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 case of malignant fibrous histiocytoma arising primarily in the left maxillary sinus is described. The patient, a 39-year-old male, who had suffered from sinusitis for 20 years, began to have paresthesia or sharp pain of the left side of the face and toothaches of the left maxilla. At operation a white fibrous tumor developing extensively from the lateral wall to the upper and medial walls of the left maxillary sinus and into the ethmoidal sinus was noted. Following a gradual progression of dyspnea, he died approximately one year after the onset in spite of radiation therapy and anticancer chemotherapy. An autopsy revealed recurrence of the tumor in the left maxillary sinus with wide-spread metastases to the lungs, pleurae, pancreas, kidneys and bone marrows. The direct cause of death was respiratory failure due to extensive growths of the pulmonary and pleural metastases.
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PMID:Malignant fibrous histiocytoma of the maxillary sinus. 624 13

Among 137 patients with small cell carcinoma of the lung (SCCL) treated on two consecutive protocols, leptomeningeal metastases were documented in 12 patients (9%), 10 antemortem by cerebrospinal fluid (CSF) cytology, one by myelogram, and one only at necropsy. Signs and symptoms included confusion in seven, limb weakness in six, paresthesias in three, headache in two, urinary incontinence in two, and nausea and vomiting, diplopia and neck pain in one patient each. Nine of the 12 patients had evidence of other metastases while three patients relapsed first in the CSF and one had disease only in the leptomeninges. Treatment for this complication including irradiation, intrathecal chemotherapy, or systemic chemotherapy was generally ineffective with a median duration of survival of 50 days (range 5 to 130) after diagnosis of leptomeningeal. Necropsies showed thick tumor deposits along cord, distal nerve roots, cauda equina, and in Virchow--Robbins spaces with deep invasion into adjacent neural substance in six of the seven. Leptomeningeal involvement appears to have become manifest as median survival has increased. CSF cytology should therefore be examined in patients who develop unusual neurological findings during the course of this disease and methods of prevention may need to be considered in future studies.
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PMID:Leptomeningeal carcinomatosis in small cell carcinoma of the lung. 625 38

Metastasis of a tumor to the jaws can simulate an infection, but the presence of paraesthesia and loose teeth or inadequate response to treatment should alert the clinician to a more serious cause. A malignant melanoma metastatic to the jaws illustrates these points.
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PMID:Melanoma metastatic to the mandible. Report of a case. 640 79

Eighteen patients with advanced refractory breast carcinoma were treated with vincristine (VCR), 0.5 mg I.V. bolus followed by continuous I.V. infusions of 0.25 mg/m2/day for 5 days every 3 weeks. The daily dose of VCR was infused in 1000 ml D5W to which was added hydrocortisone 50 mg and heparin 3000 U. Patients received from one to six courses (mean 2.3 courses). No objective responses were observed. Stable disease was noted in five patients who had skeletal metastases only. Disease progression occurred in the remaining 13 patients, 10 of whom had received prior VCR by bolus injection. The principal toxicity consisted of constipation without ileus and hyporeflexia-paresthesias. Vincristine, administered by continuous I.V. infusion according to this dose and schedule does not appear to be effective in the treatment of patients with advanced refractory breast cancer.
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PMID:Vincristine by continuous infusion in refractory breast cancer: a phase II study. 661 19

A review of the Japanese literature revealed 41 well-documented metastatic tumours of the mouth and jaws. The incidence was 1.5 times higher in females than in males and 76% were in the fourth to seventh decades with a mean of 44 years. Instead of the breast which is the most frequently encountered site of origin of metastatic tumours in Caucasians, the uterus followed by the lung, kidney and stomach was the site of primary carcinoma with the highest incidence. Histologically, carcinomas of glandular origin showed the highest rate of metastasis which was followed by choriocarcinomas. Squamous cell carcinoma and sarcoma were unusual. Metastasis occurred in the gingiva in 23 cases and bony involvement was noted in 16 cases. The most common symptoms were swelling, pain, bleeding, paraesthesia and loosening of teeth. The radiographic appearance was quite variable with no specific diagnostic characteristics. The oral lesions were treated by surgery, irradiation or chemotherapy in 32 cases, while no treatment was carried out in seven cases. Prognosis was very poor with 33 fatal cases due to multiple metastases.
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PMID:Metastatic tumours of the mouth and jaws. A review of the Japanese literature. 696 Nov 86

A 43-year-old woman presented with incontinence, weakness, and paresthesia, consistent with the cauda equina syndrome, 10 years after having a pituitary tumor surgically removed and 4 years after excision of two "meningiomas" of the cervical cord. The patient was also hypertensive and had a cushingoid habitus. Emergent surgical decompression of the spinal cord revealed intradural metastatic adrenocorticotropic hormone-producing pituitary carcinoma. Pituitary carcinomas are rare. The majority of reported cases of adrenocorticotropic hormone-producing carcinoma have exhibited metastases outside the central nervous system. To our knowledge, this represents the first case of an adrenocorticotropic hormone-producing pituitary carcinoma presenting with the cauda equina syndrome. A review of all reported cases of pituitary carcinoma indicated that central nervous system metastases were more common than metastases to distant sites, and patients with distant metastases experienced a shorter duration of disease than did those with central nervous system metastases.
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PMID:ACTH-producing pituitary carcinoma presenting as the cauda equina syndrome. 780 65

The purpose of this study was to determine whether methotrexate, vinblastine, doxorubicin, and cisplatin, each individually active in metastatic breast cancer (MBC), could, in combination, produce an overall response rate, median survival, and long-term survival sufficiently promising to merit its consideration for phase III trials in MBC and as induction therapy prior to autologous bone marrow transplant. From July 1986 through February 1990, 30 patients with stage IV, measurable breast carcinoma received M-VAC: methotrexate--30 mg/m2 days 1, 15, 22; vinblastine--3 mg/m2 days 2, 15, 22; doxorubicin--30 mg/m2 day 2; cisplatin--70 mg/m2 day 2. Cycles were repeated at 4-week intervals for up to six courses. Median age was 53 years (range 34-64 years). Prior treatment included adjuvant cyclophosphamide, methotrexate, and 5-Fluorouracil in 12 patients, radiotherapy in 13 patients, and hormonal therapy in 14 patients. Eleven patients were ER (+) at the time of initial diagnosis. Five patients had disease restricted to bone and/or nodes; the other 25 had visceral-dominant sites of metastases, with or without bone involvement, or evidence of rapid, inflammatory chest wall relapse. Twenty-nine of 30 patients were evaluable for toxicity and response; all were evaluable for survival. The major overall response rate was 83%, with a 21% complete remission rate. The chief toxicity was bone marrow suppression, with grade 4 granulocytopenia in 20 patients, grade 3 in 7 patients, and grade 3 and 4 thrombocytopenia in 5 patients. Grade 3 stomatitis occurred in 9 patients. Renal insufficiency was clinically insignificant, and neurotoxicity mild, with 7 patients sustaining grade 1 or 2 paresthesias. Median time to progression was 9 months and median survival 19 months (range, 5-84+ months) with 4 patients still alive at least 45+ months or more from the start of treatment and 2 presently free of progressive disease. Although highly toxic, M-VAC produces a response rate and survival duration in visceral-dominant MBC competitive with, if not superior to, conventional regimens such as CAF (Cytoxan, doxorubicin, 5-fluorouracil); it therefore merits further investigation in conjunction with hematopoietic growth factors and as cytoreductive therapy prior to autologous bone marrow transplantation.
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PMID:Phase II evaluation of methotrexate, vinblastine, doxorubicin, and cisplatin (M-VAC) in advanced, measurable breast carcinoma. 787 68

Approximately 20 per cent of melanomas greater than 0.76 mm in thickness will metastasize to the regional lymph nodes if treated with wide local excision alone (WLE). Elective lymph node dissection (ELND) is associated with significant morbidity, which includes lymphedema, wound complications, and paresthesias of the extremity. An alternative operative approach uses selective lymphadenectomy with the identification of the sentinel node, defined as the first node in the lymphatic basin that drains the primary cutaneous site. This study consisted of 132 patients with melanomas greater than 0.76 mm. One hundred nine patients (83%) had histologic negative sentinel nodes, and 23 patients (17%) had one or more sentinel nodes positive for disease. In patients with metastatic disease, 30/35 (86%) sentinel nodes were positive, and 25/357 (7%) nonsentinel nodes were positive (P < 0.001). In 18 patients (78%) of the 23 patients with metastatic disease, the sentinel node was the only node positive, strongly suggesting that there is an orderly progression of metastases. Two patients developed metastatic nodal disease after removal of a negative sentinel node (false negative rate = 1.5). The mean follow-up was 1 year. Sentinel node histology reflects the histology of the remainder of the nodes in the lymphatic basin and "skip" metastases, defined as a negative sentinel node but positive nodes higher in the regional chain positive for metastases or an axillary recurrence after a negative sentinel node biopsy, are rare for malignant melanoma. Harvesting the sentinel node in patients with intermediate or greater thickness melanoma will, therefore, identify a subset of patients with metastatic disease who have the most to benefit from a complete node dissection. This surgical approach allows for complete pathological staging and therapeutic management of patients while significantly reducing expense and overall morbidity.
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PMID:The tumor biology of melanoma nodal metastases. 854 Jun 54

CI-973 is a water-soluble platinum diamine complex whose antitumor activity is greater than that of cisplatin in some murine tumors. It has shown activity against cisplatin-resistant tumors. This phase II trial had the objectives of determining the therapeutic efficacy of CI-973 in patients with metastatic breast cancer who had been treated with one prior chemotherapy regimen, and of further defining the toxicity of the agent and the reversibility of its toxicity. CI-973 was administered as an intravenous infusion over 30 min with no prehydration or antiemetic programs. Treatment cycles were repeated at 21-day intervals. Patients with histologically confirmed metastatic breast cancer, measurable disease, and good performance status who had received only one prior chemotherapy regimen for metastatic disease were eligible for treatment. Adequate hematologic, renal, and hepatic function were required. A total of 26 patients received a median of two courses of CI-973 (range, 1-18 courses). Hematologic toxicity was severe: nearly all patients experienced granulocytopenia with granulocyte counts of 0 at all dose levels. Nevertheless, neutropenic fever and documented systemic infection were uncommon, and there were no hospitalizations for neutropenic fever or infection. Visceral disease dominated in this patient group. Of the 26 patients, 14 had visceral disease, 6 had bone or bone marrow disease, and 6 had skin, soft-tissue, or lymph-node disease. Of the 26 patients treated, 25 were evaluable for response. There were two partial remissions, one in liver and one in bone, and three minor responses, for a response rate of 8%. Nonhematologic toxic effects were mild and consisted of nausea and vomiting, fatigue, minimum peripheral paresthesia, and hypomagnesemia. Further study of CI-973 at the dose and schedule used in this study is not warranted. Because this agent had no significant extramedullary toxicity, intensification of the dose of CI-973 with concomitant administration of colony-stimulating factors has the potential to improve response in this patient population.
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PMID:A phase II study of CI-973 [SP-4-3(R)]-1,1-cyclobutane-dicarboxylato (2-)] (2-methyl-1,4-butanediamine-N, N') platinum in patients with refractory advanced breast cancer. 864 5

A 46-year-old man presented with low dorsal pain and paresthesia. Computed tomography showed an osteolytic lesion involving most of the vertebral body and the left pedicle of the 12th thoracic vertebra (T12). Contrast-enhanced magnetic resonance imaging (MRI) of the spine showed an enhancing soft-tissue mass that involved the T11 and T12 vertebral bodies, as well as that of the first lumbar vertebra; the mass caused cord compression. Another lesion was identified at T9. The findings of percutaneous needle aspiration biopsy of the lesion were consistent with metastatic astrocytoma, a diagnosis confirmed at surgery. MRI of the brain showed an asymptomatic lesion of the left temporal lobe; histologic confirmation of malignant astrocytoma was obtained by stereotactic biopsy. This report shows that metastatic bone disease secondary to malignant astrocytoma may manifest itself before the primary lesion becomes symptomatic. This presentation of astrocytoma was unusual because there were no symptoms of the intracranial tumour and because metastatic disease to the bones is less common than to the chest and the lymph nodes.
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PMID:Spinal metastases as a first presentation of malignant astrocytoma. 885 73


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