapy in inoperable non-small-cell lung carcinoma]. 868 68

Nineteen cases of thymic carcinoma treated in our hospital (mean age 60.0 years, seven males and twelve females) were studied clinically. Thirteen cases (68.4%) had subjective symptom; for example, chest pain, face edema or cough. Two cases (10.5%) had the associated diseases; one had gammaglobulinemia, the other one had Cushing syndrome and hypogammaglobulinemia. The histological subtypes were eleven squamous cell carcinomas (SCC) (57.9%), three undifferentiated carcinomas, two small cell carcinomas, one papillary adenocarcinoma and one lymphoepithelioma-like carcinoma. The 5 year survival rate of all cases was 42.7%. The 10 years survival rate was 21.4%. The median survival time was 56.1 months. There were one Stage I case, nine stage III cases, four stage IVa cases and five stage IVb cases. More than stage III cases were eighteen (94.7%). Five cases of stage IVb were T2N1M0, T3N1M0, T3N0M1 and T4N0M1. The 5 year survival rate of SCC was 65.6%, and that of the other subtypes was 14.3%. The cases resected completely were only eight cases (42.1%), and the 5 year survival rate of these was 70.0%. On the other hand, the rate of five cases resected incompletely was 53.3%. Metastasis occurred in 12 cases (63.2%). Metastasis occurred frequently in pleura, lymphnode, lung, bone and liver. The radiotherapy for SCC was effective and the 5 year survival rate was 83.3%. Furthermore, there were some long survivors in the cases undergone incomplete resections by postoperative radiotherapy jointly. On the other hand, the chemotherapy was not effective in our series. However, it was reported recently that the regimen including cisplatin was effective. So it was impressed that the combined therapy including surgery radiotherapy and induction chemotherapy would be important to obtain better results.
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PMID:[Clinical study of nineteen thymic carcinomas]. 871 65

One hundred and thirty-six patients with bone cancer pain were treated with 153Sm-EDTMP (ethylenediamine-tetramethylene phosphonic acid). Pain free was noted in 49 cases (36%, 49/136) and pain relief in 77 cases (56.6%, 77/136), the total relief rate being 92.6% (126/136). The data from 76 patients with moderate and severe pain showed there were no significant relationships between the patients' age, the dose of 153Sm-EDTMP and the analgesic effects (P > 0.05). The pain relief observed in the patients with chest pain (ribs metastases) was earlier than that in other groups (P < 0.05). We didn't find any clinical side-effects, so 153Sm-EDTMP is safe for use.
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PMID:[153Sm-EDTMP for moderate and severe bone cancer pain]. 873 58

In patients with non-metastatic but inoperable non-small cell lung cancer that is locally too extensive for radical radiotherapy (RT), but who have good performance status, it is important to determine whether thoracic RT should be the minimum that is required to palliate thoracic symptoms or whether treatment should be more intensive, with the aim of prolonging survival. A total of 509 such patients from 11 centres in the UK between November 1989 and October 1992 were admitted to a trial comparing palliative versus more intensive RT with respect to survival and quality of life. They were allocated at random to receive thoracic RT with either 17 Gy in two fractions (F2) 1 week apart (255 patients) or 39 Gy in 13 fractions (F13) 5 days per week (254 patients). Survival was better in the F13 group, the median survival periods being 7 months in the F2 group compared with 9 months in the F13 group, and the survival rates 31% and 36% at one year and 9% and 12% at 2 years, respectively (hazard ratio = 0.82; 95% CI0.69-0.99). There was a suggestion of a trend towards greater benefit in fitter patients. Metastases appeared earlier in the F2 group. As recorded by patients using the Rotterdam Symptom Checklist, the commonest symptoms on admission were cough, shortness of breath, tiredness, lack of energy, worrying and chest pain. These were more rapidly palliated by the F2 regimen. Psychological distress was generally lower in the F13 group. Three patients (two F13, one F2) exhibited evidence of myelopathy. As recorded by patients using a diary card, 76% of the F2 compared with 81% of the F13 patients had dysphagia associated with their RT. This was transient, lasting for a median of 6.5 days in the F2 group compared with 14 days in the F13 group. In conclusion, the F2 regimen had a more rapid palliative effect. In the F13 group, although treatment-related dysphagia was worse, survival was longer.
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PMID:Randomized trial of palliative two-fraction versus more intensive 13-fraction radiotherapy for patients with inoperable non-small cell lung cancer and good performance status. Medical Research Council Lung Cancer Working Party. 897 64


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