Cases reported "Neoplasm Metastasis"

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1/13. Secondary hypertrophic osteoarthropathy. An unusual cause of arthritis in childhood.

    Although an uncommon occurrence in childhood, hypertrophic osteoarthropathy secondary to tumors- most commonly to osteogenic sarcoma with pulmonary metastasis-may cause severe join pain and swelling. The syndrome should be considered in the differential diagnosis of acute arthritis in childhood
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keywords = osteoarthropathy
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2/13. Hypertrophic osteoarthropathy in a child with nasopharyngeal carcinoma.

    We report a 13-year-old boy with nasopharyngeal carcinoma, skull metastases and hypertrophic osteoarthropathy. Although the metastases and the primary tumour responded well to chemotherapy, hypertrophic osteoarthropathy persisted during follow-up.
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ranking = 1.2
keywords = osteoarthropathy
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3/13. Radionuclide bone images in hypertrophic pulmonary osteoarthropathy.

    Hypertrophic Pulmonary Osteoarthropathy (HPO) can be differentiated from osseous metastasis on conventional bone images using technetium 99m radiopharmaceuticals. Periosteal new bone formation appears as symmetric circumferential deposition of radionuclide in the diaphyseal cortex of tubular bones. In contrast, asymmetrical deposits in the medullary canal are indicative of metastatic disease. The etiologies of hypertrophic osteoarthropathy are discussed.
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keywords = osteoarthropathy
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4/13. A case of hypertrophic osteoarthropathy associated with nasopharyngeal carcinoma in a child.

    Hypertrophic osteoarthropathy is characterized by clubbing of the digital tips and periosteal reaction of long bones. Most of the cases are associated with malignancy or other conditions such as congenital heart disease, liver cirrhosis, pulmonary fibrosis, biliary atresia, and gastrointestinal polyps. Hypertrophic osteoarthropathy associated with malignancy is rare in children. A few cases of hypertrophic osteoarthropathy in children with nasopharyngeal carcinoma have been reported, however, there has been no report of such case in korea. We present a case of hypertrophic osteoarthropathy associated with nasopharyngeal carcinoma with lung metastasis in a 14-yr-old boy. In this case, hypertrophic osteoarthropathy regressed after intensive chemotherapy, but subsequently the patient died of progressive lung metastasis.
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ranking = 1.8
keywords = osteoarthropathy
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5/13. Hypertrophic osteoarthropathy associated with metastatic melanoma.

    Hypertrophic osteoarthropathy (HOA) is one of the paraneoplastic syndromes most commonly associated with non-small-cell lung cancer. Although pulmonary metastasis is the second most common initial site of melanoma metastasis, HOA is rarely detected in patients with metastatic melanoma in the lung. We report a case of a 45-year-old woman with advanced melanoma who developed HOA after her disease had progressed through first-line systemic therapy. The patient's diagnosis of HOA was made on the basis of digital clubbing, arthralgia, pain, joint effusion and periosteal bone formation on X-ray with negative rheumatologic laboratory studies. Only six cases of HOA in metastatic melanoma have been reported previously. This diagnosis should be considered with lung metastases and the presentation of polyarthralgia with appropriate laboratory and imaging findings. Interestingly, the patient responded to bisphosphonates and second-line chemotherapy with carboplatin and paclitaxel, which is commonly used for lung cancer, not advanced melanoma. As with many paraneoplastic syndromes, successful treatment of the underlying disease was associated with a rapid resolution of the symptoms.
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ranking = 1
keywords = osteoarthropathy
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6/13. Calcified mixed malignant tumor of the liver.

    Two adult patients died from mixed hepatic tumors of the liver with metastasis. The outstanding findings in both patients were a long clinical course, roentgenologically identifiable calcification of the tumors, and, in one, hypertrophic osteoarthropathy and spider angiomas. Mixed hepatic tumors are rare in adults, only 14 possible previous cases have come to our attention. The mixed hepatic tumors of adults are morphologically different from the more common mixed hepatoblastomas of infancy and childhood. Calcification in a slow-growing tumor in an adult without cirrhosis may indicate a mixed hepatic tumor.
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ranking = 0.2
keywords = osteoarthropathy
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7/13. Pulmonary osteoarthropathy. association with mesenchymal tumor metastases to the lungs.

    Six of 18 patients with sarcomatous tumors metastatic to the lung had hypertrophic pulmonary osteoarthropathy (HPO), and, in three patients in whom tumor regression was achieved by cytotoxic chemotherapy or surgery, the clinical and radiologic changes of HPO were reversed. All six patients had large mass lesions (greater than 5 cm) that impinged on the pleural surface, and the pathophysiologic mechanism resulting in the clinical syndrome of HP may be related to the anatomic relationship of the tumor and the pleura. The use of radionuclide scanning to detect HPO in the absence of roentgenographic signs or clinical symptoms is discussed.
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ranking = 1
keywords = osteoarthropathy
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8/13. Hypertrophic osteoarthropathy in association with pulmonary metastasis from osteogenic sacroma.

    Hypertrophic osteoarthropathy in children is rare, especially when it is associated with lung metastsis. The patient reported herein had metastic osteogenic sarcoma and failed to respond to chemotherapy or thoractomy. There are several theories as to the pathogenesis of osteoarthropathy, but none is totally convincing. vagotomy or transection of intercostal nerves has been advocated to relieve the symptoms of osteoarthropathy.
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ranking = 1.4
keywords = osteoarthropathy
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9/13. Bone scanning in management of metastatic osteogenic sarcoma.

    Bone scan findings are presented from five consecutive cases of metastatic osteogenic sarcoma. Every patient had pulmonary metastases which concentrated the bone imaging radiopharmaceutical to some degree. In one patient, the diagnosis of pulmonary metastasis was made prior to our seeing any radiographic abnormalities. The mechanism by which skeletal imaging agents localize in pulmonary lesions is not clear. Unsuspected skeletal metastases were also discovered on scans in two patients, both of whom had normal radiographs. diagnosis of hypertrophic pulmonary osteoarthropathy was made in one patient with normal radiographs. These findings indicate that bone scans as well as radiographs should be performed routinely in preoperative staging and followup of patients with osteogenic sarcoma.
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ranking = 0.2
keywords = osteoarthropathy
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10/13. strontium-89 therapy: strontium kinetics and dosimetry in two patients treated for metastasising osteosarcoma.

    We report a study of strontium kinetics in two patients who received 89Sr therapy for disseminated osteogenic sarcoma, together with estimates of absorbed dose to the principal metastases and to bone marrow. In neither patient did tumour uptake of strontium have a significant effect on whole-body retention. In one patient, whole-body strontium kinetics agreed closely with the ICRP standard model, while in the second, retention was extremely prolonged, probably due to hypertrophic osteoarthropathy. strontium-85 scintigraphy, surface counting and high-resolution whole-body profiles agreed in showing that in both patients tumour turnover of strontium was very rapid, with a biological half-life of only a few days. Absorbed dose to tumour was found to be comparable in magnitude to the mean bone-marrow dose. We have no reason to believe that 89Sr therapy was of clinical benefit to either patient.
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ranking = 0.2
keywords = osteoarthropathy
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