[On some aspects of skeletal metastasization of thyroid tumors].
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8 cases are reported of anaplastic cerebral gliomas with metastases outside the neuraxis, which were seen among about 1600 gliomas. The series included 4 males and 4 females ranging in age from 5 to 58 years at the time of death. There were 2 children with anaplastic ependymomas, one adult with oligodendroglioma, and 5 young or middle-aged adults with astrocytomas grade III or IV. All patients had one or more craniotomies, and 5 had radiotherapy before the appearance of remote tumor deposits. The survival times ranged from 7 to 31 months in cases with gliomas grade II, and from 8 to 18 months in high-grade astrocytomas. All tumors showed invasion of the meninges and/or ventricle walls, and in 4 cases they transgressed the dura and surrounding bone or soft tissues. In 6 autopsy cases there was widespread dissemination of gliomas through the CSF pathways. Remote metastases involved regional or distant lymph nodes in 7, the lungs in 2, the vertebrae, lungs, pleura, parotis and mediastinum in one patient each. The possible pathways for distant spread of intracranial gliomas and the factors which are considered responsible for their rare occurrence are discussed.
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In clinical oncology emergency situations are either manifestations of the underlying disease or effects of the treatment. The successful treatment of emergency situations is not only important in diseases in which cure is possible. It contributes also essentially to an optimal palliation for not curable disease states in oncology. Some special examples from the point of view of internal medicine are briefly discussed.
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