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 58-year-old woman was hospitalized because of shortness of breath, cough, weakness, and physical signs suggestive of mitral stenosis. Echo-Doppler examination revealed a left atrial mass. This was removed and turned out to be a fibrosarcoma. Recurrence of the tumor with metastases into the pericardium, thyroid goiter, and left kidney led to the patient's death 6 months later. The clinical and pathological features of our rare case are compared with those in the literature.
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PMID:Intracardiac primary fibrosarcoma. Case report and literature review. 141 1

Cervical squamous cell carcinoma rarely metastasizes to the heart, and cardiac tamponade secondary to pericardial involvement has been only rarely reported. We describe a case of recurrent cervical squamous cells carcinoma presenting with cardiac tamponade secondary to extensive pericardial metastases. The patient, a 38-year old woman, initially presented with Stage IIIB cervical squamous cell carcinoma. She responded well to radiation and chemotherapy, there was no clinical or radiographic evidence of persistent disease after the initial therapy. Sixteen months after presentation, she developed shortness of breath and chest pain. The patient received additional chemotherapy; however, she died 17 months after her initial presentation. At autopsy, metastatic keratinizing squamous cell carcinoma extensively involved the pericardium and superficial myocardium. This case illustrates the unusual occurrence of recurrent cervical squamous carcinoma presenting with cardiac dysfunction secondary to pericardial metastases.
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PMID:Recurrent cervical squamous cell carcinoma presenting with cardiac tamponade. Recurrent cervical carcinoma-tamponade. 883 61

Metastasis from basal cell carcinoma (BCC) of skin is rare. A case of a 58-year-old male presenting with increasing shortness of breath and right pleural effusion is described. Open right pleural biopsy demonstrated metastatic carcinoma consistent with BCC. Review of medical records from another hospital revealed that four years previously a recurrent BCC had been excised from the left back. One and three years prior to this excision, a skin lesion at this same site had been treated with electrocautery. Review of the skin excision slides demonstrated infiltrating BCC histologically very similar to the metastatic pleural neoplasm. The patient died two months after the pleural biopsy. At autopsy, the cutaneous BCC had not recurred and metastatic BCC extensively infiltrated the pleura bilaterally, with focal involvement of underlying lung parenchyma, subcarinal lymph nodes, diaphragm, and pericardium.
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PMID:Metastatic basal cell carcinoma: report of a case presenting with respiratory failure. 203 26

Twenty-six patients with metastatic cancer were entered into a phase I trial of concurrent recombinant interleukin-2 (IL-2) and recombinant interferon-gamma (IFN-gamma). IL-2 was administered as a continuous intravenous infusion for 5 days. IFN-gamma was administered by a daily intramuscular (IM) injection during the 5 days of IL-2 administration. Treatment was repeated twice after 9-day rest periods. After a 2-week rest, patients without evidence of tumor progression were retreated. Natural killer (NK)- and lymphokine-activated killer (LAK)-cell activity were assayed in each patient before treatment, on day 1, and on day 5 of each cycle. Constitutional symptoms occurred in most patients but were not dose-limiting. Other toxicities included hypotension responsive to fluids, transient elevations in liver function tests, erythema/pruritus, eosinophilia, and transient leukopenia/thrombocytopenia. The maximum-tolerated dose (MTD) of the combination was 1 x 10(6) U/m2/d of IL-2 combined with 0.50 mg/m2/d of IFN-gamma. The dose-limiting toxicity was pulmonary manifesting as rales and shortness of breath. The dose of the combination that resulted in the optimal generation of in vivo LAK-cell activity was a dose of at least 0.25 mg/m2/d of IFN-gamma combined with 1 x 10(6) U/m2/d of IL-2. Objective clinical responses were seen in five of 26 patients. These included a partial response of 2 months duration in a patient with non-Hodgkin's lymphoma (NHL), mixed responses in a patient with NHL and two patients with renal cell carcinoma (RCC), and an ongoing assessable response in a patient with bone metastases from RCC. The recommended dose for phase II trials of this combination is 0.50 mg/m2 of IFN-gamma and 1 x 10(6) U of IL-2.
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PMID:A phase I trial of recombinant interleukin-2 combined with recombinant interferon-gamma in patients with cancer. 211 71

A 60-year-old man presented with a 3-month history of shortness of breath. He was found to have a right thoracic mass involving the right middle and lower lobes, pulmonary hilum, and mediastinum. Diagnosis could not be established by pleural fluid cytology, pleural biopsies, bronchoscopy, and ultrasound-guided needle biopsies. A diagnostic exploratory thoracotomy was performed. Massive hemorrhage was encountered upon opening the pleura, and bleeding was controlled by performing a radical pneumonectomy. Histology revealed angiosarcoma, pulmonary primary. The patient survived for 68 days. At autopsy, he was found to have adenocarcinoma of the prostate, adenocarcinoma of the rectum, carcinoid of the ileum, and leiomyoblastoma of the stomach as well as diffuse metastases from the angiosarcoma. This represents the fourth reported case of primary pulmonary angiosarcoma.
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PMID:Primary pulmonary angiosarcoma associated with multiple synchronous neoplasms. 361 93

Several types of neoplastic conditions are included in the differential diagnosis of pneumonia. Bronchial obstruction with cancer can produce obstructive pneumonia that results in intractable infection. Bronchogenic carcinoma and metastatic cancer involving the airways may produce this clinical presentation. Bronchioloalveolar carcinoma is a relatively common form of primary lung cancer that characteristically presents as a chronic infiltrate associated with cough, hypoxemia, shortness of breath, and mucus hypersecretion. This cancer has two distinct histological types with markedly different prognosis. The mucinous variety is much more likely to be multicentric and rapidly progressive whereas the nonmucinous variety may be localized. Lymphoproliferative diseases may also present in an infiltrative appearance. Kaposi's sarcoma infiltrating the lungs, particularly associated with acquired immune deficiency syndrome, presents a diagnostic dilemma because of the high incidence of pulmonary infection in these patients.
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PMID:Neoplastic mimics of pneumonia. 748 Nov 27

We present 25 cases of a primary pulmonary sarcoma bearing histological, immunohistochemical, and ultrastructural features indistinguishable from those of monophasic synovial sarcoma of soft tissue. The patients were 11 men and 14 women between the ages of 16 and 77 years. Clinically, the most common symptoms were chest pain, cough, shortness of breath, and hemoptysis. The lesions involved all lung segments. Grossly, they varied in size from 0.6 to 20 cm and were described as soft to rubbery tumors with areas of necrosis and hemorrhage, some with cystic changes. Two lesions involved the bronchial wall and in one case the tumor was described as encircling the bronchial tree. Histologically, all of the lesions were characterized by an atypical spindle cell proliferation with a solid growth pattern. Areas of myxoid, neural, hemangiopericytic, and epithelial-like growth pattern were observed. Mitoses, necrosis, and hemorrhage were seen in all lesions in varying proportions. Immunohistochemical studies for epithelial membrane antigen (EMA) and keratin showed strong focal positivity in 25 of 25 and 23 of 25 lesions, respectively. Immunohistochemical study for vimentin showed diffuse strong positivity in all lesions. Other immunostains, including desmin, smooth muscle actin, and S-100 protein, were negative. Electron microscopy in three cases showed spindle cells with elongated nuclei containing abundant cytoplasmic rough endoplasmic reticulum and well developed desmosome type intercellular junctions. Follow-up information ranging from 2 to 20 years was obtained in 18 patients. Six patients died of their tumors, whereas four patients died of unrelated causes without evidence of recurrence or metastases. Eight patients were alive with disease (recurrence and/or metastases) from 1 to 7 years after diagnosis. Four patients were alive and well without evidence of recurrence or metastases from 2 to 20 years (mean follow-up, 12.5 years). The present group of lesions appears to constitute a distinctive and as yet previously undescribed primary sarcoma of the lung, which probably represents the visceral counterpart of monophasic synovial sarcoma of soft tissue in a pulmonary location. Because of their distinctive biology these lesions should be distinguished from a variety of primary and metastatic malignancies of the lung.
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PMID:Primary pulmonary sarcomas with features of monophasic synovial sarcoma: a clinicopathological, immunohistochemical, and ultrastructural study of 25 cases. 775 Sep 31

Swainsonine, an alpha-mannosidase inhibitor which blocks Golgi oligosaccharide processing, represents a new class of compounds that inhibit both rate of tumor growth, and metastasis, in murine experimental tumor models. In this first phase I study, the quantitative and qualitative toxicities of swainsonine have been studied in patients given a continuous i.v. infusion over 5 days, repeated at 28-day intervals. Dose levels were escalated in increments of 100 micrograms/kg/day from 50-550 micrograms/kg/day. Nineteen patients with both solid tumor and hematological malignancies were given a total of 31 courses. Hepatotoxicity, particularly in patients with liver metastases, was the dose-limiting toxicity. The maximum tolerated dose (MTD) and the recommended starting dose (MTD -1 level) were 550 and 450 micrograms/kg/day, respectively. Common side effects included edema, mild liver dysfunction, a rise in serum amylase, and decreased serum retinol. Acute respiratory distress syndrome possibly precipitated by swainsonine resulted in a treatment-related death in a patient with significant pretreatment hepatic dysfunction. One patient with head and neck cancer showed > 50% shrinkage of tumor mass for 6 weeks after treatment. Two patients with lymphangitis carcinomatosis on chest X-ray noted improvement in cough and shortness of breath during the infusion of swainsonine and for 1 week thereafter. Clearance and serum half-life for swainsonine were determined to be approximately 2 ml/h/kg, and 0.5 day, respectively. Golgi oligosaccharide processing, a putative anticancer target for swainsonine was inhibited in peripheral blood lymphocytes as evidenced by a marked decrease in leukoagglutinin binding after 5 days of treatment. Oligomannosides in patient urine increased 5-to 10-fold over the 5 days of treatment, indicating that tissue lysosomal alpha-mannosidases were also blocked by swainsonine. Urine oligomannoside accumulation reached steady state at 3 days, approximately 1 day after serum drug levels reached steady state. The fraction of HLA-DR-positive cells in peripheral blood lymphocytes increased following 5 days of swainsonine treatment, an effect similar to that observed for peripheral blood lymphocytes from normal subjects cultured with swainsonine. No significant changes in CD3, CD4, CD8, CD16, and CD25 were observed. Swainsonine produces minimal toxicity when administered i.v. to cancer patients at dosages that inhibit both Golgi alpha-mannosidase II and lysosomal alpha-mannosidases. Detection of hepatic metastases or liver enzyme abnormalities prior to treatment predict for more significant toxicity.
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PMID:A phase I study of swainsonine in patients with advanced malignancies. 813 47

Metastasis to the breast from extramammary malignancies is rare, but its recognition is important because the prognosis and treatment differ from that of primary breast cancer. We report a case of ovarian cancer with metastasis to the breast, which was found at the time of presentation. A 57-year-old woman presented with shortness of breath and was found to have a malignant pleural effusion. A right breast nodule contained papillary adenocarcinoma. Laparotomy showed bilateral ovarian papillary cystadenocarcinoma with dissemination in the peritoneal cavity. DNA image analysis showed multiple aneuploid stem lines. Immunohistochemical staining was positive with ovarian tumor marker OC125 but negative with breast tumor marker gross cystic disease fluid protein-15 (GCDFP-15) and estrogen receptor. The breast specimen was positive with OV632, a more specific tumor marker for ovarian cancer, thus favoring the ovary as the site of the primary tumor.
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PMID:Ovarian carcinoma metastasis to the breast case report and review of the literature. 842 14

Three cases of primary pulmonary rhabdomyosarcoma in adults are presented. The patients were all men between the ages of 57 and 78 yr (mean 67.5). All patients presented with symptoms referable to their tumors, including cough, shortness of breath, pleuritic chest pain, and weight loss. In one patient, a history of tobacco and alcohol abuse was obtained. Anatomically, two tumors were located in the left upper lobe and one in the left lower lobe. Grossly, the tumors ranged in size from 6 to 11.5 cm and were tan-gray, firm masses with areas of necrosis and hemorrhage. Histologically, the tumors were characterized by a spindle cell proliferation admixed with areas showing a pleomorphic cell population with numerous rhabdomyoblasts and areas of hemorrhage and necrosis. Immunohistochemically, all three tumors showed strong positivity with desmin and myoglobin antibodies and negative staining with antibodies against keratin, epithelial membrane antigen, and S-100 protein. All patients had a fatal outcome. Two patients died a few days after admission with respiratory distress; the third one died 2 years after diagnosis with widely metastatic disease. Autopsy findings in all cases disclosed disseminated metastases to multiple abdominal and thoracic organs. Primary pulmonary rhabdomyosarcoma should be considered in the differential diagnosis of poorly differentiated pulmonary neoplasms in adults and should be distinguished from other primary and metastatic sarcomas.
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PMID:Primary pulmonary rhabdomyosarcomas: a clinicopathologic and immunohistochemical study of three cases. 853 1


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