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

The Radiation Therapy Oncology Group has conducted several randomized clinical trials to evaluate the efficacy of various radiation therapy schedules in palliating symptomatic brain and bone metastases. Among the patients entered in these studies, there were 225 patients with primary tumors of the genitourinary tract. Of these, 68 patients had cerebral metastases and 157 patients had osseous metastases. These patients were analyzed further as to the effectiveness of radiotherapy in palliation of their symptoms, and the results were compared to those for comparable metastases in patients with other primary sites. Relief of symptoms occurred in 54% of neurologic function (NF) Class III and 28% of NF Class II patients with cerebral metastases. This result compared favorably with those for the total group of patients consisting of patients with brain and bone metastases from various primary sites. Improvement was seen in 80% of patients with headaches and 88% of patients with convulsions. Motor loss improved in 62% of the patients. Of the patients with bone metastases, 81% with prostatic carcinoma and 59% with renal primaries had lessening of pain. Complete relief of pain at eight weeks occurred in 36% of the patients, compared to 24% in the total group. The median survival for patients with solitary bone metastases from a prostatic primary was 39 weeks, compared to 30 weeks for those with multiple metastatic sites.
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PMID:The role of radiation therapy in the palliation of metastatic genitourinary tract carcinomas. A study of the Radiation Therapy Oncology Group. 618 81

We investigated the effect of the synthetic vitamin A derivative isotretinoin (13-cis-retinoic acid) on advanced cancers in 103 patients and on preneoplastic lesions in five patients. Six of 14 patients with squamous cell epithelial cancers had objective regressions of skin or subcutaneous metastases. Three of five patients with preneoplastic lesions had objective responses. The major dose-limiting toxic effects were reversible dermatitis, emotional lability, and headaches. We conclude that the growth of some squamous cell epithelial malignancies can be inhibited by isotretinoin and suggest that other retinoids should be evaluated as antitumor agents.
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PMID:Activity of isotretinoin against squamous cell cancers and preneoplastic lesions. 621 Dec 33

Among 137 patients with small cell carcinoma of the lung (SCCL) treated on two consecutive protocols, leptomeningeal metastases were documented in 12 patients (9%), 10 antemortem by cerebrospinal fluid (CSF) cytology, one by myelogram, and one only at necropsy. Signs and symptoms included confusion in seven, limb weakness in six, paresthesias in three, headache in two, urinary incontinence in two, and nausea and vomiting, diplopia and neck pain in one patient each. Nine of the 12 patients had evidence of other metastases while three patients relapsed first in the CSF and one had disease only in the leptomeninges. Treatment for this complication including irradiation, intrathecal chemotherapy, or systemic chemotherapy was generally ineffective with a median duration of survival of 50 days (range 5 to 130) after diagnosis of leptomeningeal. Necropsies showed thick tumor deposits along cord, distal nerve roots, cauda equina, and in Virchow--Robbins spaces with deep invasion into adjacent neural substance in six of the seven. Leptomeningeal involvement appears to have become manifest as median survival has increased. CSF cytology should therefore be examined in patients who develop unusual neurological findings during the course of this disease and methods of prevention may need to be considered in future studies.
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PMID:Leptomeningeal carcinomatosis in small cell carcinoma of the lung. 625 38

Clinical investigations and computed brain scanning were done in 305 patients with primary extracerebral malignant tumours. One third of the patients had cerebral metastases. In most patients with brain metastases extracerebral secondary tumours were known already. Silent brain metastases were present in only 0.6% of all investigated tumour patients. All other patients had either objective neurologic-psychiatric defects or a least symptoms (headache, vomiting). Use of cranial computed tomography in all tumour patients as a pure screening method is thus not justified. The indication for the investigation is dependent on the clinical symptomatology. However, not only objective neurologic-psychiatric defects must be taken into account, but also occurrence of new symptoms.
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PMID:[Computed tomographic brain scanning in the diagnosis of metastatic neoplasms (author's transl)]. 627 97

A 65-year-old woman with known breast carcinoma developed headaches, followed shortly by disequilibrium, vertical diplopia and dysarthria. Cranial computerized tomography (CCT) demonstrated a dense, irregularly enhancing pontine lesion with associated mass effect. She received dexamethasone (Decadron) and radiotherapy and subsequently expired. Postmortem examination disclosed a ruptured brain stem arteriovenous malformation within a massive hemorrhage along with necrotic atypical cells suggestive of metastatic disease.
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PMID:Brain stem vascular malformation simulating a hemorrhagic metastasis: report of a case with pathologic correlation. 648 86

This 74-year-old female suddenly complained of severe headache, nausea, vomiting and dizziness on June 19, 1981. She was brought to nearby hospital. During the following six days, the state of consciousness gradually worsened and left-sided hemiparesis and convulsion attack arose and she was admitted to our clinic on June 25, 1981. Cerebral angiograms revealed an aneurysm of the right middle cerebral artery. Diagnosis of subarachnoid hemorrhage due to the rupture of an aneurysm was tentatively made and conservative therapy was done. On the second hospital day, she had nasal bleeding and began to excrete tar-like stool. Laboratory examination revealed thrombocytopenia, increase of FDP and prolongation of prothrombin time. Her liver and renal functions gradually worsened after this episode. On the 13th hospital day, she expired. General autopsy showed wide spread adenocarcinoma with metastases to the lung, lymph nodes and bones. Examination of the head revealed an unruptured aneurysm and bilateral diffuse subdural clotted hemorrhage. The dura was tightly adherent to the skull and partially thickened. No abnormal findings were found in the brain. On microscopical examination of the dura, there were fresh hemorrhage and many of the innumerable dilated small vessels contained tumor in the inner dural layer. Even by extensive examination, the origin of the malignancy could not be identified. We concluded that the initial symptoms just like of subarachnoid hemorrhage were due to the dural metastasis and subdural hematoma. Sixteen cases of subdural hematoma secondary to metastatic neoplasm were reported previously. We made some discussion about the pathogenesis and symptomatology of this type of subdural hematoma.
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PMID:[Subdural hematoma due to metastatic dural carcinomatosis associated with DIC--a case report]. 662 89

A 24-year-old female complained of headache and vomiting. The brain-CT scan demonstrated a tumor shadow in the right cerebellar hemisphere. The tumor was partially resected, and irradiation therapy was started. She died of intraventricular hemorrhage about 6 months after the onset of symptoms. Autopsy revealed a recurrent tumor mass in the cerebellum extending to the brain stem. It showed systemic metastases to the leptomeninx, liver, bones and ovaries. Histological examination showed a tumor which was a primarily composed of typical medulloblastoma cells with occasional Homer-Wright type rosettes. It partly showed glioblastoma-like configuration. Some tumor cells were positive for GFAP by the PAP method, suggesting glial differentiation.
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PMID:[Autopsy case of atypical medulloblastoma in an adult]. 666 12

Of 23 cases of metastatic retinoblastoma treated between 1922 and 1979, seven had metastases limited to the cranial vault and 13 had cranial metastases plus distant metastases. Globe pathology showed invasion of the optic nerve and/or the choroid in all but two patients, but was not predictive of the metastatic pattern. Initial signs of metastases were neurologic impairment and an orbital or body mass; first symptoms were anorexia or weight loss, vomiting, and headache. Most cases occurred by 3 years of age. Death occurred within 5.8 months on the average, despite therapy. Useful tests for determining the extent of disease were bone marrow aspiration, lumbar puncture, skull films, EEG, and brain scan. Computed tomographic scans of the head, bone scans, bone marrow aspiration, automated blood chemistry analysis, and lumbar puncture with immediate ethyl alcohol processing should prove to be useful to detect metastatic disease.
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PMID:Metastatic patterns of retinoblastoma. 670 86

Sixty patients from two Radiation Therapy Oncology Group (RTOG) studies with cerebral metastases from malignant melanoma were analyzed to determine the response to whole brain irradiation. General performance status, neurologic function, and specific neurologic symptoms were evaluated for rate and duration of improvement. Also analyzed was the influence of chemotherapy and steroids, although neither was a controlled factor. Results indicate a significant benefit from radiation therapy in terms of symptomatic and neurologic function improvement. Symptomatic improvement was observed in 76%, with 31% completely improved. Of the four most frequent symptoms, complete or partial improvement was observed as follows: headache--27 of 37 patients (73%); motor loss--14 of 23 patients (61%); impaired mentation--13 of 24 patients (62%); and convulsions--10 of 12 patients (83%). Improvement in neurologic function class was observed in 18 of 44 patients (41%). Median survival for Study 1 patients was 10 weeks (range 1-200) and that of Study II patients 14 weeks (range 1-76). These results are comparable to those found in radiation therapy of brain metastases from all other primary tumors.
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PMID:Value of radiation therapy in the management of patients with cerebral metastases from malignant melanoma: Radiation Therapy Oncology Group Brain Metastases Study I and II. 676 93

We studied 43 patients with metastases to the base of the skull to determine whether clinical symptoms localized the lesions accurately. We identified five clinical syndromes: orbital, parasellar, middle fossa, jugular foramen, and occipital condyle. The orbital and parasellar syndromes were characterized by frontal headache, diplopia, and first-division trigeminal sensory loss. Proptosis occurred with the orbital but not the parasellar syndrome. The middle-fossa syndrome was characterized by facial pain or numbness. The jugular foramen syndrome was characterized by hoarseness and dysphagia, with paralysis of the ninth through eleventh cranial nerves. The occipital condyle syndrome was characterized by unilateral occipital pain and unilateral tongue paralysis.
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PMID:Metastasis to the base of the skull: clinical findings in 43 patients. 697 14


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