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)

The extragonadal germ cell tumor are uncommon neoplasms which account for only 1-5% of germ cell tumors, and its prognosis is poor. We report here the use of combination chemotherapy with cisplatin, etoposide, bleomycin, and vinblastine (PVeBV) for the treatment of retroperitoneal germ cell tumor. A 28-year-old male with complaints of abdominal pain and lumbago, without any abnormality in both testes by physical and ultrasonographic examination, showed retroperitoneal tumor by abdominal computed tomography. The serum alpha-fetoprotein and lactate dehydrogenase were elevated. The retroperitoneal tumor was treated surgically. The pathological diagnosis was mixed germ cell tumor. The lung and supraclavicular lymph node metastases disappeared completely after 3 courses of PVeBV chemotherapy with cisplatin (40 mg/m2 per day) and etoposide (100 mg/m2 per day) for 5 consecutive days, with vinblastine (0.2 mg/kg) on day 1, and bleomycin (30 mg/body) given on days 1, 8, and 15. Granulocyte colony-stimulating factor and serotonin receptor antagonist application were available on acute phase toxic effects. The patient is now alive and well, without recurrence, more than 26 months after the operation.
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PMID:Retroperitoneal germ cell tumor treated by PVeBV chemotherapy: a case report. 1037 39

We report a case of advanced gastric cancer complicated by disseminated intravascular coagulation successfully treated with chemotherapy consisting of 5-fluorouracil and cisplatin. The patient was a 53-year-old woman who complained of loss of appetite, weight loss, and low back pain. Based on the laboratory data, a diagnosis of disseminated intravascular coagulation was made. Gastroscopy revealed gastric carcinoma (Borrmann type 3) that was continuously bleeding, and chest computed tomography showed a solitary lung metastasis and bilateral pleural effusion. Bone scintigraphy revealed multiple bone metastases. Accordingly, we made a diagnosis of stage IV gastric cancer complicated by disseminated intravascular coagulation. We selected the 5-fluorouracil and cisplatin combination chemotherapy for treatment and obtained the patient's consent. After two cycles of the 5-fluorouracil and cisplatin therapy, the bleeding symptoms improved and the disseminated intravascular coagulation process was successfully controlled. We concluded that disseminated intravascular coagulation caused by gastric cancer may be improved when the primary cancer and its metastases are brought under control by treatment with FP combination chemotherapy.
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PMID:Advanced gastric cancer associated with DIC successfully treated with 5-FU and cisplatin: a case report. 1194 41

Neurologic complications continue to pose problems in patients with metastatic prostate cancer. From 15 to 30 percent of metastases are the result of prostate cancer cells traveling through Batson's plexus to the lumbar spine. Metastatic disease in the lumbar area can cause spinal cord compression. Metastasis to the dura and adjacent parenchyma occurs in 1 to 2 percent of patients with metastatic prostate cancer and is more common in those with tumors that do not respond to hormone-deprivation therapy. Leptomeningeal carcinomatosis, the most frequent form of brain metastasis in prostate cancer, has a grim prognosis. Because neurologic complications of metastatic prostate cancer require prompt treatment, early recognition is important. Physicians should consider metastasis in the differential diagnosis of new-onset low back pain or headache in men more than 50 years of age. Spinal cord compression requires immediate treatment with intravenously administered corticosteroids and pain relievers, as well as prompt referral to an oncologist for further treatment.
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PMID:Neurologic complications of prostate cancer. 1201 6

Choroid plexus papillomas (CPPs) are generally regarded as benign tumours, with a favourable long-term prognosis. Complete resection should result in cure. We present a case of diffuse craniospinal seeding from an apparently completely resected fourth ventricular primary tumour. A 51-year-old male is discussed, who presented 5 years following complete resection of a CPP from the fourth ventricle, with a progressive history of left sided tinnitus, hearing loss, impotence and recent low back pain. Imaging demonstrated multiple craniospinal lesions explaining his symptomatology. Differential diagnosis lay between long standing CSF seeding, malignant transformation in the primary tumour, or metastatic spread from an undefined source. He underwent whole body FDG-PET scan which demonstrated a single metabolically active lesion in the sacral canal. A subtotal excision biopsy of this sacral lesion was performed which was indistinguishable histologically from the primary tumour resected from the fourth ventricle. Histological and functional imaging characteristics of the primary tumour have been unhelpful in predicting its subsequent behaviour. The present case illustrates the extremely rare consequences of metastases from this histologically benign tumour and adds to the literature on metastatic craniospinal disease.
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PMID:Metastatic choroid plexus papilloma: a case report. 1206 30

Patients commonly present to family physicians with low back pain. Because the majority of patients fully or partially recover within six weeks, imaging studies are generally not recommended in the first month of acute low back pain. Exceptions include patients with suspected cauda equina syndrome, infection, tumor, fracture, or progressive neurologic deficit. Patients who do not improve within one month should obtain magnetic resonance imaging if a herniated disc is suspected. Computed tomographic scanning is useful in demonstrating osseous structures and their relations to the neural canal, and for assessment of fractures. Bone scans can be used to determine the extent of metastatic disease throughout the skeletal system. All imaging results should be correlated with the patient's signs and symptoms because of the high rate of positive imaging findings in asymptomatic persons.
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PMID:Neuroimaging in low back pain. 1207 23

Sarcoidosis is a disease process of unknown cause that exhibits heterogeneous clinical manifestations. Although the mediastinum and lungs are most commonly involved, the granulomatous process may also affect the skeleton, skin, eyes, kidneys, spleen, and liver. A 51-year-old woman with low back pain and no history of cancer was found to have a suspicious lesion at L4 on magnetic resonance imaging. Findings of bone scintigraphy were consistent with multiple metastases, and computed tomography of the chest identified two small indeterminate pulmonary nodules. Similarly, findings of fluorodeoxyglucose positron emission tomography were consistent with widespread skeletal metastases, but a primary tumor was not identified. Biopsy of a left femur lesion was diagnostic of active sarcoidosis with no evidence of cancer.
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PMID:Unsuspected skeletal sarcoidosis mimicking metastatic disease on FDG positron emission tomography and bone scintigraphy. 1259 22

A 21-year-old male presented with right scrotal discomfort. Right high orchiectomy revealed non-seminoma and he was diagnosed with stage I non-seminoma. Since acute myeloid leukemia (AML) was diagnosed incidentally, no adjuvant therapy was given and he received chemotherapy for AML. One year later, he complained of lumbago and general malaise. Complete remission of AML had been achieved and bone marrow puncture revealed no signs of recurrence. Computed tomography showed retroperitoneal lymph node swelling, inferior vena caval embolus distal to the hepatic vein, and multiple lung nodules. Metastasis of testicular neoplasm was suspected and chemotherapy with Bleomycin, Etoposide, and Cisplatin was started. On the fourth day of chemotherapy, the patient complained of sudden dyspnea and acutely went into shock. Pulmonary embolism was diagnosed and an inferior vena cava filter was placed. Chemotherapy was continued for four courses and the tumor showed complete remission. He has been free of disease for 24 months. In rare cases of testicular cancer with inferior vena caval embolus, the physician should be aware of the possibility of causing pulmonary embolism after chemotherapy.
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PMID:[Testicular cancer with inferior vena caval embolus causing pulmonary embolism following chemotherapy: a case report]. 1523 86

Although the construct of "a symptom-free day" has been widely applied in asthma and gastric reflux disease, there is no analogous concept in the field of pain management. This study represents the initial development of a "day of acceptable or manageable pain control," a construct which reflects patients' daily strategic use of pain medication in order to allow the accomplishment of desired activities while minimizing side effects. Focus group methodology was used to extract patient-generated themes of "an acceptable day of pain control." Fifty-three outpatients with persistent moderate to severe average pain intensity due to osteoarthritis (n=18), metastatic cancer (n=15), and low back pain (n=20) participated. Participants preferred the term "manageable" or "tolerable" to "acceptable." Thematic analysis revealed components of a manageable/tolerable day of pain control as including: 1) taking the edge off the pain, 2) performing valued activities; 3) relief from dysphoria and irritability; 4) reduced medication side effects; 5) feeling well enough to socialize. Additional cancer-specific themes included relief from fatigue and ability to have a positive day when one's future days were perceived as being limited. The set of themes is presented and their relevance for developing a measure of "a manageable day of pain control" discussed. Study findings identify a novel construct that can inform development of an outcome for evaluating the effectiveness of different pharmacotherapies for pain management.
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PMID:Acceptable, manageable, and tolerable days: patient daily goals for medication management of persistent pain. 1550 24

In children with low back pain (LBP), a specific cause is often identified. LBP has a relatively high prevalence during school years. However, only a minority of the children suffering from LBP seek medical attention. Protracted back pain in childhood is a serious condition that should be thoroughly investigated. This article is a systematic review of the intrinsic causes of LBP. Imaging modalities are discussed, with emphasis on magnetic resonance imaging. We have divided the intrinsic causes of LBP into four main groups: mechanical, developmental, infectious/inflammatory, and neoplastic. Disk protrusion is prevalent in young athletes. Spondylolysis and spondylolisthesis are the most common causes of chronic LBP in children. Thoracic or thoracolumbar Scheuermann disease causes kyphosis while a lumbar localization is more painful. Childhood diskitis is associated with fever and leukocytosis. Spinal inflammatory arthritides in children include juvenile rheumatoid arthritis, the juvenile spondyloarthropathies, and SAPHO syndrome, where spine as well as sacroiliac joint changes may be seen. Cysts, tumors, tumor-like lesions, and metastases are infrequent causes of back pain in children. Several of these conditions are described and illustrated in this review of LBP in children and adolescents.
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PMID:Imaging of low back pain in children and adolescents. 1566 19

Metastatic cancer of unknown primary site represents approximately three percent of all new cancer diagnoses. Expensive and invasive diagnostic procedures are often performed although the primary tumour is detected in less than 25 percent of cases. We present a 63-year-old woman presenting with low back pain and was found on positron emission tomography (PET) to have lung cancer. The pros and cons of PET in the diagnostic process of patients with metastatic cancer of unknown primary site are reviewed. PET should be considered in the diagnostic process of patients with unknown primaries, and unnecessary invasive procedures may be avoided.
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PMID:Positron emission tomography: useful in detecting metastatic cancer of unknown primary site. 1590 52


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