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

Many tumors, especially when metastasizing, produce a variety of symptoms. Two frequent sets of complications due to metastasizing cancer (mainly to the bones), i.e. vertebral metastases and chronic pain, are reviewed. In the case of vertebral metastases, the fitting of an orthopedic corset should--and as a rule can--be avoided. Treatment of this complication is by systemic therapy and/or radiotherapy. Symptoms or signs of medullary compression are indications for emergency treatment by the radiotherapist or the neurosurgeon. In the case of chronic pain, regular oral intake of the Brompton mixture is an alternative to injections of analgesics in that it prevents rather than alleviates pain and is only slightly addiction-forming.
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PMID:[Therapy of complications due to neoplasm metastases]. 68 96

When reviewing the bibliography of this rare metastatic location of cancer of the prostate gland, we have only been able to compile the observations published by HUMPHREY (1), BROTHERUS (2) and SMITH (3) wo describe cases with the same location and characteristics. All the observations of metastasis in the epididymis of cancer of the prostate gland constitute unexpected findings during the course of surgical castration operations. The morphology is always the same, small indurated nodules respecting the rest of the epididymis. On the other hand, metastases in the epididymis of extraurinary adenocarcinomas most of which were digestive, were not discovered until the increased size and pain in the testicle attracted the patient's attention and the exploration led to the identification of the tumour in the epidiymis (2, 4, 5). However, primitive malignant tumours of the epididymis constitute an infrequent lesion. In the literature there were found to be more primitive tumours in relation to the metastatic ones and it was difficult to establish the diagnosis of a primitive tumour of the epididymis without having previously ruled out the possibility of other distant neoplasias which are sometimes even asymptomatic.
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PMID:[P. Metastasis of prostatic carcinoma to the epididymis]. 69 9

A case of chondrosarcoma of the hand recurred 4 times over a period of 32 years. Forty-seven cases of hand chondrosarcomas have been found in the literature. Histological diagnosis is difficult in differentiating chondrosarcomas from benign chondromas. Pain and swelling are the main symptoms of recurrence. The diagnosis is established by arteriography and excisional biopsy. Extraskeletal hand chondrosarcomas do not metastasize and other hand chondrosarcomas do so only rarely. Block excision of localized amputation is the treatment of choice.
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PMID:Chondrosarcoma of the hand. 72 58

In an effort to determine the potential of radiotherapy or surgery in alleviating the symptoms and signs of metastic cancer to the spinal neuraxis, 77 cases with documented malignant disease in this area were studied retrospectively over a 2 year period. Emphasis must be placed on early diagnosis, and recognition of intractable day and night pain as a hallmark of cancer of the spine. This symptom was found to be present for many months before the diagnosis could be made on plain X-rays. Bone-scanning, tomography, and myelography were consistently found to be useful adjuncts to early diagnosis. This study points out that operative intervention is ineffective in relieving the signs and symptoms of cord compromise, and adds significantly to the general morbidity of the patient. This was a consistent finding in cases with metastases to the thoracic spine who had developed neurological dysfunction secondary to their tumors. Radiation therapy should be considered a useful form of palliation for the pain associated with metastatic cancer.
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PMID:Metastatic cancer of the spinal column. 72 81

The authors report a series of 100 consecutive patients with spinal metastases causing cord or cauda equine compression, who were treated with surgical decompression. Of these, 30% (all women) had breast cancer. The most common primary neoplasm in man was prostatic carcinoma. Pain was the earliest and most prominant symptom, followed by weakness. Bladder dysfunction was recorded in 40 patients. The thoracic region was the most common site of cord compression (76 patients). Surgical treatment involved urgent and extensive laminectomy decompression. Concomitant spinal stabilization was required in 10 cases, involving posterior rib graft fusion in seven and Harrington rod instrumentation in three. At last follow-up review, 29 of these patients were living with an average postoperative survival of 2.3 years; 71 patients had died with an average survival of 8.8 months. Surgical decompression produced effective pain relief in 70% of the patients. Postoperatively, 58 patients could walk; of these, 40 were walking and continent of urine 6 months following surgery (including five patients who were totally paraplegic on admission). Positive approach and aggressive management in this problem can achieve results superior to those generally reflected in the literature.
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PMID:The neurosurgical management of spinal metastases causing cord and cauda equina compression. 73

Patients with poorly differentiated prostatic carcinoma and skeletal metastases were randomized to treatment with 2.6-cis-diphenylhexamethylcyclotetrasiloxane (2.6-cis) and estramustine-17-phosphate (estramustine). Parallel with the clinical study a group of non-randomized patients were treated with 2.6-cis. Cytological regression of the tumor could be registered in half of the estramustine group but not in the 2.6-cis group. There were no drug-related changes in blood chemistry, kidney function tests, hematology or liver enzymes. There was in increase in acid and alkaline phosphatase in both groups but more pronounced in the 2.6-cis group. In both groups follicle-stimulating and luteinizing hormone values were depressed. Testicular and penis atrophy was observed in the 2.6-cis group. Relief of pain and marked improvement of conditions occurred in the majority of the cases in both groups. In general, no tumor regression was observed during administration of 300 mg. 2.6-cis daily for at least 3 months. Some tumor regression was noted during 600 mg. estramustine therapy daily.
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PMID:Clinical experimental randomized study of 2.6-cis-diphenylhexamethylcyclotetrasiloxane and estramustine-17-phosphate in the treatment of prostatic carcinoma. 73 10

Employing the Siemens Scintimat II, a skeletal scintigraphy was successfully appled in the early detection, localisation and delineation of bone metastases to the knee from rhabdomyosarcoma of the right pectoral region. However repeated radiographs of the knee continued to be negative. As all other treatment approach of the painful knee: physiotherapy (short wave diathermy) had failed to produce relief, radiotherapy was applied as a last resort; the swelling regressed and the pain disappeared. This was indicative of the positive detection of early rhabdomyosarcoma metastases to be bones as a positive scan is seen in all areas of bone accretion whether malignancy is present or not.
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PMID:Tc 99m bone scanning in early detection of rhabdomyosarcoma metastases. A case report. 75 62

Immunotherapy of malignant melanoma with BCG may be divided into two basic groups: 1. treatment of minimum residual disease. 2. direct intralesional application of BCG. In 19 patients with a histologically confirmed malignant melanoma, direct intralesional application of BCG was used to treat relapsing patients. In 10 of the 19 patients (group A) the relapse was confined to the primary region without signs of distant dissemination. In the remaining 9 patients (group B) signs of the lesion were present prior to BCG application. Our clinical and cytological evaluation bore on local reactions, systemic side reactions and response of non-injected lesions. In patients without signs of distant dissemination, local regression, characterized by a flattening and disappearance of lenticular metastases with scar formation, was achieved in 8/10 patients, while in the noninjected lesions, regression was noted in only 4/10 patients. In 4 patients of group A complete remission lasting 4-6 months was achieved. In the group of patients with signs of distant dissemination, local regression was observed in 6/9, while noninjected lesion regressed in only 1/9. Systemic response to BCG was characterized by febrile reactions with, in the majority of the patients, nausea till vomiting, muscular pain, pain of joints. In the majority of the patients the reaction passed away within 24 hr. A pretreatment with antipyretic and antihistaminic drugs proved of great help. The effect of BCG on the subsequent fate and survival of the patients is not discussed.
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PMID:Intralesional BCG application in malignant melanoma. 79 45

In four patients with intractable pain from metastatic cancer, application of current through electrodes placed on the anterior surface of the cord produced analgesia and pain relief below the level of implant without the development of paresthesias. Application of current through electrodes placed on the dorsal columns in these patients also relieved pain, but to a lesser degree and with the development of associated paresthesias. In one patient, application of current from anterior electrodes to posterior electrodes produced a zone of dissociated sensory loss. While it is simpler to implant electrodes over the dorsal columns, the anterior location may be superior when currents are to be applied for the pain relief in the lower lumbar and sacral dermatomes.
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PMID:A comparison between anterior and posterior spinal implant systems. 80 54

This is a report of three patients who presented at the Mayo Clinic over a two-year period. All were initially diagnosed as having Bell's palsy but were later found to have a malignant neoplasm causing the paralysis. Two of the patients had breast carcinoma metastases involving the mastoid portion of the facial nerve. The third patient had an adenocarcinoma of the deep lobe of the parotid that involved the facial nerve distal to the stylomastoid foramen. The course of the facial paralysis in the two patients with the metastitic breast disease was almost identical. It consisted of episodes of pain in the mastoid area. generally in the late evening or during the night, often awakening the patient from sleep. This was then followed by peripheral facial-nerve paralysis, sometimes partial and at other times complete. These episodes lasted from 10 minutes to several hours and then resolved completely. They recurred over several months. The patients were completely asymptomatic and normal on examination in the intervals between episodes of paralysis until it became permanent. Metastatic lesions causing facial paralysis are extremely rare in the literature. In those cases that have been reported, the paralysis was progressive from the start and in the vast majority of cases was either painless or associated with other aural symptoms such as otorrhea, hearing loss, and periauricular swelling. There are two unusual features of these two cases: 1. the initial presentation of a breast metastasis as a facial paralysis; in the first case there were no other metastatic lesions present at diagnosis, whereas the second patient had other, asymptomatic, metastatic nodules; and 2. the multiple, brief, recurring episodes of facial paralysis, which have not previously been reported as a mode of presentation of metastitic disease. The third patient was diagnosed as having Bell's palsy. A facial nerve decompression was performed, and the nerve apparently looked normal. The paralysis failed to resolve. He was later found to have adenocarcinoma of the deep lobe of the parotid that involved the facial nerve distal to the stylomastoid foramen. A report of only one similar case could be found in the literature. The sequence of events in these three cases emphasizes the importance of submitting a patient suspected of having Bell's palsy to a thorough otoneurologic examination.
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PMID:Facial palsy: unusual etiology. 83 Oct 48


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