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)

Metastasis of prostate cancer to the parotid gland is exceedingly rare, with only 4 cases reported in the literature. We present the case of an 83-year-old white man who had a painless parotid mass that was diagnosed as metastatic prostate cancer. Immunohistochemical staining with prostate-specific antigen was positive. This is the first case of prostate cancer presenting with a painless parotid mass. Prostate cancer can be metastatic to the head and neck region, and this should be kept in mind when treating patients with this disease.
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PMID:Prostatic carcinoma presenting with painless parotid mass. 754 35

We report a total of 169 serial bone scan studies conducted in 21 patients with histologically proven metastatic cancer of the prostate. Aim of the study was to investigate the concordance of findings on bone scans with serum acid phosphate (AP) levels and the clinical performance status (CPS) of the patients, and to see how important bone scan is by itself in determining the metastatic progression in the follow-up. Eighty-seven and 86% of scans demonstrated changes concordant with AP and CPS levels subsequently. It was also found that 100% of the progressions on bone scans along with elevated levels of AP had been confirmed as metastatic progression, whereas only 41% of progressions on bone scans solely had been shown to be metastases in the follow-up investigations. Findings on bone scans not in correlation with clinical findings and serum AP levels are mostly misleading. Use of bone scans in conjunction with serum AP levels and most probably with prostate-specific antigen and CPS is the most reliable and therefore treatment modality changes should not be based on bone scans only.
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PMID:How significant are serial bone scans in monitoring advanced prostatic cancer? 761 75

The factors that determine tumor aggressiveness are multifactorial: age, stage, and grade. Even a well differentiated tumor in a young patient may be aggressive someday because of genetic drift and tumor heterogeneity. In a recent review of 826 favorably selected cases managed with conservative therapy, metastatic disease had developed in 19% with grade I tumors, 42% with grade II, and 74% with grade III at 10 years. Recognizing that < 20% of men present with grade I disease, most prostate cancers are a threat to life in men who are going to live longer than 10 years. On the other hand, some tumors at presentation are too far advanced to cure. To improve the accuracy of preoperative staging in identifying these cases, we have developed nomograms based upon clinical stage, grade, and serum prostate-specific antigen (PSA). Traditionally, patients with high-grade tumors (Gleason 8-10) were never considered candidates for radical prostatectomy because of their poor expectancy for long-term survival. However, with improvements in the staging of prostate cancer and with a reduction in the morbidity of radical prostatectomy, a subset of these patients are potential candidates for curative therapy. We have recently studied the clinical outcome of 72 men with Gleason scores of 8-10 on needle biopsies who presented with clinically localized disease (9 T1c, 22 T2a, 17 T2b, 13 T2c, and 11 T3a). Of the 63 men who underwent radical prostatectomy, 46 (68%) had negative lymph nodes; nine did not undergo surgery because of positive lymph nodes identified from frozen section. The actuarial likelihood of an undetectable serum PSA at 5 years was 43% for men with negative lymph nodes and 45% for men with organ-confined disease. Thus, with proper evaluation, some men with even the most aggressive tumors can be cured by surgery if their pelvic lymph nodes are negative.
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PMID:Can aggressive prostatic carcinomas be identified and can their natural history be altered by treatment? 765 23

The prostate-specific membrane antigen (PSMA) glycoprotein is recognized by the monoclonal antibody (MAb) 7E11-C5.3 as a predominant 100 kDa and minor 180 kDa component in LNCaP cell line extracts and its expression has been shown by immunohistochemistry to be highly restricted to prostate epithelium. The aim of the present study was to utilize Western blot analysis to determine if PSMA could be detected in human tissue extracts and body fluids and if so, which molecular forms were present. PSMA was detected as 120 and 200 kDa bands in normal, benign and malignant prostate tissues and seminal plasma. Further analysis demonstrated that the larger molecular form of PSMA may be a dimer of the lower m.w. species. The PSMA glycoprotein was not detected in the majority of non-prostate tissue extracts examined except for a low yet significant amount in normal salivary gland, brain and small intestine, suggesting that PSMA may not be as prostate-specific as originally thought. Since the prostate-specific antigen (PSA) has been shown to be maximally shed into the serum in high-grade and metastatic prostate carcinomas, it was surprising that PSMA could not be detected in serum by Western blot analysis even in patients with actively progressive metastatic disease. Second generation antibodies generated against different epitopes may be required to determine if PSMA is shed into serum. Our results support the hypothesis that PSMA is a novel prostate biomarker.
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PMID:Detection and characterization of the prostate-specific membrane antigen (PSMA) in tissue extracts and body fluids. 766 26

Curative radical therapy for prostate cancer depends on accurate diagnosis of metastatic spread to pelvic lymph nodes. The authors measured prostate-specific antigen (PSA) levels in homogenized pelvic lymph nodes to determine the antigen's diagnostic value and its correlation with histologic findings. No PSA was detectable in the lymph nodes of either women or of men without prostate cancer. A dilution of prostate cancer tissue with nodal tissue showed that PSA is detectable in this assay to a concentration of 1:100,000. In 38 patients who underwent pelvic lymph node dissection for staging stage B prostate cancer the histologic findings were correlated with PSA content. All nine patients with histologic evidence of metastatic disease had measurable PSA in their nodes. Of the 29 patients with no histologic evidence of metastatic disease, 23 had no detectable PSA in their nodes. The six patients with negative histologic findings and positive findings for PSA had no progression of disease at 18-month follow-up. The authors conclude that the measurement of PSA in pelvic lymph nodes can add substantial information to that obtained by standard histologic examination.
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PMID:The value of prostate-specific antigen levels in pelvic lymph nodes for diagnosing metastatic spread of prostate cancer. 768 Feb 71

NK cell activity was measured in 24 patients with untreated prostate cancer (11 subjects with localized disease, D0, and 13 patients with stage D tumor) and 10 healthy controls. In these same subjects serum prostate-specific antigen (PSA), prostatic acid phosphatase (PAP), testosterone, prolactin and cortisol concentrations were assessed. The data obtained were correlated with both tumor spread (localized vs disseminated disease) and grade (well-differentiated cancer, G1, vs moderately and poorly differentiated carcinoma, G2 and G3). In patients with stage D0 cancer mean NK activity (33.0 +/- 10.6) was virtually identical with the mean value recorded in healthy men (34.5 +/- 7.1), while in subjects with stage D1-D2 disease NK activity was significantly reduced (11.9 +/- 7.1). These findings correspond with our data on treated subjects, in whom NK activity level was found to correlate well with the presence of tumor cells in the circulation. In subjects free of malignant tumors but with a chronic disease (diabetes, arthritis, severe rheumatic disorders) mean NK activity was clearly reduced (5.7 +/- 1.5). The use of NK activity data as a probe for tumor metastases was found to be statistically as reliable as was the application of the PSA serotest (but not serum PAP concentrations). None of the measured hormonal parameters correlated well with tumor stage. Both testosterone and prolactin serum concentrations were found to be lower in the G2 and G3 cancer group than in well-differentiated (G1) tumors, in accordance with the published literature.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Comparison between NK cell activity and prostate cancer stage and grade in untreated patients: correlation with tumor markers and hormonal serotest data. 768 Dec 42

A 66-year-old man presented with a mass just behind the lower part of the left ear. A biopsy showed a moderately differentiated adenocarcinoma that was prostate-specific antigen (PSA)- and prostate-specific acid phosphatase (PSAP)-positive. This finding suggested a metastasis of a prostatic carcinoma. Extensive clinical and radiographical examination revealed no primary prostatic carcinoma or other metastases and serum levels of PSAP and PSA were not elevated. The reliability of the PSA and PSAP staining was studied in a series of 25 adenocarcinomas of various primary sites in females and in 26 salivary gland tumors in both males and females, because a primary adenocarcinoma of salivary gland seemed another possibility in this case. As expected, there was no immunoreactivity for PSA and PSAP in the adenocarcinomas from females, but 6 of 11 pleomorphic adenomas, 0 of 4 monomorphic adenomas, 1 of 6 mucoepidermoid carcinomas, and 1 of 2 adenocarcinomas not otherwise specified (NOS) of the salivary gland showed at least focal staining of both PSA and PSAP. The conclusion was that the patient had a primary salivary gland adenocarcinoma NOS. In males with PSA- and PSAP-positive adenocarcinoma without signs of primary prostatic carcinoma, a salivary gland origin should be considered.
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PMID:Prostate marker immunoreactivity in salivary gland neoplasms. A rare pitfall in immunohistochemistry. 750 3

Serial serum prostate-specific antigen (PSA) levels were analyzed retrospectively for prognostic implications in 70 patients with locoregional (Stages B2, C, and D1) prostate cancer who were managed with high energy neutron beam therapy. Three groups of patients were identified. Group I included 30 patients whose serum PSA level decreased to the reference range (0-4 ng/mL) following neutron therapy and remained so subsequently: 28 (93%) remained disease-free and 2 (7%) have failed distantly. All 30 patients (100%) had no evidence of locally progressive disease. This group was categorized as having a good prognosis. The mean time for serum PSA value to decline to reference range was six months; calculated mean time to achieve a stable base-line PSA was 53 +/- 37 days. Follow-up period ranged from twelve to fifty-six months (median: 21 months). Group II consisted of 13 patients in whom there was an initial decrease in serum PSA to reference range followed by a subsequent increase: 6 of 13 (46%) have no overt clinical progression of disease; 7 (54%) have either persistent locoregional or distant metastatic disease. Follow-up period was from twelve to seventy-two months (median: 39 months). Calculated mean time to achieve stable baseline PSA for serum PSA in this group was 61 +/- 21 days. Group III patients had a persistently elevated or rising serum PSA concentration. Of 27 patients in this group, only 9 (33%) have no evidence of disease progression, while 18 patients (67%) have failed already, either locoregionally or distantly. Follow-up period ranged from twelve to sixty-nine months (median: 21 months). Mean time to achieve stable baseline of serum PSA in this cohort of patients with a poor prognosis was 108 +/- 76 days. We conclude that PSA has a predictable prognostic value in patients with locally advanced prostate cancer managed with high energy neutron beam therapy. Rapid normalization of PSA after therapy indicates a good prognosis. Persistent elevation signifies either presence of persistent locoregional disease or development of distant metastases. Subsequent elevation of the serum PSA concentration after definitive therapy signals progression of prostate cancer.
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PMID:Prognostic implications of prostate-specific antigen in patients with locally advanced prostate cancer treated with high energy neutron beam therapy: preliminary results. 768 57

We report a case of primary renal carcinoid, which is a very rare neoplasm: to our knowledge, only 19 cases have been previously reported. The tumor displayed histologic features typical of carcinoid tumors from other sites, including growth in nests and ribbons, uniform cells with finely granular, eosinophilic cytoplasm, and stippled chromatin. Electron microscopy confirmed the presence of membrane-bound dense-core granules. Immunohistochemical analysis revealed staining for chromogranin A, neuron-specific enolase, Leu-7, and synaptophysin, as well as pancreatic polypeptide. An interesting finding was the positive staining for prostatic acid phosphatase, while staining for prostate-specific antigen was negative. Although prostatic acid phosphatase is commonly seen in primary gastrointestinal hindgut carcinoids, in this case a primary hindgut carcinoid was ruled out by clinical examination and endoscopy. The patient developed metastases to the liver, but was well and without symptoms 15 months after diagnosis.
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PMID:Primary renal carcinoid. Case report and literature review. 768 15

Changes in prostate-specific antigen (PSA), used to estimate PSA doubling times, may reflect prostate cancer growth. To determine if PSA doubling time prior to diagnosis predicted outcome in men with prostate cancer, we evaluated 16 men with prostate cancer who had (1) serial PSA determinations (mean 9.9) on frozen sera from twelve to twenty-six years before diagnosis; (2) at least five years of follow-up in those subjects without metastatic disease (range 5.5-12.3 years); and (3) archival material from diagnosis available for pathologic evaluation. PSA doubling time prior to diagnosis was investigated with relation to patient outcome (regardless of treatment) and the known predictors of tumor behavior, Gleason score and nuclear morphometry. In 5 of 16 men who had evidence of metastatic disease at diagnosis, metastasis developed or they died of prostate cancer during follow-up (group 1). Eleven of 16 had no evidence of metastatic disease during follow-up (group 2). Both Gleason score and variance of nuclear roundness (VNR) were significantly greater for group 1 (p < 0.05). There was no significant difference between the two groups with respect to PSA doubling time, and the PSA level at diagnosis did not correlate with the development of metastatic disease. One of 5 men with no PSA level greater than 4.0 ng/mL prior to diagnosis died within two years of diagnosis. These data suggest that (1) a normal PSA at diagnosis does not exclude an aggressive cancer, and (2) changes in PSA that occur before the diagnosis of prostate cancer may not always predict outcome. Since PSA level is influenced by tumor grade, an inability to correct PSA for tumor grade could have influenced the results.
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PMID:Relationship between changes in prostate-specific antigen and prognosis of prostate cancer. 769 58


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