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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Nine patients with the Zollinger-Ellison syndrome seen at a single referral centre between 1976 and 1981 are presented to highlight changes in the recognition, diagnosis and management of the condition. Less well recognized manifestations such as diarrhoea and features of the multiple endocrine neoplasia (MEN) type I syndrome are described, and the simplification of the pre-operative diagnosis by the use of both the serum gastrin estimation and the secretin provocation test considered. The problem of tumour localization is discussed with special reference to the newer techniques such as ultrasound, endoscopic retrograde cholangiopancreatography (ERCP) and CAT scanning, and the value of arteriography confirmed. The striking advances in management during the past few years are stressed with special reference to the role of the H2-receptor blocking drugs. Despite their profound inhibitory effect on both acid secretion and symptoms, all patients with the exception of those with proven metastases or the MEN type I syndrome underwent laparotomy to exclude a resectable lesion. If no resectable lesion was found truncal vagotomy was performed to facilitate acid secretory control post-operatively and H2-receptor blocking drugs continued in a dose necessary to maintain basal acid secretion under 5 mmol/hr.
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PMID:Changing concepts in the presentation, diagnosis and management of the Zollinger-Ellison syndrome. 613 24

Pulmonary dissemination of breast cancer is frequent in those patients who have died of the disease and in those survivors who have not been cured after removal of the breast and X-ray treatment in the advanced states of the disease. When the metastases are identified, they are almost always multiple and bilateral. The appearance of a solitary, late pulmonary coin lesion (metachrone) in someone with breast cancer certainly suggests a pulmonary metastasis, but in fact, it is more likely to be a second cancer than a metastasis, that is, a primary bronchopulmonary cancer. The presence of a solitary pulmonary coin lesion in someone who has or who has had breast cancer, presents therefore certain particular problems. After having controlled by xerotomography or CAT that there is no pulmonary diffusion in either lung, that there is no invasion of other tissues or organs, and after having controlled locally around the breast cancer, then it is imperative to remove the lesion without delay since it is certainly malignant and most probably a second cancer, that is a primary broncho-pulmonary cancer, an adenocarcinoma, detected at an asymptomatic stage. the prognosis of a broncho-pulmonary adenocarcinoma, depends on the precocity of its removal.
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PMID:[Surgical treatment of pulmonary round foci detected in one male and eight female patients with breast cancer. Solitary metastasis, a second primary bronchopulmonary cancer or benign round foci? (author's transl)]. 624 93

The evaluation of size and histological type of primary tumors of the lung and of the draining regional lymph nodes needs a very extensive diagnostic program. This means a standardized basic program (case history, physical examination, laboratory diagnosis, X-rays of the chest, cytologic evaluation of the sputum, and bronchoscopy), and further examination depending on the findings in the individual patients (lung scan, mediastinoscopy, needle biopsy, angiography, thoracoscopy, and sometimes diagnostic thoracotomy). Looking for distant metastases it is necessary to investigate the most frequently involved organs: the liver (sonography, scan, CAT scan, laparoscopy), the skeleton (scan, X-ray, biopsy), the central nervous system (CAT scan, electroencephalogram, liquor cytology, myelography), and the retroperitoneal space (sonography, CAT scan). It is absolutely necessary to follow this program in patients with small cell carcinoma. Contrary, in patients with other types of lung cancer the whole diagnostic program is indicated when clinical signs evoke suspicion of metastases. The limits of the different diagnostic procedures are discussed.
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PMID:[Methods and problems in staging bronchial carcinomas]. 625 17

Computerized axial tomographic scans (CAT scans) of thorax and abdomen were used as part of the initial staging procedure of 50 consecutive patients with small-cell bronchogenic carcinoma (SCBC). The aims were to define the extent of the primary tumor and metastatic spread, and to compare the information obtained from CAT scans with conventional staging procedures. With CAT scanning, spread of the primary tumor was found to be far more extensive than originally believed when defined by conventional assessment. Of 35 patients conventionally staged as localized T1 or T2 tumors, 27 (77%) had their stage increased to extensive T3 disease. similarly, subcarinal lymph nodes were found in one patient when conventional methods were used (2%), but 16 patients (32%) were found when CAT scan was used. Unsuspected adrenal metastases were found in eight patients (16%) and retrocrural nodes in four patients (8%). Thirty-seven patients (74%) were found to have Stage III tumors when conventional staging was used; 47 patients (94%) were found to be Stage III following CAT scanning, demonstrating that, within the thorax, localized tumors are very uncommon. CAT scanning demonstrates the degree of intrathoracic spread very clearly, and has a valuable role in the initial investigation of patients with SCBC if the planned treatment includes radiotherapy.
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PMID:Computerized axial tomography in the pretreatment assessment of small-cell carcinoma of the bronchus. 626 27

A total of 49 patients were treated using intraarterial cis-platinum infusions at a dose of 100 mg/m2. The patients were separated into three groups. There were 13 patients with metastatic tumors, 10 with recurrent malignant gliomas, and 22 patients with high-grade gliomas who received intraarterial cis-platinum as part of an adjuvant program. In addition, four nongliomatous primary brain tumors were treated in this fashion. Cis-platinum was filtered immediately prior to intraarterial infusion using a 0.22-micron filter. Response to treatment was evaluated by follow-up CAT scans and neurologic examinations. There were three complete and eight partial responses in metastatic tumors, and eight partial responses in recurrent gliomas. The median survival was 19 weeks for patients with metastatic disease, and 16 weeks for patients with recurrent gliomas. Those high-grade glioma patients who received intraarterial cis-platinum as adjuvant chemotherapy along with CCNU and radiation therapy had a projected median survival of 91+ weeks. Toxicity from intraarterial cis-platinum following drug filtration was markedly reduced when compared with previous reports. Only five patients experiencing visual or central nervous system toxicity utilizing filtered cis-platinum and no radiographic or histopathologic evidence of central nervous system toxicity was observed. Bilateral deafness was observed following vertebral artery infusion in both patients treated in this manner and thus vertebral artery infusions should be avoided. Systemic toxicity was mild. Intracarotid infusion is a safe, well-tolerated delivery system for filtered cis-platinum with a high response rate for patients with both metastatic and primary malignant brain tumors.
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PMID:Intraarterial cis-platinum chemotherapy for patients with primary and metastatic brain tumors. 654 19

In order to assess the accuracy of CAT in the follow-up of the patients affected by ovarian carcinoma, we compared the results of this method to those of second-look laparotomy in 19 patients. In 16 out of 19 patients the CAT showed the presence or absence of disease correctly. There were 3 false negatives, caused by small diffuse peritoneal metastases, and no false positives. The results of this study show that CAT, though useful in studying the evolution of abdominal and pelvic carcinomas, cannot replace the surgical second-look in cases of ovarian cancers, due to the high incidence of false negatives.
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PMID:The role of computerized axial tomography in the follow-up of patients with carcinoma of the ovary. 671 64

Computertomography of the lumbar spine shows exactly shape and size of the spinal canal. CAT of Patient with chronic nerve root compression syndrom revealed mostly bony narrowness of the intervetebral notch, - foraminal entrapment -, and thickening of the laminae - laminar compression -. Following alterations were vissible by CT scanning Bony entrapment of the notch by degenerative hypertrophy of the facets. Idiopathic stenosis of the spinal canal. Developed stenosis of the spinal canal. Unilateral idiopathic narrowness of the recessus lateralis Spondylolysis. Postoperative calcification in the notch area. Prolapsed disc with and without contrastmedium Metastasis within L4 vertebra. Spondylitis tuberculosa.
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PMID:[CT-scanning of the lumbar spine (author's transl)]. 742 12

The prognosis for irradiated patients with localized prostatic carcinoma following transurethral resection of the prostate (TURP) has been debated. Controversy centers upon whether or not TURP has an adverse effect on the outcome. A retrospective analysis of 264 patients treated during 1974-1991 with radical external beam radiotherapy was performed. Ten patients who were irradiated postoperatively were excluded. One hundred and nine patients with urinary obstruction underwent TURP. In another 155 patients, pathological diagnosis was made by needle aspiration or tru-cut biopsies. One hundred and one patients received endocrine manipulation, 58 (40%) in the needle biopsy group, and 43 (39.5%) in the TURP group. Lymph node staging by pelvic lymphadenectomy (20 cases), lymphangiography (15 cases), and CAT and/or NMR (113 cases) was performed in 148 patients. Nodal metastases were found in 38 patients, 19 in the needle biopsy group, and 19 in the TURP group. Disease-related, disease-free and metastasis-free survivals were calculated for all stages and within each tumor stage and histological grade for both groups. Correlation of pretreatment factors with clinical outcome was evaluated by multivariate analysis. Overall, disease-related survival was significantly higher (P = 0.05) in patients undergoing needle biopsy than in those who had TURP (58% vs. 38% at 10 years). This difference was more significant in the subset of patients with well differentiated tumors (P < 0.01). However, no difference could be observed between the two groups in histological grade 2 and 3 tumors or by stage comparison.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Prognostic impact of transurethral resection on patients irradiated for localized prostate cancer. 756 20

There are presently three classifications of metastatic gestational trophoblastic tumors (MGTM). The first is that of low-risk and high-risk neoplasia devised by Hammond, now designated the National Cancer Institute classification. The second is that of FIGO that attempts to conform to the staging of other gynecologic malignancies by that organization. The third is a scoring system adopted by World Health Organization (WHO) from the original devised by Bagshawe. This scoring system is finding the widest acceptance and is increasingly being used for treatment planning. However, different investigators not only define risk groups differently from the WHO recommendation, but also modify the WHO scoring system in novel, individualistic ways that changes the total score and outcome assessment. This results in patients with the same risk factors being placed in different WHO risk groups. Comparison of therapy between center is then invalidated. Furthermore, it would appear preferable that the WHO scoring system is restricted to metastatic neoplasia. To achieve a uniform scoring system for MGTN there needs to be consensus (i) whether lung metastases should be detected by chest X ray or CAT scan; (ii) whether the size of metastases should be measured clinically or radiologically (including ultrasound, CAT scan, and MRI); (iii) are multiple lung or brain metastases counted by CAT scan or MRI; (iv) are ABO blood groups to be included so that the number of points is uniform for different centers; and (v) that idiosyncratic and individual categories are not added or omitted from the score.
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PMID:The trophoblastic Tower of Babel: classification systems for metastatic gestational trophoblastic neoplasia. 789 99

The authors illustrate their experience in the systematic use of intraoperative ultrasonography of the liver in patients undergoing surgery due to gastrointestinal cancer. The liver is the organ in which metastases from colorectal, stomach, pancreatic, and biliary cancer are most often localised. Between January 1991 and April 1992 95 patients underwent intraoperative ultrasonographic controls of the liver. In all cases the liver was studied using traditional image diagnosis: standard ultrasonography and CAT. On the basis of their experience the authors observed 12 cases negative for metastases using CAT and traditional ultrasonography which were positive using intraoperative ultrasonography, 2 cases which were positive for secondary hepatic lesions using traditional diagnostic tools but negative following histological tests guided by intraoperative ultrasonography. In the case of false negatives using traditional methods, those metastases revealed by intraoperative ultrasonography were above all located deep down and in segments which are difficult to explore, or were so small that they were not visible or palpable during intraoperative controls of the viscera. Intraoperative ultrasonography of the liver has been found to be a more sensitive test (97% of the best series) than standard ultrasonography (65%) or CAT (43%). Higher resolution due to the characteristics of the method is coupled with the possibility that intraoperative ultrasonography may be used to guide biopsies of the metastases revealed, thus allowing histological confirmation to be obtained: for this reason the risk of false positives is virtually zero.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Intraoperative ultrasonography in the diagnosis of liver metastasis from gastrointestinal neoplasms]. 812 89


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