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Query: UMLS:C0684249 (lung carcinoma)
 23,830 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We evaluated the usefulness of double-dose (0.2 mmol/kg of gadoteridol) contrast-enhanced magnetic resonance imaging (C-E MRI) in detecting brain metastases of lung cancer. We prospectively enrolled 134 patients with lung cancer who had no neurologic symptoms and who underwent a staging work-up. Patients were assigned to receive both contrast-enhanced computerized tomography (C-E CT) and double-dose C-E MRI. Double-dose C-E MRI detected brain metastases in 19 patients, while C-E CT detected brain metastasis in only 12 of the 19 (P = 0.02). The 3-month survival rate for patients in double-dose C-E MRI group was found to be 2.06 times that of patients in a C-E CT group (P = 0.029), although the survival rate fell to 1.45 (P = 0.387) at 6 months. The results imply that double-dose C-E MRI changed the clinical stage of lung cancer patients. We concluded that double-dose C-E MRI improves the rate of detection of brain metastases during the initial staging of lung cancer.
Lung Cancer 2004 Dec
PMID:Magnetic resonance imaging and computed tomography in the diagnoses of brain metastases of lung cancer. 1554 21

A 29-year-old woman with gross hematuria was referred to our hospital. Cystoscopy revealed a nonpapillary broad-based tumor on the right lateral wall of the urinary bladder, which a transurethral biopsy identified as transitional cell carcinoma (G2). CT and MRI suggested that the carcinoma invaded beyond the bladder wall. We performed a radical cystectomy with hysterectomy and the construction of an ileal neobladder. Pathological examination of the specimen indicated that it was small-cell undifferentiated carcinoma at the stage of pT2bpN0. For adjuvant chemotherapy, four cycles of CPT-11 and CDDP chemotherapy were performed, which is currently the usual chemotherapy for small-cell lung carcinoma in Japan. The patient is alive without any evidence of tumor recurrence at 12 months after surgery.
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PMID:[A young patient with invasive small cell carcinoma of the urinary bladder: a case report]. 1591 92

Current imaging modalities fail to define precisely the extent of disease in MPM and are inaccurate in selecting patients for treatment. Previous studies have shown that CT and MRI provide anatomical information that is often imprecise in the preoperative staging of MPM. Consequently, about 25% of patients are found to have unresectable tumor at the time of exploratory thoracotomy. PET is now widely recognized as an important staging modality in many cancers, and PET SUV is reported as a prognostic indicator in several malignancies. However, only a few previous studies have investigated the utility of FDG PET scan in MPM. From 1998 to 2003, 65 patients with MPM underwent PET scans. Median PET SUV in the primary tumor was 6.6 (range, 2-23). The median follow-up for all surviving patients was 16 months. Median survivals were 14 and 24 months for the high and low SUV groups, respectively. In a multivariable analysis, high SUV tumors were associated with a 3.3 times greater risk of death than low SUV tumors (p = 0.03). Mixed histology carried a 3.2 times greater risk of death than epithelial histology (p = 0.03). SUV of >4 and mixed histology are poor risk factors in malignant pleural mesothelioma. These findings suggest that FDG-PET can be used to stratify patients for treatment and clinical trials.
Lung Cancer 2005 Jul
PMID:The role of PET in the surgical management of malignant pleural mesothelioma. 1595 Jul 96

The pineal region is an unusual site for brain metastasis and most metastatic pineal lesions are asymptomatic. Rarely the symptoms of metastatic involvement of the pineal gland precede those of the primary tumor or other metastatic sites. An 83 year-old man presented with gait disturbance and limitation of upward gaze. Brain MRI showed homogeneous enhancement of a solitary mass in the pineal region with obstructive hydrocephalus. A stereotactic biopsy was performed, and small cell carcinoma was diagnosed. A systemic investigation for the primary lesion subsequently revealed small cell carcinoma of the lung. The patient was referred for radiotherapy and chemotherapy. Although rare, metastatic tumor should be considered in the differential diagnosis of pineal region tumors, particularly in elderly patients.
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PMID:Isolated pineal region metastasis of small cell lung cancer. 1609 55

The purpose of this study was to describe the use of parallel imaging technique (PAT) using dynamic MRI in lung and tumour mobility during the breathing cycle. 20 patients with stage I non-small cell lung carcinoma were investigated using two dynamic gradient echo sequences with PAT (TrueFISP (fast imaging with steady precession), and fast low angle shot (FLASH). Craniocaudal distance from the apex to the diaphragm of the thorax and tumour mobility during the breathing cycle were measured. Signal-to-noise ratio (SNR) of the tumour was determined. In spite of the different temporal resolutions both trueFISP and FLASH sequence proved to be adequate to continuously measure lung motion and tumour mobility. SNR of the tumour was significantly higher using the trueFISP sequence than FLASH sequence (20.7+/-3.6 vs 5.8+/-2.3, p<0.01). Mobility of the tumour bearing hemithorax was significantly lower compared with the non-tumour bearing hemithorax (p<0.05). Dynamic MRI using PAT allows for continuous quantitative documentation of tumour mobility and lung motion. Because of the higher SNR, trueFISP sequence provides a better delineation of intrapulmonary lesions with a sufficient temporal resolution.
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PMID:Quantitative analysis of lung and tumour mobility: comparison of two time-resolved MRI sequences. 1611 Jan 7

Paraneoplastic limbic encephalitis is a rare clinical entity, most often associated with small cell lung cancer. We report a case of a 54-year-old man presenting status epilepticus, cognitive dysfunction and loss of short term memory associated with epidermoid lung carcinoma. CT scan was normal whereas MRI revealed hyperintensities on T2WI and FLAIR images in the temporolimbic regions. Treatment of the primary tumour was followed by neurological improvement.
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PMID:[Paraneoplastic limbic encephalitis associated with epidermoid lung carcinoma]. 1623 68

EKB-569 is a potent, low molecular weight, selective, and irreversible inhibitor of epidermal growth factor receptor (EGFR) that is being developed as an anticancer agent. A phase 1, dose-escalation study was conducted in Japanese patients. EKB-569 was administered orally, once daily, in 28-day cycles, to patients with advanced-stage malignancies known to overexpress EGFR. Two patients with advanced non-small cell lung cancer with EGFR mutations and acquired gefitinib resistance from the phase 1 study are described in detail. Case #1 is a 63-year-old man with smoking history. He received treatment from 4 March 2004. Because he had no severe adverse events, a total of 10 courses of therapy were completed through December 16. Grade 2 skin rash and ALT elevation, and grade 1 diarrhea and nail changes developed. A chest CT scan on 4 August 2003 revealed multiple pulmonary metastases that had decreased in size. Case #2 is a 49-year-old woman with no smoking history. She received therapy from 9 February 2004. She received a total of five courses of the therapy until 22 June 2004. Grade 3 nausea and vomiting and grade 1 diarrhea and dry skin developed. A chest CT scan on March 3 revealed multiple pulmonary metastases that had decreased in size. A brain MRI on March 4 showed that multiple brain metastases also had decreased in size. Based on RECIST criteria, they had stable disease but radiographic tumor regression was observed.
Lung Cancer 2006 Mar
PMID:EKB-569, a new irreversible epidermal growth factor receptor tyrosine kinase inhibitor, with clinical activity in patients with non-small cell lung cancer with acquired resistance to gefitinib. 1636 94

Gefitinib--a specific inhibitor of epidermal growth factor receptor (EGFR)-associated tyrosine kinase--has demonstrated efficacy in a subgroup of patients with non-small-cell lung carcinoma (NSCLC) who fail conventional chemotherapy. It is also reported to have an antitumor effect in brain metastases from NSCLC. Additionally, EGFR mutations have shown a strong association with gefitinib sensitivity for NSCLC. Here, we assessed the efficacy of gefitinib in brain metastases from NSCLC and evaluated the association of this efficacy with EGFR mutations. We retrospectively reviewed eight cases in which patients were suffering from brain metastases before the initiation of gefitinib treatment. Brain tumor response could be evaluated by MRI in these patients; EGFR gene analyses were also available. We evaluated whether objective tumor response was observed after gefitinib treatment and assessed the efficacy of gefitinib as effective, noneffective, or not assessable in consideration of the influence of previous radiotherapy. Of the eight patients, the efficacy of gefitinib was assessed as effective in three and as noneffective in three. All three patients demonstrating effective efficacy had EGFR mutations in the tyrosine kinase domain (deletion mutation in two patients and point mutation in one patients), whereas none of the three patients demonstrating noneffective efficacy had EGFR mutations. Gefitinib appears to be effective in treating brain metastases in a subgroup of patients. Our data suggested a possible association between the efficacy of gefitinib in the treatment of brain metastases and EGFR mutations.
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PMID:EGFR mutations in patients with brain metastases from lung cancer: association with the efficacy of gefitinib. 1651 Aug 49

A frequent side effect after radiotherapy of lung tumors is a decrease of pulmonary function accompanied by dyspnea due to developing lung fibrosis. The aim of this study was to monitor lung motion as a correlate of pulmonary function and intrathoracic tumor mobility before and after radiotherapy (RT) using dynamic MRI (dMRI). Thirty-five patients with stage I non-small-cell lung carcinoma were examined using dMRI (trueFISP; three images/s). Tumors were divided into T1 and T2 tumors of the upper, middle and lower lung region (LR). Maximum craniocaudal (CC) lung dimensions and tumor mobility in three dimensions were monitored. Vital capacity (VC) was measured and correlated using spirometry. Before RT, the maximum CC motion of the tumor-bearing hemithorax was 5.2 +/- 0.9 cm if the tumor was located in the lower LR (middle LR: 5.5 +/- 0.8 cm; upper LR: 6.0 +/- 0.6 cm). After RT, lung motion was significantly reduced in the lower LR (P < 0.05). Before RT, the maximum CC tumor mobility was significantly higher in tumors of the lower LR 2.5 +/- 0.6 vs. 2.0 +/- 0.3 cm (middle LR; P < 0.05) vs. 0.7 +/- 0.2 cm (upper LR; P < 0.01). After RT, tumor mobility was significantly reduced in the lower LR (P < 0.01) and in T2 tumor patients (P < 0.05). VC showed no significant changes. dMRI is capable of monitoring changes in lung motion that were not suspected from spirometry. This might make the treatment of side effects possible at a very early stage. Changes of lung motion and tumor mobility are highly dependent on the tumor localization and tumor diameter.
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PMID:Therapy monitoring using dynamic MRI: analysis of lung motion and intrathoracic tumor mobility before and after radiotherapy. 1662 38

Pituitary metastasis and sarcoidosis are two causes of pituitary stalk thickening. Their association has been described ago three decades. In this setting, we report a case of panhypopituitarism revealing pituitary metastasis from a small-cell lung carcinoma associated with sarcoidosis. A 49 year-old smoking patient with type 2 diabetes was admitted for acute adrenal failure with polyuria polydipsia syndrome and a pituitary tumor syndrome. Hormone explorations confirmed anterior pituitary insufficiency. Water restriction revealed central diabetes insipidus. The hypothalamic-pituitary MRI revealed a 1-cm sellar mass with nodular thickening of the stalk. The chest radiograph showed a heterogeneous opacity in the left lung. The thoraco-abdominal scan demonstrated a mass in the left lung highly suggestive of malignancy and many enlarged mediastinal nodes, hepatic nodules, and hypertrophy of the left adrenal. Bronchoscopy was performed three times and showed infiltration of the left bronchial tree but histological examination of the bronchial biopsies was negative for all samples. Ultrasound-guided biopsy of the liver was achieved and histology demonstrated sarcoidosis. The diagnosis of sarcoidosis was incompatible with the deterioration of the patient's general status. Subsequent radiographic explorations showed an increase in the size of the tumor mass and histological evaluation of a scan-guided trans-thoracic biopsy demonstrated small-cell carcinoma. Small-cell lung carcinoma is the most common cancer with pituitary metastasis. The proposed link between sarcoidosis and malignancy has remained controversial but has not been proven false.
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PMID:[Panhypopituitarism revealing metastasis of small-cell lung carcinoma associated with sarcoidosis]. 1684 Sep 19


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