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)

We report the case of a patient with Verner-Morrison syndrome due to a malignant MEN I-associated vipoma. Marked tumor-associated hypercalcemia could be treated successfully with somatostatin analogues prior to surgical therapy of the pancreatic tumor. Sixteen months after extirpation of the primary tumor recurrent tumor growth was diagnosed; at this time the patient was clinically asymptomatic and had no abnormal laboratory test results. Liver metastases and local metastases were identified using somatostatin receptor scintigraphy. We report and discuss the use of somatostatin in the treatment of tumor-associated symptoms in endocrine tumors and the possibility of identifying endocrine tumors by means of somatostatin receptor scintigraphy.
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PMID:[Somatostatin in preoperative therapy and postoperative diagnosis of a patient with Verner Morrison syndrome]. 128 41

In this review, we evaluate radiological techniques currently used to localize gastroenteropancreatic (GEP) endocrine tumors. We also describe the visualization, using intravenous (IV) administration of two isotope-labeled somatostatin analogues (123I-Tyr3-octreotide and 111In-DTPA-octreotide) of islet-cell tumors in 25 patients and carcinoids in 39 patients. The primary tumor and previously unrecognized distant metastases were visualized in 20 of the 25 patients (80%) and in 37 of the 39 patients (95%). Parallel in vitro detection of somatostatin receptors on those tumors also visualized in vivo showed that ligand binding to the tumor in vivo represents binding to specific somatostatin receptors. The detection of somatostatin receptors on tumors in vivo predicted a good suppressive effect of octreotide on hormonal hypersecretion by these tumors. It is an easy, quick, and harmless procedure that is valuable in the localization of primary endocrine pancreatic tumors and their often radiologically and clinically unrecognized metastases. Future prospective controlled studies comparing this procedure with other radiological investigative techniques should demonstrate its sensitivity and specificity and determine the place of somatostatin receptor imaging in the localization of GEP endocrine tumors.
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PMID:The visualization of gastroenteropancreatic endocrine tumors. 135 84

The development and clinical studies of contrast agents for cross-sectional abdominal imaging presently focus on the diagnosis of liver diseases and suitable oral contrast agents for MR imaging. The well-known paramagnetic agent, gadopentetate dimeglumine is now used for improving the differential diagnosis of liver lesions such as focal nodular hyperplasia in dynamic MR studies. Preclinical studies and initial clinical trials indicate that the new paramagnetic hepatobiliary contrast agent, manganese dipyridoxal diphosphate, might improve the sensitivity of MR imaging in the detection of liver lesions. With respect to dynamic contrast-enhanced CT in the detection of liver lesions, interest has focused on the question of the optimal scanning technique. Promising results have been obtained in initial studies of contrast agents for sonography, called microbubbles. This substance produces good visualization of the vascular status of liver tumors. Nuclear medicine somatostatin receptor imaging may be of special clinical interest because it allows even very small somatostatin-positive metastases to be detected and thus provides specific information for therapy planning in patients with positive scan results. Initial studies have shown that using contrast enhancement with MR imaging of the pancreas improves the contrast between pancreatic tissue and lesions. Manganese dipyridoxal diphosphate is taken up by pancreatic tissue, though the exact mechanism remains to be clarified, and may therefore have potential as a future MR contrast agent for evaluation of the pancreas. A number of oral MR contrast agents have now been tested in larger clinical trials. Both positive and negative oral agents are safe and well tolerated and achieve the aim of reliably delineating the gastrointestinal tract from other organs and pathologies in the abdomen.
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PMID:Contrast materials for cross-sectional imaging of the abdomen. 158 Nov 39

Somatostatin receptors have been characterized on biopsy specimens from small-cell lung carcinoma (SCLC) and on cultured human SCLC cells. We recently described the in vivo visualization of various somatostatin receptor-positive tumors, such as carcinoids and endocrine pancreatic tumors, after injection of 123I-Tyr-3-octreotide, a radiolabeled somatostatin analog. In the present study, this imaging procedure using 123I-Tyr-3-octreotide is reported in 11 patients with lung tumors. In five of eight patients with SCLC (63%), we were able to demonstrate tumor deposits using 123I-Tyr-3-octreotide scintigraphy. Unexpected metastases were found in two patients. In one of three patients with SCLC in whom tumor was not visualized, nonvisualization may have been caused by tumor necrosis and recent radiotherapy. In one of two patients with malignant small-cell tumors as described by Askin, the neoplasm was visualized. Like SCLC, these tumors are thought to derive from neuroendocrine cells. In one patient, a squamous-cell carcinoma and a bronchial adenoma were not visualized. We conclude that in the majority of patients with SCLC, the tumor and its metastases can be visualized using 123I-Tyr-3-octreotide scintigraphy. However, the value of this new technique in terms of specificity and sensitivity requires further studies in a larger group of patients.
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PMID:Radioiodinated somatostatin analog scintigraphy in small-cell lung cancer. 165 97

Because of its widespread distribution within the nervous system and the gastro-enteropancreatic (GEP) system and its diverse physiological inhibitory actions on various gastrointestinal functions, including endocrine and exocrine secretion, motility, liver and splanchnic blood flow and absorption, native somatostatin has been viewed as a possible therapy for many diseases. However, its short duration of action and consequent limited clinical usefulness have been overcome with the availability of Sandostatin, a long-acting, synthetic octapeptide analogue of the naturally occurring hormone. Sandostatin represents a significant advance in the treatment of GH and TSH secreting pituitary tumours and GEP endocrine tumours (carcinoid tumour, VIPoma, glucagonoma, insulinoma, and gastrinoma). Preclinical in vitro and animal studies have shown the antineoplastic activity of the compound. Moreover, because of a possible direct effect on somatostatin receptor-positive endocrine tumour cells and indirect effect whereby Sandostatin lowers GH, IGF-1 and numerous gastrointestinal peptides, Sandostatin may prove useful as an adjunctive therapy in cancer patients. In vivo labelling of somatostatin receptor-positive tumours with radiolabelled somatostatin analogues now allows localisation of such tumours and their metastases. Moreover, targeted irradiation of these tumours by beta particle emitting isotopes attached to such somatostatin analogues may become possible. The use of Sandostatin in acute oesophageal variceal bleeding, pancreatic pseudocysts, gastrointestinal and pancreatic external fistulae, short bowel syndrome, dumping syndrome and AIDS-related refractory hypersecretory diarrhea has provided encouraging results. Preliminary reports indicate efficacy of Sandostatin in psoriasis, autonomic neuropathy (postprandial and orthostatic hypotension) and its ability to reduce height velocity in tall adolescents. The ultimate role of Sandostatin as a therapeutic agent in these disorders is being explored in prospective clinical trials.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Future medical prospects for Sandostatin. 198 Jul 78

Because of its widespread distribution within the nervous system and gastroenteropancreatic (GEP) system, and its diverse physiological inhibitory actions on various gastrointestinal functions, including endocrine and exocrine secretion, motility, liver and splanchnic blood flow and absorption, native somatostatin has been viewed as a possible therapy for many diseases. However, its short duration of action and consequent limited clinical usefulness have been overcome with the availability of Sandostatin (octreotide, Sandoz Ltd), a long-acting, synthetic octapeptide analog of the naturally occurring hormone. Sandostatin represents a significant advance in the treatment of growth hormone (GH) and thyrotropin (TSH)-secreting pituitary tumors and GEP endocrine tumors (carcinoid tumor, VIPoma, glucagonoma, insulinoma, and gastrinoma). Preclinical in vitro and animal studies have shown the antineoplastic activity of the compound. Moreover, because of a possible direct effect on somatostatin receptor-positive endocrine tumor cells and an indirect effect whereby Sandostatin lowers GH, insulin-like growth factor type 1 (IGF-1), and numerous gastrointestinal peptides, Sandostatin may prove useful as an adjunctive therapy in cancer patients. In vivo labeling of somatostatin receptor-positive tumors with radiolabeled somatostatin analogs now allows localization of such tumors and their metastases. In addition, targeted irradiation of these tumors by beta particle-emitting isotopes attached to such somatostatin analogs may become possible. The use of Sandostatin in acute esophageal variceal bleeding, pancreatic pseudocysts, gastrointestinal, and pancreatic external fistulae, short bowel syndrome, dumping syndrome and acquired immunodeficiency syndrome (AIDS)-related refractory hypersecretory diarrhea has provided encouraging results.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Future medical prospects for Sandostatin. 220 87

In small-cell lung cancer (SCLC), CT scan remains the most accurate imaging modality for evaluating local extension and specific sites of metastatic disease. The role of nuclear medicine in the work-up of SCLC is still limited to the detection of bone metastases. Recently, a new potential diagnostic tool has been introduced based on the presence of somatostatin receptors in SCLC. With the use of radiolabelled somatostatin analogues it is hoped that an equally effective but simpler staging system has been found that gives a better separation of prognostic subgroups. This article reviews the role of nuclear medicine in general and somatostatin receptor scintigraphy in particular in the imaging and staging of SCLC. Clinical value in terms of sensitivity and specificity is discussed in relation with other imaging and staging modalities.
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PMID:Imaging and staging of small-cell lung cancer: is there a future role for octreotide scintigraphy? 749 57

Somatostatin receptors are present on most hormone-secreting tumours. They are the pathophysiological basis for the successful control of hormonal hypersecretion by pituitary adenomas, metastatic islet cell tumours and carcinoids during treatment with the long-acting somatostatin analogue octreotide. There is also evidence for inhibition of tumour growth in some of these patients. Visualization of somatostatin receptor-positive tumours is possible in vivo after the administration of ([111In]diethylenetriaminepentaacetic acid)octreotide. Primary tumours are detected and often metastases that were previously unrecognized. Tumours that secrete growth hormone or thyroid-stimulating hormone and non-functioning pituitary adenomas, islet cell tumours, carcinoids, paragangliomas, phaeochromocytomas, medullary thyroid carcinomas and small-cell lung cancers are visualized in 70-100% of cases. Meningiomas, renal cell cancers, breast cancers and malignant lymphomas are often somatostatin receptor positive, allowing their localization with this scanning procedure. In some of these tumours discrepancies have been noted between binding studies with somatostatin-14, somatostatin-28 and octreotide, which suggests the presence of somatostatin receptor subtypes on some tumours. Most hormone-secreting tumours react in vitro to octreotide with an inhibition of hormone release and growth. Cultured meningioma cells react to octreotide with a stimulation in growth, possibly by interference with the autocrine inhibitory growth control by interleukin 6. This suggests that the presence of somatostatin receptors on human tumours does not automatically imply a beneficial effect of somatostatin analogue therapy.
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PMID:Somatostatin receptors: clinical implications for endocrinology and oncology. 758 49

Ectopic ACTH syndrome represents a cancer-induced amplification of a property [proopiomelanocortin (POMC) peptides production] normally present in the cells from which the cancer originated but with aberrant posttranslational processing of POMC resulting in a greatly elevated secretion of ACTH precursors. The classic ectopic ACTH-producing tumors described in the 1960s were highly malignant but more recently slowly growing tumors such as carcinoids are reported with increasing frequency. Clinical features of patients with ectopic ACTH were analyzed, including biochemical abnormalities, plasma ACTH, cortisol and urinary steroids. Dynamic tests such as high-dose dexamethasone suppression, metyrapone and ovine-CRH (oCRH) stimulation were explored, as well as inferior petrosal sinus ACTH sampling before and after oCRH. Among the tumor markers examined, elevation of ACTH precursors was uniformly present followed by increased output of calcitonin, gut hormones, oncofetal and placental hormones in decreasing order. Since more than 90% of ectopic ACTH tumors are neuroendocrine in nature exhibiting APUD characteristics, their 2 markers, neuron-specific enolase and chromogranins are very useful. The imaging procedures for localization of the tumor ranged from chest X-rays to computed tomography and magnetic resonance of the chest and abdomen. Abdominal ultrasonography was also useful. Finally somatostatin receptor scintigraphy permitted demonstration of unrecognized tumors and/or metastases, even when the tumors were occult. The ACTH content, immunostaining for APUD markers and altered POMC processing were evaluated in ectopic tumors and/or metastases. Occult ectopic ACTH syndrome of more than 4-6 months of symptoms without the emergence of an obvious source was reviewed. Since the tumors are often clinically and biochemically undistinguishable from pituitary-dependent Cushing's disease, inferior petrosal sinus sampling for ACTH after oCRH stimulation established the diagnosis in over 90% of the cases. 60% of the occult tumors were thoracic carcinoids (3/4 bronchial carcinoids), followed by small cell lung cancer and pancreatic neuroendocrine tumors. In 12% the primary etiology was not detected. The rare syndrome of ectopic CRH syndrome (6 published cases) leading to excessive stimulation of the pituitary which became hyperplastic and secreted excessive amounts of ACTH is discussed. Finally, the 12 published cases and 1 unreported patient with ectopic CRH-ACTH tumors were reviewed, the majority being metastatic small cell lung carcinomas, bronchial and thymic carcinoids.
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PMID:Ectopic ACTH syndrome. 762 46

There is little experience with imaging of thyroid carcinoma tissue by somatostatin receptor scintigraphy. Our case report describes an acromegalic patient, in whom 111In pentetreotide scintigraphy did not only demonstrate a receptor-positive pituitary tumor but also visualized metastases from a papillary thyroid carcinoma which had no correlate in radioiodine scintigraphy carried out under hypothyroid conditions. The possible role of this radiopharmaceutical in dedifferentiating thyroid carcinoma is discussed for its usefulness in tumor localisation and its predictive value for the outcome of an octreotide therapy.
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PMID:[Imaging of metastases from thyroid carcinomas using 111In-pentetreotide scintigraphy]. 767 48


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