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)

More bony malignancies are metastatic than primary tumours. Usually, it is not difficult to distinguish a metastasis from a primary tumour; however, when the metastasis is the first manifestation of malignant disease, diagnosis may cause numerous difficulties and lead to therapeutic errors. A patient with one year's history of pain in the right crus who was initially suspected of having sciatica and venous thrombosis was referred to an orthopaedic department when radiographs of the crus were suspicious for an osteosarcoma. CT and MRI scans revealed a tumour originating in the proximal fibula with numerous periosteal reactions. A biopsy indicated metastatic adenocarcinoma. Further diagnostic examinations didn't reveal the primary tumour. A PET scan showed a small pulmonary nodule of unknown aetiology. The patient underwent limb-sparing surgery followed by chemotherapy. The diagnostic work-up of bony malignancies may pose difficulties. Despite a characteristic presentation of sarcomas of bone in imaging examinations, it may be impossible to distinguish metastases and primary tumours. This problem especially concerns patients in whom metastases are the first manifestation of malignant disease and imaging examinations show no abnormalities in internal organs. Histopathological evaluation should be mandatory for all bone tumours which are not confirmed metastases before any therapeutic decisions are made. One must be aware of limitations and errors related to diagnostic work-up in oncology, including histopathological examinations. Sometimes it may be impossible to obtain a result of microscopic analysis compatible with the clinical presentation.
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PMID:Metastasis of adenocarcinoma of an unknown primary site to the right crus simulating sarcoma - a case report. 2389 5

Epithelioid hemangioendothelioma (EHE) is a rare vascular neoplasm that has the ability to recur locally and metastasize. Thus, it is important to distinguish this tumor from other epithelioid vascular neoplasms. A 47-year-old man presented to our hospital with a pelvic mass with severe ischialgia and weight loss. Surgical resection was performed, and the mass was found to have dark red multiloculated cysts with hemorrhage and calcification. The histopathologic examination showed a central sclerotic, hypocellular zone and a peripheral cellular zone. Only the peripheral portion of the wall revealed nested tumor cells in light blue myxoid stroma. These tumors are typically composed of short strands or cords of bland epithelioid cells with occasional intracytoplasmic lumens embedded in a myxohyalinized stroma. The tumor cells were positive for CD31 and CD34 and negative for factor VIII-related antigen, CK (AE1/AE3) and S-100. The tumor nuclei showed distinct break-apart signals with individual green and/or red signals, indicating the presence of CAMTA1 rearrangement. In this study, we report a case of EHE that was difficult to diagnose based on histology alone. Therefore, we also performed fluorescence in situ hybridization, and found that the tumor harbored a CAMTA1 gene rearrangement, which confirmed the diagnosis.
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PMID:Epithelioid hemangioendothelioma with extensive cystic change and CAMTA1 rearrangement. 2413 32

Low back pain and sciatica are highly debilitating conditions affecting all socioeconomic groups at an increasingly early age. They are caused by different often concomitant spinal disorders: disc or facet joint disease, spondylolysis (with or without listhesis), vertebral body and interapophyseal arthrosis, spinal stenosis, radicular and synovial cysts and, more rarely, infections and primary or metastatic cancer. Treatment of low back pain and/or sciatica requires an accurate diagnosis based on thorough history-taking and physical examination followed by appropriate imaging tests, namely computed tomography, and/or magnetic resonance scans in addition to standard and morphodynamics X-rays of the spine. In recent years, several reports have demonstrated the utility of oxygen-ozone therapy in reducing the size of herniated discs. The present study reports on the outcome of oxygen-ozone treatment in 576 patients with non-discogenic low back pain caused by degenerative disease of the posterior vertebral compartment (facet synovitis, Baastrup syndrome, spondylolysis and spondylolisthesis, facet degeneration).
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PMID:Non-discogenic low back pain treated with oxygen-ozone: outcome in selected applications. 3317 14


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