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

In a retrospective study 101 patients who underwent surgery for a parotid mass were evaluated. The different diagnostic modalities (sialography, ultrasound, needle biopsy and frozen section) are described and discussed. Eighty-one tumors proved to be benign, of which 56 patients had a pleiomorphic adenoma, ten of them had a recurrent pleiomorphic adenoma, all after an enucleation, which again proved to be an inadequate operation for a parotid mass. The 20 malignant parotid tumors had a poor clinical outcome. Of the 18 patients with a malignant primary parotid tumor three showed a local recurrence and five metastatic disease within five years. The morbidity of parotid surgery is mainly due to post-operative facial nerve weakness (30%), which is mostly reversible, and the Frey syndrome (10%).
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PMID:The management of parotid tumors; a ten-year experience. 357 55

Brain metastases are rare in well-differentiated thyroid carcinoma but when present they can lead to the patient's death. Iodine-131 therapy for intracerebral thyroid carcinoma metastases causes radiation-induced acute cerebral edema that can lead to CNS complications and even death. We present a case in which a patient with intracerebral 131I uptake developed seizures, slurred speech, and muscle weakness 12 hr following 131I therapy. The patient's CT scan, post-therapy, confirmed an intracranial metastasis with a significant amount of surrounding edema. Radiotherapists, when using external beam radiation to treat intracerebral metastases, commonly place these patients on steroids, glycerol, or mannitol prior to instituting therapy, to prevent complications from radiation-induced cerebral edema. This technique could be applied to 131I therapy of intracranial thyroid carcinoma metastases as well.
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PMID:Cerebral edema following iodine-131 therapy for thyroid carcinoma metastatic to the brain. 371 81

To characterize the neurological complications of cancer patients admitted to a community hospital, the charts of all cancer patients evaluated by a neurologist during a single year were reviewed. Nine percent (N = 93) of cancer patients received neurological consultation compared to 3.6% of other patients. The neurologic problem preceded the diagnosis of cancer in 11% of patients. Complications were most common with known metastases. Neurologists frequently discovered signs not noted by the referring physician: 52 patients were paretic, with weakness reported in only 31; cranial nerve complaints were described in 3, but found in 20; sensory abnormalities were noted in 8, but found in 26. A change in mental status was confirmed in 33% and ataxia in 10%. After consultation, distant metastasis was diagnosed in 40% of patients, direct extension in 8%, metabolic encephalopathy in 14% and remote effects of cancer and side effects of cancer therapy in 4% each. Other patients had unrelated diagnoses. In most cases, the neurologic consultation let to a change in treatment, with radiotherapy directed to a symptomatic tumor mass the most common beneficial outcome.
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PMID:Neurological consultation in the management of patients with systemic cancer admitted to a community hospital. 376 59

Five cases of intramedullary spinal cord metastasis are presented and an additional 50 cases from the English language literature since 1960 are reviewed. Lung cancer and breast cancer were the most frequently occurring primary neoplasms, but a wide variety of solid tumors may cause intramedullary spinal cord metastasis. The presenting symptoms were pain and/or weakness. The neurologic status deteriorated rapidly in the majority of patients in a period to days to weeks. Progression to a cord hemisection syndrome or cord transection occurred in approximately half of the patients. The characteristic myelographic appearance of fusiform swelling of the cord was seen in one third of the patients, but the myelogram was normal in 42%. Plain radiographs of the spine showed no evidence of metastatic disease in three fourths of cases. The cerebrospinal fluid protein level was frequently elevated, but results of cytologic studies were usually negative. High-resolution computer-assisted tomographic scanning may show intramedullary metastases. Radiation therapy combined with corticosteroid administration offers the only effective palliation. The recognition of intramedullary spinal cord metastasis is an ominous finding. Intramedullary spinal cord metastasis generally occurred in the setting of widespread systemic and intracranial disease, but occasionally was the only site of relapse. More than 80% of patients died within 3 months. Heightened awareness of this entity may lead to early diagnosis at a stage when neurologic deficits are reversible and, it is hoped, more effective palliation can be achieved.
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PMID:Clinical features and natural history of intramedullary spinal cord metastasis. 405 74

We report a case in which a 71-year-old man with a giant cell glioblastoma who had a spontaneous intracerebral hematoma including subarachnoid hemorrhage and extraneural multiple metastases followed by the craniotomy 9 months later. He had complained of nausea and vomiting on 20, October, 1981 and admitted to the Ohara hospital. For that reason, he was admitted to our hospital on 29, October, 1981 and a CT scan showed a large subcortical high dence mass accompanied by adjacent edema in the right frontal lobe. Gradually he got worse with Korsakoff's syndrome and motor weakness of the left side. Total removal of the hematoma and adjacent tissue by transcortical route on 24, November, 1981 was performed, followed by 60Co radiation therapy to the local area, chemotherapy and immunotherapy. The surgical specimen showed typical features of giant cell glioblastoma with intratumoral hemorrhage. After 9 months of the operation, he had complained of the subcutaneous tumor in the supraclavicular region and swelling of the right arm. After the second admission on 30, August, 1982, a biopsy of the tumor revealed malignant tumor cells resembling intracerebral giant cell glioblastoma. He died on 29, November, 1982. At autopsy, extraneural metastases were revealed at some lymph nodes, organs and bones. However, a primary tumor was not found in the other organs. Lymph node: cervical, supraclavicular, mediastinal, bronchial, pancreaticoduodenal, hepatic hilus, mesenteric, retroperitoneal, and parastomach. Organ: esophagus, Ileum, jejunum, adrenal gland and kidney. Bone: vertebra (thoraco-lumbar), sternum, rib. Positive reaction to GFA protein antibody was demonstrated in the tumor cells in the periphery of the surgical specimen of the brain tumor.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[An autopsy case of extraneural metastases of giant cell glioblastoma with intracerebral hemorrhage]. 408 47

28 patients underwent surgical treatment because of pathological fractures of the hip joint. 13 patients suffered from fractures of the femur because of benign tumours, whereas surgical treatment became necessary because of malignant tumours or because of fractures caused by metastases in 15 patients. Special attention is drawn to six patients out of the latter group. In these cases, spontaneous femoral fracture was caused by weakness subsequent to irradiation of malignant genital tumours. The results of our treatment were generally good in the first group. Poor results or even failure of treatment occurred comparatively often in the patients of the second group. The patients of the second group underwent surgical treatment mainly to reduce or eliminate pain, to regain mobility, to facilitate care and, last but not least, to shorten the hospitalisation period. Whenever possible, we tried to carry out complete surgery in both groups in respect of stability and function, because we believe that combined surgical and chemotherapeutical treatment can relieve the effects and arrest the progress of malignant disease and may exercise an influence on the survival time.
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PMID:[Pathologic fractures of the hip joint]. 614 61

A chemotherapeutic combination of bleomycin-adriamycin-cisplatin has been used to treat 21 consecutive patients with primary advanced or recurrent cervical carcinomas. Four complete (19.0%) and four partial remissions were recorded. The responding patients had significantly longer survival levels compared with the remaining 13 with stable disease. No patient had progressive disease during treatment. The median survival of the complete series was 9.2 months. The objective response rate was 14.3% for tumors within previously irradiated pelvic tissues but 100% (75.0% complete remissions) for distant metastases. Anemia, anorexia, and progressive weakness were troublesome side effects, however, and they seriously limited the clinical usefulness of this bleomycin-adriamycin-cisplatin regimen in the treatment of primary advanced and recurrent cervical carcinomas.
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PMID:Bleomycin-adriamycin-cisplatin combination chemotherapy in the treatment of primary advanced and recurrent cervical carcinoma. 619 10

Among 137 patients with small cell carcinoma of the lung (SCCL) treated on two consecutive protocols, leptomeningeal metastases were documented in 12 patients (9%), 10 antemortem by cerebrospinal fluid (CSF) cytology, one by myelogram, and one only at necropsy. Signs and symptoms included confusion in seven, limb weakness in six, paresthesias in three, headache in two, urinary incontinence in two, and nausea and vomiting, diplopia and neck pain in one patient each. Nine of the 12 patients had evidence of other metastases while three patients relapsed first in the CSF and one had disease only in the leptomeninges. Treatment for this complication including irradiation, intrathecal chemotherapy, or systemic chemotherapy was generally ineffective with a median duration of survival of 50 days (range 5 to 130) after diagnosis of leptomeningeal. Necropsies showed thick tumor deposits along cord, distal nerve roots, cauda equina, and in Virchow--Robbins spaces with deep invasion into adjacent neural substance in six of the seven. Leptomeningeal involvement appears to have become manifest as median survival has increased. CSF cytology should therefore be examined in patients who develop unusual neurological findings during the course of this disease and methods of prevention may need to be considered in future studies.
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PMID:Leptomeningeal carcinomatosis in small cell carcinoma of the lung. 625 38

Naturally-occurring hyperadrenocorticism was diagnosed in an 11-year-old female Dachshund with signs of polydipsia, polyuria, pendulous abdomen, weakness, depression and lethargy, and laboratory test abnormalities comprising lymphocytopaenia, eosinopaenia, hypercholesterolaemia and increased plasma alkaline phosphatase concentration. While awaiting hormonal test results, an adrenocorticolytic drug (o,p'-DDD) was administered for 14 days, during which the patient deteriorated. Hormonal assays suggested a functioning adrenocortical tumour, but the poor condition of the patient precluded adrenalectomy. An adrenocortical carcinoma with hepatic metastases was found at necropsy.
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PMID:Functioning adrenocortical tumour in a dog. 628 91

An 11-year-old white girl was admitted to The Children's Hospital of Philadelphia in July 1983 for evaluation of metastatic tumor. She had been well until July 1982, when a mass developed over the right scapula. Treatment with warm compresses and antibiotics resulted in no improvement, and incision and drainage were unproductive. A biopsy at another hospital was interpreted as showing a primitive neuroectodermal tumor. There was no evidence of metastatic disease. She then underwent excision of the tumor with the underlying scapula. No further treatment was administered. She remained well until February 1983, when she began to complain of occasional lower back and thigh pains. Her symptoms worsened over the succeeding 3 months, despite treatment with analgesics and physical therapy. By May 1983, she was no longer able to attend school because of weakness and pain, and had sustained a 10% weight loss during the previous 2 months. She was admitted to her original hospital, where bone scan and bone marrow biopsy showed disseminated tumor; she then came to The Children's Hospital of Philadelphia. On examination, she appeared acutely and chronically ill. It was very uncomfortable for her to move, and she walked with a slow, stooped, shuffling gait. She complained of tenderness in the lower back and both sides. There were no other abnormalities on examination. The hemoglobin level was 9.7 gm/dl, following transfusion at the other hospital; white blood cell count was 6,900/mm3 with a normal differential, and the platelet count was 480,000/mm3. A 24-hr urine test for VMA excretion was normal. She underwent bone marrow aspiration and biopsy, and the radiographs and pathology slides from the other hospital were reviewed.
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PMID:Extracranial primitive neuroectodermal tumor. 632 31


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