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)

Hepatomegaly and abnormal liver function can occur in nonmetastatic malignancies. A patient with metastatic prostatic adenocarcinoma that had spared the liver and extrahepatic biliary tree is described. He had puzzling episodes of jaundice for a period of 2 1/2 years. The results of appropriate investigations and an exploratory laparotomy performed dlring the patient's four antemortem hospitalizations were indicative of "recurrent intrahepatic cholestasis," the cause of which remained an enigma even after exploratory laparotomy. At autopsy, no evidence of hepatic metastases or extrahepatic biliary obstruction was found. Alcohol, hepatotoxic drugs, toxins, viral and chronic active hepatitis, hemolysis, and extrahepatic biliary obstruction were eliminated as causes of the jaundice. We believe that the intermittent intrahepatic cholestasis is one of the nonmetastatic manifestations (nonmetastatic hepatopathy of malignancy) of the prostatic adenocarcinoma.
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PMID:Intermittent cholestatic jaundice and nonmetastatic prostatic carcinoma. 92 51

RESULTS. Four patients with metastasizing epithelioid leiomyosarcoma of the stomach, three females and one male (15, 20, 22, and 25 years of age, respectively), are reported. Two patients had recurrent tumors in the gastric remnant. Liver metastases occurred in all patients, three of whom had lymph node metastases; two had peritoneal metastases. The patients are alive at 17, 19, 27 and 48 years after the diagnosis was made and 17-27 years after the first demonstration of metastases. One woman had multiple chondromatous hamartomas of the lung. Operations were performed when the patients had symptoms and during periods of no symptoms, as directed by the second-look principle. One patient had 10 operations. None of the patients received adjuvant therapy. All three women have given birth to healthy children after metastases were diagnosed. Three of the primary tumors were large (10-20 cm) and multinodular, features that have been associated with unfavorable prognosis. The four primary tumors had a similar light microscopic appearance, characterized by moderate cell and nuclear pleomorphism and low mitotic activity, 0.03-0.1/mm2. Ultrastructurally, a network of intermediate filaments was found within the cytoplasm of the tumor cells corresponding to the immunohistochemical positivity for vimentin. The immunohistochemical findings (negative immunoreaction for desmin and alpha smooth-muscle actin) and the ultrastructural analysis produced no evidence of the production of smooth-muscle cell myofilaments. However, there were tumor cells with an abundance of mitochondria and a paucity of filaments, features that may be characteristic of epithelioid leiomyomatous tumors. In addition, immunohistochemical negativity for cytokeratins, epithelial membrane antigen, S-100 protein, neuron-specific enolase, and chromogranin militate against an epithelial or neuroectodermal cell differentiation. CONCLUSIONS. An awareness of this type of gastric leiomyosarcoma in children and young adults is of importance in making correct assessments of prognosis and choosing an active therapeutic approach. The biologic background to the clinical behavior of these metastasizing tumors remains an enigma. Additional studies are needed to elucidate the biology of these tumors.
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PMID:Metastasizing gastric epithelioid leiomyosarcomas (leiomyoblastomas) in young individuals with long-term survival. 164 4

Rectal carcinoma remains an enigma to surgical and medical oncologists. The chemo- and radiotherapeutic approaches have been fraught with failure, and when this happens the patient is left to the challenge of the surgical oncologist who sometimes must perform extensive re-resection to include adjacent structures. Experienced surgical judgement is assisted by preoperative and intraoperative criteria, which are contraindications to resection: preoperatively, they include metastases, fixation of tumour to pelvic wall, sciatica, obstruction of both ureters and leg edema. Intraoperatively, metastases within aortic nodes or beyond the pelvis and extension of disease laterally or deep to pelvic wall or to multiple loops of bowel are all contraindications. These tumours are often slow to metastasize so that aggressive local surgical resection is warranted to minimize the morbidity prone complications associated with low-lying perineal or pelvic recurrence of rectal cancer.
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PMID:The management of recurrent rectal carcinoma. 241 73

Lung metastases, which are an expression of the new phase of the underlying neoplastic disorder, have been treated in the recent years by multiple disciplinary approach. When the metastases to the lungs are multiple, it is indicative of extensive tumor burden, and the organ plays an insignificant role in the distribution of the metastases in the different lobes of the lungs. However, when the pulmonary metastases appear after a prolonged disease-free interval it becomes an enigma; when the metastases are solitary, the majority (over 80% in this series) are located in the upper zone of the lungs. This study of 28 patients with solitary lung metastases explores the possible etiology of this clinical observation and proposes that the pattern of perfusion and anatomopathological features of the upper lobes are the main reasons why these lobes are prevalently the sites for solitary lung metastases.
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PMID:Solitary pulmonary metastasis: an enigma. 356 Sep 57

Pain intensity and the importance of pain for the cancer patient depend on a variety of individual factors and show considerable divergence (Bonica and Ventafridda 1979). They are greatly influenced by the enigma of the cancer disease as well as the consequential psychiatric problems (Frey 1980). An effective neurological analysis of the cancer pain, although demanding for the physician, is important for further specific diagnostic procedures and for the indication of appropriate therapy. Sometimes thorough neurological examination can lead to the first diagnosis of the carcinoma; when there is already evidence of metastases, the unfavorable prognosis can be made at the same time.
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PMID:Analysis of cancer pain by the neurologist. 669 6

Kaposi's sarcoma (KS) is an unusual neoplasm that has proved to be an enigma in many ways since its original description by Kaposi in 1872. Its epidemiology has stimulated tremendous interest, amplified markedly in 1981 when it became known as an original defining part of the complex of immune disorders now known as AIDS. The cell of origin, etiology, and therapy for both AIDS-associated and AIDS-unassociated KS continue as matters of intense investigation. In fact, whether it is a reactive hyperplasia or a true malignancy is still a matter of debate, as is the concept of multicentricity versus metastases. Epidemiologic studies suggest that a separate agent apart from HIV-1 may cause KS. A newly postulated KS-associated herpes virus may be linked. The role of the HIV-1 tat gene product, basic fibroblast growth factor, scatter factor, oncostatin M, and other factors that regulate the growth of KS cells are discussed, as well as therapeutic options.
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PMID:Kaposi's sarcoma: advances and perspectives. 863 78

Local tumor recurrence after complete resection may be due to treatment factors or represent a manifestation of tumor biology. The association of local tumor recurrence, distant metastases, and death in patients undergoing treatment for extremity soft tissue sarcoma (STS) has been described but continues to be enigmatic. After definitive multimodality treatment for extremity STS, local tumor recurrence is associated with development of distant metastasis, and metastases are implicated in subsequent disease-specific death. The relationship is an enigma, and the causality is unclear. Conversely, for patients with retroperitoneal STS, a direct relationship between local tumor recurrence and disease-specific death has been shown. In this article, current concepts are analyzed and reviewed.
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PMID:The biological significance of failure at the primary site on ultimate survival in soft tissue sarcoma. 1051 84

Electrophysiological studies in gliomas have demonstrated action potentials in neoplastic cells. These "spiking tumor cells" are, however, an enigma. In attempt to find evidences for spikes within tumoral borders, 21 patients with different intracerebral tumors were preoperatively screened for the occurrence of epileptogenic discharges using multichannel MEG and EEG. A correlation between histopathology and the distance between dipole and tumor border could be found. Glioma patients showed epileptic activities closer to the border than those with mixed glioneuronal neoplasms and metastases. Four glioma patients demonstrated epileptic activity within the tumor boundary, however, not in the deep center of the tumor. Patch-clamping of cells from acute glioma slices did not yield a correlation between the presence of voltage-gated sodium channels in tumor cells and the MEG/EEG data. Our results demonstrate that the zone with the highest epileptogenic potential is different in gliomas and other brain tumors. However, our data do not strongly suggest that glioma cells are directly involved in the generation of tumor-associated epilepsy in vivo via their capability to generate action potentials.
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PMID:Source localization and possible causes of interictal epileptic activity in tumor-associated epilepsy. 1096 98

Malignant endocrine disorders have been an enigma over the last few decades, from genetic, clinical, and imaging perspectives. The detection of the primary tumor and the identification of recurrent disease have been essentially based on various anatomic techniques, with localization procedures extensively developed for staging, follow-up, radio-guided surgery, and therapy. Frequently, the lesions are too small to cause anatomic alterations, or they are obscured by the changes in anatomic planes that occur after initial surgery. Small lesions, however, are the ones that can potentially be cured. Thus, every attempt should be made to localize these sites before further growth and dissemination occur beyond the scope of cure. Since the advent of iodine-131 for staging and follow-up of patients with differentiated thyroid carcinoma, the search has led to the use of radioiodinated metaiodobenzylguanidine (MIBG) for recurrent pheochromocytoma and neuroblastoma, to the development of antibodies to carcinoembryonic antigen for the staging and treatment of medullary thyroid carcinoma, and to the characterization of peptide receptors on neuroendocrine tumors. Additionally, there has been a breakthrough with the use of positron emitters in nuclear oncology, including F-18-fluorodeoxyglucose, for I-131-negative metastases of differentiated thyroid carcinoma, recurrent medullary thyroid carcinoma, malignant pheochromocytoma, and adrenocortical carcinoma. Undoubtedly, optimal care of the patient requires both the expertise of the treating endocrinologist and the use of various imaging techniques in the diagnosis, staging, and follow-up of these diseases.
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PMID:Nuclear endocrinology as a monitoring tool. 1143 May 30

The aim of this paper is to explore current trends in the diagnosis, investigation and treatment of patients presenting with axillary lymph node metastases without a primary in the breast being found and, more rarely, those cases with metastatic breast cancer where the primary remains unknown--the so-called, 'occult' breast cancer. A retrospective study of 25 reported cases were selected from our database at the Royal Marsden and 6 patients were found to have true 'occult' breast cancer. These 6 patients are all still alive with no primary ever having been found in the breast. A literature review was then undertaken exploring the changing trends in this diagnostic enigma. MRI scanning, it is reported, may reveal the primary. Occult cancers in which imaging totally fails to show the primary will become increasingly rare. The prognosis of these, however, may be surprisingly better than one would expect from the nature of their presentation.
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PMID:'Occult' breast cancer. 1177 39


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