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

Lymph nodes are a common site of metastatic cancer. The ability to view the three-dimensional configuration of complex biological structures, rendered in solid model form, might help to further elucidate the pathophysiology of metastatic disease. This paper presents a method for three-dimensional reconstruction from serial sections of a lymph node containing metastatic adenocarcinoma. The reconstruction and subsequent animation were carried out using the P3D graphics software (developed at the Pittsburgh Supercomputing Center) and rendered by the Dore high-speed renderer on an Ardent Titan graphics workstation. As different views of the model were produced, they were recorded a frame at a time on U-matic video tape. A three-dimensional solid-modeled object portrays metastatic, neoplastic elements within a lymph node.
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PMID:A three-dimensional reconstruction of metastatic adenocarcinoma in lymph node. 235 83

The surgical treatment of extensive metastatic diaphyseal lesions of the humerus with pathologic fractures is difficult. Patients with failed internal fixation often have large segments of bone loss. Rigid fixation often is not possible in these cases. Four patients were treated with a titanium segmental defect (SD) prosthesis with good clinical results. A comparative in vitro analysis of fixation with the SD prosthesis, a Rush rod, and a dynamic compression plate (DCP) augmented with methylmethacrylate was performed. The SD prosthesis performed better than the Rush rod and DCP in both the nondestructive four-point bending test and the destructive torsional test. The reconstructed humeri using the SD prosthesis had a torsional strength approaching that of an intact specimen. Hence, the SD prosthesis is a useful adjunct device in treating patients with extensive destructive lesions of the humerus secondary to metastatic disease and hematologic malignancies and in patients with malignant diseases who have had failed attempts at internal fixation.
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PMID:Metastatic diaphyseal fractures of the shaft of the humerus. The structural strength evaluation of a new method of treatment with a segmental defect prosthesis. 280 86

An 82-year-old man developed a soft-tissue sarcoma in the subpectoral pocket of a titanium-covered pulse generator that had been replaced 8 months previously without evidence of tumor. The tumor represented a metastatic manifestation of a malignant fibrous histiocytoma situated in the contralateral lower pulmonary lobe. The patient died some weeks postoperatively due to cachexia. Autopsy revealed no further metastases. The appearance of cancer in patients with pacemakers is probably coincidental and not related to material or electrochemical stimulation, although the site of the generator pocket might be oncotactic because of the irritation that would trap tumor cells and provide disruption in the intracellular endothelial barrier allowing migration of the tumor cells into tissues. Possible causes and relationships are reviewed.
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PMID:Sarcoma of the lung in a pacemaker pocket--simple coincidence or oncotaxis? 619 80

A retrospective review of 36 patients treated with posterior cervical plating and autogenous iliac crest bone graft was performed to evaluate the results of posterior cervical plating in terms of fusion, outcome, technique, and complications. Numerous methods of cervical stabilization have been described with varying fusion rates and complications. Compared to wiring techniques, there is little information concerning the results of posterior cervical plating. Thirty-six patients with cervical instability underwent posterior plating with lateral mass screw fixation. Twenty-two had acute traumatic instability, four had late traumatic instability, six had metastatic disease, and four had postlaminectomy spondylotic instability. A Minerva brace was worn postoperatively for 3 months and fusion was assessed by bone incorporation on plain films, stable dynamic flexion-extension views, and absence of neck pain. Postoperative MRI and CT imaging was assessed in those patients who underwent these modalities. Fusion occurred at an average of 3 months in all patients. One patient demonstrated postoperative neurologic deterioration, but this resolved with subsequent decompression. Six patients had loosening of short, unicortical screws, but this did not affect the fusion result in five of these patients. The use of titanium implants allowed operative CT and MR imaging without the excessive artifact associated with stainless steel implants. Posterior cervical plating with lateral mass fixation and bone grafting offers a reliable method of achieving fusion. Bicortical lateral mass screws are less likely to loosen than unicortical screws, and no major complications occurred.
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PMID:Posterior plating of the cervical spine. 760 16

A calf spine corpectomy model was employed to compare the ability of various spinal instrumentation techniques to restore stability after destruction of the anterior and middle columns. The constructs tested were an intact specimen, a Harms titanium cage, a cross-linked rectangular anterior Texas Scottish Rite Hospital construct, posterior segmental Luque rods combined with a cross-linked rectangular anterior TSRH construct, posterior Luque rods alone, cross-linked posterior Luque rods, and posterior Luque rods embedded in polymethyl-methacrylate (PMMA). When compared to the intact state, only the combined anterior/posterior construct and the anterior TSRH construct were able to restore axial, sagittal, and torsional stiffnesses to levels equal to or higher than control levels. Embedding Luque rods in PMMA provided greater stiffness than either Luque rods alone or cross-linked Luque rods. If the anterior and middle columns of the spine are incompetent, as frequently occurs with metastatic disease, the goal of surgical treatment is to restore spinal stability while decompressing the neural elements. Either anterior or posterior techniques may be used. The findings of this study imply that commonly used spinal instrumentation constructs differ in their ability to restore axial, sagittal, and torsional stiffnesses to normal levels.
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PMID:Spinal instrumentation for metastatic disease: in vitro biomechanical analysis. 843 12

Corpectomy with methylmethacrylate reconstruction and stabilization in patients with metastatic disease of the spine has been performed for several years. Stainless steel Steinmann pins or K-wires are commonly used to facilitate fixation of the acrylic to the vertebral bodies above and below the resection site. The use of these ferromagnetic substances precludes the optimal use of magnetic resonance imaging in the postoperative period. We now report the use of commercially available titanium screws in conjunction with the methylmethacrylate to eliminate this problem and provide for improved postoperative imaging.
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PMID:Corpectomy and stabilization with methylmethacrylate in patients with metastatic disease of the spine: a technical note. 860 16

Percutaneous implantation sites were used by the same operator in 141 patients (87 females and 54 males) with usually metastatic cancer. A titanium Districath implantable chamber and a 1.1 mm inner diameter silicone catheter were used. Percutaneous venous access was via the subclavian vein in 139 cases (98.6%). Mandatory safety measures were emphasized. Insertion was complicated by puncture of the subclavian artery in 6 cases (4.2%). There were no case with abscess, disunion, infection or death due to the method. The chamber was removed in 7 cases due to: 3 ruptures of the catheter, 2 septicaemias, 1 rejection reaction and 1 psychological intolerance. In our series, percutaneous implantation via the subclavian vein has been a reliable and rapid technique with little morbidity.
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PMID:[Implantable sites in cancerology. The percutaneous technique. Results of a homogeneous series of 141 cases]. 881 61

The authors present their experience in the operative treatment of unstable lesions at the cervicothoracic junction. Ten patients, six men and four women, underwent operative procedures at the cervicothoracic junction (C7-T1) between 1990 and 1997. Six patients had sustained fracture-dislocations, three patients had metastases and one patient had a primary malignant lesion. All the patients had significant cervical pain and neurologic deficit. The spinal cord and nerves were decompressed in all cases. Posterior stabilization was accomplished using various types of implants including hooks, wires and rods. Anteriorly, the spine was stabilized with plates and screws. Partial or complete vertebrectomy was performed in five cases and a titanium cylinder or an iliac autograft replaced the vertebral body. Five patients were submitted to a posterior operation only, and the other five to bilateral procedures. In four of these a one-stage operation was performed and in the last case a two-stage procedure. The anatomic and biomechanical characteristics of the cervicothoracic junction require a precise pre-operative analysis of the local anatomy and the selection of the proper implants for anterior and posterior stabilization.
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PMID:Operative treatment of unstable injuries of the cervicothoracic junction. 1048 29

Despite advances in screening procedures and the use of adjuvant therapy, approximately 50% of patients with colorectal cancer eventually will develop metastatic disease. Long-term disease-free survival can be achieved in 25% to 40% of selected patients who undergo resection of liver or lung metastases. For all other patients, treatment is palliative. For decades, 5-fluorouracil was the only available drug for colorectal cancer; hence, numerous trials were performed that used various administration schedules and modulating agents to improve therapeutic efficacy. The addition of leucovorin to 5-FU improves response but not survival. Infusion schedules alter the toxicity profile but have a negligible impact on survival. Irinotecan was the first new drug to demonstrate activity in colorectal cancer. It was used initially in the second-line setting, where it was shown to improve quality of life and survival over best supportive care or infusional 5-FU. Recently, irinotecan has been incorporated into the front-line treatment of metastatic colorectal cancer in combination with 5-FU and leucovorin; this combination improves survival by approximately 3 months. Careful patient selection and adherence to strict dose adjustments are essential to prevent significant toxicity when patients are treated on this regimen. The oral fluoropyrimidine capecitabine recently has been approved for the front-line treatment of patients with colorectal cancer who are not appropriate candidates for combination therapy. Oxaliplatin, a novel DACH (diaminocyclohexane) platinum with definite activity in colorectal cancer, is approved for this disease in Europe and is undergoing phase III clinical trials in the United States. Other drugs with potential activity in colorectal cancer include raltitrexed, pemetrexed disodium, and the epothilone analog BMS-247550 (Bristol-Myers Squibb, New York, NY). Novel cytostatics with promising activity in colorectal cancer are being evaluated in clinical trials, including epidermal growth factor receptor inhibitors, such as IMC-C225 (Imclone Systems, New York, NY) and ZD1839 (AstraZeneca, London, UK), angiogenesis inhibitors such as bevacizumab and SU5416 (Sugen, San Francisco, CA), and vaccines such as CEAVac (Titan Pharmaceuticals, San Francisco, CA). For those patients whose disease is localized to the liver, there also is an emerging role for local therapies, including cryosurgery, radiofrequency ablation, and hepatic artery infusional chemotherapy, and resection. The emergence of these new drugs and new interventional modalities has allowed physicians who treat colorectal cancer to move beyond 5-FU.
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PMID:Metastatic colorectal cancer. 1205 92

This paper reports one case of primary fibrosarcoma affecting the mandible in a 41-year-old woman. Microscopically, the tumor was cellularized with an intense mitotic activity, and areas of necrosis and hemorrhage, and the cells showed immunoreactivity only for vimentin, establishing the diagnosis of primary intraosseous fibrosarcoma. The patient underwent tumor surgical resection, supraomohyoid neck dissection and mandible reconstruction with fibula flap and titanium bar. She also received post-surgical radiotherapy and is in follow up for 36 months without signs of recurrence or metastases.
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PMID:Primary intraosseous fibrosarcoma of jaw. 1605 82


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