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 investigation of rather insensitive metabolic parameters (protein, fibrinogen, blood urea nitrogen (BUN), blood glucose) reveals significant differences between tumor-bearing and tumor-free patients as well as benign and malignant neoplasms. Whereas metastases and glioblastomas (GBM) show significantly elevated BUN levels (21.9 +/- 1.7; 8 +/- 2.2 mg/dl) compared to benign tumors (meningioma WHO I, astrocytoma I, II) (16 +/- 0.9 mg/dl) and tumor-free matched controls (e.g. 13.9 +/- 1.4 mg/dl) only metastases depict higher glucose (141.7 +/- 11mg/dl) counts. Fibrinogen, significantly elevated in malignancy (395 +/- 25.2; 397.2 +/- 25.9 mg/dl) is without difference between meningioma, astrocytoma (253.2 +/- 16.6; 271.5 +/- 16.5 mg/dl) and controls (e.g. 270.1 +/- 10.8 mg/dl). Correlating BUN with total protein reveals a metabolic mismatch to nearly all tumor patients, regardless of dignity, as compared to tumor-free patients. Neuroendocrinoimmunological changes are the most likely reason for these overt as well as occult findings, making investigation of more sensitive metabolic parameters a rewarding task.
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PMID:Unspecific metabolic blood parameters as used in clinical routine may differentiate malignant from benign cerebral tumors. 765 23

The case of a 52-year-old woman with acromegaly, diabetes insipidus, and visual impairment caused by a metastatic growth hormone-releasing hormone (GRH)-produced pancreatic tumor is reported. Serum growth hormone (GH) and somatomedin C levels were elevated to 14 ng/ml (normal < 5 ng/ml), and 3.20 U/ml (normal < 1.88 U/ml), respectively. Paradoxical increases were observed in GH levels after glucose tolerance and thyrotropin-releasing hormone-stimulation tests. Biopsy of a pituitary tumor observed on computerized tomography scans and magnetic resonance studies revealed a metastatic cancer. When circulating GRH levels were measured, a marked increase in plasma GRH (1145 pg/ml; normal < 4-1 pg/ml) was observed. The patient died of cachexia due to metastases. Postmortem examination revealed that a primary tumor, a malignant endocrine lesion, was present in the pancreas, with metastatic tumors in the pituitary, lung, liver, and adrenal glands. Synthesis and production of GRH by the tumor was demonstrated by Northern blotting and immunohistochemical analysis. The pituitary gland showed hyperplastic, but not adenomatous changes. The authors stress the importance of both exploration for an ectopic source of GRH and the search for a GH-producing pituitary adenoma when unusual signs and symptoms are seen in patients with acromegaly.
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PMID:Acromegaly, diabetes insipidus, and visual loss caused by metastatic growth hormone-releasing hormone-producing malignant pancreatic endocrine tumor in the pituitary gland. Case report. 767 23

In 27 examinations of 24 patients with differentiated thyroid carcinoma an alternating pattern of metastases with either 131I- or FDG-uptake was found. In the follow-up of these patients this flip-flop pattern was seen in 89% (17/19) of patients with metastases and uptake of 131I or FDG as described here as uptake types 1 and 2 (type 1: FDG-positive and 131I-negative; type 2: FDG-negative and 131I-positive). In 4 patients a mixed type was observed (uptake type 3), i.e. a combination of metastases with uptake types 1 and 2 in the same patient. Metastases of papillary or follicular thyroid carcinoma without uptake of iodine have all been found to be FDG-positive in patients with an increase of thyroglobulin and with negative diagnostic results from other imaging modalities, and were histologically confirmed by surgery. False-negative or false-positive cases were not observed in this study. The FDG uptake showed an inverse proportionality to iodine uptake and to tumor differentiation. Increased glucose metabolism is a sign of higher malignancy.
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PMID:[18FDG whole-body PET in differentiated thyroid carcinoma. Flipflop in uptake patterns of 18FDG and 131I]. 767 41

We evaluated levels of insulin-like growth factor-I and interleukin-1 alpha and beta in patients with pancreatic cancer; the role of these substances in tumor spread and in hyperglycemia was also investigated. Thirty pancreatic cancer patients (21 with hyperglycemia) were compared with others with diseases causing hyperglycemia [liver cirrhosis (14 cases, 12 with hyperglycemia), chronic pancreatitis (20 cases, 12 with hyperglycemia), type I diabetes mellitus (13 cases, all hyperglycemic)]. Insulin-like growth factor-I was significantly reduced in patients with liver cirrhosis, probably due to a reduced hepatic capacity for synthesis. It was increased in 6 of 30 pancreatic cancer patients; in these subjects it was correlated with alanine aminotransferase and C-peptide, but not with tumor diameter or the presence of metastases. Interleukin-1 alpha and beta were both elevated in pancreatic cancer patients. The former was high, while the latter was low when liver metastases were present. Neither was related to glucose or C-peptide levels. In summary, insulin-like growth factor-I levels are increased in some pancreatic cancer patients but this does not seem to favor tumor spread; however IGF-I could be involved influencing glucose homeostasis. Interleukin-1 alpha increased, while interleukin-1 beta decreased in pancreatic cancer patients with metastases, suggesting a different involvement of these two substances in pancreatic cancer spread.
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PMID:Insulin-like growth factor-I, interleukin-1 alpha and beta in pancreatic cancer: role in tumor invasiveness and associated diabetes. 778 9

Radiographic imaging techniques have proved to be of limited value in characterizing chest masses. Likewise, scintigraphic techniques with tumor-seeking single photon emitting agents have shown marginal practical benefit. In contrast, high resolution PET with [F-18]-2-fluoro-2-D-deoxyglucose (FDG) offers a unique opportunity to distinguish benign from malignant processes by determining metabolic characteristics. PET scan results, including graphical analysis of tumor transfer constants (Patlak plot) in 21 patients with primary lung cancer, were compared to clinical outcome (histologic proof or clinical follow-up of longer than 1 year) in 54 patients who had chest masses identified by CT and/or plain film. The patients were categorized into three groups. The first group (N = 23) had primary, unknown, lung masses. Differentiation of benign from malignant tumors by PET had a sensitivity of 100% and a specificity of 67%. The second group (N = 13) had proven lung carcinoma or lymphoma and post-therapy PET scanning for recurrent tumor. In this setting, PET had a sensitivity of 83% and a specificity of 80%. The third group (N = 18) had extrathoracic malignancies and suspected pulmonary metastases. Metastatic lesions were identified with a sensitivity of 87% and specificity of 83%. Glucose uptake by normal tissue is variable and inflammatory/infectious processes can have high FDG uptake and overlap with the glucose uptake of malignant tissue. FDG PET is useful in characterizing chest tumors based on the level of their metabolic activity. Malignant tissue has a high glucose uptake. Elevated FDG uptake by an active inflammatory process may produce overlapping results.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Characterization of chest masses by FDG positron emission tomography. 778 82

A 49-year-old woman had a right adrenalectomy for pheochromocytoma in April 1989. In May 1990 she underwent an operation to remove paraaortic lymph nodes, and the lymph nodes showed pheochromocytoma. Twenty-two months after the first operation, metastases to the left cervical nodes, lung, and liver occurred. Her blood pressure was 172/104 mmHg; fasting plasma glucose (FPG), 342 mg/dl; urinary noradrenaline (NA), more than 2000 micrograms/day; and plasma NA, 17.28 ng/ml. Treatment with the CVD regimen (cyclophosphamide, 750 mg/m2 on day 1; vincristine, 1.4 mg/m2 on day 1; dacarbazine, 600 mg/m2 on days 1 and 2, every 21 days) was begun on February 14, 1991. After 3 cycles of the CVD regimen her blood pressure was 140/82 mmHg; FPG, 157 mg/dl; urinary NA, 917 micrograms/day 1; and plasma NA, 4.54 ng/ml. The size of the metastatic lesions in the liver had decreased. Treatment with the CVD regimen was continued until May 1992. After that she did not go to the hospital for about 2 months. Metastatic lesions progressed gradually and treatment with the CVD regimen was repeated again. She was admitted to the hospital on February 17, 1993 because of appetite loss and nausea. Her blood pressure was 188/94 mmHg; FPG, 197 mg/dl; HbA1c, 9.5%; urinary NA, 18265.3 micrograms/day; and plasma NA, 47.20 ng/ml. She was treated with the CVD regimen in 2 repeated cycles (28th cycle of treatment with the CVD regimen) but there was no effect. She died following hemoptysis on March 15, 1993.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of malignant pheochromocytoma treated with a combination of cyclophosphamide, vincristine, and dacarbazine (CVD). A review of the Japanese literature of malignant pheochromocytoma treated with a combination of CVD]. 785 22

We report a case of carcinomatous meningitis from transitional cell carcinoma of the urinary bladder. A 70-year-old man with invasive bladder cancer and multiple pulmonary metastases received 3 courses of systemic M-VAC (methotrexate, vinblastine, doxorubicin, and cisplatin) chemotherapy, after which the primary tumor and pulmonary metastases diminished in size and number. During the 4th course of chemotherapy, he complained of nausea, headache, diplopia, and neck stiffness. Computer tomographic (CT) scan of the brain showed no evidence of parenchymal metastases, cerebral hemorrhage, or infarction. Cerebrospinal fluid examination revealed an increase in cells along with elevated protein and depressed glucose concentrations, but no malignant cells were identified. He died two weeks after the onset of neurological symptoms. Autopsy revealed numerous tiny metastatic lesions in the leptomeninx, so called carcinomatous meningitis, without parenchymal metastases in the brain. Although metastases to the central nervous system from transitional cell carcinoma of the bladder, especially carcinomatous meningitis rarely have been reported, this unusual complication will be seen more frequently with the development of more effective systemic chemotherapy such as M-VAC.
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PMID:[A case of carcinomatous meningitis from transitional cell carcinoma of the urinary bladder]. 786 65

Visualization of lactate dehydrogenase (LDH) activity with Neotetrazolium as final electron acceptor under anaerobic conditions and an incubation medium containing polyvinyl alcohol showed that under normal physiological conditions a zonal distribution of LDH activity is present in the liver lobule of male rats. Periportal hepatocytes contain more LDH activity than pericentral hepatocytes. This difference is due to the role of LDH both in gluconeogenesis (periportal cells) and glycolysis (pericentral cells). In livers containing metastases from colon carcinoma, areas of the parenchyma which are not affected by tumour growth maintain such zonation in the lobule, whereas areas close to metastatic foci show increased activity which is distributed uniformly over the lobule. This change may be explained by a Cori's cycle-like relationship between malignant cells and the surrounding hepatocytes due to glucose consumption and lactate production by the tumour cells. Within the metastatic foci, a zonation of LDH activity was also observed. Malignant cells close to the edge of the tumours contained the lowest activity, whereas activity increased inwards. Cancer cells directly surrounding necrotic areas showed the highest activity. Such patterns are in line with increasing anaerobic glycolysis towards the inner metastatic regions. Anaerobic glycolysis supplies limited amounts of ATP with concomitant lactate production but also large amounts of metabolites for RNA, DNA, lipid and complex carbohydrate synthesis. Lactate that is produced by the metastases induces adaptive changes in surrounding hepatocytes to convert this excess of lactate effectively.
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PMID:Changes in the zonation of lactate dehydrogenase activity in lobules of rat liver after experimentally induced colon carcinoma metastases. 787 78

Primary meningeal hemangiopericytomas (formerly referred to as angioblastic meningiomas) are by most authors no longer considered to be actual meningiomas but rather thought to be intracranial hemangiopericytomas. Their biological behavior is usually malignant, with recurrences and metastases, often at intervals of years. Both intracranial and extracranial hemangiopericytomas may, however rarely, be accompanied by paraneoplastic hypoglycemias. Our own characteristic observations are based on a female patient aged 67 at the time of her death, in whom a meningeal tumor was resected first at the age of 41. Later recurrencies were removed at the age of 52 and 58 respectively. Three years prior to her death liver metastases had developed followed by increasingly frequent attacks of early morning hypoglycemia with blood sugar levels ranging between 1.4-2.3 mmol/l. Specific examinations revealed low endocrine production of insulin and a distinctly decreased insulin-like growth factor (IGF) I of 25 ng/mb (normal 120-130) and a normal value of total IGF II of 724 ng/ml (normal 400-900), though with a big macromolecular share. The observed paraneoplastic hypoglycemia is probably brought about by coincidence of blocked hepatic glucose production, suppressed lipolysis and increased peripheral glucose uptake. Autopsy revealed a third intracranial recurrence of meningeal hemangiopericytoma and a large metastatic liver. No other sites of metastases were found. Histologic, immunohistologic and electron microscopic findings showed the characteristics features of a hemangiopericytoma. Light microscopic pictures of the primary tumor, recurrences and metastases were identical. Additional autopsy findings were a papillary carcinoma of the right kidney, an angiomyolipoma of the left kidney and a thecoma of the left ovary.
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PMID:[Recurrent and metastasizing hemangiopericytoma of the meninges with paraneoplastic hypoglycemia]. 812 96

The value of the superparamagnetic contrast medium AMI-25 and its clinical acceptability was investigated in a phase-III-multicenter study. 18 patients with primary and secondary hepatic tumours were studied using T2- and T1-weighted spin-echo sequences, FATSAT sequences and FLASH-2-D-breathold sequences, both before and after intravenous application of AMI-25 (0.2 mmol GE/ml 15 mmol/kg KG in 100 ml 5% glucose infusion), using a 1.5 Tesla MRT (Magnetom 63 SP, Siemens). In 6 patients the MRT findings could be correlated with in vitro results within 30 minutes following surgical resection. In 8 patients a diagnosis of metastases was made. Amongst patients with primary liver tumours (FNH 6 cases, HCC 3 cases, adenomatosis 1 case) 3 of the 10 patients showed more lesions following the injection of contrast; similarly, in 4 patients of the 8 with secondary tumours contrast increased the number of visible lesions. The absence of contrast enhancement separated primary from secondary lesions. Amongst the patients with secondary liver tumours, in vitro correlation always showed more tumours than had been visualised whereas there was exact in vivo/in vitro correlation amongst patients with primary liver tumours.
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PMID:[The value of the liver-specific superparamagnetic contrast medium AMI-25 for the detection and differential diagnosis of primary liver tumors versus metastases]. 816 44


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