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)

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

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

Four cases of small cell carcinoma characterized by a striking involvement of the pleural sheets were investigated. The patients, four adult males with a long history of cigarette smoking, presented with symptoms common to pleural tumors, including cough and chest pain. Malignant cells were identified in pleural effusions of all cases and in the bronchial aspirate of one patient. Antitumoral treatments included chemo- and/or radiotherapy. Survival ranged from three to 17 months. At autopsy, the serosal sheets resulted to be extensively involved by thick tumor rinds, associated with massive hilar metastases. Histologically, the tumors were composed of small epithelial cells, expressing carcinoembryonic antigen and keratins and occasionally neuroendocrine markers. Our findings indicate that small cell carcinoma should be added to the group of pseudomesotheliomatous lung carcinomas and, above all, that it deserves distinction from ordinary mesothelioma, especially the small cell variant, because of its medico-legal implications and possible antitumoral treatment.
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PMID:Small cell carcinoma of lung simulating pleural mesothelioma. Report of 4 cases with autopsy confirmation. 882 17

To investigate the chance of discovery of metastatic lung tumors and the five-year survival rates of patients undergoing surgical resection, we followed 99 patients who underwent initial surgical treatment at our hospital between 1979 and 1996. With regard to primary organs or sites, 32 patients had rectal cancer, 27 patients had breast cancer, 19 patients had colon cancer and 21 patients had osteosarcoma. For 22 of 99 patients (22%), discovery was due to subjective symptoms such as cough and sputum (n = 12), chest (or back) pain (n = 7) or hemosputum (n = 5). Ten of 19 patients (53%) with colon cancer experienced subjective symptoms which led to the discovery of metastases. In 76 of 99 patients (78%), metastatic lung lesions were not discovered through subjective symptoms. In 63 of those 76 patients, such lesions were initially found by plain chest roentgenography or CT. In 20 of 21 patients (95%) who had osteosarcoma, metastatic lung tumors were discovered by chest roentgenography or CT. In 14 of 76 patients, all of whom had metastatic lung carcinomas, the lesions were discovered through elevated levels of tumor markers. Therefore the importance of periodic chest roentgenography and tumor marker testing was demonstrated. Disease-free interval (DFI) was over six years in five of 32 patients (16%) with rectal cancer and 13 of 27 (48%) with breast cancer. DFI was less than five years for 15 of 19 patients (79%) with colon cancer, and less than two years for 16 of 21 (75%) with osteosarcoma. Thus, DFI differed according to the sites of the tumors. The five-year survival rates of 97 patients were examined. Patients were divided according to the sites of their primary tumors, and then subdivided according to the type of surgery they received. Patients were thus divided into five categories: I) those who underwent incomplete resection of metastatic lung lesions, II) those who underwent complete resection of both pulmonary lesions and involved mediastinal lymph nodes, III) those who had undergone previous treatment for tumors in organs other than the lung, IV) those who underwent complete resection of multiple lung lesions, and V) those who underwent complete resection of solitary lung lesions. For all primary sites, none of the patients in group I) survived for more than two years. Therefore complete resection seems very important for the treatment of metastatic lung tumors. With regard to the other groups, several facts were noted. For rectal cancer, the five-year survival rate of groups V) and III) was 55.6% in either case. Therefore complete resection of rectal cancer metastatic to the lung may improve the five-year survival rate even for patients who have previously been treated for cancers in organs other than the lung. For colon cancer, the five-year survival rate of group V) was 51.4%. Complete resection of only a solitary lung lesion may improve the five-year survival rate for colon cancer. For breast cancer, the five-year survival rate of group V) was 37.5% and that of group II) was 60.0%. This may indicate that for patients who have both pulmonary lesions and mediastinal lymph node involvement, complete resection of both is important. For osteosarcoma the five-year survival rate of group IV) was 26.0%. Thus, osteosarcoma patients have a chance of survival if they undergo complete resection of lung metastases.
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PMID:[Diagnosis and surgical treatment of metastatic lung tumors]. 883 35

One hundred patients operated for left atrial myxoma in the same surgical department underwent clinical and anatomical assessment at long-term from 1959 to July 1995 (66 women and 34 men, average age 52.2 years). The clinical presentation was related to mitral valve obstruction in half the cases (dyspnoea, cough, pulmonary oedema), the presentation in the other half of cases being very variable. The widespread use of echocardiography has relegated other investigations to a subsidiary role: auscultation, radiology, ECG (9 cases diagnosed by echocardiography performed for another indication). Serious complications of left atrial myxoma include systemic embolism : 37 cases out of the 100 in this series, including 10 plurifocal but mainly cerebral (19 cases including 11 isolated cerebral emboli). Surgical treatment is well established, should not be deferred and gives excellent results (2 early postoperative deaths out of 100 cases in the early years of the study). There were 6 cases of recurrences including 3 cases of Carney's syndrome. Clinico-pathological correlations showed that mitral stenotic effects occurred when the tumour diameter exceeded 5 cm and embolism was associated with tumours having multiple villositi. Histopathological analysis distinguished between active and inactive tumours, differentiated or not, and enabled the elaboration of hypotheses on the rate of growth of the tumour and on the absence of true metastases. Histopathological techniques also show the presence of lymphoplasmocytic infiltration, the sign of secretion of interleukin 6 by the myxoma, a cytokine involved in the general inflammatory process and which explains the unusual clinical presentation sometimes observed.
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PMID:[Myxoma of the left atrium, Clinical outcome of 100 operated patients]. 895 35

We report a 67-year-old man who developed pulmonary hypertension as an initial clinical manifestation of occult gallbladder adenocarcinoma. He had a 6-week history of persistent dry cough followed by progressive dyspnea on exertion. Physical examination and chest roentgenogram revealed signs of precapillary pulmonary hypertension. He died of shock 1 h after pulmonary angiography, which failed to show any intravascular filling defects. Autopsy disclosed a mucin-producing small adenocarcinoma (2 cm diameter) and a gallstone in the gallbladder with a few small metastases to peri-aortic, peri-bronchial and mediastinal lymph nodes. Macroscopically, there was no gross thrombotic pulmonary embolism or pulmonary metastases. However, microscopically, more than 60% of the small pulmonary arteries less than 1 mm in diameter were occluded with pulmonary tumor microemboli. This case emphasizes the need to include tumor pulmonary embolism in the differential diagnosis of pulmonary hypertension whether or not there is evidence of an underlying malignant tumor.
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PMID:Subacute pulmonary hypertension due to pulmonary tumor microembolism as a clinical manifestation of occult gallbladder adenocarcinoma. 907 Sep 64

We report a 36-year-old woman with right hemiplegia, anosognosia, and rapidly deteriorating course. She was well until the end of January, 1995 when she had an onset of fever, sputum, and cough. A 5 x 5 tumor was found in her left lower lobe. She was admitted to the Pulmonary Medicine on May 24, 1995 when she was 36-year-old. General physical examination was unremarkable. Bone scintigraphy revealed increased uptake in the skull, sternum, right scapula, vertebrae, right femur, and in ribs. Cranial CT scan revealed a large mass lesion in the right frontal subcortical region with central low density and peripheral high density areas, and small low density lesions in the right thalamic area and in the right posterior frontal region; ring enhancement was observed in the latter two lesions. On the second day of admission, she noted left-sided weakness which improved by corticosteroid treatment. On June 17, there was a sudden onset of left hemiparesis and a neurologic consultation was asked. Upon neurologic examination, she appeared somnolent but could understand verbal commands. She showed constructional apraxia, neglect of the left hemisphere, and anosognosia. Cranial nerves were unremarkable. Motor-wise, she showed flaccid left hemiplegia. Deep tendon reflexes were exaggerated on the left and the plantar response was extensor bilaterally. Nuchal stiffness was noted. Her cranial CT scan on June 17 revealed enlargement of the right frontal mass lesion. The subsequent course was complicated by DIC and progressive worsening of her consciousness. On June 18, she was comatose and pupillary light reflex was lost. She developed Cheyne-Stokes respiration and expired on that evening. The patient was discussed in a neurological CPC, and the chief discussant arrived at the conclusion that the patient had a primary adenocarcinoma in the lung with multiple metastases including the brain. The fulminant terminal course was ascribed to hemorrhage within the tumor and subsequent central type of transtentorial herniation. Opinions were divided regarding the cause of hemorrhage; some participants thought hemorrhage was caused by DIC. Post-mortem examination revealed an adenocarcinoma arising at the S6 segment of the left lung with multiple organ metastases. In the brain, a huge hemorrhagic metastasis was found in the right frontal lobe and a non-hemorrhagic metastasis in the right thalamic region. Probably, the size of the metastases influenced the occurrence of hemorrhage. The direct cause of the death was transtentorial herniation.
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PMID:[A 36-year-old woman with acute onset left hemiplegia and anosognosia]. 912 37

A 70-year-old man was admitted to the hospital because of mild dyspnea, a cough, and hemoptysis. A chest X-ray film and a computed tomographic scan showed a mass in the S1.2 region of the left lung, and swollen mediastinal lymph noes. Cytologic examination of sputum sample resulted in the diagnosis of lung cancer. The tumor did not respond to chemotherapy, and the patient died after seven months. Autopsy disclosed a solid tumor of left lung and many cystic lesions in the liver. Histological examination of the lung lesion revealed adenosquamous cell carcinoma. Metastatic lesions in the liver consisted of adenosquamous cell carcinoma, with predominantly squamous cell carcinoma. Cases of lung cancer in which hepatic metastases have many cystic cavities are rare.
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PMID:[Adenosquamous cell carcinoma of the lung with multiple cystic metastases in the liver]. 916 47

During the period 1977-95, 20 patients underwent surgery for carcinoid tumour in the bronchus at the University Hospital of Trondheim (n = 16) and Innherred County Hospital (n = 4). All the tumours were typical carcinoid tumours. Median age of the patients was 41 years (range 16-78 years). The observation period averaged 7.5 years (0.5-18 years). The most common symptoms were cough, dyspnoea, wheezing and pneumonia. One patient had carcinoid syndrome. Chest X-ray were negative in three of the patients. Bronchoscopy was carried out in all the patients. Biopsies were taken in ten of them, and the diagnosis was conclusive in five cases. Lateral thoracotomy was performed in all the patients. The surgical procedures were lobectomy (15), segmental/wedge resection (3), bronchotomy with tumour resection (1) and sleeve resection (1). 19 patients were still alive at the time of follow-up, with no tumour recurrence. One patient died from cerebral stroke eight years after surgery. Good long-term results were found, and the study supports the use of limited lung resection or bronchoplasty operations to treat carcinoid tumour in the bronchus if the primary tumour is localised and there are no metastases.
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PMID:[Surgical treatment of carcinoid bronchial tumor]. 923 5

A 74-year-old man was admitted to our hospital with a cough. His chest X-ray film, chest CT scan and MRI showed a tumor of the chest wall. Histology of a percutaneous needle biopsy revealed malignant fibrous histiocytoma (MFH). The tumor enlarged rapidly, and the patient underwent resection including the 6th, 7th and 8th ribs and partial resection of the right diaphragm and the right middle and lower lung lobes. Multiple pulmonary metastases were found 40 days after the operation, and the patient died of respiratory failure 4 months after surgery. Although MFH is one of the most common soft tissue sarcomas, lesions arising from the chest wall are uncommon. We stress the need for early diagnosis and aggressive surgical resection in the treatment of MFH arising from the chest wall.
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PMID:[Malignant fibrous histiocytoma of the chest wall: a case report]. 925 46


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