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)

A rare autopsy case of mediastinal bronchogenic cyst with malignant transformation is presented. The cyst had been located in the anterior mediastinum for at least 28 years in a 52 year old male. Chest X-ray findings showing rapid enlargement of the cyst and biopsy of the spine for lumbago made a clinical diagnosis as suspicious mediastinal cystic teratoma with malignant transformation metastasizing to the spine. Postmortem examination revealed that the cyst was located in the anterior mediastinum extending to the left pulmonary hilum and had no connection with the tracheobronchial tree. The cyst wall consisted of bronchus-like tissue including ciliated epithelium, hyaline cartilage, smooth muscle and mucoserous glands. There were no teratomatous components in the wall. Malignant tumor predominantly consisting of round cells occurred in the thickened cyst wall and grew into the cyst cavity with direct invasion of the lung and metastases to the liver, adrenal glands, bone marrow of the lumbar spine and lymph nodes. An immunohistochemical study showed that the tumor cells frequently expressed cytokeratin, epithelial membrane antigen and carcino-embryonic antigen, occasionally CA19-9, vimentin and neuron-specific enolase. From these findings, the tumor was diagnosed as undifferentiated carcinoma arising in the mediastinal bronchogenic cyst.
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PMID:Congenital mediastinal bronchogenic cyst with malignant transformation: an autopsy report. 889 29

A 40-year-old patient was seen because of a three-month history of low back pain unresponsive to standard therapy. Crush fractures of T12 and L2 were seen on plain radiographs. A magnetic resonance imaging study disclosed lesions of all the vertebral bodies from T12 to the sacrum sparing the disks and epidural space. Histologic features of a vertebral biopsy specimen was consistent with malignant fibrous histiocytoma of the bone. The multifocal distribution caused some reluctance to accept this diagnosis, which was, however, confirmed by detailed immunohistochemical studies and reevaluation of the histologic slides by independent observers who were unaware of the initial diagnosis. Chemotherapy with doxorubicin and cisplatin was started but the patient died 15 months after the diagnosis. Malignant fibrous histiocytoma mainly affects the metaphyses of the long tubular bones. The spine is a very uncommon site of localization of this tumor. The multifocal spinal lesions in our patient may have been produced by metastases from an unidentified primary or by direct spread via the perivertebral soft tissues of a primary located in a vertebral body. The management of malignant fibrous histiocytoma relies on a combination of surgery and chemotherapy. Although complete excision of the tumor can be followed by prolonged survival, the prognosis is bleak in unresectable forms.
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PMID:Multifocal malignant fibrous histiocytoma of the spine. 917 2

A 38-year-old man, with hepatitis C and a history of intravenous drug use had hepatocellular carcinoma. Severe low back pain was the result not of metastases but of extramedullary hematopoiesis. This was not confirmed by biopsy but seemed unequivocal on magnetic resonance imaging.
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PMID:Spinal extramedullary hematopoiesis secondary to hepatocellular carcinoma. Case report and literature review. 941 53

We reviewed the clinical records of 149 patients with pathologically proved cauda equina lesions in order to define the relative frequency and clinical presentations of the various diagnoses. The most common pathology was ependymomas (47 patients) followed in frequency by nerve sheath tumors (35 patients), metastases (27 patients), nonependymal glial neoplasms (six patients), meningiomas (six patients), lipomas (five patients), paragangliomas (five patients) and various other diagnoses (19 patients). Mean patient age at presentation for the various lesions included: metastases (51.5 years), nerve sheath tumors (49.7 years), nonependymal glial tumors (46.5 years), paragangliomas (41.2 years), ependymomas (38.3 years), meningiomas (34.7 years), and lipomas (18.4 years). ANOVA showed that the relationship between age and diagnosis for these groups to be statistically significant at a high level (P = 0.002). Low back pain was the most common symptom and occurred in 44 patients. Other symptoms included unilateral lower extremity pain or tenderness (24 patients), bilateral lower extremity pain or tenderness (16 patients), and bilateral lower extremity weakness (16 patients). No relationship between pathologic diagnosis and specific symptoms was found.
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PMID:Lesions of the cauda equina: a clinical and pathology review from the Armed Forces Institute of Pathology. 949 Dec 94

Over a two-year period, 48 sequential patients were selected because they showed type I or II end plate changes on magnetic resonance imaging (MRI) and/or had positive single-photon emission computerized tomography (SPECT) scan in the area of disc degeneration. They were selected out of a large group of patients who were being evaluated by MRI and SPECT scan for low back pain. In this group of 48 patients, 47 had positive SPECT scans at the disc space, which on MRI indicates degenerative disc disease. Of these, 38 had end plate changes on the MRI, but 10 did not have end plate changes on the MRI even though their SPECT was positive. None of the 48 patients had evidence of other pathology such as fracture, metastatic disease or spondylolysis. The MRI changes were both of type I and type II and thought to represent increased vascularization of the fibrous tissue or fatty replacement of marrow in the area of the end plate. Based on this study, we are proposing that a positive end plate SPECT in degenerative disc disease is related to marrow changes in the region of the end plate of the disc. Also, we are proposing that SPECT may be of value in delineating early end plate changes prior to the MRI showing type I or type II change in the same area.
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PMID:SPECT and lumbar MRI in back pain with emphasis on changes in end plates in association with disc degeneration. 955 44

In recent years there has been spectacular progress in the approach to various disorders of the spinal column. Owing to improved methods of osteosynthesis there is no longer so much need for long periods of postoperative bed rest. Of all the scolioses, idiopathic scoliosis is most common. The vast majority of these cases are not clinically significant. What is seen in the remaining cases if left untreated is a progression in the curvature during growth. Progressive idiopathic scoliosis can be effectively treated using conservative methods. Screening at school is an important part of this process. If the curvature proves progressive and skeletal growth is not complete a brace can be prescribed. Use of this strategy and form of treatment can avoid progression of the curvature and development of serious deformities. This conservative therapy has markedly reduced the need for corrective surgery. Scheuermann's disease is characterized by a fixed dorsal thoracic kyphosis. Progressive Scheuermann's kyphosis can be effectively treated using a brace. The majority of fractures of the vertebral bodies can be treated conservatively. However, serious fractures normally require surgical intervention. In the industrialised Western world, low back pain is a major health problem and the foremost cause of disability and unfitness for work. Low back pain caused by degenerative disease of the spinal column should be treated using a multidisciplinary approach. The development of advanced operative techniques and osteosynthesis methods has made it possible to treat metastases of the spine surgically. The effects of this treatment on the quality of life are encouraging.
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PMID:[One hundred years of orthopedics in the Netherlands. IV. Spinal abnormalities]. 962 1

Individuals who have severe back pain have trouble bending, may not be able to put on their shoes, have difficulty in ambulation, and may not be able to clean their own houses. What distinguishes these individuals with low back pain from those afflicted with other conditions (i.e., congestive heart failure, metastatic cancer, symptomatic acquired immune deficiency syndrome) is prognosis. Back pain essentially never shortens life. Acute back pain has a very benign prognosis, with more than 90% of the individuals returning to functional status equivalent to their baseline status within 3 months of the onset of pain. Patients who have chronic back pain have a significantly worse prognosis, but most cohort studies show that substantial numbers of chronic back pain patients improve over time with supportive therapy.
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PMID:Disability: how successful are we in determining disability? 985 77

Radical hepatectomy was carried out on a patient with hepatocellular carcinoma (HCC) located in segment VIII of the liver. The patient was a 56-year-old man who showed positive for hepatitis C antibody and negative for hepatitis B surface antigen. Six months after hepatectomy, a lumbar plane X-ray and computed tomography examination revealed bone metastases in the lumbar vertebrae. The patient was subsequently treated by radiation to the lumbar vertebrae in response to lumbago. The metastatic lesion has been well controlled by radiotherapy on an outpatient basis with no recurrence for 5 years and 3 months. The prognosis of patients with HCC with distant metastases is poor. It is believed that the long survival of this patient can be attributed to successful radiotherapy of the bone metastasis after hepatectomy and the lack of recurrence in the liver.
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PMID:A case of hepatocellular carcinoma with bone metastasis responding to radiotherapy after successful hepatectomy of primary lesion. 1021 62

We experienced that two lung cancer patients who had been considered to be potentially resectable were preoperatively pointed out enlarged adrenal glands. Therapeutically, discrimination between benign and malignant adrenal mass lesion is an important problem. Case 1: After a 3 course neoadjuvant chemotherapy, a 50-year-old man had a left adrenalectomy, which revealed non-functional adenoma. One month later, a left lower lobectomy for T3N2 adenocarcinoma was performed. Case 2: A 64-year-old man had a right upper lobectomy for T2N0 adenocarcinoma, firstly. Two months later, a left adrenalectomy was done because a rapid growth and lumbago, which revealed metastatic adenocarcinoma originating from the lung. The patient died of brain and stomach metastases 4 months postoperatively.
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PMID:[Primary lung cancer with solitary adrenal tumor]. 1031 37

Primary sarcomas of the kidney are exceptional, representing 1 to 3% of all renal tumours in adults. They have a poor prognosis. The authors report a case of primary leiomyosarcoma of the kidney in a 44-year old patient, presenting in the form of low back pain and haematuria. Treatment consisted of radical nephrectomy. Two months later, the patient presented with hepatic metastases. The patient is currently receiving chemotherapy.
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PMID:[Primary leiomyosarcoma of the kidney. A case report]. 1037 Sep 57


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