Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Electric pulses can cause transient permeabilization of cell membranes (electroporation) and this can be utilized to increase the uptake of chemotherapy (electrochemotherapy). Preclinical studies have shown that in vivo electroporation causes transient shut down of blood flow both in normal and, in particular, malignant tissues. We report the successful palliation of a malignant melanoma patient with bleeding skin metastases using electrochemotherapy. In an on-going study of combined electrochemotherapy and low dose interleukin-2, one patient with bleeding skin metastases was included. Nine skin metastases, of which seven were ulcerated, were treated. After intratumoral bleomycin injection, needle electrodes with two arrays 4 mm apart were inserted into the tumours. Eight square wave electric pulses each 99 micros in duration and with an applied voltage to electrode distance ratio of 1.2 kV/cm were administered. In all the treated lesions, bleeding immediately stopped on administration of the electric pulses and did not recur. The treated metastases developed crusts and the lesions healed in a matter of weeks. Treatments were given under local anaesthesia, lasted a few minutes, and patient discomfort was brief and modest. In conclusion, we propose that electrochemotherapy should be considered for the palliation of haemorrhaging metastases as it is an efficient, tolerable, brief, outpatient, once-only treatment.
 ...
PMID:Efficient palliation of haemorrhaging malignant melanoma skin metastases by electrochemotherapy. 1119 81

We describe a case of gastric metastasis from a lobular carcinoma of the breast in a 45-year-old woman who had undergone a left mastectomy with axillary dissection 7 years earlier. At the current presentation, she had been experiencing progressive epigastric discomfort for 3 months. The initial diagnosis was early gastric carcinoma, diffuse type, based on gastric biopsy findings and ultrasonographic endoscopy. A definitive diagnosis of metastatic breast cancer was confirmed after subtotal gastrectomy of a presumed primary early gastric carcinoma. Although gastrointestinal metastases from breast cancer are not rare, the early stage of the gastric lesion and the absence of further disease dissemination make this case unusual. The onset of gastrointestinal symptoms in a patient with a history of breast carcinoma should prompt the physician to rule out the possibility of gastric metastases.
 ...
PMID:Metastatic carcinoma of the breast resembling early gastric carcinoma. 1121 10

Classification of laryngeal dysplasia, the most appropriate treatments and criteria for evaluation of the results is still a highly controversial issue. The objectives of the present study on the treatment of laryngeal dysplasia lesions are to: 1) evaluate the relative incidence of the various forms of dysplasia in relation to grading of the histopathological findings; 2) establish the prognosis for the various forms of dysplasia considered; 3) determine the results achieved by the author's treatment protocol according to the characteristics of the dysplasia; 4) critically evaluate the classifications of laryngeal dysplasia found in the literature in view of the results of the present study. The study involved 141 patients with vocal cord dysplasia (134 men, 7 women; mean age: 56.2 years) who had come under observation at the E.N.T. Dept. of the University of Naples "Federico II" between January 1981 and April 1998. In all cases the dysplasia was removed by CO2 laser microlaryngoscopy. Of the 141 patients 89 (63.2%) showed mild dysplasia, 14 (9.9%) moderate dysplasia, 20 (14.2%) severe dysplasia and 18 (12.7%) in situ carcinoma. The five-year survival rate showed an overall actuarial survival of 89.1% for all patients while the corrected actuarial survival was 98.5% and local disease control was 86.1%. In 17 cases (12%) the dysplasia lesion recurred, in 11 (7.8%) an infiltrating carcinoma arose. Recurrences in the dysplasia were encountered in 9% of the patients with mild lesions, 7.1% of those with moderate dysplasia, 15% of the subjects with the severe form and in 27.7% of those with in situ carcinoma. An infiltrating carcinoma arose in 5.6% of the cases of mild lesion, in 7.1% of the medium dysplasias, 5% of the severe forms and in 22.2% of those with in situ carcinoma. The recurrences and infiltrating carcinomas were successfully treated with endoscopic CO2 laser surgery. Only three cases (2.1%) required radical surgery (total laryngectomy): these were patients who had not quit smoking and who had not adhered to the planned follow-up. One of the latter patients died with widespread metastases of the laryngeal cancer. The significantly higher incidence of dysplasia recurrences (P = 0.028) and infiltrating carcinomas (P = 0.015) in those patients with in situ carcinoma shows that, when preparing classification and determining prognosis, these pathologies should be considered separately. Moreover, they require a particularly precise follow-up. In conclusion, the following observations can be drawn from the study: mild and moderate dysplasias are more frequent as compared to severe dysplasia and carcinoma in situ; carcinoma in situ should be distinguished for classification and prognosis from dysplasias, considering their different clinical course and evolution; CO2 laser surgery in these forms is a valid therapeutic approach for its precision, the achievable results, the reduced discomfort to patients and for its evident cost-effectiveness.
 ...
PMID:[Microlaryngoscopy treatment of laryngeal dysplasia with CO2 laser]. 1143 21

Laparoscopic liver resection has not yet been established, although recent reports document that liver resection can be performed safely by the laparoscopic approach. Other interventional procedures like cryoablation have also been introduced in treatment of liver metastases. In this report 11 liver resections performed laparoscopically in eight patients are presented. Six patients had colorectal metastases, one a metastases from a malignant melanoma, and one patient had focal nodular hyperplasia. Two patients received synchronous cryoablation of remaining liver metastases. During follow up, two patients received percutaneous cryoablation of liver recurrences monitored by an open configuration magnetic resonance scanner. All except one of the tumors we attempted to remove had free resection margins (re-resection of new metastasis). No complications occurred except an atelectasis of the left lower pulmonary lobe in one patient. Median postoperative hospital stay was 3 days, and median postoperative opioid-dependent days was 1. The report demonstrates that minimally invasive techniques may safely be combined in hepatic intervention, and that the advantages of minimally invasive surgery, such as reduced hospital stay and less patient discomfort, also applies to liver resections.
 ...
PMID:Liver tumors and minimally invasive surgery: a feasibility study. 1144 89

In the 50 years since Leksell developed the concepts and initial hardware for modern brain radiosurgery, the treatment has progressed to the point where it is used commonly for arteriovenous malformations, benign masses, and metastases. Radiosurgery offers patients an effective treatment of life-threatening lesions with a reasonably low risk for discomfort and injury. In the 1990s, the procedure was used widely as primary and adjuvant treatment. The difficulty of defining the boundaries of primary brain cancers makes determining treatment targets problematic. Better imaging and computing offer a bright future for the technology.
 ...
PMID:Stereotactic radiosurgery for brain tumors. 1177 Feb 96

Paraneoplastic syndromes are caused by hormones or other substances produced by cancer cells and may be the first sign of cancer. A wide range of paraneoplastic syndromes, including endocrine, neurologic, and cutaneous disorders, occurs in patients with cancer. More than 30 cutaneous paraneoplastic syndromes have been identified; this article reviews some of the more common syndromes--acanthosis nigricans, Paget's Disease, acquired ichthyosis, telangiectasia, hypertrichosis lanuginosa acquisita, erythroderma, Bazex's Syndrome, and necrotizing migratory erythema. When these syndromes are diagnosed during the course of a malignancy, professional caregivers may misinterpret them as indicative of metastatic disease or other disorders and patients may be misdiagnosed and not receive optimal treatment. Paraneoplastic syndromes also compromise quality of life by often causing skin impairment and discomfort. Therefore, nurses must be aware of the signs and symptoms of these cutaneous disorders and know how to care for patients with paraneoplastic syndromes.
 ...
PMID:Cutaneous paraneoplastic syndromes. 1189 23

A 52-year-old man underwent endoscopy because of discomfort in the hypopharyngeal region, and a 1.5-cm tumor was found on the pharyngoesophageal junction. In 1992, the patient was treated for advanced cervicothoracic esophageal cancer by preoperative chemotherapy and esophagectomy with radical lymph adenectomy and right thoracotomy. Reconstruction with a gastric substitute by cervical esophagogastrostomy was performed and postoperative adjuvant radiotherapy followed. Histologically, the esophageal tumor had invaded the adventitia and showed metastases to regional lymph nodes and vascular involvement with a free surgical margin. Hypopharynx was also included in the irradiation field. Therefore, we tried to resect another primary tumor on the pharyngoesophageal junction by the endoscopic mucosectomy technique with an esophageal multipurpose tube (np-EEM). The tumor was resected on August 21, 1996, but follow-up endoscopy revealed residual or another primary tumor on the pharyngoesophageal junction in October 1996. The first resected specimen revealed a positive cut margin that might indicate incomplete resection. Three months later we performed a second mucosectomy. No problems occurred during or after tumor resection. Both treatments were performed without hospitalization, and the patient returned to his normal daily life on the day following tumor resection. Follow-up examinations have shown no sign of cancer recurrence on the pharyngoesophageal junction for more than 4 years.
 ...
PMID:A case of cancer on the pharyngoesophageal junction treated by ambulatory endoscopic mucosectomy. 1199 47

The purpose of the present study was to identity ways to prevent negative side effects in homechemotherapy. We conducted continuous hepatic arterial infusion chemotherapy (CHAI) in 122 cases of unresectable hepatic metastases from colorectal cancer. We continuously administered 5-FU at 250 mg/day for 7 days using a pump system. We also conducted systemic chemotherapy (FP therapy) in 145 cases of advanced or recurrent colorectal cancer in our outpatient clinic. Based on these experiences, we analyzed the problems of homeochemotherapy. The rate of negative side effects was 15.1% with CHAI. More than half were cases of abdominal pain. Because we had established an observation system for emergency cases, there were no fatal accidents. With FP therapy, about 40% of patients had gastrointestinal discomfort, but the rate of those with higher than grade 3 was low (1-2%). We conclude that it is very important to establish a hospital system to respond quickly to any negative effects of homeochemotherapy.
 ...
PMID:[The prevention of negative side effects in homeochemotherapy]. 1214 17

We report a case of gallbladder cancer associated with pancreaticobiliary maljunction. The patient was a 60-year-old woman who consulted a local doctor because of discomfort in the right hypochondriac region. Abdominal ultrasonography (US) showed a gallbladder abnormality, and she was referred to Kurume University Hospital, where she was hospitalized for further study and surgery. Abdominal US revealed a sessile tumor with an irregular surface in the fundus of the gallbladder. The internal echo of the tumor was nonhomogeneous, and the structure of the gallbladder wall was partly torn. The common bile duct and the left intrahepatic bile duct were dilated. Abdominal computed tomography (CT) showed an elevated lesion with the same degree of imaging effect as that of the liver on the peritoneal side of the fundus of the gallbladder. The structure of the gallbladder was preserved, and the gallbladder was well demarcated from the surrounding tissue. No hepatic or lymph node metastases were noted. Endoscopic retrograde cholangiopancreatography (ERCP) visualized the pancreaticobiliary maljunction where the pancreatic duct joined the bile duct, entering an approximately 2-cm-long common channel. Dilatation of the common bile duct and intrahepatic bile ducts was observed and diagnosed as the IV-A type according to the Toya classification. Abdominal angiography in the arterial phase showed dilatation of the cystic artery and hyperplasia of vessels but no apparent encasement. In the venous phase, a deep-staining tumor was observed. From the above findings, we made a diagnosis of gallbladder cancer complicating pancreaticobiliary maljunction, and performed an operation. Since intraoperative US showed that the outermost layer of the gallbladder was in part ill-demarcated, we diagnosed the depth of penetration as ss, and performed cholecystectomy and bile duct resection and hepatic resection (S4a and S5), and lymphnode dissection (D2; dissection of groups 1 and 2 lymphnodes). The resected specimen grossly showed a papillomatous lesion with a cauliflower-like surface. The histopathologic diagnosis was papillary adenocarcinoma, depth ss, stage II. Tumor cells proliferated in a papillomatous pattern and were mostly confined to the muscular coat but partly infiltrated into the subserosal coat. In the diagnosis of pancreaticobiliary maljunction, it is crucial to consider complicating gallbladder cancer.
 ...
PMID:A case of gallbladder cancer associated with pancreaticobiliary maljunction. 1223 75

We report a 65-year-old man with advanced gastric cancer that showed a remarkable response to treatment with a new combination of paclitaxel (TXL) and low-dose 5-fluorouracil and cisplatin (FP) as neoadjuvant chemotherapy (NAC). The patient was admitted to our hospital complaining of epigastric discomfort. Endoscopic examination revealed type 3 advanced gastric cancer, which was confirmed to be adenocarcinoma by biopsy. Tumor markers of serum carcinoembryonic antigen (CEA) and alpha-fetoprotein (AFP) were elevated to 768.7 ng/ml and 2,782.8 U/ml, respectively. Computed tomography (CT) showed multiple liver metastases, and metastases to group 3 lymph nodes. After three courses of NAC, the CEA and AFP levels decreased to 245.0 ng/ml and 754.0 U/ml, respectively. Computed tomography revealed marked reduction of the primary tumor, liver metastases, and lymph nodes. Shrinkage of the primary tumor was also shown by gastrography and endoscopy. Distal gastrectomy was then performed because of pylorus stenosis. The resected specimen showed tub 2, pSS, pN3, ly2, v2 and Grade 2 histological responses. About half of the nodal metastatic lesions were degenerated. The patient is doing well and undergoing treatment with hepatic arterial infusion chemotherapy as an outpatient. TXL + low-dose FP as NAC may be one of the new tactics against advanced gastric cancer.
 ...
PMID:[A case of advanced gastric cancer showing pylorus stenosis with multiple liver metastases, that respond remarkably to neoadjuvant chemotherapy of combined TXL and low-dose FP]. 1266 2


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>