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)

The development of a rapid rate of regeneration of osteomalacic bone in a patient treated for acute granulocytic leukemia has been demonstrated for the first time. This positive bone balance was most intense at the time of maximal depletion of leukemic tissue. The authors postulate that new formation of osteomalcic bone is due to inability to maintain the rate of calcification parallel to that of bone formation. A similar abnormality occurs in egg-laying birds, in rapidly growing children on a diet suboptimal in vitamin D who have rickets, and in some patients with osteoblastic metastases.
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PMID:Osteomalacic new bone formation during chemotherapy of acute granulocytic leukemia. 28 69

A case of hypophosphataemic osteomalacia occurring in association with a carcinoma of prostate is described. Although only palliative treatment to the primary tumour was possible, worthwhile remission of bone symptoms, due to osteomalacia, was achieved with pharmacological doses of vitamin D. The presence of extensive skeletal metastases modified the radiological features of osteomalacia. Major alterations in the distribution of calcium within the skeleton were observed during a period when total body calcium remained unaltered. This observation may be of relevance to other cases in which osteosclerotic metastases develop.
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PMID:Osteomalacia and carcinoma of prostate with major redistribution of skeletal calcium. 108 99

Severe hypercalcemia is a medical emergency requiring urgent treatment. It most commonly is caused by malignant tumors, as in the case study, but can also be caused by advanced hyperparathyroidism or high serum levels of vitamin D. The patient described in the case study shows clinical evidence of volume contraction due to hypercalcemia-related anorexia and vomiting. His elevated serum concentrations of urea nitrogen and creatinine reflect intravascular volume depletion and hypercalcemia-induced reduction of renal perfusion. He is also likely to have irreversible renal damage as a result of nephrocalcinosis. His central nervous system depression is most likely a result of hypercalcemia, but other central nervous system disorders such as cerebral metastases should be considered. Appropriate treatment would include intravenous fluids to correct volume depletion, dilute extracellular fluid calcium, and promote renal calcium excretion. Before waiting for the effects of volume expansion, the first dose of an inhibitor of bone resorption should be given. The agent of choice now (this may change when second-generation bisphosphonates become available) is plicamycin. Etidronate is a reasonable second choice. Because both drugs require at least 48 hours before their hypocalcemic action is manifest, calcitonin could be used to accelerate the rate of decline of the serum calcium. As the patient becomes more alert, weight-bearing and ambulation should be encouraged. With this combination of therapeutic modalities, this patient's serum calcium level should be corrected within 3 to 5 days. Intermittent injections of mithramycin or etidronate could be given on an outpatient basis approximately once a week in order to maintain the serum calcium within the normal range. One of the most important aspects of treatment in hypercalcemic patients is eradication of the underlying disease, which usually calls for specific antitumor therapy, including chemotherapy, radiation therapy, or surgery. Most of the agents currently available for the correction of hypercalcemia have cumulative toxicities or are only transiently effective and, therefore, their use should be considered a temporizing measure until specific treatment directed at the primary disease takes effect.
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PMID:Management of severe hypercalcemia. 200 13

In the past, chemotherapy has had only a minor role in the treatment of retinoblastoma. There are three clinical settings in which chemotherapy may be useful, namely, in intraocular retinoblastoma, in cases of micrometastatic spread, and where there are overt extraocular metastases. Clinical trials in all three settings have been impeded by biological, statistical, and ethical limitations. Extensive review of the literature, including case reports, small retrospective series, and occasional prospective studies, does not lead to any clear conclusions. However, responsiveness of retinoblastoma to chemotherapy in each of the above categories has been documented, and cyclophosphamide is consistently the most effective single agent. For small intraocular tumors, there may be a role for a combination of nonoperative treatment modalities. Whether decreased occurrence of extraocular relapse is produced by the use of adjuvant chemotherapy for presumed micrometastatic disease remains controversial A prospective randomized study of stratified high-risk categories of patients needs to be done on an international level. The most widely accepted regimen in this setting is the combination of cyclophosphamide and vincristine. Improving the survival of patients with overt metastases is a major challenge, which is especially relevant to the less developed parts of the world. Several multiagent regimens, particularly in combination with bone marrow transplantation, offer some promise. Experimental models are being used to overcome some of the limitations of clinical studies. Evaluations of responsiveness to chemotherapy, both in cell culture and animal models, are being conducted. Other areas being investigated include pharmacologic enhancement of radiotherapy and hematoporphyrin photodynamic therapy, use of tumor cell targeting techniques, differentiating agents, vitamin D, and immunotherapy. The nude mouse intraocular xenograft model appears to confirm clinical observations for responsiveness to conventional therapeutic agents.
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PMID:Chemotherapy in retinoblastoma: current status and future directions. 206 30

The unusual causes of hypercalcemia have been reviewed. These disorders are rarely derived as the cause of hypercalcemia from the usual tests that one obtains in working up hypercalcemic patients (such as PTH level, phosphorus, urinary calcium). These diagnoses (particularly drug-related hypercalcemia) can be determined only from a careful history. The vast majority of hypercalcemic patients have disease secondary to cancer, hyperparathyroidism, or disorders of vitamin D metabolism. It should be noted that some hypercalcemic patients may have more than one disease. Therefore, before assuming that a hypercalcemic patient with Paget's disease, thiazide ingestion, immobilization, or so forth has hypercalcemia secondary to the primary disorder, hyperparathyroidism and cancer should also be considered. Similarly, serum calcium levels can normalize in some patients with mild hyperparathyroidism or bony metastases with mobilization and/or cessation of thiazide therapy.
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PMID:Unusual causes of hypercalcemia. 267 71

We report 2 cases of true hypocalcemia (not caused by decreased binding proteins) associated with metastatic prostate cancer and review previously reported cases. Hypocalcemia is a common but frequently unrecognized complication of prostatic cancer. Estrogen therapy often is associated with the hypocalcemia, which may be asymptomatic. The hypocalcemia is always associated with osteoblastic metastases and usually it is associated with increased serum alkaline phosphatase activity, acid phosphatase activity and serum parathyroid hormone concentration. Serum concentrations of magnesium, phosphorus and vitamin D frequently are decreased. Patients are in a positive calcium balance. The osteoblastic metastases seem to act as a calcium sink, creating a "hungry tumor phenomenon". The role of estrogens may be to stop the resorption of normal bone resulting in lower serum calcium concentrations.
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PMID:Hypocalcemia associated with estrogen therapy for metastatic adenocarcinoma of the prostate. 317 54

Transiliac undecalcified bone biopsy specimens were taken after tetracycline double labeling from 14 patients with radiologic evidence of osteosclerotic metastases from prostatic carcinoma. The histomorphometric analysis showed an increased trabecular bone volume in all patients, and in seven morphologic and dynamic evidence of osteomalacia (Group 1). The seven other patients demonstrated an extension of apposition surfaces without evidence of osteomalacia (Group 2). Group 1 was different from Group 2 in terms of a greater increase in serum alkaline phosphatase and a lower urinary calcium. In four Group 1 patients, a second bone sample taken after two to six months of treatment with vitamin D and calcium provided evidence of improving osteomalacia. The high incidence of osteomalacia in osteosclerotic metastases of prostatic origin appears to be the result of the increase in bone formation induced by prostatic cells, and the unability to satisfy the high calcium demand for new bone.
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PMID:Histomorphometric analysis of sclerotic bone metastases from prostatic carcinoma special reference to osteomalacia. 668 95

Assays of serum immunoreactive parathyroid hormone are clinically useful in the differential diagnosis of hypercalcaemic states and in the assessment of the severity of parathyroid bone disease in uraemic patients. Serum immunoreactive calcitonin measurements are essential in the investigation of individuals who might be suffering from medullary carcinoma and may be used in the detection of metastases. Serum 25-hydroxyvitamin D assays should be performed in patients receiving pharmacological doses of vitamin D to monitor patient compliance and to prevent the occurrence of vitamin D intoxication. Low values in patients with renal failure and in patients with malabsorption are highly suggestive of the presence of osteomalacia. The measurement of serum levels of dihydroxylated vitamin D metabolites is currently of doubtful relevance though such measurements may become useful in monitoring patients receiving these compounds therapeutically.
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PMID:The measurement of calcium-regulating hormones in clinical medicine. 720 1

Assays of serum immunoreactive parathyroid hormone are clinically useful in the differential diagnosis of hypercalcaemic states and in the assessment of the severity of parathyroid bone disease in uraemic patients. Serum immunoreactive calcitonin measurements are essential in the investigation of individuals who might be suffering from medullary carcinoma, and such measurements may be used in the detection of metastases. Serum 25-hydroxyvitamin D assays are useful in patients receiving pharmacological doses of vitamin D, to monitor patient compliance and to prevent the occurrence of vitamin D intoxication. Low values in patients with renal failure and in patients with malabsorption and highly suggestive of the presence of osteomalacia. The measurement of serum levels of dihydroxylated vitamin D metabolites is currently of doubtful clinical relevance, though such measurements may become useful in monitoring patients receiving these compounds therapeutically.
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PMID:Testing for disorders of calcium metabolism. 746 49

Comparative pathology may serve as a practical tool for therapy by comparison of normal and abnormal structures of the digestive tract in animals and men. A better understanding of colon cancer as the most common solid neoplasm after lung cancer in the industrialized world is sought. In the so-called developed nations and in animals colon cancer is less frequent. The pathogenesis of colon cancer involves environmental and genetic factors. Several types of colorectal cancer can be discerned and the species distribution ranges from invertebrates to man. Colorectal neoplastic progression is species-specific. An intraspecies-specific comparison of large bowel cancer is also valuable. Alteration of signal transduction pathways and somatic mutations of oncogenes are described, as well as the occurrence, research and current treatment. Metastasis of neoplasms of the colon and of the rectum can be studied by intraspecies-specific comparison. Sections of this review deal with vitamin D and cancer and close with present therapies for colorectal cancer.
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PMID:Interspecies comparative pathology of colorectal neoplasms: relevance for treatment. 772 40


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