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)

Peripheral nerve stimulating devices were implanted for pain control in 33 patients with a variety of disabling chronic pain conditions, which had persisted despite usual medical and surgical therapy. The implants were placed on major nerves innervating the area of the patient's pain. Records were obtained of each patient's stated relief from pain produced by nerve stimulation, along with assessments of narcotic withdrawal, ability to return to work, sleep pattern, and relief from depression. Based on these five criteria 17 patients were judged to be treatment failures, while eight patients had excellent results, and seven had intermediate results. Twelve of the failures were in patients with either low back pain with sciatica, or pain from metastatic disease. The most dramatic successes occurred in patients with peripheral nerve trauma. The incidence of complications has been low, and two patients have used the stimulator for 5 years without adverse effects. Techniques of peripheral stimulator implantation, possible mechanisms of action, and conclusions regarding peripheral nerve stimulation in the treatment of chronic pain are discussed.
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PMID:Peripheral nerve stimulation in the treatment of intractable pain. 108 48

Radical dose radiation therapy alone or combined with limited surgery has been employed in the management of 100 patients with primary (71) and recurrent (29) sarcoma of soft tissue. Results of this experience show that a combination of conservative surgery and radiation therapy, based upon radical dose levels and sophisticated techniques, is effective: only 13 of 100 patients showed local regrowth during a followup of 2-12 years. This may be compared with an expected congruent to 25 recurrences had treatment been radical surgery (wide resection or amputation). For lesions located on the distal extremities (elbow-hand, knee-foot) there were local failures in only 3 of 59 (5 percent). Further, 75 percent of patients treated by the improved techniques utilized in the recent 8 years retained a useful limb which is free of pain or edema. Histopathologic grade is demonstrated to be an important indicator of prognosis of local recurrence and of disease-free survival. Local recurrence rates were 0/23, 9/53, and 4/24 for Grades 1, 2, and 3. Disease-free survival rates were 19/23 (86 percent), 27/53 (51 percent), and 4/24 (17 percent) for Grades 1, 2, and 3, respectively. Invasion of skin appeared to be a sign of poor prognosis; 8 of 9 such patients developed distant metastases.
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PMID:Sarcoma of soft tissue: clinical and histopathologic parameters and response to treatment. 112 98

Three cases of a distinctive soft tissue fibrous tumor with spotty calcification demonstrate the lesion originally described by Keasby as Juvenile Aponeurotic Fibroma. The tumor tends to occur on the volar surface of the hands and feet in children and adolescents but may be seen in other areas in all age groups. Size rarely exceeds 3.0 cm. The tumors are fixed to the fascial layers. In previously reported patients pain was not described as an important factor, but both pain and tenderness were striking in all 3 of our cases. Microscopically the dominant feature is a fribrous stromal pattern of fusiform cells with inclusions of mast cells. Spotty calcification is a constant finding and appears to increase with duration of tumor. Local recurrence after excision and an aggressive histologic appearance may raise the question of malignancy. However, neither destruction of normal tissue surrounding the tumor nor metastases have occurred. Local exicision is the treatment of choice.
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PMID:Juvenile aponeurotic fibroma. Report of three cases and a review of the literature. 112 77

Five patients with cystadenoma of the pancreas were seen during a period of 22 years at this institute. This rare benign tumor occurred predominantly in middle age women, with the presenting symptoms of pain and an epigastric mass, but without a history suggestive of pancreatitis or abdominal trauma. Selective celiac and superior mesenteric antiography is helpful in establishing the diagnosis. If this cystic tumor is not recognized and adequately treated, the surgeon may miss the opportunity for cure. Cystadenoma should be suspected when a cystic mass arising from the body or tail of the pancreas is encountered without evidence of metastases. Although surgical extirpation is the preferable treatment, undue risks should not be undertaken because of the slow growth rate of this benign tumor. Due to the known association of this tumor with other malignant lesions, diabetes mellitus as well as multicystic tumors of the liver and kidneys, these patients should be thoroughtly investigated.
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PMID:Cystadenoma of the pancreas. 112 84

A short review of the relevant literature is followed by the presentation of a case of follicular cancer of the thyroid with uptaking spinal metastases. Five months after almost total thyroidectomy for right macrofollicular goitre and left follicular cancer, a 131-I scintiscan showed uptake in the right lobe of the thyroid and IX and X dorsal vertabrae. Resection of the remainder of the thyroid was followed by the administration of 100 and then 150 mC of 131-I. The result at 10 months was satisfactory, though not final; no uptake at the Xth vertebra, reduced uptake at the IXth, disappearance of subjective and objective symptoms of spinal pain.
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PMID:[A case of follicular carcinoma of the thyroid gland, with uptaking metastases, treated with surgery and isotope therapy]. 114 74

A pretherapeutic evaluation of skeletal metastases should be carried out in all patients with proven mammary cancer including early stages. The scintigraphy is more reliable for detecting bone metastases than the conventional roentgenological survey. We recommend to employ complementally skeletall scintigraphy and conventional X-ray survey in the search for bone tumors. Negative scintigraphical results do not require any supplementary research. In case of a pathological scan or skeletal pain, a target roentgneological examination should be carried out to differentiate between benign diseases and neoplatic lesions.
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PMID:[Pretherapeutic evaluation of bone matastases in patients with potentially curable breast cancer (author's transl)]. 119 78

The authors describe a case of osteoblastic metastasis in a patient with Zollinger-Ellison syndrome resulting from the presence of a pancreatic tumor, which they believe is the first such case documented. Following a total gastectomy for hyperacidity in a 53-year-old woman, a gradually enlarging liver was treated with steptozotocin. Radiation therapy to the areas of bony metastases resulted in complete alleviation of pain.
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PMID:Osteoblastic bone metastasis in Zollinger-Ellison syndrome. 124 75

The objective of this study was to utilize transfer factor to stimulate cell-mediated immunity to specific tumor antigens in cancer patients. Thirty-five selected patients with advanced recurrent cancer, who were not suitable for further conventional therapy, were treated with transfer factor. Transfer factor was prepared from cohabitants of the patients and administered at 2-week intervals. This immunotherapeutic approach produced a clinical effect in 13 patients in terms of regression of tumor (1), arrest of metastatic disease (14), or pain relief (14). Conversion of dermal reactivity to specific tumor antigens was observed during periods of clinical improvement. Despite continued immunotherapy, the duration of clinical improvement was short (2 weeks to 12 months). Seven of the 11 patients not responding to therapy exhibited serum blocking of lymphocyte responsiveness. In 11 patients there is insufficient data to evaluate the clinical effectiveness of this therapy. The results suggest that transfer factor can stimulate specific cell-mediated immunity in cancer patients and produce a clinical effect on tumor under certain circumstances.
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PMID:Transfer factor therapy in patients with cancer. 124 71

Information on lesions that are metastatic to the bones of the feet is limited. Review of the literature revealed only 17 cases, nine of which were confirmed histologically. Our series involved the clinical records, roentgenograms, and pathologic specimens in eight cases of biopsy-proven metastatic involvement of the bones of the foot. In three additional cases, there was clinical and roentgenographic evidence of metastatic osseous foot lesion but biopsy was not done to provide histiolgic confirmation. Genitourinary malignancies tended to be associated with metastasis to the bones of the feet, the calcaneus being the commonest site of involvement. Although metastatic lesions of the foot are rare, foot pain may be suggestive of an occult carcinoma. Foot pain was the initial presenting complaint in five of our eight cases. The pathogenesis of these distal metastatic lesions remains obscure. Specific problems in management are associated with osseous metastases of the foot.
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PMID:Metastatic tumors to the bones of the foot. 126 Jun 68

Progesterone, like estrogens, is used in the treatment of metastatic breast cancer. The 3 most active derivatives are megestrol, norethisterone acetate, and medroxyprogesterone acetate (MPA). This study evaluates the use of MPA in treating metastatic breast cancer in 40 postmenopausal women (average age, 63 years; average duration of postmenopause, 14 years) who have either not responded to or have relapsed after therapy with estrogens and androgens. 18 patients received a depot preparation of MPA intramuscularly in a loading dose of 3.2 g over a 2-week period and then 400 mg at 2-4 week intervals. 22 patients received the drug orally in a dose of 200 to 300 mg daily. Patients were evaluated after 6 weeks of therapy. Criteria for evaluating response were those used by the Eastern Cooperative Oncology Group. Only 2 of 40 patients exhibited an objective response (disappearance of metastatic lymph node for 9 months in 1 and well-documented clinical improvement and control of brain metastases for 22 months in another). 2 patients had mixed responses of chest wall metastases (regression of some but not all lesions) lasting 3 and 4 months respectively. 5 patients had obvious subjective response (pain relief) but no objective response. Overall response rate was 22%: 4 objective responses (10%) and 5 subjectives responses (12%). Route of administration did not correlate with response. Tumor stimulation and clinical deterioration occurred in 4 patients. It appears that MPA therapy is costly and of minimal usefulness as secondary therapy in metastatic breast cancer. Further studies should focus on megestrol and norethisterone acetate which have been documented to have better response rates.
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PMID:Response to medroxyprogesterone acetate (NSC-26386) as secondary hormone therapy for metastatic breast cancer in postmenopausal women. 126 Jul 80


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