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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinical beginning of diffuse pleural mesothelioma is a pleurisy. Initially pleura may be normal at X-ray examination, then either a pachypleuritis or a tumorous pleura appears. Thery serious since there is in the literature no cured case. The average survival time from diagnosis to death is 15 months. At terminal stage mesothelioma does not invade the other coelomic cavities. It may remain limited to the hemithorax where it has started, invading then the organs by contiguity. Metastasis may occur but their frequency is very variable, from 30 to 70% according the literature. On a therapeutic point of view all was tried: Surgery is rarely curative but may reduce temporarily effusion pain and dyspnea. Radiotherapy at high doses produces a partial effect in some series, but results are variable. Chemotherapy: adriamycin could be the most promising agent. At present time according to many authors no treatment seems to change the course of the disease.
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PMID:[Evolutive patterns of diffuse pleural mesothelioma (author's transl)]. 11 73

The results obtained with a new hormone therapy using medroxyprogesterone acetate (MAP) in previously untested single and total doses in the treatment of advanced breast cancer are reported. Fifty-two postmenopausal patients were treated with an average total dose of 40 g of MAP for a period of 30 days. Nineteen of 44 patients (43%) had complete or partial remission, while the disease remained unchanged in nine of 44 patients (20%). Disease progression occurred in 12 of 44 patients (27%). Partial or complete remission occurred in 12 of 18 (67%) and four of six (67%) of the patients with dominant osseous and soft tissue metastases respectively. Three of ten (16%) of those with visceral metastases had remission. The average duration of remission was 7 months. Average survival times were 15.5 months for patients with remission, 8 months for those with no change, and 2.5 months for those with disease progression. From a subjective standpoint, pain was reduced significantly or disappeared in 34 of 36 patients (94%); this was also the case with respect to dyspnea (13 of 16 patients [81%]), anorexia (24 of 29 [83%]), asthenia (28 of 35 [80%]), and walking impairment (15 of 24 [63%]). When relapse occurred, patients previously treated with massive doses of MAP received further treatment with higher doses of MAP; four of 22 (18%) of the patients attained partial remission once again. Positive effects were also seen in subjective performance status, body weight, and EKG. We also describe the new clinical and toxicologic features of this treatment.
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PMID:A possible new approach to the treatment of metastatic breast cancer: massive doses of medroxyprogesterone acetate. 35 Mar 87

28-year-old sportsman developed chest pain, dyspnoea, haemoptysis and swelling of the right leg. 8 weeks later he also complained of blurred vision. Ophthalmoscopy revealed subretinal infiltrates diagnosed as tumour metastases by fluorescein angiography. The patient died 10 weeks after the first symptoms. At autopsy large mediastinal embryonal carcinoma was diagnosed, and both eyes revealed choroidal metastases. This rare tumour usually involves young men and is invariably fatal within a few months. Exceptional bilateral choroidal metastases constituted the presenting sign.
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PMID:Mediastinal embryonal carcinoma with bilateral choroidal metastases. Fluorescein angiographic and histopathologic study. 54 44

Report on 5 cases of adenoidcystic carcinoma of the larynx and review of the literature, containing about 60 further reports. About 80% of these tumors arise in the subglottice laryngo-tracheal transition region, 20% in the ventricular cord and the epiglottis. The vocal cords containing no mucus glands are never the origin of adenoid cystic carcinomas. These tumors grow under an intact mucosa and reach very often an enormous extension until dyspnoea, dysphagia and recurrent never paresis lead to diagnosis. The clinical course of these tumors ist not preditable--even not by their histological structure. In some cases the outcome is rapidely fatal by local growth and metastases, in others a many year long survival can be reached, but there exists no reliable report on a "cured" adenoid cystic carcinoma of the larynx. By radical surgery only better results can be expected. Irradiation produces long lasting remissions in some cases.
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PMID:[Adenoid-cystic carcinoma of the larynx (author's transl)]. 65 64

A very rare case of a myxosarcoma with metastases to the brain is reported. A 33-year-old female was admitted to our hospital because of lassitude, fever, slight left hemiparesis, headache and other signs of intracranial hypertension and cardiac symptoms such as dyspnea and palpitation. She had the cardiac symptoms once 14 years before, which reappeared and rapidly aggravated two months before the admission. Cerebral angiography revealed a mass in the right temporal lobe and physical and laboratory examinations revealed mitral value failure and hyperthyroidism. On the next day, March 19, 1976, a grossly cystic 60 gm tumor was totally removed which was largely imbedded in the subcortex of the right temporal lobe. The symptoms except for the cardiac symptoms and disseminated intravascular coagulopathy rapidly improved, but headache and left hemiparesis returned 13 days postoperatively. She died suddenly 18 days after the operation due to acute cardiac failure. Autopsy revealed two separate hard and solid tumors both attached to the mitral valve and occupied the whole left atrium and another metastasis to the frontal lobe which had not been diagnosed before the death. Microscopic examinations including electronmicroscopic study established the diagnosis of myxosarcoma in all the four tumors.
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PMID:[Brain metastases from primary cardiac myxosarcoma--report of a case (author's transl)]. 71 43

Post-morten examination of a fourteen-year-old mare of the Gelderland breed, which had been treated for severe dyspnoea and had subsequenlty died, revealed the presence of haemothorax, atelectasis of the lung and a metastasized haemangiosarcoma of the left ovary. The haemothorax could have resulted from rupture of one of the metastases.
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PMID:[Dyspnoea due to intrathoracic haemorrhage and haemangiosarcoma in a horse (author's transl)]. 94 33

A retrospective study was undertaken in 1990 of 188 patients with the diagnosis of non small cell carcinoma of the lung referred to the Department of Radiation Oncology in 1984. Most patients (178/188) received a course of radiotherapy. This was definitive in 23, palliative in 148 (primary site in 113, metastases in 16, primary plus metastases in 19) and postoperative in 7. This report is a 5 year followup of the 171 patients treated by radiation alone, to assess factors that influence survival. Tumour histology was 50% squamous, 23% adenocarcinoma, 16% large cell and 4% unspecified, non small cell carcinoma. In 8% no histological diagnosis was obtained. The most common symptoms were cough (44%), dyspnoea (43%), chest pain (37%), haemoptysis (33%) and systemic symptoms (36%). Tumour stage (TNM) was assessed retrospectively as I(5%), II(8%), IIIA(18%), IIIB(22%) and IV(28%). A subgroup of 31 cases (18%) of uncertain staging (I-III) was analysed separately and in 2 cases (1%) no staging information was available. Palliative intent of treatment and poorer performance status were related significantly to increasing stage of disease. The effects of palliative treatment were recorded in 79 cases; in 71 there was a reduction in symptoms. The median survival from diagnosis was 8 months (range < 1-72). Using univariate and multivariate analyses, significant and independent prognostic factors for improved survival were good performance status, absence of systemic symptoms, lower tumour stage and curative intent of treatment (higher radiation dose). However the 5-year survival was only 2%. Long-term survival was associated predominantly with early stage disease but not with the type or intent of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Non small cell carcinoma of the lung. A retrospective study. Presented at the 41st annual meeting of the Royal Australasian College of Radiologists, September 1990, Perth. 128 99

Primary cardiac rhabdomyosarcoma is rare and its extension to the mitral valve even rarer. We report a case of left atrial rhabdomyosarcoma involving the mitral valve. The patient was a 62-year-old man who complained of recurrent pre-syncopal episodes, dyspnoea often sudden in onset, asthenia and major weight loss (10 kg in one month). 2-D echocardiography revealed a 4.9 cm2 wide mass attached to the atrial side of the anterior mitral leaflet and to the adjacent inferior interatrial septum, where it seemed to have origin. CT scan and scintigraphy revealed bone, kidney and spleen metastases. The patient underwent emergency cardiac surgery because of increasing pre-syncopal and dyspnoeic episodes due to obstruction by the intracardiac mass. At surgery a tumor was found infiltrating the left atrial wall, the interatrial septum, the mitral anulus and the anterior mitral leaflet up to its tip. Invasion of mitral anulus did not allow mitral valve replacement, so that an excision of the intracardiac mass was performed as extensively as possible. Histology revealed a rhabdomyosarcoma. A post-operative chemotherapy cycle had to be stopped due to onset of atrial fibrillation and dyspnoea. 2-D echo monitoring revealed rapid new growth of the tumor across the basal portion of mitral valve leaflet to the atrioventricular orifice. After several episodes of increasing dyspnoea, the patient had a pulmonary oedema and died.
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PMID:[Primary cardiac rhabdomyosarcoma involving the mitral valve]. 129 26

We report a case of renal cell carcinoma with pulmonary metastases treated with recombinant alpha interferon and subsequently presenting as congestive heart failure due to a dilated cardiomyopathy. A 66-year-old man presented himself to the department of internal medicine at our hospital with a complaint of persistent cough with sputum on August 27, 1988. Ultrasonogram, computed tomography and angiography showed a right renal cell carcinoma and chest x-ray films disclosed bilateral multiple nodular shadows, probably representing metastases of the renal tumor. After being transferred to our department, the patient underwent the ligation of the right renal artery and vein and the postoperative treatment with recombinant alpha interferon, achieving a complete response for pulmonary metastases and a partial response for the primary region. On February 14, 1990 the patient was admitted to our hospital with a complaint of dyspnea to be diagnosed as congestive heart failure due to dilated cardiomyopathy. The interferon therapy was suspected to have caused the heart disease, and four months after discontinuation of interferon therapy the heart failure symptoms had improved, but hypokinesis of the cardiac wall still persisted. To our knowledge, this may be the first case of alpha interferon-related cardiomyopathy in Japan.
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PMID:[Dilated cardiomyopathy following alpha interferon therapy of renal tumor with pulmonary metastases: a case report]. 141 58

This report is an analysis of the medical records of 83 patients registered between 1960 and 1980 at Helsinki University Central Hospital as having malignant pleural mesothelioma. 65 of 83 patients had histologically confirmed malignant mesothelioma, and are the focus of this analysis. The remaining 18 (22%) patients were excluded because malignant mesothelioma was only confirmed cytologically, or because the primary tumor was not a mesothelioma. The ratio of men to women was 2:1.30 of 65 (46%) patients were not known or not likely to have been exposed to asbestos. The main symptoms at presentation were dyspnea, cough, chest pain, fatigue and weight loss. The median survival from diagnosis was 12 months, and from the onset of symptoms 18 months. Clinical stage and performance status were significant prognostic factors. Hematogenous metastases were present at autopsy in most cases. Disease and performance status therefore need to be well established and documented in clinical trials involving mesothelioma.
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PMID:Diagnosis and prognostic factors in malignant pleural mesothelioma: a retrospective analysis of sixty-five patients. 143 23


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