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)

Calcitonin determination is of central importance in the diagnosis and follow-up of medullary thyroid carcinoma. Stimulation tests must be applied, particularly for early recognition of familial medullary thyroid carcinomas and for early diagnosis of relapses/metastases, since the basal calcitonin levels are still within the normal range initially. The pentagastrin stimulation test has proven to be the most effective one, though it is associated with considerable adverse effects. TRH is also able to stimulate calcitonin secretion in medullary thyroid carcinoma. The present study examines the value of TRH stimulation compared with pentagastrin stimulation in patients with occult or manifest metastases of medullary thyroid carcinoma. Both patients with occult metastases displayed a marked calcitonin increase after pentagastrin stimulation, but not after TRH stimulation. While calcitonin increased after pentagastrin in the two patients with manifest metastases, TRH produced a clear rise in only one of them and even caused the serum calcitonin concentration to drop continuously in the other one. Thus, TRH cannot be regarded as a reliable calcitonin stimulant in medullary thyroid carcinoma.
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PMID:Is thyrotropin-releasing hormone as reliable a calcitonin stimulant as pentagastrin in medullary thyroid carcinoma? 211 16

Hypercalcemia is a common metabolic problem in patients with metastatic breast cancer. Osteolytic bone destruction with release of calcium into circulation and humoral factors can lead to hypercalcemia. Clinical manifestations may be so mild as to be overlooked or include severe nervous system, gastrointestinal and renovascular complications. Treatment with saline infusions to replenish intravascular volume and restore renal function provides the basis for other therapeutic interventions. A variety of pharmacologic approaches include intravenous fluids, diuretics, steroids, calcitonin, bisphosphonates, and plicamycin. Investigation of new agents, particularly bisphosphonates and gallium, continues. The optimal treatment of hypercalcemia in breast cancer patients has not been defined, though control of metastatic disease obviously is of utmost importance.
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PMID:Management of hypercalcemia in breast cancer. 214 69

Five thyroid carcinomas showing clinically aggressive biologic behavior were retrospectively reviewed to evaluate the possible presence of morphologic differences from conventional thyroid carcinomas. They were originally diagnosed as follicular carcinomas, medullary carcinoma, papillary carcinoma, and mixed papillary and medullary carcinoma. There were three males and two females. The age at the time of initial diagnosis ranged from 36 years to 67 years (mean 56 years). The size of the tumor varied from 4.5cm to 10cm (mean diameter 7cm). One patient died of brain metastasis four years after the initial therapy and the other four patients are still alive with local recurrences and/or metastases to bone, spinal cord, lung, and buttock. Histologically these lesions are categorized into two different groups: insular variant and columnar cell variant. Insular variant was characterized by well-defined nests (insulae) that are composed of small, uniform cells, frequent tumor necrosis, and hyalinization of the stroma. Columnar cell variant was characterized by tall columnar cells with marked nuclear statification. All five cases stained positively for thyroglobulin and negatively for calcitonin. With the above clinical and histopathological findings, we interpreted these lesions as a poorly differentiated carcinoma, biologically in an intermediate position between well differentiated and anaplastic carcinomas. The rapid and often fatal outcome associated with these variants of poorly differentiated carcinoma warrants aggressive treatment at the time of diagnosis.
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PMID:Poorly differentiated carcinoma of the thyroid retrospective clinical and morphologic evaluation. 220 66

Two unusual medullary carcinomas of the thyroid gland and their metastases contained a population of cells (20% to 25%) with the characteristic clear nuclei of papillary carcinoma. The predominant component of the tumors exhibited the typical growth pattern and cytologic features of medullary carcinoma with abundant amyloid deposits. The cells with clear nuclei lined follicle-like or tubular structures. In both the primary and the metastatic lesions, immunoreactive thyroglobulin was demonstrated only in the cells with clear nuclei, while calcitonin, carcinoembryonic antigen, and neuron-specific enolase were present only in cells of the predominant medullary carcinomatous component. Moreover, intense and diffuse staining for cytokeratin was seen only in the cells with clear nuclei, but not in those of the major medullary carcinomatous component. These findings suggest the existence of a distinctive variant of mixed medullary-papillary carcinoma that can be recognized with routine stains.
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PMID:Mixed medullary-papillary carcinoma of the thyroid: a previously unrecognized variant of thyroid carcinoma. 222 23

A 75-year-old woman with lung adenocarcinoma in whom autopsy revealed metastasis to microfollicular adenoma of the thyroid is described. A thyroid tumor specimen from this patient was initially interpreted as representing primary encapsulated follicular carcinoma of the thyroid associated with a component of poorly differentiated carcinoma of follicular cell origin. The widespread involvement of the lungs and other sites was also interpreted as metastases from the poorly differentiated carcinoma component within the encapsulated follicular carcinoma of the thyroid. Subsequent meticulous histologic examination revealed that the thyroid tumor was a microfollicular adenoma, and that the component of poorly differentiated carcinoma within it was the same as the lung carcinoma. Immunohistochemical investigation revealed that the poorly differentiated carcinoma cells within the thyroid tumor were stained positively with polyclonal and monoclonal antibodies against carcinoembryonic antigen (CEA) and negative for thyroglobulin and calcitonin. The carcinoma cells from the lungs and other sites also showed positive staining for CEA. These findings support the view that the component of poorly differentiated carcinoma was a metastatic lesion from the primary lung carcinoma to the microfollicular adenoma of the thyroid. The present study emphasizes that attention should be directed to thyroid metastasis, even if it is within a thyroid primary neoplasm.
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PMID:Lung carcinoma metastatic to microfollicular adenoma of the thyroid. A case report. 223 14

The authors present an unusual case of thyroid neoplasia firstly diagnosed as an anaplastic carcinoma with no rise in plasma thyroglobulin (Tg) and treated with total thyroidectomy and radioiodine administration. After 18 months regional lymph node metastases were present with a rise in plasma calcitonin (Ct) (8000-14000 pg/ml); lymphectomy and external radiation were performed and histology revealed a metastasis from thyroid medullary carcinoma. After 3 years, mediastinal and right supraclavicular masses were present with a concomitant rise in plasma calcitonin (from 700 to 3400 pg/ml); all neoplastic lesions showed radioiodine uptake and plasma Tg was 8.9 ng/ml. A biopsy of the supraclavicular region was taken and 131I therapy was attempted, but the patient died after 6 months. Immunocytochemistry of the biopsy revealed the presence of a medullary carcinoma-follicular variant: the neoplastic cells were variably reacting with anti-Ct and anti Tg, and, moreover, the two antigens were sometimes observed in the same cell bodies. The metabolic pattern and the clinical course of this tumour are discussed, and the authors propose that Ct and Tg plasma levels be evaluated and a total body scan (WBS) with radioiodine be performed in all cases of medullary or poorly differentiated thyroid carcinomas.
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PMID:Thyroid carcinoma with biphasic clinical course and evolution in medullary carcinoma-follicular variant. A case report and an immunocytochemical demonstration of calcitonin and thyroglobulin in the same neoplastic cells. 224 75

Between 1986 and 1989 172 patients were operated on thyroid cancer. Twenty-nine (17%) of them had a medullary carcinoma. In 20 of these patients (69%) the carcinoma occurred in a sporadic and in 9 (31%) patients in a familial form. Eighteen patients (62%) had to be operated because of tumor recurrence and in 4 of them additional surgery was necessary because of distant metastases. Due to tumor recurrence 7 patients underwent multiple operations during the above period. Adequate first operation was performed only in 6 patients (33%). Based on family screening a carcinoma was diagnosed in 4 patients in its occult stage. Diagnostic methods include biochemical and imaging methods. Calcitonin is the most sensitive tumor marker. Basal and stimulated serum calcitonin analysis provides a very efficient method to detect medullary carcinoma in early tumor stage and to treat the disease curatively. DNA-analysis improves early diagnosis of persons at risk.
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PMID:[Progress in the diagnosis and therapy of C cell carcinoma of the thyroid gland]. 228 Jun 48

Eighty-four carcinoids of the colon and rectum were studied with emphasis on prognostic features, immunohistochemical characteristics, and pitfalls in diagnosis. Follow-up data were available on 35 patients. Tumors with adenocarcinomatous components, or those resembling small cell carcinomas of the lung, were excluded. Eighty-one tumors were in the rectum and three tumors were in the distal sigmoid colon. Neuron-specific enolase, chromogranin, and Leu-7 were positive in 87%, 58%, and 53% of the tumors, respectively. Hormones were positive in the following percentages: serotonin, 45%; pancreatic polypeptide, 46%; glucagon, 10%; gastrin, 3%; somatostatin, 3%; adrenocorticotrophic hormone, 1%; cholecystokinin, 0%; calcitonin, 0%; and insulin, 0%. Many tumors elaborated more than one hormone. Fifty-five percent of the tumors were argyrophil and 28% were argentaffin. Carcinoembryonic antigen was present in 24% of the tumors; 82% of the tumors contained prostatic acid phosphatase. Three patients had liver metastases; their tumors ulcerated, invaded muscularis propria, and had more than 2 mitoses per 10 high-power fields (HPF). One patient with a 2.5-cm tumor without mitoses had regional lymph node metastases. All non-metastasizing tumors had less than one mitosis in 10 HPF. We conclude that large bowel carcinoid tumors are essentially limited to the rectum and sigmoid, that they are indolent if mitotically inactive and smaller than 2 cm, and that most show production of a selected group of endocrine markers.
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PMID:Rectal and colonic carcinoids. A clinicopathologic study of 84 cases. 229 59

A large mediastinal tumour was discovered radiologically in a 50-year-old man, with at times blood-tinged sputum and dyspnoea. Parasternal needle biopsy revealed a thymic carcinoid. After surgical excision of the tumour, which had argyrophilic foci (total weight of tumour 1,605 g), histochemical analysis demonstrated neuron-specific enolase, synaptophysin and chromogranin, as well as calcitonin (as the only hormone). For the first time in a thymic carcinoid, radioimmunoassay demonstrated growth-hormone-releasing hormone (2 micrograms/g tumour tissue). Post-operative radiotherapy (total dosage 50.5 Gy) was instituted because histological examination had shown invasion of the capsule and blood vessels. There has been no local recurrence or metastases after three years.
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PMID:[Morphology and clinical picture of thymus carcinoid]. 231 18

Nine patients with metastatic cancer who had pain refractory to traditional treatments received a subarachnoid injection of salmon calcitonin. Eight of the nine patients reported pain relief after subarachnoid injection varying from 1 hr to 5 days. Four of the responding patients subsequently received an epidural injection of salmon calcitonin, and two of these patients reported pain relief. Although many patients experienced pain relief, nausea and vomiting appeared to be a significant side effect, occurring in seven out of nine patients.
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PMID:Subarachnoid and epidural calcitonin in patients with pain due to metastatic cancer. 232 59


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