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

The authors report two cases of differentiated carcinoma of the thyroid with pulmonary involvement showing as miliary shadowing radiologically which preceded the diagnosis of the thyroid neoplasm by 35 and 6 years respectively. The two patients had undergone cervical radiotherapy in infancy for lymphadenopathy whose aetiology had not been determined. The scintigraph with iodine 131 showed tht in two cases there was a bilateral and diffuse pulmonary uptake in keeping with pulmonary lesion of metastatic origin. Our observations recall the possibility of a slow evolution of pulmonary metastases and carcinoma of the thyroid and the role of cervical irradiation in the development of such cancers. With miliary shadowing a metastatic origin, in particular that of the thyroid, should be considered and in the majority of cases the proof could be supported using iodine 131 scintigraphy. The delay in appearance of pulmonary metastases during the course of cancer of the thyroid is variable. They occur most often after the initial diagnosis or more rarely preceding the discovery of a primary thyroid cancer. The pulmonary metastases may be asymptomatic. This neoplasm may benefit from a specific effective therapy and prolonged remissions have been described even with metastases.
Rev Mal Respir 1996
PMID:[Pulmonary metastases with a prolonged development. Two cases of thyroid cancers]. 871 Dec 38

One hundred patients operated for left atrial myxoma in the same surgical department underwent clinical and anatomical assessment at long-term from 1959 to July 1995 (66 women and 34 men, average age 52.2 years). The clinical presentation was related to mitral valve obstruction in half the cases (dyspnoea, cough, pulmonary oedema), the presentation in the other half of cases being very variable. The widespread use of echocardiography has relegated other investigations to a subsidiary role: auscultation, radiology, ECG (9 cases diagnosed by echocardiography performed for another indication). Serious complications of left atrial myxoma include systemic embolism : 37 cases out of the 100 in this series, including 10 plurifocal but mainly cerebral (19 cases including 11 isolated cerebral emboli). Surgical treatment is well established, should not be deferred and gives excellent results (2 early postoperative deaths out of 100 cases in the early years of the study). There were 6 cases of recurrences including 3 cases of Carney's syndrome. Clinico-pathological correlations showed that mitral stenotic effects occurred when the tumour diameter exceeded 5 cm and embolism was associated with tumours having multiple villositi. Histopathological analysis distinguished between active and inactive tumours, differentiated or not, and enabled the elaboration of hypotheses on the rate of growth of the tumour and on the absence of true metastases. Histopathological techniques also show the presence of lymphoplasmocytic infiltration, the sign of secretion of interleukin 6 by the myxoma, a cytokine involved in the general inflammatory process and which explains the unusual clinical presentation sometimes observed.
Arch Mal Coeur Vaiss 1996 Sep
PMID:[Myxoma of the left atrium, Clinical outcome of 100 operated patients]. 895 35

The authors report a case of leiomyosarcoma of the descending thoracic aorta presenting with dissection and operated as an emergency. Palliative repair from the oncological point of view comprised the insertion of an aorto-aortic tube. Local radiotherapy was completed by a course of chemotherapy controlling multiple bone and adrenal metastases at 15 months. A review of the literature did not reveal any other cases of haemorrhagic leiomyosarcoma of the descending thoracic aorta. Histological findings were similar to those of the reported case as were the therapeutic attitudes to limit or extinguish disseminated metastases explained by the arterial character of the tumour.
Arch Mal Coeur Vaiss 1997 Sep
PMID:[Fissured leiomyosarcoma of the descending thoracic aorta. Apropos of a case and review of the literature]. 948 80

Two cases of pulmonary artery angiosarcomas are reported. Pulmonary artery tumor was diagnosed during exploratory thoracotomy in the first case. It was suspected on magnetic resonance imaging and confirmed by surgery in the second case. The therapeutic was a right pneumonectomy for the first patient and a tumor resection followed by chemotherapy and radiotherapy on cerebral metastases for the second patient. Both our patients died, 13 and 44 months after surgery. On the basis of histological and immunohistochemical findings both tumors were angiosarcomas. Ultrastructural examination in the second case revealed an endothelial differentiation. The review of 142 previously reported cases of pulmonary artery sarcomas and these ultrastructural findings suggest that pulmonary artery sarcomas may have multiple origins; leiomyosarcomas deriving from arterial smooth muscle; angiosarcomas deriving from the endothelium and undifferentiated sarcomas or "myointimal sarcomas" deriving from myointimal cells.
Rev Mal Respir 1998 Jun
PMID:[Sarcoma of the pulmonary artery]. 967 39

Bronchial cancer associated with a homolateral malignant pleurisy is classed as T4 whether the pleural disease is a direct extension or metastatic. Effusions without neoplastic cells do not enter into the TNM classification. Investigations of pleural disease consist initially of needle biopsies, completed sometimes by a thoracoscopy, which enable a precise staging and also the achievement of a pleurodesis. A review of the literature does not currently establish the value of a pleurectomy in cases of a homolateral effusion in bronchial carcinoma. Surgical excision may be carried out in a case of neoplastic pleurisy where no pleural invasion is found without knowing the benefits in terms of survival. The inverse exists, with local or diffuse pleural invasion without pleurisy, which are difficult to evaluate by imagery techniques. Thus certain authors recommend pleural lavage during surgical operations for bronchial cancer even without pleural disease: positive cytology seems to be a poor prognostic feature and would justify adjuvant treatment. Thoracoscopy should be carried out when the neoplastic nature of a pleurisy has not been established by needle biopsy in order to evaluate the resectability of the tumour in the absence of surgical contra-indication. In the case of a disabling neoplastic pleurisy a pleurodesis carried out at the time of pleuroscopy may avoid the recurrence of the effusion. Talc is most often employed for pleurodesis but Bleomycin or Tetracycline are also used. In the case of failure to re-expand a shrunken lung the failure of the pleurodesis may lead to a pleuroperitoneal shunt. The type of homolateral pleural disease in bronchial cancer with local invasion by contiguity as against pleural metastases should appear in the TNM classification because there are different treatments and also a different prognosis.
Rev Mal Respir 1998 Jun
PMID:[Pleural effusion]. 969 Mar 6

For a long time, thoracic radiotherapy has been the standard treatment of stage III non-small cell lung cancer. Because of the low rate of cure and the high rate of metastases in this group, strategies that combine radiotherapy with chemotherapy have undergone extensive investigation during the past decade with both positive and negative results. The combined treatment can be administered either sequentially, concurrently, or in an alternating mode. Some of the randomized trials have reported a positive impact of the addition of chemotherapy to radiotherapy with a positive impact of 2 to 4 months in terms of median survival. New therapeutic strategies are needed in order to improve control of both local disease and distant metastases. Improved local control could be achieved with higher radiation doses, conformal radiotherapy, altered fractionation schedules and possibly adjuvant surgery. Control of extrathoracic micrometastases may be improved with new combined modality strategies and new drugs. Increased toxic effects of these combined modality treatments should not diminish the expected therapeutic efficacy.
Rev Mal Respir 1998 Jun
PMID:[Radiotherapy in a multidisciplinary approach]. 969 Mar 11

The tumour biology of non-small cell bronchial cancer integrates recent developments and a dynamic schema of the phenomena of tumour progression and diffusion of the metastatic disease. There is no leap of known biological disruption between Stage II and Stage III. The latter is defined by anatomical criteria and is a transition in the continuum of the natural history of these cancers. The moto for the tumour progression is the genotypic instability and phenotypic diversification. Metastatic microscopic disease constitutes the first cause of failure in the treatment of Stage III non-small cell bronchial cancer. Among prognostic factors for survival emphasis is placed on the alterations of p53 expression, different types of aneuploidy, anomalies of the expression of cellular adhesion molecules and finally, tumour diversification towards a metastatic phenotype.
Rev Mal Respir 1998 Jun
PMID:[Biological perspectives]. 969 Mar 13

The authors report the case of a right atrial angiosarcoma extending to the right ventricle, presenting with a massive pericardial effusion, in a 30 year old man. The patient underwent surgical ablation of the tumour with right atrial reconstruction, tricuspid valvuloplasty, plicature of the right ventricle and a right coronary artery bypass graft with complementary chemotherapy. This case illustrates the decisive contribution of multiplane transoesophageal echocardiography in the preoperative investigation, providing accurate information about the site and extension of the tumour, and even about the malignant character of the pathology. Magnetic resonance imaging, though useful, did not provide any further information in this case. Unfortunately, thoracic CT scan, performed 15 days after surgery, showed the presence of pulmonary metastases, confirming the very poor prognosis of these tumours.
Arch Mal Coeur Vaiss 1998 Oct
PMID:[Multi-plane transesophageal echocardiography in cardiac angiosarcoma. Apropos of a case]. 983 95

We report the case of a young woman initially treated with surgery, radiotherapy, chemotherapy and BCG therapy for stage II malignant melanoma involving the limbs. Considering that the risk of metastasis is usually maximal between 2 and 5 years after initial treatment, metastatic dissemination of this melanoma was rather unusual. Metastases were observed locally, regionally, and in the lungs 8, 10 and 12 years respectively after the primary diagnosis. Repeat surgery was performed to resect pulmonary nodules. Such surgery is possible in less than 10% of the cases of metastatic melanoma. Our patient has survived without relapse for 21 years after the initial diagnosis and 8 years after the last tumor excision. Recurrent pulmonary metastasis without extrapulmonary dissemination would suggest the tumor cell population was composed of a particular metastatic phenotype.
Rev Mal Respir 1999 Apr
PMID:[Long-term survival of a patient with melanoma with late recurrence of pulmonary metastasis treated by repeat surgery]. 1033 64

The authors report the case of a 70 year old man with a past history of nucleation of the left eye thirty years previously, in whom two masses, one in the right atrium and the other in the left ventricle, were chance findings on transthoracic echocardiography. After surgery, during which the right atrial tumour was removed and the left ventricular tumour biopsied, histology confirmed the malignant melanomatous nature of the tumours. Further investigations did not detect a primary tumour or other secondary ones. The choroidal origin of these metastases cannot be excluded. After 5 years follow-up, the patient remains in good general condition and the tumours have not recurred or progressed. The literature is reviewed with reference to this case report.
Arch Mal Coeur Vaiss 2000 Nov
PMID:[Intracardiac metastasis of malignant melanoma. Literature review and case report]. 1119 Apr 62


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