Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0677930 (primary tumor)
 20,210 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The treatment results in 59 patients with extradural spinal cord compression (ESCC) who were treated with irradiation between April 1987 and December 1988 were analyzed prospectively. Eighty percent of the patients presented with back pain, which preceded ESCC by an average of 6 weeks. The most common primary tumor was lung cancer (27% of cases), followed by prostate cancer and breast cancer. The prognostic significance of pretreatment motor function, degree of spinal cord block, radiosensitivity of tumor, and radiation dose schedule was determined with multivariate analysis. Only pretreatment motor function was found to be a significant factor in determining functional prognosis (P = .0058). Even with the increasing clinical awareness of ESCC, 78% of the patients in the current series were nonambulatory at presentation. Therefore, computed tomographic myelography or magnetic resonance imaging is recommended for patients with back pain and bone destruction at the site of the complaint if local radiation treatment is not planned.
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PMID:Extradural spinal cord compression: analysis of factors determining functional prognosis--prospective study. 235 2

Metastatic Spinal Cord Compression (MSCC), an oncologic emergency, is a frequent complication of many neoplastic diseases in an advanced stage. Our experience is reported, which was obtained with a series of 61 patients following a diagnostic-therapeutic protocol aimed at early diagnosing MSCC and at assigning the major role in therapy to radiotherapy (RT) alone. Fifty-seven patients with an average follow-up of 13 months (range 4-26) were evaluable. Diagnosis was always made by means of myelography and/or myelography plus CT. In 50 cases the treatment consisted in RT alone and the remaining 7 patients had surgery before RT because of diagnostic doubts; in 1 case the patient was operated on because stabilization was necessary. A dose of 30 Gy was delivered, over 2 weeks, (TDF = 62) to those tumors which were considered as radiation-responsive and having a better prognosis (myeloma, lymphoma), whereas all the other histologies were given a split-course regimen (5 Gy x 3 days, stop x 4 days, +/- 3 Gy x 5 days; TDF = 68). All patients received medium or high doses of steroid depending on the degree of neurologic involvement. Patients with chemo/hormone-responsive primary tumors also received chemotherapy and/or hormone therapy. The clinical parameters considered in evaluating the response to treatment were backache, motor performance, and sphincter function. Respectively 86%, 47% and 44% of patients responded. Early diagnosis was the most important prognostic factor, whereas histology of the primary tumor was important in cases with severe neurologic damage only. The results obtained are similar to those reported in literature and confirm the value of the diagnostic-therapeutic approach used, which suggests continuing this trial.
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PMID:[Diagnostic-therapeutic integration in metastatic spinal cord compression. Analysis of a prospective study]. 260 32

Forty patients with known primary tumor and progressive back pain, suspected of having spinal metastatic disease, underwent magnetic resonance (MR) examinations of the thoracic and lumbosacral spine. Conventional radiographs and CT scans of the spine were all normal. The radionuclide bone scans were equivocal. In 21 patients focal or diffuse vertebral MR abnormalities were detected. In nine patients the lesions were hypointense on T1 sequence, and the same lesions were demonstrated poorly or not at all on T2 and proton density sequences. In eight other patients the bone marrow metastases presented with strong signal intensity on T2 and were poorly or not at all demonstrated on T1 and proton density sequences. In three patients with multiple myeloma, the signal intensity pattern of the vertebrae was diffusely heterogeneous, with alternating small foci of strong and weak signals (a mosaic-like pattern). Following the MR studies, needle biopsy confirmed the malignancy in the 21 patients who had shown abnormalities. No correlation between the type of primary tumor and the signal intensity of the vertebral metastases was shown. Possibly the mosaic pattern shown in three of the multiple myeloma patients represents a special case.
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PMID:Early MR demonstration of spinal metastases in patients with normal radiographs and CT and radionuclide bone scans. 274 77

A non-randomized prospective trial in which radiotherapy (RT) alone played the major role in the treatment of metastatic spinal cord compression (MSCC) is reported. Diagnosis was formulated on myelography and/or myelography plus computed thomography (CT). Of 51 cases treated, 48 are evaluable. The therapy consisted of radiation alone (42 cases) or decompressive laminectomy followed by radiotherapy (6 cases). Surgery was performed when the site of the primary tumor was unknown. The group of patients who received radiotherapy alone (42 of 48 evaluable cases) are analysed in this report. Medium to high doses of steroids were administered to all patients depending on the gravity of the case. Patients with chemo- or hormone-responsive primary tumors also received chemotherapy and/or hormone therapy. Pain relief, assessed by comparing use of narcotics and minor analgesics before and after treatment, was achieved in 54% cases (confidence limits, CL = 38-69%). In 36% (CL = 22-51%) of patients back pain diminished to the point when only milder analgesics were necessary (partial remission). Motor performance, based on patients' ability to walk, improved in 48% cases (CL = 31-65%). The 19 patients who were ambulatory before RT, did not deteriorate after treatment. Sphincter function, evaluated by patient's need for indwelling catheter, improved in 3 of 7 automatic dysfunction cases. It was found that early diagnosis was more important than primary tumor type for predicting a good was found that early diagnosis was more important than primary tumor type for predicting a good prognosis. In fact, all ambulating patients responded to treatment independent of the radiosensitivity of the tumor histology.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Role of radiotherapy in metastatic spinal cord compression: preliminary results from a prospective trial. 277 51

Twenty-three patients with pancreatic cancer who survived greater than or equal to 3 years after surgical treatment and 56 who survived less than 12 months were studied. The association of steatorrhea with long survival was significant (p less than 0.05), and the association of back pain with short survival showed a trend toward significance (p = 0.06). Other presenting symptoms, as well as the age, sex, or past medical history of the patients; the gross morphology of the tumor and regional lymph nodes; the operations performed; and the use of postoperative adjuvant therapy had no significant influence on survival. Certain histopathologic characteristics of the resected specimens were significantly associated (p less than 0.05) with a poor prognosis: malignant infiltration of the pancreatic capsule, proximity of the tumor to lymphatic and blood vessels, a round-cell infiltrate at the tumor margin, and epithelial atypia in the uninvolved pancreatic ducts. The association of Broders' grades 3 and 4 in the primary tumor and metastases to lymph nodes showed a trend toward significance with short survival. Multivariate analysis confirmed that the associations of Broders' grades 3 and 4 in the primary tumor, a round-cell infiltrate at the tumor margin, and atypia of the pancreatic ductal epithelium with short survival were statistically significant.
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PMID:Factors influencing survival after resection for ductal adenocarcinoma of the pancreas. 300 74

Leiomyosarcoma of the left kidney seen in a 58-year-old man is reported. On April 10, 1982, he complained of left flank pain. He visited our hospital and left solitary renal cyst was suspected. He had been treated as an outpatient, but left flank pain became exacervated. On May 18, he was admitted to our hospital. On June 7, radical nephrectomy was done under the diagnosis of left renal cell carcinoma. At operation, the tumor invased directory to the psoas muscle and abdominal wall, and could not be completely resected. Pathological diagnosis was renal cell carcinoma with sarcomatoid change. On July 1, he was discharged from the hospital. In December, left flank distention appeared and back pain became exacervated. On February 8, 1983, he was readmitted to our hospital. Low density area was found in left psoas muscle by CT scanning and recurrence of renal cell carcinoma was suspected. alpha-Interferon therapy had been done, but tumor increased remarkably and caused ileus. He died on June 14, 1983. The autopsy revealed a child head-sized cystic tumor in the upper retroperitoneal space, a 5 X 5 X 5 cm metastasis of the left lobe of the liver, a 3 X 3 X 4 cm tumor to the left upper lobe with cavity formation and direct invasion into the spleen, diaphragma and gastric serosa. These metastatic lesions were leiomyosarcoma. Retrospectively, the primary tumor of kidney revealed primary leiomyosarcoma of kidney.
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PMID:[A case of leiomyosarcoma of the kidney]. 372 30

A 75-year-old woman presented with rapidly progressive intestinal and general symptoms including diarrhea, melena, weight loss, back pain, and lassitude. Endoscopy revealed multiple intestinal polyps which, microscopically, consisted of metastatic tumor deposits composed predominantly of spindle-shaped tumor cells. The primary tumor, a mixed spindle-cell and clear-cell carcinoma, was later identified in the kidney at autopsy. The patient had a cholecystectomy 13 years previously.
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PMID:Metastatic spindle-cell renal carcinoma presenting as multiple intestinal polyps. 376 93

Primary carcinoma of the fallopian tube is not frequent and, thus, the diagnosis rarely is made preoperatively. We described a patient who had back pain, an epigastric abdominal mass, a palpable right kidney and a palpable scalene node. Because of upper gastrointestinal problems 1 year previously, a gastric or pancreatic malignancy was suspected after a scalene node biopsy revealed moderately differentiated adenocarcinoma, with the primary tumor unknown. Excretory urography, retrograde pyelography and computerized axial tomography confirmed the diagnosis of retroperitoneal fibrosis. It was only by laparotomy that the primary tumor was identified. The etiology, incidence, natural history, treatment and prognosis of fallopian tube carcinoma and retroperitoneal fibrosis are discussed.
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PMID:Fallopian tube carcinoma associated with retroperitoneal fibrosis. 746 68

On the basis of the authors' experience in the treatment of 257 skeletal neoplasms of the lumbar spine, the features of back pain, which in 96% of the cases constitutes the first symptom of these diseases, are discussed. The overall clinical aspects firstly depend on the stage of the primary tumor: latent, active, aggressive for benign tumors; intra- and extra-compartmental for malignant tumors. Symptoms may include elements which suggest specific lesions, such as osteoid osteoma, eosinophilic granuloma, aneurysmal bone cyst, or high-grade malignant tumors such as Ewing's sarcoma, while lumbar metastasis from carcinoma do not seem to have distinctive features. Site and localization of the tumor are also important variables. The treatment of neoplastic back pain depends on diagnosis, and cannot be adequate if it is not planned on the basis of a complete preoperative study, taking into account not only surgery, but also adjuvant therapy.
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PMID:Low back pain in tumors: diagnosis and treatment. 807 83

Metastasis to the uterus from extragenital sites is uncommon. We report on a rare case of salivary duct carcinoma (SDC) of the parotid gland with metastasis to the uterus, diagnosed by cervical smear. To the best of our knowledge, this is the first case reported in the literature. A 61-yr-old woman with a prior diagnosis of SDC was admitted to hospital with a fractured left humerus, back pain, and vaginal bleeding. A cervical smear and an endometrial aspiration were performed. The cervical smear showed numerous fragments and many isolated tumor cells in a clean background. The tumor cells were large and had abundant, granular/vacuolated cytoplasm. The nuclei were slightly pleomorphic, with fine chromatin and 1-2 small nucleoli. The malignant cells were morphologically identical to the primary tumor and correlated with the tumor in the endometrial aspiration. A diagnosis of metastatic salivary duct carcinoma was made. Although metastatic SDC to the uterus is rare, this possibility should be considered in the differential diagnosis of a positive cervical smear. This case also illustrates the importance of appropriate clinical history, including the knowledge of a primary tumor which may prevent unnecessary clinical investigations. Diagn. Cytopathol. 1999;21:271-275.
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PMID:Metastatic salivary duct carcinoma to the uterus: report of a case diagnosed by cervical smear. 1049 21


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