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 62-year-old woman developed neurologic deficits 7 months after pulmonary lobectomy for alveolar cell carcinoma of the lung. CT scan of the head demonstrated two metastases with marked peritumoral edema. Administration of Decadron, chemotherapy and 3,000 rad cranial radiation resulted in dramatic improvement of dysphasia and right hand paresis. Almost 2 months later, rhythmic, involuntary movements of the left hand developed. There was progression to multifocal seizures, grand mal seizures, postictal depression, status epilepticus, and coma, with death 9 days after onset of the movement disorder. Bronchoalveolar carcinoma was widely disseminated in lungs and bones, and as three metastases in brain. Bland "ischemic" necrosis in a pseudolaminar pattern was present in the neocortex. Innumerable Cowdry type A intranuclear inclusion bodies were seen in neurons, astrocytes, and oligodenodroglia. Immunofluorescence demonstrated Herpes simplex virus type 2 antigen and electron microscopy revealed virions with the morphology of the Herpes group. The case is significant for (1) the concurrence of intracranial metastases and Herpes simplex encephalitis, and (2) the causal agent, Herpes simplex virus type 2. The implication for the clinical neurocientist is the potential in a patient with systemic cancer, for the causation of neurologic complications by more than one factor or mechanism.
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PMID:Herpes simplex type 2 encephalitis concurrent with known cerebral metastases. 22 22

99 patients with late epilepsy were investigated in our EEG laboratory. In intervals of maximal 100 days (averaged 23 days) a waking EEG recording and a CTAT were carried out. The average age was 43. 62.5% of the pathological CTATs were found in partial seizures with elementary symptomatology. In patients with generalized seizures the diagnosis of symptomatic epilepsy could be made in 20 cases (34%) with the help of computerized tomography. Generalized seizures were related to tumors only in 8.5% in our case material. In 20 of 99 EEGs in our patients there was a continuous delta wave focus, 12 of these with epileptogenic activity. Of these 20 patients, 18 showed a pathological result in computerized tomography. Eight tumors or metastases, 8 cases of atrophy (7 local and 1 diffuse) as well as 1 case of encephalitis could be diagnosed. 12 EEGs showed continuous or intermittent theta wave foci. Computerized tomography never gave a pathological finding in these patients. If one compares the results of CTAT and EEG in cases of tumor, the agreement between positive tomography and the pathological EEG is very high (97%): 33 positive CTATs comapred with 31 positive EEGs. Our investigations with computerized tomography show organic findings in 34 of 99 epilepsies, that is about 34%.
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PMID:Computerized transverse axial tomography (CTAT) in the diagnosis of epilepsy. 40 52

The possibility of a patient with malignant melanoma having a catastrophic event as the presenting sign of tumor dissemination cannot be dismissed. Should such an event occur, it would pose not only a risk to the patient, but also a potential risk to others. Since 1971, 712 patients with malignant melanoma have been evaluated. Twenty patients presented with brain metastases and an additional 12 patients developed brain metastases simultaneously with other organ involvement. Four patients (0.6%) had a catastrophic event, such as a stroke or seizure, with no antecedent symptoms. Microstaging of a primary melanoma by the methods of Clark and Breslow, in addition to the recognition of the presence or absence of regional lymph node metastases, provides reliable information for predicting the probability of tumor dissemination. Patients with deep primary melanomas or with lymph node metastases should be advised regarding their participation in potentially hazardous occupations or recreations.
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PMID:Disseminated melanoma presenting as a catastrophic event. 71 81

193 patients with epilepsy were investigated by EEG and by computerized tomography (C.T.). 55.5% of the pathological C.T. scans were found in partial seizures with elementary symptomatology. In patients with generalized seizures the diagnosis of symptomatic epilepsy could be made in 40 cases (35.7%) with the help of computerized tomography. In 38 EEG there was a continual delta-wave focus, 18 of these with epileptogenic activity. Of these 38 patients, 34 showed a pathological result in computerized tomography. 19 tumors or metastases, 11 cases of atrophy (10 local and one diffuse) as well as one case of encephalitis could be diagnosed. The remaining 3 patients showed indefinate findings with C.T. 19 EEG showed intermittent theta-wave foci. Computerized tomography gave 5 pathological scans in these patients. If one compares the results of computerized tomography and EEG in cases of tumor, the agreement between positive tomography and the pathological EEG is very high (95%): 64 positive C.T. compared with 61 positive EEG. Our investigations with computerized tomography show organic findings in 67 of 193 epilepsies, that is about 35%.
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PMID:[Computerized transverse axial tomography in the diagnosis of epilepsy; an electroencephalo-tomographic study (author's transl)]. 82 65

As a casuistic contribution to differential diagnosis of thrombosis of cerebral veins and sinuses a case of occlusion of sinus sagittalis superior by infiltration of an intracerebral metastasis from a teratoma of testis is reported. The leading symptoms - epileptic seizures, progressive hemiplegia, choked papilla and clouding of consciousness - gave rise to the tentative diagnosis of a cerebral tumor; in carotis angiography however, the metastasis was not detected, merely the occlusion of the sinus was demonstrated. Therefore the progress of the syndrome was misinterpreted as caused by an advancement of a venous thrombosis. Only autopsy showed the symptomless primary tumor and its formation of metastases.
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PMID:[Occlusion of sinus sagittalis superior by infiltration of a tumor metastasis (author's transl)]. 104 Dec 51

A functional, insulin-secreting pancreatic (islet cell) carcinoma was diagnosed in a 17-year-old male Siamese cat. Diagnosis was made on the basis of clinical signs (i.e., seizures and stupor) that resolved temporarily after correction of hypoglycemia with feeding or intravenous administration of glucose, the finding of an inappropriately increased serum insulin concentration in the face of hypoglycemia, and prolonged resolution of hypoglycemia after surgical removal of the tumor. Primary islet cell tumor of the pancreas was confirmed by biopsy. The cat died 18 months later, and necropsy revealed metastases to regional lymph nodes and liver. Specimens of the tumor and metastatic lesions both stained positively for insulin.
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PMID:Insulin-secreting pancreatic (islet cell) carcinoma in a cat. 132 Jan 19

HIV-1-related neurological diseases, excluding opportunistic infections and HIV encephalitis, are considered here. Most occur in severely immunosuppressed patients, with CD4 counts of under 200 x 10(6) l-1. Primary brain lymphoma and metastases from systemic non-Hodgkin's lymphoma, the second commonest cause of cerebral mass lesions in AIDS, are usually aggressive B cell tumours. Their poor median survival after treatment, compared with that of lymphomas in non-AIDS patients, seems related to systemic complications, particularly opportunistic infections. Kaposi's sarcoma produces neurological symptoms exceptionally. Cerebral infarction is often unrecognized clinically but large vessel arteritic occlusions may occur. Intracranial haemorrhages occur mostly in thrombocytopenic patients. Seizures are frequently referred to the neurologist; investigation may lead to a diagnosis of AIDS. Nearly 50% of patients with seizures have cerebral toxoplasmosis or cryptococcal meningitis; HIV-1 encephalitis is presumed to be the cause in 30%. A subacute or chronic vacuolar myelopathy with pyramidal and posterior column signs is the commonest form of spinal cord involvement in AIDS; its cause remains unknown. Peripheral nerve syndromes occur at all stages of HIV-1 infection. Distal symmetrical peripheral neuropathies are the most frequent, particularly a painful form with axonal atrophy, associated with CMV infection, and seen during ARC or AIDS. Mononeuritis multiplex due to vasculitis, CMV, or lymphoma and a serious lumbosacral polyradiculopathy due to CMV are infrequent. The commonest myopathy is due to zidovudine (AZT); it usually responds to drug withdrawal. The nature, prognosis and optimal management of most other myopathies is yet to be determined.
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PMID:Other neurological diseases in HIV-1 infection: clinical aspects. 134 49

Extracranial metastasis of primary central nervous system neoplasms is uncommon and has not been described in the dog. We report the clincopathologic features of intracranial meningioma with pulmonary metastasis in three dogs (case No. 1: 13-year-old castrated male Boxer dog; case No. 2: 14-year-old spayed female Dachshund; case No. 3: 6-year-old spayed female German Shepherd Dog). Case No. 1 presented with ataxia, lethargy, vomiting, and leaning and falling to the right, and had a transient remission following radiation and corticosteroid therapy; case No. 2 had a history of seizures that were unresponsive to primidone, left-sided postural reaction deficits, ataxia, and circling to the right; case No. 3 had only intermittent episodes of vomiting Computed tomography of case Nos. 1 and 2 revealed peripherally located homogeneous contrast-enhancing intracranial masses. Postmortem examination revealed intracranial masses with single or multiple pulmonary nodules in all three cases. Histologically, the intracranial and pulmonary masses were meningotheliomatous meningiomas with atypical features including brain infiltration, necrosis, nuclear atypia, prominent nucleoli, and moderate cell density. All of the primary meningiomas had low mitotic rates. The current interest in early diagnosis and aggressive clinical/surgical management of canine patients with meningioma and other primary central nervous system neoplasms will likely result in an increased detection of extracranial metastases.
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PMID:Intracranial meningioma with pulmonary metastasis in three dogs. 162 30

Of 29 consecutive children treated for malignant primary tumors of the central nervous system (CNS) at this institution, postoperative examination showed radiographic or cytologic evidence of neuraxis dissemination in 10 (34%). Given the historically poor results in disseminated CNS tumors treated with surgery and radiation therapy alone, these ten patients were treated prospectively with an investigational Phase II protocol consisting of preirradiation cisplatin (90 mg/m2 on day 1) and etoposide (150 mg/m2 on days 3 and 4). The diagnoses included medulloblastoma (n = 4), malignant glioma (n = 3), cerebral primitive neuroectodermal tumor (n = 1), pineoblastoma (n = 1), and mixed glioma of the brainstem (n = 1). Postoperative neuraxis scanning with computed tomography, magnetic resonance imaging, or spinal myelography showed measurable intracranial or spinal metastases in all children. The cerebrospinal fluid (CSF) cytologic examination was positive for tumor cells in five. The best responses, based on serial imaging of neuraxis metastases, included two complete responses, four partial responses, and three stable disease states. One patient had progressive disease at the primary site despite stable disease in the spine; progressive neuraxis disease was documented in only one patient during chemotherapy. Clearance of tumor cells from the CSF was documented in three patients. The adverse effects of chemotherapy, consisting of transient myelosuppression and mild ototoxicity, were minimal. Reversible neurologic deterioration occurred in two patients; one patient became acutely quadriplegic after a prolonged convulsive seizure without radiographic evidence of tumor progression.
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PMID:Neuraxis dissemination in pediatric brain tumors. Response to preirradiation chemotherapy. 173 73

In the immunocompromised patient, even mild forms of any combination of headache, meningismus, altered mental status, or focal neurologic signs should initiate an evaluation for possible CNS infection. The limited signs and symptoms of acute CNS infection are not due to specific organisms but to pathologic changes at the neuroanatomic site of infection. The initial clinical history, examination, laboratory, and neuroradiographic data will narrow the problem to one of several groups of agents, although it may not be possible to specify a single causative agent. It should be remembered that several concurrent infections (i.e., CMV and toxoplasmosis, aspergillosis, and bacterial sepsis) may be present. Thus, the clinician should rely on broad antibiotic coverage appropriate to the suspected causative agent or agents at the site of infection. It may be necessary to offer broad-spectrum antibiotic coverage for a CSF presentation that is subsequently found to result from a viral illness or from a noninfectious cause. However, one should avoid undertreating those infections for which specific therapy can be offered, and broad-spectrum treatment usually will not be regretted. Uncertainty in diagnosis following noninvasive procedures should lead to a brain biopsy. Although many of the infections discussed in this article have a poor prognosis, some of the most common pathogens, such as Cryptococcus, Listeria, and Toxoplasma, have effective specific therapies to which the patient should have access as rapidly as possible. The clinician who has successfully treated a patient with CNS infection should remain vigilant for late sequelae or recurrence of infection. Chronic treatment of some infections, such as toxoplasmosis or aspergillosis, may be necessary. The reintroduction of steroids for the treatment of an underlying cancer may reactivate previously treated disease, such as cryptococcosis, and periodic CSF surveillance is appropriate under these circumstances. Recurrence of the symptoms should raise the suspicion of recurrent or new infection, and the patient also should be evaluated with CT or MRI for the development of hydrocephalus or for new metastatic disease. In patients who have had varicella-zoster infection, postherpetic neuralgia and delayed arteritis may develop. Seizures, hearing loss, and neuropsychologic sequelae may follow any meningoencephalitis. The patient should always be reevaluated for the possibility of infection with a different opportunistic organism. CNS infections remain a major cause of morbidity and mortality in immunosuppressed patients with malignancies. In one series, 60% of such patients died as a result of their CNS infection, many at a time when the underlying disease had an otherwise good prognosis.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Central nervous system infections in cancer patients. 175 29


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