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

Lymph nodes are involved in a wide variety of diseases, particularly in cancer. In the latter, precise nodal staging is essential to guide therapeutic options and to determine prognosis. For long, imaging of the lymphatic system has been limited to lymph vessel,especially via the exclusive use of conventional lymphography, at the expense of invasive procedures and patient's discomfort. Three main technical advances, however, have recently completed the clinical armamentarium for lymph node imaging: first, the refinement of cross sectional imaging, i.e. CT and MRI, combined or not with dedicated contrast agents, has progressively replaced conventional lymphography in oncology situations; second, the development of intra-operative sentinel node mapping has profoundly modified the diagnostic and therapeutic procedures in several cancer situations, mostly melanoma and breast cancer; finally, the increased availability of functional imaging, especially through the use of FDG-PET, has greatly contributed to the accuracy improvement of nodal metastases identification. The aim of this review will thus be to briefly review the anatomy and physiology of the lymphatic systems and to overview the basic principles of up-to-date lymph node imaging.
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PMID:Lymph node imaging: basic principles. 1647 89

Fracture of the proximal femur due to metastatic disease is a significant cause of morbidity and mortality among breast cancer patients. Prophylactic surgical fixation is advised for patients at risk of fracture and typically involves placement of an orthopaedic implant. We propose that some proximal femora with metastases can be repaired by removing the lesion and filling the resulting defect with bone cement (polymethylmethacrylate), a procedure that could be performed percutaneously without the use of hardware. We studied the strengths of 12 matched pairs of cadaveric proximal femora under single-limb stance loading. One femur from each pair remained intact, while a simulated metastatic lesion, measuring approximately 75% of the neck diameter, was burred into the neck of the contralateral femur. The defects were repaired using a procedure similar to the one proposed. Femoral strength was measured via mechanical testing to failure. The strengths of the repaired femora averaged 94.7% of the strength of their respective contralateral intact femur (standard deviation, 8.7%). These findings suggest that the proposed procedure may be useful for some patients with metastases in the femoral neck. If the proximal femur could be safely repaired using the proposed technique in place of conventional surgical fixation, the patient would benefit from a shorter and less invasive surgical procedure, less pain and discomfort, greatly reduced recovery time, and a shorter hospital stay-all at a much lower cost.
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PMID:Feasibility of a percutaneous technique for repairing proximal femora with simulated metastatic lesions. 1694 54

Secondary neoplasms of the testis have been reported with an incidence of 0.02% to 2.5% on autopsy. Other than leukemias and lymphomas, the most common sites from which metastases occur are the lung and prostate gland. We report the case of a 58-year-old patient, recently diagnosed with gastric carcinoma, who presented with swelling and discomfort of the left testis. An ultrasound scan of the scrotum suggested a malignant mass. Orchiectomy was performed, and the subsequent pathologic examination revealed the mass to be a gastric carcinoma metastasis that appeared to mimic a testicular primary clinically.
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PMID:Testicular metastasis from gastric carcinoma. 1707 Mar 83

Prostate cancer progression is commonly manifested by obstructive uropathy, regional lymphatic metastases and hematogenous metastases to the axial skeleton. Radiotherapy is a mainstay in the palliation of symptomatic metastatic prostate cancer and is most often used for the palliation of painful metastatic bone lesions, resulting in a relief of pain in about 80-90% of patients and a reduction of analgesics. In metastatic disease compromising the integrity of the spinal cord or a nerve root, radiotherapy can be used as an urgent intervention to minimize neurological dysfunction and local progression or as an adjunct to surgical decompression. Local progression is often associated with hematuria, ureteric obstruction and perineal discomfort. Symptoms of metastatic lymphadenopathy like leg edema and back discomfort caused by pelvic or paraaortic metastases are related to the immediate anatomic structures affected. Radiotherapy for localized hormone-refractory prostate cancer has an excellent local control rate; nevertheless, the prognosis is poor, the majority of patients failing with distant metastasis within few years. The role of radiotherapy in hormone-refractory and metastatic prostate cancer, considering the patient's individual situation, are presented and discussed.
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PMID:Hormone-refractory and metastatic prostate cancer - palliative radiotherapy. 1854 93

We describe a patient whose complaints were related to pericardial effusion due to prostatic carcinoma. An 80-year-old man was admitted to our hospital because of chest discomfort and dyspnea. The chest radiograph revealed cardiomegaly and computed tomographic scan showed a large pericardial effusion. Pericardiocentesis revealed sanguinous exudates. Cytologic study suggested metastatic adenocarcinoma or malignant mesothelioma. He died suddenly because of ventricular tachycardia. At autopsy, the major finding was poorly differentiated adenocarcinoma of the prostate with metastases to the mediastinum.
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PMID:[Pericardial effusion due to metastatic prostate cancer: a case report]. 1854 64

When a male patient(age: 63)came to our hospital to report his discomfort in swallowing on February 16, 2005, we observed that a tumor of the subcircular type 2 had invaded his descending aorta directly, which was equivalent to the range from tracheal bifurcation to esophagogastric junction. At the same time, we found multiple metastases in lymph node which were from both cervixes to the range around the aorta abdominalis, and pleural effusion on both sides. We diagnosed them as small cell type undifferentiated esophageal carcinoma(T4N4M1, Stage IVb)with esophagus lesion. We started chemotherapy with irinotecan(CPT-11)and cisplatin(CDDP)in accordance with the guideline of the treatment for lung small cell carcinoma. Five days after we began the chemotherapy, leukopenia(grade 4)and abrupt bloody diarrhea were observed. Although we conducted intensive care, on day 7 he died of multiple organ failure caused by sepsis. Pathologic anatomy reported was necrosis of intestinal mucosa which ranged widely from his duodenum to rectum. We reported this fatal case of small cell type undifferentiated carcinoma of the esophagus caused by treatment with CPT-11, which triggered abrupt diarrhea and bloody discharge.
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PMID:[A fatal case of small cell type undifferentiated carcinoma of the esophagus with sudden diarrhea and bloody discharge by CPT-11]. 1893 79

We report a case of pharyngeal metastasis of hepatocellular carcinoma (HCC). Any oral cavity involvement of HCC, especially pharyngeal metastasis, is extremely rare. The resected specimen contained a pedunculated polypoid lesion and histological examination revealed an epithelial tumor with a trabecular growth pattern, covered with intact squamous mucosa. Immunohistochemical studies were positive for hepatocyte-specific antigen and alpha-fetoprotein. At the time of writing, the patient, a 73-year-old man, was alive but with multiple recurrent lesions in the remnant liver, 1 year after resection of the pharyngeal metastasis. Oral metastases should be treated surgically or endoscopically if possible for the symptomatic relief of oral discomfort, pain, and bleeding; however, the prognosis is generally poor.
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PMID:Hepatocellular carcinoma with pharyngeal metastasis: report of a case. 1895 69

A 46-year old female patient presented with non-specific epigastric discomfort that had been present for 6 months. Endoscopic work-up showed a small gastric polyp and biopsy samples revealed adenocarcinoma. There was no evidence of metastatic disease or penetration of the muscle layer on endosonography, rating the tumor as early gastric cancer. Endoscopic submucosal dissection was unsuccessful due to bleeding complications and the patient was treated with subtotal gastrectomy. Surprisingly, the final histological diagnosis revealed a highly differentiated neuroendocrine tumor and the initial diagnosis had to be revised.
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PMID:[Early gastric cancer--or not]. 1908 48

Melanoma patients with lymph node metastases have to deal with diagnostic tests to exclude the presence of distant metastases; results of the tests could have major implications for their prognosis and treatment. There are, however, few studies concerning the patients' psychological issues and perception of diagnostic tests. The aim of this study was to describe the burden of diagnostic tests [radiograph, computed tomography (CT) and positron emission tomography (PET)] experienced by melanoma patients with lymph node metastases. Patients were asked to complete a questionnaire concerning satisfaction and burden experienced during the diagnostic tests. The levels of embarrassment, discomfort and anxiety for the different tests, as well as total scores for each burden were calculated. Logistic regression was used to examine factors associated with the degree of experienced burden. Fifty-nine of the 68 patients completed the questionnaire and the response rate was 87%. The overall mean scores on satisfaction and quality of life were high. More than half of the patients experienced no burden during PET, 65% no burden during computed tomography and 80% no burden during chest radiograph. Patients experienced significantly more discomfort during the PET scan than during the CT (P=0.003). Less burden was experienced (in univariate analysis) by patients who were more satisfied. The overall experienced burden by patients is low and should therefore not interfere with primary choice for a diagnostic test based on accuracy, costs and percentage of patients upstaged. Attention should be paid in explaining the procedure and answering questions of the patients to reduce burden.
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PMID:Perception of burden experienced during diagnostic tests by melanoma patients with lymph node metastases. 1943 Apr 4

Metastatic malignant mesothelioma of the pleura is uncommon at the time of initial diagnosis. When metastases are present, the major sites always include regional lymph nodes, the contralateral lung, liver, adrenal glands and kidneys. Here, we describe an extremely rare case of isolated pancreatic metastasis of mesothelioma of the pleura in a 40-year-old man who initially presented with epigastric discomfort and hunger pain, which were refractory to medical treatments. The possibility of pancreatic metastatic lesion should be considered in patients with malignant pleural mesothelioma in the presence of refractory epigastric tenderness.
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PMID:Isolated pancreatic metastasis of a malignant pleural mesothelioma. 1960 32


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