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

Metastatic cardiac liposarcoma is rare. A right ventricular liposarcoma metastasis is described in a 46-year-old man, who was admitted with significant shortness of breath and fatigue, and in whom a large lobulated low attenuation mass occupying most of the right ventricular cavity, with extension through the right ventricular apex and a small-to-moderate pericardial effusion was detected by electrocardiogram-gated cardiac computed tomography. The patient had an antecedent history of a left upper arm liposarcoma treated with surgical resection, chemotherapy, and postoperative radiotherapy 3 years earlier. Surgical resection was performed with the majority of the neoplasm removed though; the right ventricular apex and epicardial extension of tumor could not be fully resected. The histopathologic analysis revealed a liposarcoma, similar to the one resected in the left arm 3 years earlier. Electrocardiogram-gated cardiac computed tomography was able to visualize the metastatic tumor within the heart, accurately evaluate cardiac function and allow for prompt surgical treatment that produced relief of symptoms, and assess for further metastatic disease within the thorax.
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PMID:Metastatic shoulder liposarcoma to the right ventricle: CT findings. 1752 30

A 16-year-old student presented with a 4-week history of progressive shortness of breath, loss of appetite, and occasional blood-tinged sputum. The chest X-ray revealed massive right-sided pleural effusion with cardiomegaly. An echocardiogram revealed a large pericardial mass with massive pericardial effusion. Subsequent computed tomography of the thorax revealed a large heterogeneous mass in the right lung with extension into the pericardium. Lung biopsy revealed primitive neuroectodermal tumor (PNET) with small round blue cells, Homer-Wright rosettes, and CD99 positivity. We discuss pericardial metastases of PNET and its implication in this patient.
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PMID:Primitive neuroectodermal tumor of the lung with pericardial extension: a case report. 1800 74

The purpose of this study was to describe (1) the aggressiveness of care in a population of patients who die of lung cancer and (2) differences in care between a sample of lung cancer patients who died in an acute care hospital (DH) and a sample of lung cancer patients who were admitted to hospital during the last six months of life but were discharged and died elsewhere (DO). All lung cancer deaths in 2002 were identified in the provincial registry. Cases were linked to administrative sources of health care data to describe the population as a whole and the aggressiveness of the care that they received. Primary data were collected from a province-wide sample of patients' hospital charts focusing on reasons for admission, care in hospital, advanced planning, pain, and disposition. In total, 5,855 patients who died of lung cancer in 2002 were eligible for inclusion in the cohort. Rates of in-hospital death, emergency room visits, intensive care unit admissions, and chemotherapy use near the end of life were 59.5%, 32.2%, 5.5%, and 4.6%, respectively. The records of 491 patients were abstracted for this study. The DH and DO groups were similar with respect to age, gender, neighborhood income level, and extent of metastatic disease. The most common chief complaints were shortness of breath, pain, inability to cope at home, and altered level of consciousness. Compared to patients in the DO group, those in the DH group presented with pain more often (19% vs. 10%, P<0.005) and were more likely to be admitted with progressive chest malignancy (30% vs. 21%, P<0.05). Regardless of reason for admission, pain was commonly documented as a problem during admission: 73.5% in the DH group and 62.4% in the DO group (P<0.05). Lung cancer patients are heavy users of acute care beds and the emergency room at the end of life. Those who do or do not die in hospital are similar in many respects but our results suggest those dying in hospital have more problems with pain and burden from local chest malignancy.
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PMID:End-of-life care in lung cancer patients in Ontario: aggressiveness of care in the population and a description of hospital admissions. 1824 49

Malignant pleural mesothelioma (MPM) is a rare cancer that metastasizes to mediastinal lymph nodes (MLNs). The diagnosis of MPM metastatic to MLNs may not be straightforward. We describe 3 cases to highlight unusual entities of MPM metastatic to MLNs as follows. One patient with a history of T3N1M0, poorly differentiated esophageal adenocarcinoma and malignant melanoma presented with shortness of breath, mediastinal lymphadenopathy, and pleural effusion; metastatic disease was clinically suspected. Unexpectedly, immunohistochemical studies supported the diagnosis of MPM metastatic to the MLN on biopsy. In another case, mesothelial cell inclusions were initially diagnosed based on the light microscopy, immunohistochemistry, and lack of pleural thickening on computed tomography studies. Subsequent fine needle aspiration of an enlarged cervical lymph node found an atypical mesothelial proliferation, and metastatic mesothelioma was strongly suspected. Video-assisted thoracoscopic examination showed small visceral nodules, and pleural biopsy was diagnosed as malignant epithelioid mesothelioma. The mediastinal and cervical lymph node biopsies were reinterpreted as positive for MPM. In the last case, MLN biopsy showed a malignant epithelioid cell proliferation. Calretinin, CK5/6, WT-1, D2-40, p63, and CD5 were immunohistochemically detected in the tumor but epithelial markers and TTF-1 were negative. Metastatic mesothelioma was considered based on immunohistochemistry and computerized tomography finding of pleural thickening even though p63 and CD5 positivity were unusual. In summary, MPM may present as mediastinal lymphadenopathy with metastases or it may be a concurrent neoplasm with other malignancies or shows an unusual immunohistochemical staining pattern. Caution should be used when diagnosing mesothelial cell inclusions in MLNs.
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PMID:Unusual features of malignant pleural mesothelioma metastatic to the mediastinal lymph nodes. 1830 Dec 36

Cardiac metastases of thyroid carcinomas are rarely diagnosed ante mortem and infrequently reported in the literature. A 68-year-old man with known papillary thyroid carcinoma presented to the hospital with progressive shortness of breath. A transthoracic echocardiogram revealed a right ventricular mass. Contrast echocardiography perfusion imaging was used to evaluate the vascularity of the mass.
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PMID:Assessment of a right ventricular metastasis using contrast echocardiography perfusion imaging. 1849 Mar 29

We herein report an 80-year-old man with prostatic carcinoma who developed eosinophilic pneumonia and intrathoracic metastases. He presented with shortness of breath, cough, and fever as a chief complaint. Chest X-ray and computed tomography showed bilateral pulmonary nodules, intrathoracic lymphadenopathy, and right-sided consolidation. Positron emission tomography (PET) using (18)F-fluorodeoxyglucose (FDG) showed poor uptake in these nodules and lymph nodes. The patient subsequently received a pelvic computed tomography scan, which revealed a massively enlarged prostate. The serum prostate specific antigen level was elevated to 4,181.2 ng/mL, and a transrectal biopsy revealed prostatic adenocarcinoma. Based on the morphological and immunohistochemical findings, the nodules in the lung and the lymph nodes were diagnosed as secondary neoplasm from the prostate. As for right-sided consolidation, remarkable bronchoalvelar lavage fluid eosinophilia was detected, that was compatible with eosinophilic pneumonia. Eosinophilic pneumonia in this case disappeared and has not recurred by treatment of prostatic carcinoma and steroid therapy for a week, and was regarded to be tumor-associated. Although prostatic carcinoma with an initial manifestation of intrathoracic metastases and eosinophilic pneumonia is uncommon, physicians should suspect the condition. In addition, we should also keep in mind that prostatic carcinoma sometimes shows poor uptake in FDG-PET. PET: Positron emission tomography, FDG: (18)F-flouorodeoxyglucose.
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PMID:Eosinophilic pneumonia and thoracic metastases as an initial manifestation of prostatic carcinoma. 1867 Jan 49

We report the case of an 18 year old woman presenting with shortness of breath and pain in the left shoulder. Imaging of the lungs revealed pleural effusion and calcification of the left pleura. An osteosarcoma of the left humerus was the final diagnosis. A review of the literature reveals that calcified pleural metastatic disease in cases of osteosarcoma has been infrequently reported. Other causes of pleural calcification are briefly discussed.
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PMID:Osteosarcoma with extensive calcified pleural metastases at diagnosis. 1918 65

Left ventricular metastases from renal cell carcinoma without vena caval or right atrial involvement are extremely rare. Herein, we present the case of a 69-year-old man who had undergone radical nephrectomy for renal cell carcinoma in 1984. Eighteen years thereafter, we discovered metastatic disease in his left ventricle.When the metastasis was identified, the patient had no symptoms other than shortness of breath. He underwent surgical removal of a highly vascular mass from the left ventricular wall and resection of a nodule in the upper right pulmonary lobe. Upon pathologic examination, both tumors were metastatic renal cell carcinomas. The patient recovered uneventfully and was free of cardiac recurrence more than 6 years after the surgery. We describe our treatment of this patient and discuss some current approaches to the treatment of renal cell carcinoma that has metastasized to the heart.
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PMID:Renal cell carcinoma, metastatic to the left ventricle. 1943 86

Trastuzumab (Herceptin) is well documented in reducing suffering and mortality from breast cancer. The clinically most important side effect of Herceptin is cardiotoxicity, which is reported in 2.6% to 4.5% of patients receiving trastuzumab alone and in as many as 27% of patients when trastuzumab is combined with an anthracycline in metastatic disease. We reported the case of a 50-year-old woman who presented to our emergency department (ED) because of chest pain and shortness of breath. On physical examination, holosystolic murmur over apex could be heard. Pulmonary and abdominal examinations were unremarkable. Twelve-lead electrocardiography showed sinus tachycardia and new onset of complete left bundle-branch block. Emergent transthoracic echocardiography revealed generalized hypokinesia of left ventricle and akinesia over interventricular septum and apex. She subsequently underwent immediate coronary angiography that revealed normal coronary angiography, and left ventriculogram revealed generalized hypokinesia with severe left ventricle dysfunction with ejection fraction of 33%. During right heart catheterization and endomyocardial biopsy, cardiac tamponade developed and was successfully relieved by pericardial window. She was discharged event-free 3 weeks later with conservative treatment. Although new onset of complete left bundle-branch block in a patient with chest pain may be acute coronary syndrome, careful review of medicine history is mandatory to avoid unnecessary procedure and complications.
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PMID:Trastuzumab (Herceptin)-associated cardiomyopathy presented as new onset of complete left bundle-branch block mimicking acute coronary syndrome: a case report and literature review. 1968 38

A 53-year-old man was admitted to our hospital because of an abnormal lung shadow on his chest X-ray film. His symptoms were cough and shortness of breath. Chest X-ray and computed tomography showed a large mass lesion in the right lower lobe of the lung. We diagnosed primary non-small cell lung cancer; cT3N1M1 stage IV. Systemic chemotherapy using carboplatin and paclitaxcel was performed. However, the treatment had no effect and he died two months after admission. An autopsy showed pulmonary spindle cell carcinoma, with multiple metastases to the brain, pancreas, etc. Pulmonary spindle cell carcinoma had been recognized as a variant of the squamous cell carcinoma for years, however, in the recent WHO and Japanese classification of lung tumors, it was redefined as an independent histological type. It is a rare form of lung cancer, representing 0.2 to 0.3% of all primary pulmonary malignancies and seems to have poor prognosis. We need to pay more attention to this type of lung cancer.
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PMID:[Autopsy case of rapidly progressive pulmonary spindle cell carcinoma with multiple metastases to the brain and pancreas]. 1982 89


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