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 observation of two cases of hyperworking corticosuprarenal carcinomata with diffuse metastases, has induced the authors to examine this problem on the base of the most actual bibliography of the last years. They explain in detail the 2 cases, that are a feminizing tumor in a 55 years old man and a Cushing syndrome with hypertension in a 18 years old women. The peculiar characteristic are in the first case the clinical rareness of feminizing syndrome from suprarenal carcinoma and in the second case the histopathological particularity of splenic metastases. In regard to therapy for this particular tumor, the AA. incline for the surgical removal of tumor, that can induce, in the most favourable cases, a partial or total reduction of endocrine symptomatology and for the giving in great doses of o,p'-DDD from the immediate post-operating period.
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PMID:[Associated role of surgery and antimitotic o, p'-DDD treatment in hyperfunctioning adrenal cancers with diffuse metastases]. 616 74

Naturally-occurring hyperadrenocorticism was diagnosed in an 11-year-old female Dachshund with signs of polydipsia, polyuria, pendulous abdomen, weakness, depression and lethargy, and laboratory test abnormalities comprising lymphocytopaenia, eosinopaenia, hypercholesterolaemia and increased plasma alkaline phosphatase concentration. While awaiting hormonal test results, an adrenocorticolytic drug (o,p'-DDD) was administered for 14 days, during which the patient deteriorated. Hormonal assays suggested a functioning adrenocortical tumour, but the poor condition of the patient precluded adrenalectomy. An adrenocortical carcinoma with hepatic metastases was found at necropsy.
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PMID:Functioning adrenocortical tumour in a dog. 628 91

This study concerns the history of a male patient with hormone-producing adrenal cortical carcinoma. Six months after resection of the primary tumor, lymph node metastases were detected and treatment with o,p'-DDD [1,1 dichloro-2-(o-chlorophenyl)-2-(p-chlorophenyl)ethane] (Lysodren/mitotane) was started. After 2 years, a complete histologically proven response was confirmed at laparotomy and is still sustained 2 years after the discontinuation of treatment. As a consequence of insufficient steroid replacement the patient suffered bouts of adrenal insufficiency. After 1 year of treatment, the measurement of the plasma levels of o,p'-DDD showed an accumulation of the drug. At that time, progressive major central nervous system toxicity occurred, which proved to be reversible on discontinuation of the treatment.
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PMID:Complete response of metastasized adrenal cortical carcinoma with o,p'-DDD. Case report and literature review. 636 Mar 29

In the present study two patients with aldosterone-producing adrenal carcinomas are reported. The clinical features were characterized by hypertension and severe hypokalemia with muscular weakness, flaccid paralysis of arms and legs, diarrhea and polyuria. In both cases excessively high plasma aldosterone levels and suppressed plasma renin activity were found. In contrast to most other cases with aldosterone-secreting tumours plasma cortisol, urinary free cortisol excretion, 17-hydroxy- and 17-ketosteroids were in the normal range. There was no clinical evidence of oversecretion of sex hormones. After adrenalectomy blood pressure and serum potassium normalized and the clinical symptoms disappeared. Plasma aldosterone and urinary aldosterone secretion returned to normal, while plasma renin activity remained low. Three and a half and 6 months later primary aldosteronism and the associated clinical symptoms reappeared due to hormonally active metastases. After introducing the antitumour drug o,p'-DDD in patient 1 aldosterone secretion normalized and the clinical status of the patient markedly improved. However, 10 months after diagnosis the patient died due to a haemorrhage from a liver metastasis. In patient 2 tumour-invaded regional lymph nodes were surgically removed with only minor changes in the hormone pattern.
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PMID:Primary aldosteronism due to adrenal carcinomas. 637 76

Thirty-four patients with adrenocortical carcinoma were treated with o,p'-DDD. Twenty-eight patients presented with metastases at entry, and spillage of tumour cells occurred at surgery in 6 other patients. Eight patients had objective tumour regression, of whom 7 had serum levels over 14 micrograms/ml. The 3 patients with a lasting remission had levels of greater than 15, greater than 25, greater than 25 micrograms/ml respectively during prolonged periods. Increased survival times were found in the group of 14 patients with o,p'-DDD serum levels higher than 14 micrograms/ml when compared with patients not treated after discovery of metastases. In the patients with levels less than or equal to 10 micrograms/ml no therapeutic effect was seen. Levels of over 20 micrograms/ml are associated with symptoms of reversible neuromuscular toxicity. Monitoring of serum levels during treatment is mandatory. It is suggested that serum levels of about 25 micrograms/ml during longer periods may be curative.
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PMID:The treatment of adrenocortical carcinoma with o,p'-DDD: prognostic implications of serum level monitoring. 653 15

Leydig cell carcinoma of the testicle is a rare tumor with 16 well-documented cases in the medical literature. Radiotherapy and chemotherapy have not been successful in treating patients with metastatic disease. The patient described in this report had widely metastatic Leydig cell carcinoma associated with hypertension, hypokalemic alkalosis, and an elevated serum concentration of desoxycorticosterone. He experienced an objective clinical remission and disappearance of pulmonary metastases while receiving o,p'-DDD as the sole chemotherapeutic agent. This response was similar to that found in patients with adrenal cortical carcinoma. The regression of this tumor with an adrenolytic agent, in conjunction with the similar morphologic and biochemical features of these two types of tumors, provides additional evidence of the close similarity between Leydig cell carcinoma and adrenal cortical carcinoma.
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PMID:Malignant Leydig cell tumor: objective tumor response to o,p'-DDD. 722 52

Twenty-one patients with adrenocortical carcinoma (ACC) diagnosed at three hospitals over a ten-year period were reviewed for clinical and pathologic features that might have therapeutic implications. Depending upon the extent of cellular pleomorphism, ACC could be defined as anaplastic or differentiated. Anaplastic ACC occurred more often in male patients, produced more frequent cutaneous metastases (P = 0.01), and was associated with a lack of clinical or laboratory evidence of hormone production (P = 0.01). In contrast, differentiated ACC usually occurred in women and produced clinical or laboratory evidence of hormonal excess. Median survival time of patients with anaplastic ACC was only five months, while median survival time of those with differentiated ACC was 40 months (P = 0.005). Patients with differentiated ACC survived for long periods, even with metastatic disease. Three of 5 such patients had objective responses to o,p'-DDD (Mitotane) therapy. The histopathology of ACC is an important prognostic factor and should be considered in the design of future therapeutic trials.
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PMID:A clinical and pathological study of adrenocortical carcinoma: therapeutic implications. 737 17

Adrenocortical carcinoma is a rare malignant tumor. The survival rate is related to a radical tumor resection. However, adrenocortical carcinomas are usually diagnosed in advanced stage. Although some cases of long-term regressions of metastases under op'-DDD (Mitotane) therapy have been sometimes reported the overall efficiency of mitotane in prolonging life remains controversial. Between May 1975 and January 1994, 9 patients were surgically treated for adrenocortical carcinoma at our institution. There were 6 females and 3 males, mean age 40.8 years (median 40 years). Five (55.6%) patients presented with abdominal pain, whereas 4 (44.4%) patients had symptoms of hormone secretion (cortisol). One patient was lost at follow-up. Overall survival rate was 16.8 +/- 5.9 months, the survival rates according to tumor stage were: stage I. 58 months (1 case), stage II. 6 and 16 (2 cases; mean 11 months), stage III. 7, 15.17 and 22 (4 cases, mean 15 months) and stage IV. 9 months (1 case). The progression of the disease is not controlled by the administration of op'-DDD and the best treatment is represented by surgery.
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PMID:[Adrenocortical carcinoma. Current approaches in diagnosis and treatment]. 894 4

Adrenocortical carcinoma is rare, tends to occur in the first decade as well as the fourth and fifth decades of life, and is slightly more common in women. The tumors are classified as functional or nonfunctional, depending on tumor production of corticosteroid, androgen, estrogen, or mineralocorticoid. Most patients present with large masses and with stage IV disease. Abdominal computerized tomography and magnetic resonance imaging are used in the evaluation of intra-abdominal disease. The most effective treatment for adrenocortical carcinoma is complete resection. Surgical resection remains the only potentially curative treatment for this disease. Early stage and curative resection are the two clinical factors that are of prognostic significance for long-term survival. Mitotane is the chemotherapeutic agent most often used to treat adrenocortical carcinoma. Its efficacy in prolonging survival is limited but may be enhanced by monitoring of serum levels and their maintenance at elevated values. Even for patients who undergo complete resection, recurrent and metastatic disease are extremely common. The only effective treatment for recurrent disease is reoperation.
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PMID:Adrenocortical carcinoma. 1009 48

In a 7 year old female poodle an adrenocortical tumor was diagnosed on basis of laboratory and ultrasonographic examinations. One year after adrenalectomy, a relapse was diagnosed, at that time the suspicion of metastases in the liver arose for the first time. By treatment with Mitotane in a dose aiming at completely destroying the adrenal cortex, a complete disappearance of the tumor as well as a dramatic reduction of the size of the metastases could be achieved. 12 months after the begin of the chemotherapy, the dog is in good general condition.
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PMID:[Mitotane treatment in a dog with a recurring adrenocortical carcinoma--a case report]. 1038 85


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