[Lymphography and indirect lymphoscintigraphy in the diagnosis of bladder neoplasm metastasis].
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Breast cancer commonly metastasizes to the adrenal glands. Metastases to an already existing adrenal gland tumor, however, are a rare finding. To our knowledge, this report represents the first case of a breast carcinoma metastasizing to a pheochromocytoma. Metastases of a cancer to another coexisting tumor in the same individual is an unusual event.
PURPOSE: The increasing occurrence of neoplastic metastases to the eye encouraged us to present our own observation on this topic. MATERIAL AND METHODS: We have examined 17 patients with metastatic tumors of the eye (in 6 cases there was bilateral involvement). The group included 11 females and 6 males, aged 43 to 69 years. The most common primary tumor was breast carcinoma (9 women-13 eyes); then cancers of lung (4 men), gastrointestinal tract (2 women-3 eyes), maxillary sinus (1 case); and malignant lymphoma (1 case). In 5 patients the eye was enucleated because of secondary glaucoma. RESULTS: Improvement or stopping the progression of the disease was achieved in 1 of 2 patients treated with argon laser, 3 of 6 patients treated with xenon lamp photocoagulation, and in all 8 eyes treated with gamma-therapy. In one case of metastatic tumor of the iris a partial iridectomy was performed. A case of systemic malignant lymphoma was treated pharmacologically. CONCLUSIONS: It seems that the best option of treatment of eye metastases is gamma-therapy, particularly effective in small lesions. Authors emphasize that it is necessary to perform routine ophthalmologic examinations in patients with breast cancer, lung cancer, and other neoplasms associated with high risk of metastases to the eye. This can allow to early detect eye metastases and start the appropriate treatment.
The paper presents the treatment mode of metastasis to the spine. Between 2000 and 2002 5 cases (3 men and 2 women) with metastasis to the lumbar spine were treated surgically. The metastasis derived from primary foci in the prostate (3 cases), in the breast (1 case) and in the kidney (1 case). The average age of the patients was 65 years (ranging from 53 to 74 years). In all cases a vertebrectomy was performed through an anterior approach. Titanium baskets filled with bone cement were implemented. The spine was stabilized using anterior Kaneda instrumentation (3 cases) and the posterior Omega instrumentation (2 cases). This mode of treatment yielded good results. Pain relief was achieved by decompressing the neural elements, leading to better quality of life among the operated patients.
Preliminary results of surgical treatment in 24 patients with pathologic fractures or metastatic long bone defects impending fracture are presented. Fourteen females and 10 males aged 36-72 years with femoral (18 cases), tibial (4 cases) or humeral (2 cases) involvement were followed-up for 6-48 months. In 12 patients the pain ceased or decreased, 3 patients occasionally required non narcotic analgesics, in 9 cases the pain continued. All patients with lower extremity involvement were able to ambulate with an aid of walking sticks, 2 patients with humeral fracture resumed activities of daily living. Nine patients with multiple metastases to the lungs and spine died on average 15 months after surgery. The longest survival rate was found in patients with kidney cancer-19 months, ovary cancer-17 months and breast cancer 15 months. No postoperative complications were found. In 2 patients fracture fixation lost their stability after 8 and 10 weeks due to excessive weight bearing.
PURPOSE: To present a clinical picture and results of treatment in two patients with bronchial carcinoid metastases to choroid. MATERIAL AND METHODS: Two females aged 47 and 56 with bilateral and multiple metastases of bronchial carcinoid were enrolled in this study. Choroidal metastases occurred 6-7 years after primary tumors had been diagnosed. The follow-up period ranged from 2.5 to 5 years. In one patient teleradiotherapy of choroidal metastases was performed, while in a second case plaque therapy with 106 Ru and 125 I and a diode laser therapy were used. RESULTS: After therapy, one patient demonstrated partial regression of two choroidal metastases and total regression of one tumor, while the second one, showed total regression of all intraocular tumors. One patient developed irradiation neuropathy and retinopathy as a result of teleradiotherapy, which were the main cause of decreased visual acuity in her one eye. CONCLUSIONS: Regarding the good prognosis and potentially long survival of patients with bronchial carcinoid, prompt treatment of choroidal metastases is recommended. Applied method of therapy depends on tumor size, its localization and patient's general condition.
The data on 132 patients with metastases of endometrial carcinoma into the vagina (MECV) were analysed. They had received complex (remote + contact) and contact radiotherapy alone with low-, medium- and high dosage. The following radiobiological models were employed to assess tissue response: time-dose-fractionation factor (TDFF), cumulative radiation effect (CRE) and linear-quadratic dose effect equation (LQDE) ("extrapolated dose of response"). There was no correlation between survival and dose in excess of connective tissue tolerance calculated for each radiobiological model or a dose below tolerance limit. When dosage exceeded tolerance limit the incidence of early- and late-onset radiation injuries increased significantly. In MECV patients who had received primarily radiotherapy and surgery, early-onset radiation injuries occurred in cases of overdosage from the most recent exposure. When high-dose brachiatherapy was employed as a component of complex treatment, late-onset moist epithelite of the vagina could develop, irrespective of whether radiotherapy had been given or not and whether tolerance limit had been exceeded. Late-onset injuries were recorded in cases of over-dosage who had received both radiation and surgery for primary endometrial carcinoma.
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Distant metastasis of gastrointestinal endocrine neoplasm is resistant to currently available treatments. Because hematogenic metastasis is dominant, anti-angiogenic drugs are expected to be a novel therapy for this neoplasm. In the present study, the therapeutic effect of vascular endothelial growth factor neutralizing antibody (VEGFAb) on liver metastasis of an endocrine neoplasm was investigated experimentally. Cecal transplantation into nude mice of small pieces of EN-1, a xenotransplanted human intestinal endocrine neoplasm, resulted in liver metastasis. A treated group (n = 19) received 100 micrograms/mouse of VEGFAb intraperitoneally on alternate days from day 10 after tumor transplantation, and the control group (n = 19) received saline. Five of the 19 control mice died of tumor progression, of which 2 could not be evaluated. The cecal tumor weighed 6316 +/- 2333 mg (n = 17) in the control group and 1209 +/- 837 mg (n = 19) in the treated group (P < 0.01) 6 weeks after transplantation. Liver metastasis developed in 16 of 17 control mice and in 2 of 19 treated mice (P < 0.01). The VEGF level of the whole cecal tumor in the control group was significantly higher than that in the treated group (305.1 +/- 174.1 vs. 54.7 +/- 41.2 mg; P < 0.001). VEGFAb did not cause any body weight loss (28.52 +/- 1.63 in the control vs. 28.44 +/- 1.71 g in the treated group). These results indicate that VEGFAb may be a novel therapeutic agent for endocrine neoplasm with distant metastasis.
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In a 81-years old man synchronous triple cancers (prostate, kidney and lung) were found at autopsy. The poorly differentiated prostatic adenocarcinoma metastasized to the clear cell carcinoma of the right kidney and to its solitary lung metastasis. The "neoplasm to neoplasm" metastasis and the "metastasis in metastasis" was confirmed by immunohistochemistry.
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