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)

Interventional procedures constitute a significant proportion of musculoskeletal radiology. Percutaneous needle biopsy is the ultimate diagnostic technique for the evaluation of musculoskeletal neoplasms and infections. The procedure is accurate, rapid, and safe. It is ideally suited for the diagnosis of metastatic disease and round cell neoplasms. Several needle procedures have been used for the diagnosis and treatment of low back pain. Diskography is primarily a diagnostic test used to determine the symptomatic disk level when multilevel disk disease is present and also to diagnose internal disk disruption. Nerve block with local anesthetic is also used to locate the symptomatic level in patients with multilevel abnormalities. Epidural steroid injection is a therapeutic procedure that commonly is used in patients with low back pain and has been shown to be most effective in patients with disk herniation. Facet joint injection with local anesthetic and steroid is performed to diagnose and treat the facet syndrome. Other needle procedures in the musculoskeletal system include sacroiliac joint aspiration and injection, prosthetic joint aspiration to evaluate potential infection, distention arthrography, and injections of the coccyx for coccydynia.
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PMID:Interventional musculoskeletal radiology. 798 73

Small cell carcinoma of the prostate is a rare disease, since only about 50 cases in the English literature and two cases in Japanese literature have been reported. Here we report a case that is the youngest ever described in the literature. A 24-year-old man was referred to our hospital with right dull lumbago and dysuria. He had the same symptom for one and half year before referral. IVP showed right non-visualizing kidney and left hydronephrosis. Form abdominal CT scans and cystoscopic findings a retrovesical tumor was highly suspicious. Transperineal needle biopsy specimens revealed an undifferentiated malignant tumor. His serum Neuron Specific Enolase (NSE) and LDH were remarkably high and whole body CT scan and upper GI tract examination demonstrated no lesion. He developed ileus and underwent exploratory laparotomy and colostomy was constructed. There was a large mass arising from the prostate which invaded into the peritoneal cavity, and multiple metastases were seen on the omentum and mesenteric lymph nodes. Specimens from the mass arising from the prostate and lymph nodes revealed small cell carcinoma pathologically. A panel of antibodies were used to seek potential tumor markers and to identify substances produced by the tumor cells including enzymes, cytoskeletal components and hormones. And stains were positive for the NSE and chronogranin. An intensive anti-cancer chemotherapy with VP-16 and CDDP was done with minor response (MR) and the serum tumor marker, LDH and NSE, decreased markedly. However, he had expired on the 58th hospital day.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Small cell carcinoma of the prostate]. 806 70

1. Low back pain affects approximately 80% of the adult population. There are between 200,000 and 500,000 spinal surgeries performed every year. 2. New spinal implant systems offer hope for persons with failed spinal surgery--as well as for those with spinal fractures, metastatic disease, and severe degenerative disorders. 3. Although complications can develop, the benefits of new spinal fixation systems far outweigh the problems.
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PMID:Perioperative care of patients undergoing spinal stabilization with internal fixation (continuing education credit). 806 99

Low back pain is a common complaint in primary care practice, particularly among older patients. The office-based workup starts with a careful history aimed at determining the onset, location, and severity of pain. A physical examination includes attention to gait, palpation, and some simple neurologic tests. Most patients require plain x-rays. Bone scans are useful for identifying suspected tumors and infections; CT and MRI are indicated in specific cases. Although the origin of most low back pain is indeterminate, the workup may uncover some important causes in older adults, including lumbar spinal stenosis, osteoporotic vertebral fractures, and metastatic disease to the spine.
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PMID:Low back pain: how to make the diagnosis in the older patient. 808 59

A rare case of acute subdural hematoma due to dural metastasis from malignant pleural mesothelioma is reported. A 65-year-old man was brought to a nearby hospital complaining of lumbago. He suddenly complained of headache on the third hospital day and fell into a deep coma within a short while. Computed tomography showed a crescent shaped high density area in the right fronto-temporo-parietal region with midline shift to the left side. He was admitted as an emergency case to our clinic on April 24, 1989. Under the diagnosis of acute spontaneous subdural hematoma, emergency operation was performed. Nests of malignant sarcomatous cells were found in the clot obtained during the procedure, but the origin of the tumoral cells could not be identified. The patient failed to recover from the comatose state and died with pancytopenia on the 17th hospital day. General autopsy showed wide-spread malignant pleural mesothelioma with metastases to the lung, liver and bone marrow. Examination of the head revealed dural metastatic tumor and a subdural hematoma over the left hemisphere. Histopathology showed that many tumor cell nests were found only within the dilated veins of the dura. There, acute subdural hematoma was assumed to have developed suddenly and there was massive bleeding from the capillaries of the inner vascular layer of the dura. The relevant literature about intracranial metastasis of malignant pleural mesothelioma was reviewed, and the mechanism of subdural hematoma due to dural metastasis from malignant tumor was discussed.
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PMID:[A case of acute subdural hematoma due to dural metastasis from malignant pleural mesothelioma]. 813 66

Known for its resistance to chemotherapy and radiation therapy, chondrosarcoma remains largely a surgically managed tumor predisposed to local recurrence and late distant metastasis. A 42-year-old man with known thoracic chondrosarcoma developed progressive low back pain, lower extremity weakness, and urinary incontinence. Magnetic resonance imaging and computed tomographic myelography demonstrated multiple filling defects throughout the lumbosacral region. Surgical excision of these lesions disclosed intradural, extramedullary drop metastases of the chondrosarcoma. The spread of neoplasms within the dural space is uncommon, accounting for less than 5% of spinal metastases, and has not previously been reported for chondrosarcoma.
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PMID:Intradural recurrence with chondrosarcoma of the spine. A case report and review of the literature. 835 50

Back pain and low back pain can be caused by extravertebral diseases, functional disorders or morphologic changes of the spine. Diagnosis of back pain is mainly done by clinical examination. The examination of segmental mobility is necessary to make the diagnosis of functional disorders. X-ray and laboratory are mainly used to exclude morphologic changes of the spine. Functional disorders are best treated by chirotherapy completed by rehabilitation of the active motion apparatus. The most important morphologic diseases of the spine causing back pains are deformities, especially lumbar scoliosis, infectious diseases as pyogenous or specific spondylitis, rheumatic diseases as rheumatoid arthritis, mostly at the occipitocervical region, and Bechterew's disease, furthermore instability caused by spondylolisthesis or iatrogenic low back pain as the failed-backsyndrome and tumors, which are in the majority metastases. The role of degenerative changes as a cause of back pain is difficult to estimate. The operative treatment of spinal instability, which has changed in the last years is described, as modern treatment facilities of lumbar disc herniation as chemonucleolysis or percutaneous nucleotomy.
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PMID:[The spine in adulthood]. 837 59

A case of mucinous cholangiocarcinoma is reported. The patient was a 49 year old woman with the complaint of lumbago. Imaging examination disclosed a tumor 3.5 cm in diameter in the right hepatic lobe, which showed low density on computerized tomography scans and low signal intensity on T1-weighted magnetic resonance imaging (MRI) and high intensity on T2-weighted MRI. The hepatic tumor expanded rapidly and multiple pulmonary metastases and peritoneal dissemination developed. The patient died due to respiratory failure 5 months after the initial symptom. An autopsy, a massive tumor (9.5 cm in diameter) containing abundant mucus with several surrounding daughter nodules was found in the right hepatic lobe. Metastases were widespread. Histologically, the tumor was composed mainly of numerous lobulated mucus lakes in which adenocarcinoma cells floated. Admixed signet ring cells were also noted. These gross and histologic features differ from those in other mucin-producing hepatic tumors such as biliary papillomatosis and mucinous cystoadenocarcinoma. Immunohistochemically, the adenocarcinoma cells were strongly positive for carcinoembryonic antigen, Lewis Y, Tn, and T antigens and moderately positive for carbohydrate antigen 19-9, Lewis X, sialyl-Lewis X and sialyl-Tn antigen. Mature MUC1 mucin and core protein of MUC1 mucin were also expressed to varying degrees. The rapidly expanding, widespread metastases and poor prognosis found in the present case may be the clinicopathological features of mucinous cholangiocarcinoma.
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PMID:Pathological and immunohistochemical findings in a case of mucinous cholangiocarcinoma. 856 41

Insufficiency fractures of the pelvis are commonly overlooked as causes of severe hip and low back pain. Predisposing factors include postmenopausal osteoporosis, corticosteroids, and local irradiation. Differential diagnosis includes metastatic disease to bone. We present the case of a 65-year-old woman who had a two-month history of low back pain and left groin pain. Her medical history included osteoporosis and endometrial cancer that was treated with radiation therapy to the pelvis 1 year prior to presentation. Despite bed rest, analgesics, and therapeutic modalities, her pain remained intractable and prevented ambulation. Plain radiographs showed no fracture. Computed tomography (CT) and magnetic resonance imaging showed fractures of the pelvis but were suggestive of malignancy. CT-guided bone biopsy was consistent with radiation osteonecrosis. After diagnosis and continued therapy, the patient progressed to ambulation with moderate discomfort. Failure to diagnose insufficiency fractures could lead to further pelvic irradiation, compromising already weakened bones and causing prolonged disability.
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PMID:Pelvic insufficiency fractures after irradiation: diagnosis, management, and rehabilitation. 860 69

Clinically evident metastases to the thyroid gland are rarely found antemortem. A case of a 59-year-old woman with a history of rectal carcinoma, who presented with low back pain and a mass in the right lobe of her thyroid gland, is presented. The tumour of the thyroid was found to be metastatic adenocarcinoma from her previous rectal cancer. Other synchronous metastases were noted in her lumbar spine and kidneys. The clinical finding of metastases to the thyroid gland is rare, particularly from a colorectal primary. One must consider, however, the possibility of a tumour of the thyroid gland representing a secondary malignancy in any patient with a prior history of cancer.
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PMID:Rectal carcinoma metastatic to the thyroid gland. 872 14


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