Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 47-year-old female presented with hypertension, hypokalaemia, low plasma renin, high plasma aldosterone and was found to have a left adrenal tumour 4 cm in diameter by computerized tomography. Detailed biochemical studies showed high plasma levels of 11-deoxycorticosterone and corticosterone in addition to aldosterone and 18-hydroxycorticosterone. Basal 11-deoxycorticosterone levels were particularly high. Corticosterone, 18-hydroxycorticosterone and aldosterone concentrations were abnormally sensitive to infusions of ACTH and angiotensin II. Plasma cortisol and assays for sex hormones were normal although there was evidence that cortisol derived from the neoplasm. At operation a well-differentiated adrenocortical carcinoma weighing 50 g (56 X 30 X 36 mm) was removed. There was no evidence of metastases following surgery. Adrenal function returned to normal. Review of the literature suggests that adrenocortical carcinoma should be suspected in patients who otherwise have typical features of Conn's syndrome, but whose tumours are more than 3 cm in diameter. Measurement of steroids such as 11-deoxycorticosterone in addition to aldosterone is recommended since abnormally high values may also help to distinguish between hyperaldosteronism due to adenoma and carcinoma. Previously reported cases of isolated aldosterone production by a carcinoma cannot be substantiated.
 ...
PMID:Hypermineralocorticoidism due to adrenal carcinoma: plasma corticosteroids and their response to ACTH and angiotensin II. 282 95

Adrenal enlargements were found in slightly more than 100 patients of approximately 15,000 who underwent abdominal computed tomography. A firm diagnosis was made in 61 patients. Of these, 34 were screened because of suspected metastases from nonadrenal tumours. Major causes of adrenal enlargement were metastases (20 patients), nonfunctioning adenomas (15) and hormonally active masses (9). Fine-needle aspiration biopsy was a useful diagnostic aid in patients with metastases. Surgical treatment was undertaken in 17 patients (three pheochromocytomas, one Cushing's adenoma, three Conn's adenomas, four primary carcinomas, two metastatic carcinomas, three nodular hyperplasias suspected to be part of the multiple endocrine adenopathy syndrome and one myelolipoma). Work-up of an adrenal mass includes a full history and physical examination, search for possible nonadrenal primary malignant lesions, testing for excess adrenal hormone secretion, computed tomography of the abdomen and fine-needle aspiration biopsy in selected patients.
 ...
PMID:Diagnosis and management of adrenal masses: 1987 Du Pont lecture. 334 71

Adrenal lesions can be divided into those that result in clinical syndromes due to excess hormone elaboration and those that are nonhyperfunctioning. Computed tomography (CT) is usually adequate to assess the adrenal glands in patients with hyperfunctional disease. Occasionally supplementation with radionuclide studies, magnetic resonance (MR) or venous sampling, is required. Lesions which are not hyperfunctioning are often detected as an incidental mass. The CT and MR characteristics often allow a confident diagnosis based on their imaging characteristics. The adrenal glands are a common site of metastatic disease which can be detected by CT and further characterized by MR or biopsy if the stage of disease is uncertain.
 ...
PMID:CT and MRI of adrenal lesions. 340 44

We reviewed 106 cases of adrenal masses of all types in all age groups. Thirty-three contained calcium visible on radiographs, sonography, or computed tomography (CT). Neuroblastoma was the most common calcified adrenal mass (10 cases), and occurred only in children. Adrenal cyst (6 cases) was the most common calcified adrenal mass in adults. Other calcified adrenal masses included 5 cortical adenomas, 4 adrenal carcinomas, 3 cases of adrenal hemorrhage, 2 adrenal metastases, 2 pheochromocytomas, and 1 histoplasmoma. Calcification within an adrenal mass is therefore nonspecific. All the adrenal cysts had a characteristic radiographic pattern, showing only peripheral curvilinear calcification. The presence and pattern of calcium in an adrenal mass must be correlated with other imaging features (e.g., size, homogeneity, enhancement pattern, margination) to allow correct differential diagnosis. This can best be done by CT.
 ...
PMID:Calcified adrenal masses. 360 94

The clinical manifestations of 253 neuroblastoma cases in childhood, treated in Denmark from 1943 to 1980, were reviewed. Most striking was the vagueness of symptoms in the majority of patients, only a few of whom exhibited the symptoms strongly suggestive of a neuroblastoma (i.e. the Horner syndrome, the watery diarrhoea syndrome, the dancing eye syndrome). The vagueness of the symptoms might have led to fatal procrastination of the diagnosis. The diagnostic delay has, however, no independent prognostic significance for survival in our patients (p = 0.09). The maximal tumour spread was recorded for all 253 patients, and the distribution of metastases was in accordance with the "soil-seed" hypothesis. The tumour spreads with equal frequency by local growth, by lymphatic vessels to distant lymph nodes, and by blood to bone. Only in widely disseminated tumours are metastases to the lungs, the meninges, the brain, and the reproductive organs seen to occur. Eighty-five percent of the patients, for whom data were available, excreted VMA above the normal value for their age, and 43% excreted Norepinephrine + Epinephrine (N + E) above normal levels. The excretion of both VMA and N + E was significantly correlated to stage, and thus to prognosis. Neither the level of VMA excretion nor the level of N + E had any bearing on the survival when age and stage were adjusted for. Serial VMA and N + E determinations show that patients with normal values for these parameters had significantly better prognosis than patients with elevated values during the first, second, third and fourth trimesters after the initiation of treatment. Increasing values in the individual patient were associated with a poor prognosis. We found no correlation between the initial leucocyte count and survival when age and stage were adjusted for.
 ...
PMID:Signs, symptoms, metastatic spread and metabolic behavior of neuroblastomas treated in Denmark during the period 1943-1980. 363 7

Over a 2 year period, 63 of 1,459 patients examined by computerized tomography were found to have adrenal masses. In 19 patients (1.3 percent of patients examined and 30 percent of patients with adrenal masses), they were unexpected and did not give rise to symptoms or signs. Three patients were explored. Two of the patients had adrenocortical adenomas and a third, a ganglioneuroma. Adrenal function tests were performed in 14 patients and showed evidence of Cushing's syndrome in 1 patients and revealed no abnormalities in 13. The lesions in 10 of 11 nonsurgical patients followed by computerized tomography for 11 to 36 months showed no change. One lesion became significantly smaller. In a review of 988 autopsy reports, grossly visible adrenal masses were present in 73 patients (7.3 percent), including 19 adrenocortical adenomas (1.9 percent) and 50 metastases (5 percent). We conclude that serendipitous adrenal masses are usually small, nonfunctioning, and benign, the most common lesion being adrenocortical adenoma. A protocol has been suggested for management to identify the minority of patients with functioning or malignant lesions and to avoid unnecessary surgery in the others who have benign disease.
 ...
PMID:Serendipitous adrenal masses: prevalence, significance, and management. 401 56

Malignant melanoma is an unpredictable and often virulent cutaneous malignancy. Although computed tomography is the most sensitive method for detection of intrathoracic metastases, its value in the assessment of abdominal spread has not been fully defined. We evaluated the sites of CT-identified metastases in 70 patients with pathologically confirmed malignant melanoma. Results were correlated with Clark's level, Breslow thickness, site of the primary, and clinicopathologic stage. CT detected enlarged abdominal or pelvic lymph nodes in 75% of patients with Clark's level 5 lesions but only in 24% and 33% of those with level 3 and 4, respectively. Patients with deep primary lesions of the lower extremities had a high frequency of pelvic node metastases. Liver and splenic metastases were detected in up to 25% of patients with level 4 or 5 melanoma. Adrenal and subcutaneous metastases were frequently discovered as were unsuspected nodules at the lung bases.
 ...
PMID:Computed tomography in the detection of abdominal metastases from malignant melanoma. 648 Mar 8

A simple surgical technique for maintaining normal intraocular pressure during enucleation of eyes with a malignant melanoma of the choroid consists of making an incision into the anterior chamber through clear cornea with a microvitreo-retinal blade, followed by the introduction of a No. 21-gauge scalp vein needle or a No. 23-gauge sidewall-holed needle attached to a closed system filled with balanced salt solution. Measurements of pressure fluctuations during five enucleations are given. Such a system maintains the anterior chamber and keeps fluctuations in IOP to a minimum. This may be important in preventing hematogenous dissemination of tumor cells, resulting in metastatic disease.
 ...
PMID:Normal intraocular pressure during enucleation for choroidal melanoma. 665 95

A series of 16 patients with adrenal masses were biopsied percutaneously under computed tomography (CT) guidance with 18- to 22-gauge modified Chiba needles. Adrenal adenomas, cysts, metastases, melanoma, and adrenal hemorrhage were identified. Of nine oncologic patients, four had adrenal metastases, while five had other nonmalignant adrenal masses. Thus, an adrenal mass in an oncologic patient is not always metastases. No complications occurred. The diagnostic evaluation of an adrenal mass in selected cases should include CT-guided percutaneous aspiration as a safe and reliable alternative to open surgical biopsy. CT-guided biopsy can be performed as an outpatient procedure, avoiding the cost of hospitalization and the morbidity of surgery.
 ...
PMID:The computed tomography-guided adrenal biopsy. An alternative to surgery in adrenal mass diagnosis. 670 99

Four cases of nonfunctioning adrenal adenomas associated with renal cell carcinoma are reported. The adenomas were found incidentally during angiographic examination of the renal carcinoma, and originally were thought to be metastases to the adrenal gland. Reports in the pathologic literature indicate an increased incidence of adrenal adenomas in patients with renal cell carcinoma. Adrenal adenomas occur in 12%-15% of patients with renal cell carcinoma as compared to 2%-3% of the general population. Since a vascular metastasis to the adrenal gland and an adrenal adenoma may appear identical angiographically, awareness of this association is important to avoid overdiagnosis of metastatic disease.
 ...
PMID:Adrenal adenoma associated with renal cell carcinoma. 677 83


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>