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 case was a 64-year-old man. He was diagnosed as gastric cancer, lymph node metastases, brain metastases, bone marrow carcinomas, and disseminated intravascular coagulation(DIC). He was started on methotrexate(MTX)/5- fluorouracil(5-FU)sequential therapy(weekly administration of MTX(100 mg/m(2), iv bolus)followed by 5-FU(600 mg/m(2), iv bolus)with a 3 h interval). DIC was resolved, and the tumor marker decreased remarkably. Four weeks later, he received zoledronic acid 4 mg to prevent skeletal complication. Next day, fatigue and anorexia onset. Six days later, laboratory data showed severe hypocalcemia. He was started on calcium gluconate 3.4 g/day. The calcium level was normalized in twelve days, and the symptoms were improved. MTX /5-FU therapy was resumed, and his condition remained stable. However, after the ninth dosage, he developed fatigue and low back pain, and the DIC relapsed. We started paclitaxel therapy. But it was not effective and he died ten days later. It was considered that careful attention to hypocalcemia is necessary when we use zoledronic acid for the bone marrow carcinomas treated with chemotherapy.
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PMID:[A case of bone marrow carcinosis from gastric cancer that presented hypocalcemia caused by zoledronic acid during the treatment of methotrexate/5-fluorouracil sequential therapy]. 1929 78

The presence of distant metastases from differentiated thyroid carcinoma decreases the 10-year survival rates of patients by 50%. This is a report of a 61-year-old female with follicular thyroid carcinoma who presented initially with low back pain. 2-deoxy-2-[18F] fluoro-D-glucose whole-body positron emission tomography/computed tomography (PET/CT) demonstrated a hypointensity lesion in the left thyroid gland with malignant uptake in L1 vertebra and magnetic resonance images revealed paravertebral and epidural extension of mass in L1 vertebra. After thyroidectomy, histopathological study showed a follicular carcinoma. We performed L1 total en bloc spondylectomy with expandable cage for long-term local control. The technical details of total en bloc spondylectomy in follicular carcinoma are described herein.
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PMID:Total en bloc lumbar spondylectomy of follicular thyroid carcinoma. 1935 84

Paravertebral muscle metastasis is an extremely rare cause of low back pain. Lipomas, haemangiomas, hibernomas and liposarcomas should be considered first in the aetiology of paravertebral muscle masses. Schwannoma, neurofibroma, ganglioneuroma and paraganglioneuromas that show contiguous spread should also be included in the differential diagnosis. Haematogenous metastases are most frequently caused by lung cancers. Lung cancers typically metastasize to liver, brain, bone, kidney, and adrenal glands. They rarely metastasize to skeletal muscles due to metabolism, high tissue pressure and blood flow of muscles. Our case was a 48-year-old male who had been smoking 40 cigarettes per day and presented to our clinic with low back pain and a mass in the lower back region. The mass in his lower back region was excised and histopathological examination confirmed metastasis of a neuroendocrine tumour. Further examinations revealed the lung as the primary source of the metastasis.
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PMID:An unusual cause of low back pain: paravertebral muscle metastases of lung cancer. 1935 48

Primary carcinoid tumor (well-differentiated neuroendocrine tumor) of the bone involving the sacrum is extremely rare. We report the case of a 72-year-old man who presented with a 20-year history of intermittent low back pain and was found to have an intraosseous sacral mass on imaging. A needle biopsy revealed that this lesion was a well-differentiated neuroendocrine tumor. Workup did not show any primary tumor or other metastatic disease. There was no associated tailgut cyst or sacrococcygeal teratoma. The lesion was treated with radiation therapy because a surgical approach was rejected. The patient is free of metastatic disease after 28 years evolution of the lesion, retrospectively seen to be present on a conventional radiography performed in 1980. A review of the literature revealed 20 case reports of neuroendocrine tumors arising from the presacral region (with or without associated tailgut cyst or sacrococcygeal teratoma) and sometimes extending to the sacrum. One additional case was located within the neural canal and involved the sacrum, the presacral region, and the rectal wall. Our case is the only tumor arising primarily from the sacrum. The long evolution of this lesion without any other location makes metastatic disease very improbable and this case appears to be a unique example of primary intraosseous sacral carcinoid tumor.
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PMID:Primary neuroendocrine tumor of the sacrum: case report and review of the literature. 1936 Apr 3

Osteitis Condensans Ilii (OCI) is a benign cause of axial low back pain. Although no clear etiology has been identified, the prevailing theory is that mechanical strain affects the auricular portion of the ilium and causes premature arthritis. The location of the sclerosis has been traditionally confined to the ilium and may give the false impression of sacro-iliac joint involvement. Clinicians must be guided by history, radiographic findings, and laboratory studies in differentiating OCI with other disorders; furthermore additional causes of low back pain including metastatic disease and ankylosing spondylitis must be ruled out. Treatments for the condition are primarily conservative (therapies, non-steroidal anti-inflammatory medications, and steroid injections), with surgical resection being reserved for refractory cases.
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PMID:Osteitis Condensans Ilii. 1971 Oct 79

We report a peculiar case in an 80-year-old man with multiple bone metastases due to the recurrence of thymic carcinoid tumor after surgical resection and radiation therapy ten years earlier. He was admitted to our hospital with a complaint of lumbago. Fluoro-2-deoxy-D-glucose (FDG) PET was useful for recognition of multiple bone metastases due to the recurrence of thymic carcinoid tumor, while (201)Tl-whole body scintigraphy and by (99)mTc-methylene diphosphonate ((99)mTc-MDP) bone scintigraphy did not reveal the metastases. Finally, we performed a CT-guided bone biopsy from lumbar vertebra and could obtain the diagnosis of metastases of carcinoid tumor histologically. As evident in this case, it is important to consider the recurrence of carcinoid tumor even if a long time has passed after the surgical resection and radiation therapy; also FDG-PET may be a useful diagnostic imaging modality to detect metastases from thymic carcinoid tumor to other organs.
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PMID:Clinical usefulness of fluoro-2-deoxy-D-glucose PET in a case with multiple bone metastases of carcinoid tumor after ten years. 1988 Dec 47

Kyphoplasty is a recognized treatment option in the management of symptomatic osteoporotic compression fractures, osteolytic vertebral metastases or haemangioma. To our knowledge, kyphoplasty with polymethylmethacrylate in a patient with type I osteogenesis imperfecta (OI) and a vertebral compression fracture has not been reported so far. We report on a 58-year-old patient with type I OI and a vertebral compression fracture at L2 with undislocated posterior vertebral wall and an additional older L1 fracture. Because of severe back pain resistant to conservative therapy over 5 months the indication for percutaneous kyphoplasty was made. Preoperative adjacent endplates of L2 were nearly parallel. Radiologically a minimal loss of height of the L2 vertebra was seen without adjacent fractures at 9 months follow-up. A slight increase of the preoperative kyphotic angle of overlying vertebrae L1 (8.7 degrees/10.3 degrees) and T12 (10.4 degrees/11.0 degrees) was apparent. The visual analogue scale showed decrease of low back pain from 10 to 2 allowing mobilization with a walking frame. Kyphoplasty constitutes a minimal invasive therapeutic alternative in the treatment of vertebral fractures in type I OI and pain, resistant to conservative treatment. Similar to the results of osteoporotic fractures the immediate reduction of pain and stabilization of the fracture in undislocated fragments can be achieved. No adjacent fractures occurred 9 months postoperatively after kyphoplasty in type I OI. Preoperative parallelism of the endplates seems to protect from adjacent fractures.
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PMID:The role of kyphoplasty in the management of osteogenesis imperfecta: risk or benefit? 1994 21

Small cell lung cancer (SCLC) has a very aggressive clinical progression with widespread metastases. We describe the case of a patient with SCLC treated with concurrent chemoradiotherapy. One month later, after finishing the scheduled treatment, the patient was admitted to the hospital again with symptoms of low back pain that radiated to bilateral lower legs with painful paresthesias, urinary incontinence, and constipation. After a series of examinations, including bone scan and magnetic resonance imaging, the patient received an L2-L3 laminectomy. The concluded diagnosis through histopathologic examination with immunohistochemistry was extramedullary-intradural spinal metastasis causing cauda equina syndrome. The metastatic tumour originated from the SCLC. To the best of our knowledge, this is the first reported case of SCLC metastasized to the cauda equina causing cauda equina syndrome.
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PMID:Extramedullary-intradural spinal metastasis of small cell lung cancer causing cauda equina syndrome. 2001 82

While uncommon, isolated avulsion fractures of the lesser trochanter occur in children and adolescents prior to the fusion of this apophysis as a result of athletic activities. In the elderly, isolated fractures of the lesser trochanter are rare but can occur as a result of trauma. They have been identified in patients with primary or secondary bone malignancies, which were previously considered pathognomonic for metastatic disease. In the absence of trauma, weakening of the bone due to systemic disorders such as osteoporosis or osteomalacia chronica renal failure may also be responsible. Diagnosis may be difficult with physical examination and radiographs alone. This case report details this rare fracture in 2 patients suffering from debilitating chronic disease. Patient 1 was a 30-year-old woman with an 18-year history of type 1 diabetes mellitus, a 6-year history of end-stage renal disease, hypertension, hypothyroidism, peripheral vascular disease, and a 3-year history of systemic lupus erythematosus with antiphospholipid syndrome treated with warfarin. Patient 2 was a 66-year-old woman with a history of type 2 diabetes mellitus, peripheral neuropathy, obesity, chronic obstructive pulmonary disease, gout, hypertension, and chronic neck and low back pain. Both were assessed with magnetic resonance imaging following physical examination, which revealed atraumatic avulsion of the distal iliopsoas tendon from the lesser trochanter. Following retraction of the iliopsoas tendon, the patients were treated with conservative therapy and anti-inflammatory medication. These 2 cases broaden the range of patients for whom spontaneous avulsion of the distal iliopsoas tendon should be considered in the differential diagnosis.
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PMID:Atraumatic avulsion of the distal iliopsoas tendon: an unusual cause of hip pain. 2070

Metastasis of one neoplasm to another is also known as metastasis of "tumor to tumor", "cancer to cancer", "tumor in tumor", and "one to another". We describe the case of a 75-year-old woman with the metastasis of signet-ring cell carcinoma of the stomach to clear cell renal cell carcinoma. Six years earlier, the patient had undergone gastrectomy for early gastric cancer. She complained of lumbago, and a mass was found in her left kidney. Examination of a partial nephrectomy revealed clear cell renal cell carcinoma containing signet-ring cells. Morphological and immunohistochemical findings of the signet-ring cells found in kidney cancer and gastric cancer were identical. Subsequent examinations revealed the patient had multiple bone metastases. The diagnosis of carcinoma metastasizing to renal cell carcinoma can be challenging; therefore, additional clinical information and immunohistochemical panel studies are requisite.
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PMID:Signet-ring cell carcinoma of the stomach metastasizing to renal cell carcinoma: a case report and review of the literature. 2084


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