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)

In view of the characteristic intra-abdominal spread of carcinoma of the colon and rectum [1-3], the use of intraperitoneal chemotherapy may offer an alternative to intravenous or oral drug therapy and even radiation therapy for recurrent disease [4,5]. Several investigators have demonstrated that intraperitoneal drug administration may result in portal vein levels ten to 20 times higher than those observed in peripheral venous blood samples [6]. Traditionally, intraperitoneal chemotherapy has been administered through the Tenckhoff catheter system which was originally developed for peritoneal dialysis in patients with acute or chronic renal failure [7,8]. We report a case of Tenckhoff catheter erosion into the colon with subsequent fistulization developing 20 days after intra-operative placement for intraperitoneal or "belly bath" chemotherapy; this complication occurred in a patient with locally recurrent colorectal adenocarcinoma in whom pelvic peritoneal implants without hepatic metastases were identified at reoperation. This complication of the Tenckhoff catheter system has not previously been reported in the surgical literature.
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PMID:Colocutaneous fistula complicating Tenckhoff catheter placement for intraperitoneal chemotherapy. 649 16

A 67-year-old woman died after 4 years of treatment by haemodialysis. End-stage renal failure was caused by polycystic kidney disease. Malignancy was suspected in the last 6 months of treatment because of impressive weight loss and a suspect liver-scan. Macroscopic haematuria in the first period of treatment was noted only once. Necropsy revealed renal carcinoma of the right polycystic kidney and tumour metastases in various organs. The problem of development of renal carcinoma in polycystic kidney disease in the light of the increased incidence of malignancy during chronic renal failure is discussed.
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PMID:Development of renal carcinoma in a patient with polycystic kidneys undergoing chronic haemodialysis. 739 7

Cross-sectional echocardiography was performed on 69 patients with pericardial effusion. The etiology of the pericardial effusion was malignant infiltration of the pericardium in nine patients; chronic renal failure in 10; postcardiac surgery in 31; viral pericarditis in three; tuberculous pericarditis in two; and undetermined in 14. Seven of the nine patients with pericardial metastases were noted to have irregular cauliflower-like masses protruding from the pericardium and the epicardium into the echo-free space of the pericardial effusion. These masses demonstrated a to-and-fro motion within the pericardial space during ventricular systole. The presence of pericardial metastases was confirmed at operation in four cases and the three others had intrathoracic or colonic malignancy with widespread metastases. None of the patients without pericardial metastasis showed the characteristic abnormality seen in patients with pericardial metastases. Six patients had dense linear echoes connecting the pericardium and epicardium that probably represented adhesions (confirmation at surgery in one, and confirmation at autopsy in another), with an appearance that was different from that seen in pericardial metastases. We conclude that cross-sectional echocardiography may be useful for detecting pericardial metastases.
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PMID:Detection of pericardial metastases by cross-section echocardiography. 743 93

A 15-year old male with chronic renal failure secondary to obstructive uropathy received an adult cadaveric donor kidney. Evaluation for painless macroscopic hematuria occurring 2 years after transplantation disclosed a metastatic renal cell carcinoma, which by the use of restriction fragment length polymorphism analysis was shown to be of the donor's origin. Transplant nephrectomy and cessation of immunosuppressive therapy resulted in complete regression of multiple pulmonary metastases.
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PMID:Metastatic renal carcinoma in a pediatric recipient of an adult cadaveric donor kidney. 750 73

From 1985 to 1991 the author operated on 21 bladder cancers, forming cross anastomoses on the upper urinary tracts. 19 patients underwent cystectomy. Stage T2, T3, T4 was diagnosed in 4.8%, 80.9% and 14.3% of the patients, respectively. Hydroureteronephrosis was detected in all the patients, chronic pyelonephritis developed in 16 (76.2%), chronic renal failure in 9 (42.9%). Upper and low transureteroureteronephrostomy (TUUN) was performed in 13 (61.9%), transureteropyelonephrostomy (TUPN) in 3 (14.3%), transureteropyelo-ureterosigmoidostomy in 5 (23.8%) patients. The latter technique implies successive connection of the kidneys with the sigmoid. This provided less exposure of one of the kidneys to the intestinal infection, urinary fistulas did not form. Two deaths in the postoperative period were due to metastases and thromboembolism. The authors believe that the best functional conditions for the kidneys are secured by upper TUUN, TUPN and transureteropyelo-ureterosigmoidostomy applicable in cystectomy and in normal tonicity of the upper urinary tracts.
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PMID:[Urinary diversion in cystectomy in bladder cancer patients]. 794 Nov 56

Glomus tumors are characteristically benign solitary tumors. A few cases of malignant glomus tumors have been reported; however, they are usually only locally invasive, and metastases are exceedingly rare. We report a case of widespread metastases of a malignant glomus tumor involving the skin, lungs, jejunum, liver, spleen, and lymph nodes in a 63-year-old man with end-stage chronic renal failure. At autopsy, multiple glomus body hamartomas were also noted throughout the dermis proximal to the skin tumors. Histologically, the tumor was composed of monotonous round cells in solid sheets and investing numerous capillary-sized vessels. Approximately four to six mitoses were present per high-power field. The tumor cells were strongly immunoreactive for actin and vimentin, and ultrastructurally there were whorls of microfilaments with focal condensations. This case is exceptional because of its aggressive course.
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PMID:Malignant glomus tumor. A case report of widespread metastases in a patient with multiple glomus body hamartomas. 855 13

We assessed the role of cytoreductive surgery in patients with metastatic renal cell carcinoma (RCC) selected for interleukin-2 (IL-2)-based immunotherapy. Sixty-three consecutive newly diagnosed patients with metastatic RCC were treated at our institution between April, 1990 and October, 1994. The patients were selected based on their ability to undergo a radical nephrectomy and to receive a combination of interleukin-2 and interferon alfa (IFN-alpha). The mean age was 58.7 years (range, 34-74 years). All but one patient had an Eastern Cooperative Oncology Group performance status of 0 or 1, and presented with metastatic disease and locally advanced primary tumors. All patients successfully underwent cytoreductive nephrectomy, but 6 patients (10%) required concomitant resection of caval thrombus, 3 (5%) required partial hepatectomy, 2 (3%) needed duodenal repairs, and 1 (2%) required a splenectomy. Postoperative complications were observed in 8 patients (12.7%). There were no postoperative mortalities. Seven patients (11%) could not undergo immunotherapy because of myocardial infarctions (n = 2), no growth of tumor infiltrating lymphocytes (TILs) (n = 1), deterioration of performance status (n = 1), transient ischemic attack (n = 1), chronic renal failure (n = 1), and a diagnosis other than RCC (n = 1). Overall, 56 of 63 (88%) patients selected underwent immunotherapy. Among these 56 patients, a response rate of 33.9% [7 (12.5%) complete, and 12 (21.4%) partial] was observed. Moreover, the 2- and 3-year survival rates were 43% and 38%, respectively. Our results support the argument for an aggressive approach (surgery combined with IL-2-based immunotherapy including TILs) in the management of metastatic RCC. Further studies are needed to elucidate the individual contributions of these therapeutic processes.
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PMID:Cytoreductive surgery in the management of metastatic renal cell carcinoma: the UCLA experience. 894 23

A case of multicentric gastrointestinal angiosarcoma suffering from severe melena is presented. Endoscopical examination revealed two polyps in the stomach and duodenum. Histological examination showed angiosarcoma. Although a gastroduodenectomy was performed, severe melena continued, and the patient developed respiratory failure and died. At autopsy, multiple hemorrhagic tumors were present from the duodenum to the cecum. Histologically the tumors demonstrated vasoformative structure and were immunohistochemically positive for von Willebrand factor (factor VIII related antigen), CD34, and CD31. Numerous metastases were found in various organs, including the lungs, bones, liver, gall-bladder, and lymph nodes. The patient had received hemodialysis for 21 years due to chronic renal failure. Long-term dialysis had been associated with various malignancies. Multicentric development of angiosarcoma in the present case may also be related to long-term dialysis.
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PMID:Multicentric angiosarcoma of the gastrointestinal tract. 929 36

Among patients admitted to the therapeutic department of the general hospital for 5 years, diagnosis of pericarditis was made in 110 patients (0.44%). Among the most common causes of secondary pericarditis were: chronic renal failure (31.8%), diffuse lesion of the connective tissue (17.7%), tumor metastases to the pericardium (15.5%). Primary pericarditis was, as a rule, of tuberculous etiology. Morphologically, it was adhesive or adhesive-exudative, constrictive, exudative in 13, 4.5 and 76% of patients, respectively. Half of the patients with exudative pericarditis had 300 to 800 ml of fluid in the pericardial cavity. Typical clinical manifestations were dyspnea and tachycardia. X-ray was diagnostically valuable in pericardial exudate 300 ml and more. ECG voltage fell in exudate more than 400-500 ml. Echocardiography remains an effective tool in diagnosis of pericarditis. The treatment consisted of antibiotics, antiinflammatory therapy, evacuation of the liquid from the pericardial cavity.
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PMID:[Pericarditis: 5 year records of general hospital]. 964 32

Immunosuppression in the setting of solid organ transplantation is associated with the development of a variety of malignant tumors, most commonly squamous carcinomas and non-Hodgkin's lymphomas. Sarcomas, apart from Kaposi's sarcoma, are relatively infrequent. We recently encountered a 71-year-old man with chronic renal failure, treated by allograft kidney transplantation, who developed a high-grade epithelioid angiosarcoma at the site of a nonfunctioning arteriovenous fistula, previously constructed for hemodialysis. At diagnosis, the patient had numerous satellite nodules of angiosarcoma involving the distal skin, soft tissues, and bones. After a below-elbow amputation, there was a rapid local recurrence at the amputation stump. Currently, the patient is alive with numerous pulmonary metastases, 6 months after amputation. A literature review identified three recently reported identical cases of epithelioid angiosarcoma arising in nonfunctioning arteriovenous fistulae. All three patients had been treated by kidney transplantation for renal failure, suggesting a possible causal association between these events. We performed polymerase chain reaction for human herpes virus 8, the recently recognized herpes virus proposed as a major etiologic agent of Kaposi's sarcoma, and possibly some conventional angiosarcomas, but we failed to identify any viral DNA within the tumor.
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PMID:Epithelioid angiosarcoma arising in a surgically constructed arteriovenous fistula: a rare complication of chronic immunosuppression in the setting of renal transplantation. 973 50


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