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)

A comparison between primary and metastatic germ cell tumours from 38 male patients showed that 19 of 24 metastases with residual differentiated teratoma after adequate therapy came from tumours with teratoma as a component of the primary. The correlation between the presence of teratoma in the primary and the metastases is statistically significant (P less than 0.01) and supports the view that the so called 'maturation' of germ cell tumours is due to selective destruction of anaplastic components in tumours which have already shown an inherent capacity for differentiation. Elevation of the serum concentrations of HCG and AFP on presentation with disseminated disease was significantly related to the presence of morphologically identifiable trophoblast and yolk sac elements respectively in the primary tumours (P less than 0.001). Histological identification and specific mention of teratomatous, trophoblastic and yolk sac elements in reporting germ cell tumours is therefore useful since their presence in the primary correlates with the morphology in the metastases.
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PMID:Significance of the 'maturation' of metastases from germ cell tumours after intensive chemotherapy. 620 25

The most common type of testicular tumor is the germ cell tumor, which shows peculiar histological and biological features. The histopathology of germ cell tumors of the testis is illustrated here according to the WHO classification except for extremely rare polyembryoma and teratoma with malignant transformation. The tumors are divided roughly into 2 groups, one histological type including seminoma, spermatocytic seminoma, embryonal carcinoma, yolk sac tumor, choriocarcinoma and teratoma, and more than one histological type including many possible combinations of one histological type. Seminoma and spermatocytic seminoma show some similar features to the germ cell line, while embryonal carcinoma, yolk sac tumor, choriocarcinoma, and teratoma show differentiation toward a variety of structures appearing at any stage of embryogenesis instead of the original testicular tissue. The histology of the metastatic disease may or may not be the same as that of the primary lesion. The reasons for the occurrence of histological differences between primary and metastatic tumors is discussed. Two major tumor markers of the germ cell tumor, HCG and AFP, are analyzed using immunohistochemical procedure, and the significance of immunostaining for these markers in clinicopathological study is stressed.
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PMID:[Histopathology of testicular germ cell tumors]. 621 48

A rare case of a malignant Leydig-cell tumour of the testis in a 26-year-old patient, with radical orchiectomy from an inguinal incision is described. Although the results of AFP, HCG, biochemical, X-ray, lymphographic and scintigraphic examinations were negative, the first metastases into the lungs appeared one year after the operation. Combined cytostatic treatment, polychemotherapy and X-ray therapy proved ineffective. The patient died of multiple metastases 28 months after the surgical intervention.
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PMID:Malignant Leydig-cell tumour of testis. 648 Feb 83

Seventy one patients with renal tumors treated at our clinic during the 11 years from 1970 to 1980 were clinically examined. The results are summarized as follows. The frequency of patients with renal tumors was 0.22% of the outpatients and 1.72% of the inpatients. Of the 71 renal tumors, 41 were renal adenocarcinoma, and 26 were renal pelvic tumors of which 23 were transitional cell tumors, 2 were squamous cell tumors, and 1 was adenocarcinoma. The other tumors were 1 adenoma, 1 hemangioma, 1 hematoma, and 1 foreign body granuloma. The right and left kidneys were affected at equal frequencies. Male patients were more commonly affected, the sex ratio being 39 to 32. The youngest case was a 29-year-old female, and the eldest was a 84-year-old male. As the initial symptoms and chief complaints, gross hematuria was most frequent (52 cases, 73.2%), followed abdominal tumor mass (32 cases, 45.1%), and fever (26 cases, 36.6%). Only 2 cases showed the classic triad, while 1 case had none of them. The period between onset of symptoms and admission, was within 1 year for all patients except for 2 cases. Metastasis was found in 52 cases. The lung was the most frequent site of metastasis (12 cases, 23.1%), followed by lymphnodes, bones, and liver. The clinical examinations performed and diagnostic techniques used were, renal function (BUN, Serum Cr), Hb, WBC, liver function (T. Bil, GOT, GPT), serum protein fraction, serum LDH, serum Ca, ESR, tumor marker (AFP, CEA), urine cytological examination, blood pressure, IVP (or RP), angiography. As the therapeutic method, nephrectomy was performed in 25 cases (35.2%), combined nephrectomy and irradiation therapy in 12 cases (16.9%), combined nephrectomy and chemotherapy in 11 cases (15.5%), combined nephrectomy and other therapy in 15 cases (21.1%), and conservative therapy in 8 cases (11.3%). For the entire traced series of renal tumors, the 1-, 3-and 5-year survival rates were 72.3, 49.8, and 49.8% respectively. For renal parenchymal tumors (renal adenocarcinoma), the 1-, 3-and 5-year survival rates were 77.8, 53.0, and 53.0%. The most important factor of prognosis was the stage of tumor. Patients with elevated erythrocyte sedimentation rate, and dysproteinemia also had distinctly unfavorable prognosis. In this study of therapy, the highest survival rate was seen for the patients treated by combined nephrectomy and irradiation therapy of both renal parenchymal and pelvic tumors.
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PMID:[A clinical study of renal tumors]. 668

The level of serum TPA was determined by radio-immunoassay in 19 healthy subjects and 90 patients with urogenital cancer. The normal level of serum TPA was 86 +/- 24 U/l, and the level of more than 134 U/l was determined positive. The positive rate of TPA was 38.9% in 90 patients, while that of CEA was 25.6%. In 19 patients with bladder tumor and 7 with testicular tumor, the positive rates of TPA were 52.6% and 71.4%, respectively, and the level of serum TPA was high in these positive patients. Considering the low positive rate of CEA, TPA may be a more useful marker than CEA in patients with bladder tumor and testicular tumor. Serial determinations of serum TPA and CEA showed the considerable variation of serum TPA compared with serum CEA and a temporary elevation of serum TPA following radical nephrectomy and retroperitoneal lymphadenectomy. However, the level of serum TPA fell significantly after the successful treatment in 8 patients (2 with renal cell cancer, 3 with bladder tumor, 1 with prostate cancer, 2 with testicular tumor) and rose sharply with recurrent or metastatic disease in 4 patients (2 with bladder tumor, 2 with testicular tumor). Although there was no correlation between the levels of serum TPA and serum PAP, the level of serum TPA tended to change in parallel with the level of serum AFP or HCG in 3 patients with testicular tumor.
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PMID:[Evaluation of serum tissue polypeptide antigen (TPA) in patients with urogenital cancer]. 672 13

Case 1 was a 55-year-old male with multiple pulmonary metastases after two operations to excise hepatocellular carcinoma. Treatment consisted of initial administration of 5'-DFUR (po), followed by frequent administration of low-dose epirubicin (20 mg/body once every 2 weeks iv). This resulted in disappearance of the pulmonary metastases and a striking decrease in the AFP level. Case 2 was a 68-year-old male with multiple pulmonary metastases after surgery for hepatocellular carcinoma. Treatment with 5-FU (iv; once a week) and epirubicin (20 mg/body once every 2 weeks iv) resulted in disappearance of the pulmonary metastases and a marked decrease in the AFP level. It was concluded that administration of epirubicin in frequent, low doses is a useful method for the treatment of pulmonary metastasis after surgery for liver cancer, and it can be safely performed even on an outpatient basis.
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PMID:[Efficacy of treatment with frequent and low-dose epirubicin in two cases of pulmonary metastases after surgery of liver cancer]. 757 17

Malignant germ cell tumors are an uncommon type of ovarian cancer which account for fewer than 5% of the total in Western countries and 20% in Japan. In females younger than 20, they represent approximately two-thirds of malignant ovarian tumors. Immature teratoma, endodermal sinus tumor, dysgerminoma and mixed type account for the majority (more than 80%), while embryonal carcinoma and polyembryoma are very few. The age of the patients ranges from 6 to 69 years with a median of 16-20 years. Clinically, these tumors are characterized by rapid growth and extensive intraabdominal spread. The symptoms and signs range from 1 day to 6 months with a median of 4 weeks, and the patients usually present with abdominal pain, palpable mass, abdominal distention and vaginal bleeding, and a very few with amenorrhea and precocious puberty. The size of tumors varies from 7 cm to 40 cm with a median of 15-16 cm. The tumor is rarely bilateral (12-19%) and never so in cases of endodermal sinus tumor. Diagnosis depends mainly on age, abdominal symptoms, size and consistency of the tumor, and tumor markers AFP and hCG. Surgery is the first step of management followed by adjuvant therapy, which depends on the histologic type. Dysgerminoma is very sensitive to radiation while other germ cell tumors are not. A combination chemotherapy currently used is VAC or VBP. Both are highly effective. The VBP regimen seems to have a stronger cancerocidal effect, while the VAC regimen is less toxic. VAC produces excellent results in stage I, while VBP is more effective for advanced disease. Conservative surgery and a combination chemotherapy (VAC, VBP) are appropriate for young patients who desire to retain their fertility. Second-look laparotomy is still controversial. As long as AFP or hCG or both can be used to monitor the disease in patients positive for these sensitive and reliable markers, or in an early stage with complete resection, second-look laparotomy is not useful. Survival is associated with prognostic factors, i.e., histologic type, clinical staging operation, lymph node and residual tumor. Patients with endodermal sinus tumor or mixed type tumor had a poorer outcome. The survival rate was higher in patients with earlier disease (stage I or II) and those who underwent primary surgery. Metastasis to the lymph node is not related to prognosis. The presence and size of residual tumors after surgery were closely related to the prognosis.
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PMID:Current management of malignant germ cell tumor of the ovary. 766 94

Two cases of primary extragonadal germ cell tumor of retroperitoneal origin are reported. One was a 26-year-old man complaining of back pain. He had a large retroperitoneal tumor with lung, liver and supraclavicular lymph node metastases. He was referred to us after being treated for malignant lymphoma. The serum AFP, beta-subunit of human chorionic gonadotropin (hCG-beta), CEA and CA-19-9 were elevated. The retroperitoneal disease was treated surgically and with radiotherapy. The pathological diagnosis was that of embryonal carcinoma and teratoma. The lung, liver and supraclavicular lymph node metastases disappeared completely after two courses of cisplatin-based chemotherapy. While further chemotherapy was postponed due to myelosuppression, the disease relapsed and was resistant to subsequent therapy. The patient died twelve months after he first saw us. The second case was that of a 36-year-old man complaining of edematous legs and external genitalia. He had an extensive retroperitoneal tumor with multiple pulmonary metastases. The serum AFP level was high. Suspected of having an extragonadal germ cell tumor, he was referred to us promptly. Cisplatin-based chemotherapy coupled with resection of residual retroperitoneal and pulmonary disease resulted in complete remission. The pathological diagnosis was that of possible embryonal carcinoma. Further chemotherapy was given as scheduled, using granulocyte colony-stimulating factor. The patient has been in complete remission for two years. The chemotherapeutic regimen and surgical policy in the treatment of the two patients were essentially same. Early diagnosis, adequate initial therapy and the use of granulocyte colony-stimulating factor may be relevant to the favorable prognosis in the latter case.
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PMID:Extragonadal germ cell tumor of retroperitoneal origin: report of two cases. 812 21

Following chemotherapy for metastatic nonseminomatous testicular cancer, 86 patients with normal serum markers AFP and HCG underwent resection of residual tumour masses (63 laparotomy, 11 thoracotomy, 12 both). Prognostic factors for relapse and survival were analysed with Kaplan-Meier curves and Cox regression analysis. Putative prognostic factors included age, the primary histology, prechemotherapy level of the tumour markers AFP and HCG, the extent of disease (lymph nodes, lung and hepatic metastases) before and after chemotherapy, the histology of the resected material and the completeness of the surgical procedure. Eleven patients relapsed during follow-up (median 47 months), accounting for a 5 year relapse free percentage of 87.4%. Adverse prognostic factors were (1) prechemotherapy level of HCG (> or = 10,000 IU l-1; (2) incomplete resection; and (3) the extent of disease, especially of lung metastases (prechemotherapy number < or = 3,4-19, > or = 20; or size after chemotherapy > 1 cm; or presence of any residual lung metastasis after chemotherapy without residual abdominal metastases). The histology found at resection was not associated with the risk of relapse, which might be explained by the effectiveness of postresection chemotherapy, which in the majority of these patients was a salvage regimen rather than two further cycles of the initial cytostatics. A good and a poor risk group were formed, based on HCG level and completeness of resection. The effect of salvage chemotherapy after resection of viable cancer cells needs further investigation.
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PMID:Prognosis after resection of residual masses following chemotherapy for metastatic nonseminomatous testicular cancer: a multivariate analysis. 831 13

Various prognostic models are used to predict the outcome of testicular tumour patients, and these are usually based on serum tumour marker levels (AFP and hCG), number and size of metastases to para aortic nodes, lungs and supraclavicular nodes. Greater predictive accuracy can be achieved if 'dynamic markers' are used in addition to these pretreatment variables. Dynamic markers are assessed during treatment by examining the rate of tumour marker decline. Prognostic models can subdivide patients into good risk, intermediate risk, and very poor risk groups. Cisplatin may be replaced by the less toxic carboplatin in good risk patients. High dose chemotherapy with autologous bone marrow transplantation should only be considered for very poor risk patients. Prognosis may be worse if the patient is a smoker, or if he has a first degree relative with testicular cancer. New markers such as chromosomal abnormalities or gene mutations should be examined.
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PMID:How should we identify high risk testicular tumour patients? Round table discussion. 838 51


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