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)

We report the unique case of a large, nonmetastasizing bronchial carcinoid tumor that arose within an intralobar bronchopulmonary sequestration in a 45-year-old man. The vascular supply to the sequestrated area within the left lower lobe as well as to the carcinoid tumor originated from atypical branches of the left gastric artery and the thoracic aorta. A left lower lobe lobectomy was performed. Histologically, a typical carcinoid tumor without lymph node metastases was found (T2 N0 M0). Seven years postoperatively, the patient is without signs of recurrence.
J Thorac Cardiovasc Surg 1985 Jul
PMID:Bronchial carcinoid arising in intralobar bronchopulmonary sequestration with vascular supply from the left gastric artery. Case report. 298 19

Fifty-one cases of small cell carcinoma of the lung were studied by electron microscopy in order to determine if ultrastructural subsets could be found and if these subsets predicted clinical behavior. All of these cases were considered bona fide small cell carcinoma of the lung by light microscopy. Tumors with ultrastructural features of epithelial differentiation were defined by the presence of well-formed, classic desmosomes joining adjacent cells and by additional features of squamous or glandular differentiation. Thirty-one tumors (60%) were considered "typical oat cell" by electron microscopy and 20 (40%) showed features of epithelial differentiation. Fifteen (75%) tumors with epithelial features were considered operable and nine (45%) were resected with curative intent. In contrast, 26 (84%) tumors considered typical oat cell by electron microscopy presented with extensive metastatic disease. The cancer-free 5-year actuarial survival rate of patients whose tumors showed features of epithelial differentiation was 25%. The actuarial survival rate of nine patients who underwent resection of tumors with epithelial features was 38% at 5 years. Only one patient whose tumor was considered typical of oat cell carcinoma by electron microscopy survived 5 years. Our current recommendation is to remove all clinically resectable pulmonary neoplasms with the expectation that these localized small cell tumors are likely to show epithelial features by electron microscopic analysis.
J Thorac Cardiovasc Surg 1985 Sep
PMID:Electron microscopy in selection of patients with small cell carcinoma of the lung for medical versus surgical therapy. 299 56

Malignant fibrous histiocytoma is a rare, although increasingly recognized, deep-seated pleomorphic sarcoma. A primitive tumor, it arises from tissue histiocytes and typically occurs in the extremities. Primary intrathoracic tumors have been reported rarely. The presentation of malignant fibrous histiocytoma in our series of seven patients has been varied. Two cases presented as solitary primary intrapulmonary tumors, two as primary chest wall tumors, one as an anterior mediastinal mass, one as a retroperitoneal tumor extending cephalad through the diaphragm, and one as a late metastasis from a primary pelvic site. Malignant fibrous histiocytoma is aggressive, with a propensity for early local and distant spread; three of the patients in our series died of progressive disease within 17 months of operation. The histologic nature of the tumor makes diagnosis on small biopsy specimens difficult and frequently misleading. We would suggest a policy of open biopsy to obtain adequate and representative specimens for histologic study and preoperative computed tomographic scanning to augment the clinical search for metastatic disease and to facilitate planning of subsequent radical, excisional operation. The preoperative use of deep x-ray therapy or the newer chemotherapeutic agents may reduce tumor bulk and thereby facilitate radical operation, which presently appears to be the most appropriate primary modality of treatment of malignant fibrous histiocytoma.
J Thorac Cardiovasc Surg 1986 Feb
PMID:Malignant fibrous histiocytoma in thoracic surgical practice. 300 63

Thirty-four consecutive patients with non-small cell lung cancer plus N1 nodal metastases (eight with T1 N1 M0 and 26 with T2 N1 M0) were retrospectively reviewed. Nineteen had adenocarcinoma, 11 had squamous disease, and four had large cell carcinoma. Eleven patients had surgical resection alone (32.3%), with a median survival of 13 months. Seven patients (20.6%) had resection followed by radiation therapy, with a median survival of 19.2 months. Sixteen patients (47.1%) had resection followed by radiation therapy and chemotherapy, consisting of cyclophosphamide, doxorubicin, methotrexate, and procarbazine. Median survival for the latter group was 45.5 months, significantly greater than for those treated with resection alone (p less than 0.005). We did not observe any relationship between survival and age, cell type, number or location of diseased hilar nodes, distance of tumor from the resected bronchial margin, tumor size, the presence or absence of visceral pleural involvement, or the type of resection performed. Resection in combination with adjuvant radiation therapy and chemotherapy offers improved median survival over resection alone in patients with T1 N1 M0 and T2 N1 M0 non-small cell lung cancer.
J Thorac Cardiovasc Surg 1986 Mar
PMID:The role of adjuvant therapy after resection of T1 N1 M0 and T2 N1 M0 non-small cell lung cancer. 300 76

This review includes the initial experience with NMR imaging of the liver, spleen, and pancreas at the University of California, San Francisco, using a prototype 0.35 Tesla system. This experience shows great promise for detection of hepatic metastases using T1-weighted pulse sequences. T2-weighted pulse sequences appear sensitive for detecting cavernous hemangioma of the liver and may allow tissue specific discrimination of the benign lesion from cancer. NMR is also suitable for evaluating diffuse metabolic alterations and is sensitive and specific for the diagnosis of iron overload. Detection of fatty liver requires use of chemical shift techniques as conventional NMR imaging pulse sequences are relatively insensitive. Motion artifacts and lack of an effective bowel contrast agent limits imaging of the pancreas and retroperitoneum, where CT remains the procedure of choice. The normal spleen has longer T1 and T2 relaxation times than liver or pancreas and NMR has not been successful in diagnosing splenic metastases or lymphoma on a routine basis. We conclude that NMR imaging will be valuable in the diagnosis of focal liver disorders; until fast scan techniques and effective magnetic contrast agents are available for oral and/or intravenous use, other abdominal applications will remain limited.
Cardiovasc Intervent Radiol 1986
PMID:Nuclear magnetic resonance of the liver, spleen, and pancreas. 300 15

Extended resection was performed for primary lung cancer (stage III) on 49 patients in 1973-1982. Their mean age was 61 (38-76) years. In addition to pneumonectomy (29) or lobectomy (20), surgery included resection of the thoracic wall (8 cases) left atrium (12), pericardium (15), parietal pleura (13) and oesophagus (1 case). Among the 47 "surgical survivors" (96%), the mean survival time was 19.9 +/- SD 20.3 months, and only four patients (9%) were alive after 5 years or more. The cumulative 5-year survival was 14% (4/29 patients). Poorly differentiated tumour forms (squamous cell cancer) carried the worst prognosis, whereas the type of resection and presence or absence of lymph-node metastases did not per se influence survival. The prognosis in extended resection is poorer than in standard lung resection, but superior to that in simple exploration. The surgeon therefore should always be prepared to extend a planned resection when a patient on the operating table is found to have extension of lung cancer to other intrathoracic organs, since only in invasion of the chest wall is the surgical strategy as a rule clear from the outset.
Scand J Thorac Cardiovasc Surg 1987
PMID:Extended intrathoracic resection for lung cancer. Follow-up of 49 cases. 303 10

Ivalon (polyvinyl alcohol) is a commonly used embolic agent, generally considered to be permanent. In a patient with the carcinoid syndrome, embolization of hepatic metastases with Ivalon failed to produce permanent occlusion, and recurrent tumor was supplied by many of the same small arteries identified on the original arteriogram. Occasionally, Ivalon may have only a temporary occlusive effect. A possible explanation for this phenomenon is proposed.
Cardiovasc Intervent Radiol 1987
PMID:Failure of Ivalon to provide permanent hepatic arterial occlusion. 310 22

In five patients solitary pulmonary lesions were detected radiographically during routine follow up after malignant melanoma. Surgical removal was done in each case under the tentative diagnosis of metastases. Histologically, two lesions turned out as benign chondroma, one as organized pulmonary infarction and one as bronchogenic carcinoma. Only in one patient was a melanoma metastasis present. The findings underline the usefulness also in malignant melanoma of a surgical approach in suspected solitary pulmonary metastases.
Thorac Cardiovasc Surg 1988 Aug
PMID:Solitary coin lesion in patients with malignant melanoma: an indication for thoracotomy? 318 85

Patients who are considered for major pulmonary resection are normally evaluated by spirometry and clinical assessment. Despite this, the morbidity and mortality rates are high after these operations. We retrospectively reviewed results of lung resection performed during a period of 7.5 years in 237 patients to identify other important predictors of morbidity and mortality. There were 144 male and 93 female patients with a mean age of 59.4 +/- 11.4 years. The indication for operation was lung cancer in 199 (76 stage I, 34 stage II, 89 stage IIIA-B), benign disease in 34, and metastatic disease from other primary tumors in four. Lobectomy or bilobectomy was performed in 164 patients and pneumonectomy in 73. Data on 38 preoperative and operative risk factors were correlated with information on 24 postoperative events grouped into four major categories: death, pulmonary complications, cardiovascular complications, and other problems. Logistic regression analysis and chi 2 analysis were used to identify the relationship of the preoperative risk factors to the grouped postoperative complications. The diffusing capacity of the lung for carbon monoxide was the most important predictor of mortality (p less 0.01) and was the sole predictor of postoperative pulmonary complications (p less than 0.005). This diffusing capacity can reveal the existence of emphysematous changes in the lung, even when spirometric values are acceptable, and it usually should be a part of the evaluation of patients being considered for pulmonary resection.
J Thorac Cardiovasc Surg 1988 Dec
PMID:Diffusing capacity predicts morbidity and mortality after pulmonary resection. 319 1

All 205 patients operated on for primary pulmonary cancer at Oulu University Hospital in 1975-1977 were followed up for 10 years to evaluate the prognostic influence of factors such as lymph-node invasion, size of tumour and histologic type. Preoperative mediastinoscopy was performed on 186 patients (91.2%), and revealed no mediastinal metastases in 182. Nevertheless N 2 (mediastinal) lymph nodes were found in 36 cases at operation and N 1 (perihilar or ipsilateral) nodes in 42. Despite lobectomy or pneumonectomy, all 32 patients (17.2%) with false-negative mediastinoscopy died within a year (mean 7.2 months) of operation. Pneumonectomy was performed in 67 cases (29 right, 38 left), lobectomy or bilobectomy in 125 and exploratory thoracotomy in the remainder. Most of the tumours were epidermoid carcinoma (53.7%). Adenocarcinoma was present in 20%, and large-cell carcinoma and oat-cell carcinoma each in 11.7%. Survival rates were significantly higher in patients without vs. those with lymph-node metastases and in epidermoid or adenocarcinoma vs. small-cell carcinoma.
Scand J Thorac Cardiovasc Surg 1988
PMID:Survival after surgical treatment of lung cancer. 322 27


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