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

In a previous report CT was shown to have no advantage over physical examination in the detection of metastatic neck disease. Therefore, a study was undertaken to evaluate whether MRI would show superiority to the CT in the diagnosis of neck nodes. A series of 35 patients with various head and neck tumors were evaluated clinically, radiographically and pathologically. Eight patients were excluded from the study because of various problems involving the MRI. Therefore, 27 patients with 30 neck dissections were analyzed. There was little advantage of MRI over clinical examination in the detection of metastatic neck disease. The present size criterion for the diagnosis of occult malignant nodes is not reliable. The soft tissue contrast resolution reported by MRI is inadequate to detect minimal morphological changes in lymph nodes involved by metastases, and MRI is difficult in patients who have airway or foodway obstruction.
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PMID:MRI and neck metastases: a clinical, radiological, pathological correlative study. 226 59

Eighteen patients with suspected primary or recurrent ovarian carcinoma have been investigated in each case by the assay of serum levels of the antigen CA125, immunoscintigraphy using 131I-OC125 antibody and magnetic resonance imaging using a 0.15 Tesla system. The final diagnosis was confirmed by laparotomy or laparoscopy. Serum levels of CA125 ranged between 5 and 780 units/ml (normal range less than 35). Antibody images and MRI were truly positive in 11 patients, 2 of whom were subsequently found to have bowel tumours. MRI showed greater detail of smaller lesions whilst immunoscintigraphy was more suited to the detection of distant metastases. In 7 patients the antibody images were positive whilst the serum marker levels were normal. This pilot study provides a preliminary comparison of the more recent techniques currently being evaluated for the detection of ovarian carcinoma.
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PMID:A prospective evaluation of OC125 and magnetic resonance imaging in patients with ovarian carcinoma. 235 Nov 78

From March 1985 to September 1988, 38 out-patients with nasopharyngeal carcinoma (NPC), proven by pathology and examined by CT scan or MRI with involvement of deep upper cervical lymph nodes larger than 2 cm, were treated. The invasion of the poststyloid space is probably caused by metastases of the lymph nodes deep-seated in the neck and not by direct infiltration of the primary tumor. In TNM staging, it should be considered as N1, but not T3. As to the design of radiotherapy for these cases, the upper margin of the cervical field should be moved up to the level of the external auditory meatus in order to encompass the base of the skull. If lymph nodes in the mastoid cells on the same side are involved, beta-beams with energy not lower than 15 Mev should be used to ensure enough dose in the target volume.
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PMID:[Invasion of poststyloid space and metastasis of deep upper cervical lymph node in nasopharyngeal carcinoma]. 240 Nov 73

Over the past 10 years there has been significant progress made in the recognition and treatment of soft tissue sarcomas. With the advent of CAT scans and MRI, preoperative delineation of soft tissue tumors has become readily available. The diagnostic use of these modalities in patients presenting with an ill-defined asymptomatic mass has been extremely helpful in terms of screening patients to decide whether or not a biopsy is indicated. These techniques have also provided a much clearer delineation of the anatomic extent of the primary tumor, which has been of great assistance both in radiation therapy treatment calculations as well as in preoperative surgical planning. The recognition that tumor grade is the dominant prognostic variable has resulted in the more common use of a grading system, and a more uniform reporting and stratification of end results. Recent studies with immunohistochemical staining have proven of value in determining the histogenesis of many tumors that in the past were difficult to classify accurately. Most recently the use of flow cytometry suggests that this will also be a valuable adjunct in determining tumor grade and thereby prognosis. The most recent investigations of molecular biologic evaluation of genetic DNA and RNA sequences, as well as of oncogenes are extremely interesting from a diagnostic standpoint and in demonstrating the potential of molecular biologic evaluation for understanding the origin of these tumors. Multimodality therapy with surgery, radiation, chemotherapy, or all three has resulted in a marked improvement in local tumor control for patients with soft tissue sarcomas. The combination of modalities has allowed smaller surgical excisions of the tumor and thereby preservation of the extremity and much of its function. There are currently several different methods of multimodality therapy used including neoadjuvant therapy and postoperative therapy, both of which have been proven efficacious. Chemotherapy is now playing an increased role in clinical investigation and treatment. The availability of Adriamycin, DTIC, cisplatin, and most recently ifosfamide has added several chemotherapeutic agents for use by the clinician. Combination chemotherapy and radiation is of value in the neoadjuvant setting, and several studies are now underway to determine whether postoperative adjuvant chemotherapy is of similar value in reducing systemic spread of disease. Finally, surgical resection of pulmonary metastases has been proven of value in 20% to 25% of patients who subsequently develop metastatic disease. As a result of these advances in several different treatment disciplines, the overall survival rate and quality of life of patients with soft tissue sarcoma have improved markedly over the past 10 years.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Progress in the recognition and treatment of soft tissue sarcomas. 240 92

We are reporting our experience in 23 patients with tumors of the thoracic or lumbar vertebrae treated via surgical anterior decompression and stabilization. Seventeen patients had metastatic disease and were treated with vertebral body resection followed by stabilization with anterior polymethylmethacrylate and threaded Harrington rods with sacral distraction hooks. Six patients had primary tumors and, following tumor resection and partial vertebral body resection, had autogenous bone graft struts placed anteriorly as well as posterior instrumentation. Posterior instrumentation was transpedicular one level above and below in the lumbar spine, and segmental hooks and rods three levels above and below in the thoracic spine. Nineteen patients presented with severe unremitting pain, and 16 had neurologic deficits, including 7 who were unable to ambulate. Radiation therapy was used as an additional treatment and routinely begun 2 weeks postoperatively. All patients survived the surgery, and none had neurologic deterioration immediately postoperatively. Eight patients had died at the time of review. The mean survival was 14 months and ranged from 6 to 38 months. Of the surviving patients, follow-up ranged from 24 to 40 months with an average follow-up of 30 months. Pain relief was excellent in all but two patients (93%). Motor recovery occurred to some extent in all patients, and only one remained nonambulatory. Complications were minor in three patients (13%) and major in one (4%). Tumor recurrence with neurologic deterioration occurred in two patients. We are very encouraged by these results, and we recommend that patients with tumors of the vertebral body with neurologic deficit or severe unremitting pain be studied with MRI and/or myelography and CT. The patients with gross vertebral destruction and greater than 50% collapse of the vertebral body, those in need of a tissue diagnosis, or those with major neurologic deficit can be effectively treated by anterior decompression and stabilization.
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PMID:Tumors of the thoracic and lumbar spine: surgical treatment via the anterior approach. 252 70

A case of Wilms' tumor metastatic to the liver with previously undescribed MR findings is presented. Although there is no evidence that there were hepatic metastases at presentation in this case, small lesions with this appearance would be difficult to detect with MRI. This could lead to incorrect staging of Wilms' tumor examined by MRI alone.
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PMID:Metastatic Wilms' tumor to the liver with MR findings simulating cysts: case report emphasizing need for integrated imaging. 254 90

The incidence of cervical cancer is decreasing, wherever screening programs are offered and accepted. Pathogenetic factors for dysplasia and cervical cancer among others are coital activity in early adolescence, promiscuity and low economic status. More than 80 percent of severe cervical dysplasias as a precancerous stage show the oncogenic potential of a sexually transmitted disease. The prognosis of cervical cancer widely depends on the stage found at the time of first detection. The staging procedure which then follows needs gynecological experience and skill. Clinical staging with methods auxiliary to inspection, colposcopy and palpation is still the most common method and remains to be the basis of the international data treasure of the Annual Report of FIGO, although clinical methods and even CT and MRI are insufficient for the evaluation of pelvic and/or paraaortic lymphnode metastases. To overcome the imperfection of clinical staging, surgical procedures are recommended to complete before any therapeutic decision is made, at least in cases thought to be operable. Radical hysterectomy with pelvic lymphadenectomy in stages Ib and IIa is the method of choice in most modern centers of gynecologic oncology. However, radiotherapy is still prevalent in all stages of cervical cancer as the most common therapy around the world. Further development in 5-years survival figures is expected to profit from supporting screening programs in risk populations or from expansions of already existing programs rather than from further modifications of the therapeutic modalities, already highly specialized.
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PMID:[Cervix cancer: incidence, diagnosis, therapeutic principle]. 262 51

Advances in the treatment of stage 0 to III superior sulcus tumors mandate greater accuracy in establishing tissue diagnosis, assessing tumor extent, and staging. Currently, this is best accomplished by a combination of PA chest radiography, MRI, and needle biopsy. MRI is superior to other single imaging modalities for the overall assessment of local tumor extent, bone invasion, mediastinal invasion, and perhaps in the future, determining radiosensitivity. In patients with superior sulcus tumors, evaluation of the brain, liver, and skeleton for metastases may be advisable prior to treatment with preoperative radiation and radical surgical resection.
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PMID:Superior sulcus tumors: the role of imaging. 264 14

Cross-sectional imaging techniques have dramatically improved the diagnosis of adrenal disease. In most patients with endocrine-active adrenal disease, CT is the only imaging test needed to establish the correct diagnosis. Adrenal venography with blood sampling may provide important additional information in patients with Conn adenoma. Magnetic resonance imaging and (IMBG) scintigraphy appear to be the best imaging tests for the localization of multiple or extra-adrenal pheochromocytomas. Inactive adrenal tumors detected incidentally are a problem as for as diagnosis is concerned, since inactive adrenal adenomas have to be differentiated from carcinomas and metastases. MRI is rarely helpful in these cases. For patients with a known primary tumor, the authors recommend CT-guided biopsy. In all other cases a follow-up study often reveals that the adrenal tumor detected is benign.
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PMID:[Current developments in the radiologic diagnosis of the adrenal glands]. 264 16

This paper is based on an invited lecture given at the SICOT 87 meeting in Munich. The topics discussed include: selective spinal arteriography in the management of tumours, which enables definition of the vascular supply of the cord and of the tumour and may facilitate preoperative embolisation; MRI, which allows visualisation of both bone and soft tissue; the pathogenesis of transverse fractures of the upper sacrum; the management of malunion of fractures of the thoracolumbar spine by a three stage procedure, in which an initial posterior approach allows osteotomy and definition of the pedicle, a second anterior procedure for correction of the deformity by appropriate resection of the vertebral body, and a final posterior operation in which internal fixation is carried out using pedicular screws and plates. Operation on extradural tumours of the spine is usually palliative for metastases and aims to decompress the cord by laminectomy, stabilising the spine by osteosynthesis. Total removal of a vertebral body may be needed; percutaneous resection is being used increasingly for lumbar disc resection; the development of the Cotrel-Dubousset system and the use of long transpedicular plates allows better reduction of the deformity in scoliosis.
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PMID:[Current trends in surgery of the spine]. 266 40


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