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1. Zibis AH, Wade Shrader M, Segal LS: Case report: Mesenchymal chondrosarcoma of the lumbar spine in a child. Clin Orthop Relat Res; 2010 Aug;468(8):2288-94
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  • [Title] Case report: Mesenchymal chondrosarcoma of the lumbar spine in a child.
  • BACKGROUND: Chondrosarcomas of the spine constitute 4% to 10% of all primary spinal bone tumors and approximately 70% of the cases occur during the second or third decade of life.
  • The prognosis of mesenchymal chondrosarcoma is usually poor with a tendency for late local recurrence and metastasis.
  • The patient underwent a staged circumferential resection of the tumor after three rounds of neoadjuvant chemotherapy.
  • The patient had additional chemotherapy and radiation therapy as an intralesional margin was achieved during the procedure.
  • LITERATURE REVIEW: We identified only four previously published cases of spinal mesenchymal chondrosarcoma in childhood, two of which had relatively early recurrence and poor survival, and two survived but with only short followup.
  • [MeSH-major] Chondrosarcoma, Mesenchymal / pathology. Lumbar Vertebrae / pathology
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Child. Combined Modality Therapy. Female. Humans. Neoadjuvant Therapy. Remission Induction. Spinal Neoplasms. Treatment Outcome

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  • (PMID = 20300902.001).
  • [ISSN] 1528-1132
  • [Journal-full-title] Clinical orthopaedics and related research
  • [ISO-abbreviation] Clin. Orthop. Relat. Res.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC2895837
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2. Benjamin R: Neurologic complications of prostate cancer. Am Fam Physician; 2002 May 1;65(9):1834-40
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  • From 15 to 30 percent of metastases are the result of prostate cancer cells traveling through Batson's plexus to the lumbar spine.
  • Metastatic disease in the lumbar area can cause spinal cord compression.
  • Metastasis to the dura and adjacent parenchyma occurs in 1 to 2 percent of patients with metastatic prostate cancer and is more common in those with tumors that do not respond to hormone-deprivation therapy.
  • Leptomeningeal carcinomatosis, the most frequent form of brain metastasis in prostate cancer, has a grim prognosis.
  • Because neurologic complications of metastatic prostate cancer require prompt treatment, early recognition is important.
  • Physicians should consider metastasis in the differential diagnosis of new-onset low back pain or headache in men more than 50 years of age.
  • Spinal cord compression requires immediate treatment with intravenously administered corticosteroids and pain relievers, as well as prompt referral to an oncologist for further treatment.
  • [MeSH-minor] Aged. Aged, 80 and over. Anti-Inflammatory Agents / therapeutic use. Brain Neoplasms / secondary. Dexamethasone / therapeutic use. Family Practice. Humans. Lumbar Vertebrae. Male. Meningeal Neoplasms / secondary. Neoplasm Metastasis. Spinal Cord Compression / drug therapy. Spinal Cord Compression / etiology. Spinal Cord Neoplasms / secondary

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  • (PMID = 12018806.001).
  • [ISSN] 0002-838X
  • [Journal-full-title] American family physician
  • [ISO-abbreviation] Am Fam Physician
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Anti-Inflammatory Agents; 7S5I7G3JQL / Dexamethasone
  • [Number-of-references] 30
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3. Turgut M, Gökpinar D, Barutça S, Erkuş M: Lumbosacral metastatic extradural Merkel cell carcinoma causing nerve root compression--case report. Neurol Med Chir (Tokyo); 2002 Feb;42(2):78-80

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  • A 63-year-old man presented with a rare metastatic Merkel cell carcinoma (MCC) involving the lumbosacral spine and causing nerve root compression.
  • Magnetic resonance (MR) imaging revealed an extradural soft tissue mass at the L5-S1 levels.
  • The tumor was subtotally removed and chemotherapy was administered, but he died of multiple metastases from the primary epigastric tumor.
  • Lumbosacral metastatic epidural tumor can manifest as lumbar disc disease symptoms, but MR imaging can non-invasively and rapidly reveal the presence of spinal epidural tumor and any extension to the spinal canal.
  • Extradural MCC metastasis in the lumbosacral area should be considered in the differential diagnosis of radicular symptoms caused by disc herniation.
  • [MeSH-major] Abdominal Neoplasms / surgery. Carcinoma, Merkel Cell / secondary. Epidural Neoplasms / secondary. Nerve Compression Syndromes / surgery. Spinal Neoplasms / secondary. Spinal Nerve Roots / surgery
  • [MeSH-minor] Diagnosis, Differential. Humans. Laminectomy. Lumbar Vertebrae / pathology. Lumbar Vertebrae / surgery. Magnetic Resonance Imaging. Male. Middle Aged. Sacrum / pathology. Sacrum / surgery

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  • (PMID = 11944594.001).
  • [ISSN] 0470-8105
  • [Journal-full-title] Neurologia medico-chirurgica
  • [ISO-abbreviation] Neurol. Med. Chir. (Tokyo)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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4. Hatano T, Igarashi H, Nakada J, Oishi Y, Yanada S, Furuta A, Takizawa A, Iwamuro S, Tashiro K: [Bone fracture receiving LH-RH agonists for prostatic cancer]. Nihon Hinyokika Gakkai Zasshi; 2000 Jun;91(6):542-6
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  • BACKGROUND: Luteinizing hormone-releasing hormone (LHRH) agonists are popularly used drugs in the treatment of prostatic cancer.
  • However, it has been reported that continuation of a low testosterone level following a longterm administration of these drugs reduces the bone mineral density and makes for osteoporosis, which is accountable for fracture, we measured the bone mineral density and bone metabolic markers in the cases who suffered fracture receiving LHRH agonists for prostatic cancer.
  • The bone density in the third lumbar vertebra was measured using quantitative computed tomography (QCT).
  • Osteocalcin, 1, 25- (OH)2 vitamin D, urinary type 1 collagen cross-linked N-telopeptides (NTx), parathyroid hormone (PTH) and calcitonin were measured as bone metabolic markers.
  • The period from the start of treatment to fracture was 11 to 45 months (mean 27 months).
  • No case of fracture at the site of metastasis of prostatic cancer was found.
  • [MeSH-major] Antineoplastic Agents, Hormonal / adverse effects. Fractures, Bone / chemically induced. Gonadotropin-Releasing Hormone / agonists. Goserelin / adverse effects. Leuprolide / adverse effects. Osteoporosis / chemically induced. Prostatic Neoplasms / drug therapy
  • [MeSH-minor] Aged. Aged, 80 and over. Bone Density. Humans. Male. Spine / metabolism

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  • (PMID = 10897579.001).
  • [ISSN] 0021-5287
  • [Journal-full-title] Nihon Hinyōkika Gakkai zasshi. The japanese journal of urology
  • [ISO-abbreviation] Nippon Hinyokika Gakkai Zasshi
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] JAPAN
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0F65R8P09N / Goserelin; 33515-09-2 / Gonadotropin-Releasing Hormone; EFY6W0M8TG / Leuprolide
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5. Neves N, Lima-Rodrigues F, Ribeiro-Silva M, Cacho-Rodrigues P, Eloy C, Paiva ME, Pinto R: Epithelioid hemangioendothelioma presenting as a vertebral fracture. Acta Reumatol Port; 2010 Jul-Sep;35(3):370-4
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  • Vertebral location is even more rare, and because the number of reported cases of EH is small and the follow-up periods short, the best surgical treatment, the role of radiotherapy and chemotherapy, as well as the definitive prognosis are still not established.
  • Treatment included vertebrectomy, with complete excision of the lesion, spinal canal decompression and vertebral stabilization.
  • Because of the wide resection achieved and the low aggressiveness of the lesion, no adjuvant radio or chemotherapy was undertaken, and at 6 years follow-up there are no signs of recurrence or metastasis.
  • [MeSH-major] Hemangioendothelioma, Epithelioid / complications. Lumbar Vertebrae / injuries. Spinal Fractures / etiology

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  • (PMID = 20975643.001).
  • [ISSN] 0303-464X
  • [Journal-full-title] Acta reumatológica portuguesa
  • [ISO-abbreviation] Acta Reumatol Port
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Portugal
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6. Saito T, Aizawa T, Kashimoto O, Sato T, Kokubun S: Successful treatment for rhabdomyosarcoma by total spondylectomy in a child. Tohoku J Exp Med; 2002 Dec;198(4):251-8

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  • [Title] Successful treatment for rhabdomyosarcoma by total spondylectomy in a child.
  • A 7-year-old girl with a retroperitoneal rhabdomyosarcoma having invaded the L3 vertebra was treated by combination therapy consisting of chemotherapy, surgical resection and intraoperative radiation.
  • Surgically, total spondylectomy was performed through a combined anterior and posterior procedures, and the spine was reconstructed with fibula bone grafts using a pedicle screw system made of titanium alloy.
  • Six years postoperatively, the spine was completely fused and no local recurrence or metastasis is detected.
  • [MeSH-major] Lumbar Vertebrae / surgery. Retroperitoneal Neoplasms / therapy. Rhabdomyosarcoma / therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Child. Combined Modality Therapy. Disease-Free Survival. Female. Humans. Intraoperative Period. Laminectomy. Radiotherapy, Adjuvant

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  • (PMID = 12630557.001).
  • [ISSN] 0040-8727
  • [Journal-full-title] The Tohoku journal of experimental medicine
  • [ISO-abbreviation] Tohoku J. Exp. Med.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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7. Lee DK, Park JH, Kim JH, Lee SJ, Jo MK, Gil MC, Song KH, Park JW: Progression of prostate cancer despite an extremely low serum level of prostate-specific antigen. Korean J Urol; 2010 May;51(5):358-61

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  • A 61-year-old man who had been diagnosed with prostate cancer 9 years ago and had been treated with pelvic irradiation and intermittent androgen deprivation therapy visited the emergency room because of back pain and weakness in both legs.
  • Spine magnetic resonance imaging showed a lumbar epidural mass and spine metastasis.
  • The whole-body workup revealed multiple metastases to the lymph nodes, bone, liver, and lung.
  • The patient underwent 1 cycle of docetaxel-based chemotherapy.
  • More chemotherapy could not be done because of his general weakness.

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  • (PMID = 20495701.001).
  • [ISSN] 2005-6745
  • [Journal-full-title] Korean journal of urology
  • [ISO-abbreviation] Korean J Urol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Korea (South)
  • [Other-IDs] NLM/ PMC2873892
  • [Keywords] NOTNLM ; Disease progression / Multiple organ failure / Neoplasm metastasis / Prostate-specific antigen / Prostatic neoplasms
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8. Chung JJ, Namiki T, Johnson DW: Cervical cancer metastasis to the scalp presenting as alopecia neoplastica. Int J Dermatol; 2007 Feb;46(2):188-9
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  • [Title] Cervical cancer metastasis to the scalp presenting as alopecia neoplastica.
  • This was confirmed when computerized tomography (CT)-guided lymph node biopsy showed squamous cell carcinoma of the para-aortic lymph nodes histologically consistent with the cervical primary.
  • In addition, there was evidence of lumbar spine metastasis by positron emission tomography (PET) and bone scans.
  • She received several courses of chemotherapy with cisplatin and 5-fluorouracil (5FU), as well as radiation therapy.
  • CT of the abdomen identified widespread metastases in the liver, pancreatic head, and lumbar spine.
  • The patient decided against further treatment for her advanced cervical cancer but did accept hydromorphone for pain.
  • [MeSH-minor] Female. Humans. Middle Aged. Neoplasm Metastasis


9. Naito Y, Akeda K, Kasai Y, Matsumine A, Tabata T, Nagao K, Uchida A: Lumbar metastasis of choriocarcinoma. Spine (Phila Pa 1976); 2009 Jul 1;34(15):E538-43
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  • [Title] Lumbar metastasis of choriocarcinoma.
  • STUDY DESIGN: A case of lumbar metastasis of a choriocarcinoma is presented.
  • OBJECTIVE: To present and review a rare case of metastatic choriocarcinoma in the lumbar spine.
  • SUMMARY OF BACKGROUND DATA: Choriocarcinoma is a highly anaplastic malignancy derived from trophoblastic cells characterized by the secretion of human chorionic gonadotropin (hCG) and early hematogenous metastasis.
  • However, metastatic choriocarcinoma in the spine is extremely rare.
  • Although 2 cases of metastasis in lumbar and/or sacral vertebra have been reported, the efficacy of surgical treatment for the spinal metastasis of choriocarcinoma is not yet known.
  • METHODS: The clinical course, radiologic features, pathology, and outcome of the treatment of metastatic choriocarcinoma of the lumbar spine is reported.
  • After computed tomography-guided needle biopsy, a clinical and pathologic diagnosis of lumbar metastasis of choriocarcinoma was made.
  • Surgical resection of the localized L2 vertebra lesion was performed by total en bloc spondylectomy after a poor response to initial chemotherapy with methotrexate.
  • Postsurgically, the serum level of hCG explosively increased and local recurrences around the original L2 vertebra and epidural metastasis abruptly developed.
  • Lung metastases also occurred concurrently and progressed and the patient eventually died to the disease.
  • CONCLUSION: We have reported a rare case of lumbar metastasis of choriocarcinoma after a normal-term pregnancy.
  • This is the first report of lumbar metastasis of choriocarcinoma treated by spinal surgery.
  • Because surgical resection of a lumbar metastasis of choriocarcinoma involves a substantial risk of profuse hemorrhage, local recurrence and the spread of metastasis, multiagent chemotherapy in combination with radiotherapy should be preformed before surgical resection.
  • [MeSH-major] Choriocarcinoma / secondary. Lumbar Vertebrae / pathology. Pregnancy Complications, Neoplastic / pathology. Spinal Neoplasms / secondary. Uterine Neoplasms / pathology
  • [MeSH-minor] Adult. Antineoplastic Agents / therapeutic use. Biomarkers, Tumor / blood. Biopsy. Chorionic Gonadotropin / blood. Chorionic Gonadotropin / secretion. Drug Therapy / methods. Drug Therapy / standards. Epidural Neoplasms / secondary. Fatal Outcome. Female. Humans. Hydatidiform Mole / complications. Hydatidiform Mole / physiopathology. Lung Neoplasms / secondary. Neoplasm Metastasis / pathology. Neoplasm Metastasis / physiopathology. Neoplasm Recurrence, Local. Neurosurgical Procedures. Pregnancy. Treatment Failure

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  • (PMID = 19564760.001).
  • [ISSN] 1528-1159
  • [Journal-full-title] Spine
  • [ISO-abbreviation] Spine
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Biomarkers, Tumor; 0 / Chorionic Gonadotropin
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10. Shaker MR, Yang G, Timme TL, Park SH, Kadmon D, Ren C, Ji X, Lee HM, Sehgal I, Anzano M, Sporn MB, Thompson TC: Dietary 4-HPR suppresses the development of bone metastasis in vivo in a mouse model of prostate cancer progression. Clin Exp Metastasis; 2000;18(5):429-38
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  • [Title] Dietary 4-HPR suppresses the development of bone metastasis in vivo in a mouse model of prostate cancer progression.
  • The effects of the synthetic retinoid N-(4-hydroxyphenyl) retinamide (4-HPR) on prostate cancer metastasis in vivo were evaluated in the mouse prostate reconstitution (MPR) model.
  • Previous studies have documented that loss of p53 function potentiates metastasis in this model system.
  • Under these experimental conditions, treatment with 4-HPR did not have a significant effect on primary tumor wet weight for either p53 +/- or p53 -/- MPRs.
  • For, p53 +/- MPRs the animals fed the 4-HPR diet had a slight improvement in survival and a significant reduction in the number of mesenteric metastases (P = 0.0477, t-test).
  • Notably, in p53 +/- MPRs the incidence of metastasis to lumbar spine and sternum was 92% in the control animals compared to 54% in the 4-HPR treated animals (P = 0.035, chi2-test).
  • In p53 -/- MPRs there was a trend toward a reduction in the number of soft tissue metastases to lung and liver in the 4-HPR group relative to the control diet group and a statistically significant reduction in the incidence of metastasis to bone was demonstrated in that 50% of control animals versus 30% of 4-HPR treated p53 -/- animals harbored bone metastases (P = 0 < 0.05, chi2-test).
  • Clonal analysis, by retroviral integration pattern, indicated increased clonal diversity in both the primary tumors and metastasis-derived cell lines from 4-HPR treated animals relative to the control animals.
  • In vitro treatment with 4-HPR did not reveal discriminating differences between cell lines derived from primary tumors and bone metastases or control and treatment groups in regard to growth arrest or apoptotic responses.
  • Overall these studies indicate limited anti-tumor and anti-metastatic activity in this highly aggressive in vivo mouse model of prostate cancer, yet 4-HPR treatment significantly suppressed the development of bone metastases in p53 +/- and p53 -/- MPRs revealing a novel and potentially clinically useful activity of this retinoid.
  • [MeSH-major] Antineoplastic Agents / pharmacology. Bone Neoplasms / drug therapy. Fenretinide / pharmacology. Prostatic Neoplasms / secondary
  • [MeSH-minor] Animals. Cell Division / drug effects. Diet. Disease Models, Animal. Male. Mice. Survival Rate. Tumor Cells, Cultured. Tumor Suppressor Protein p53 / metabolism

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  • (PMID = 11467776.001).
  • [ISSN] 0262-0898
  • [Journal-full-title] Clinical & experimental metastasis
  • [ISO-abbreviation] Clin. Exp. Metastasis
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA 50588; United States / NCI NIH HHS / CA / CA 68814; United States / PHS HHS / / P50-58204
  • [Publication-type] Evaluation Studies; Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Tumor Suppressor Protein p53; 187EJ7QEXL / Fenretinide
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11. Berglund RK, Lyden SP, Tsai EC, Lieberman I, Klein EA: Nonseminomatous germ cell tumor after chemotherapy with residual mass invading the spine. Eur Urol; 2006 Aug;50(2):372-4
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  • [Title] Nonseminomatous germ cell tumor after chemotherapy with residual mass invading the spine.
  • Bony metastasis is a rare feature of metastatic nonseminomatous germ cell tumor.
  • Radical inguinal orchiectomy confirmed nonseminomatous germ cell tumor, and the patient underwent chemotherapy with a residual mass and vertebral involvement by MRI.
  • Combined vertebral resection with spinal reconstruction and retroperitoneal lymph node dissection demonstrated residual fibrosis.
  • While bony metastasis of nonseminomatous germ cell tumors is rare, resection with spinal reconstruction can be accomplished with acceptable morbidity.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / secondary. Neoplasms, Germ Cell and Embryonal / surgery. Spinal Neoplasms / secondary. Spinal Neoplasms / surgery. Testicular Neoplasms / drug therapy. Testicular Neoplasms / pathology
  • [MeSH-minor] Adult. Combined Modality Therapy. Disease Progression. Humans. Lumbar Vertebrae. Lymphatic Metastasis. Male. Orchiectomy

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  • (PMID = 16626860.001).
  • [ISSN] 0302-2838
  • [Journal-full-title] European urology
  • [ISO-abbreviation] Eur. Urol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Switzerland
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12. Steinmetz MP, Mekhail A, Benzel EC: Management of metastatic tumors of the spine: strategies and operative indications. Neurosurg Focus; 2001 Dec 15;11(6):e2
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  • [Title] Management of metastatic tumors of the spine: strategies and operative indications.
  • The spinal column is the most frequent site of bone metastasis in the body.
  • Spine surgeons are often involved in the care of these patients only after nonoperative management has failed.
  • Because surgery has been viewed as no better than radiotherapy in the treatment of metastasis of the spine, it has only been used as a salvage approach.
  • Anterior approaches to the spine are now popular and familiar to most surgeons.
  • Outcomes are frequently much better when this combined treatment is used instead of radiotherapy alone.
  • In selected patients, surgery may be desired as first-line therapy before radio- or chemotherapy has been initiated.
  • The controversy surrounding surgery for metastatic spinal disease is reviewed.
  • Treatment strategies, both operative and nonoperative, are presented.
  • [MeSH-major] Case Management. Spinal Neoplasms / secondary. Spinal Neoplasms / therapy
  • [MeSH-minor] Cervical Vertebrae / surgery. Humans. Internal Fixators. Lumbar Vertebrae / surgery. Neurosurgical Procedures / instrumentation. Neurosurgical Procedures / methods. Orthopedic Procedures / instrumentation. Orthopedic Procedures / methods. Postoperative Complications. Thoracic Vertebrae / surgery. Treatment Outcome

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  • (PMID = 16463994.001).
  • [ISSN] 1092-0684
  • [Journal-full-title] Neurosurgical focus
  • [ISO-abbreviation] Neurosurg Focus
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 33
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13. Aydinli U, Ozturk C, Bayram S, Sarihan S, Evrensel T, Yilmaz HS: Evaluation of lung cancer metastases to the spine. Acta Orthop Belg; 2006 Oct;72(5):592-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Evaluation of lung cancer metastases to the spine.
  • Most metastatic spinal lesions (70%) are found at the thoracic level, 20% in the lumbar region, and 10% in the cervical region.
  • The aim of this study was to evaluate the lung cancer metastases to the vertebral column in terms of type, localisation and metastasis pattern.
  • Between the years 1995 and 2003, 168 lung cancer patients with metastatic spinal tumour who had received radiotherapy and chemotherapy were retrospectively evaluated.
  • The total number of vertebrae in which metastases were detected was 328.
  • The most common site for metastasis was the thoracic spine.
  • Additional extravertebral bony metastases were present in 37 (22%) patients; the femur (20 patients) was the most common site.
  • Only 25 of 168 patients were operated due to spinal cord compression leading to neurological deficit.
  • The rest of the patients were treated by appropriate chemotherapy and radiotherapy protocols.
  • The mean survival after diagnosis of vertebral metastasis was 7.1 months.
  • Most of the metastases involve multiple spinal levels.
  • After the diagnosis of vertebral metastasis, the mean survival is seven months.
  • Pain relief and maintaining quality of life must be balanced with the patient's life expectancy, comorbidities and immunological, nutritional and functional status in treatment decision.
  • [MeSH-major] Lung Neoplasms / pathology. Spinal Neoplasms / secondary

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  • (PMID = 17152424.001).
  • [ISSN] 0001-6462
  • [Journal-full-title] Acta orthopaedica Belgica
  • [ISO-abbreviation] Acta Orthop Belg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Belgium
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14. Chiewvit P, Danchaivijitr N, Sirivitmaitrie K, Chiewvit S, Thephamongkhol K: Does magnetic resonance imaging give value-added than bone scintigraphy in the detection of vertebral metastasis? J Med Assoc Thai; 2009 Jun;92(6):818-29
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  • [Title] Does magnetic resonance imaging give value-added than bone scintigraphy in the detection of vertebral metastasis?
  • OBJECTIVE: To determine the role of Magnetic Resonance (MR) imaging for the investigation ofpatients with suspected metastasis to the spine by bone scintigraphy.
  • MATERIAL AND METHOD: Retrospectively reviewed with comparison was made between Technetium-99m Methylene Diphosphonate (99(m)Tc-MDP) bone scintigraphy and corresponding spine MR images in 48 cases of vertebral metastasis at Siriraj Hospital.
  • The MR imaging findings were studied: location (cervical or thoracic or lumbar or sacrum spine), number of lesions (solitary or multiple lesions), pattern of enhancement (homogeneous or inhomogeneous), involvement of spinal canal, compression of spinal cord, extradural extension, other incidental findings such as pulmonary metastasis, pleural effusion, lymphadenopathy The final diagnosis was confirmed clinically and followed-up for further management (radiation or surgery) or followed-up by MR imaging (1 month-16 months) and bone scintigraphy (5 months-12 months).
  • RESULTS: Forty-eight cases (80 lesions) of vertebral metastasis were identified (25 men and 23 women; mean age 61 years and range 8-84 years).
  • The result of bone scintigraphy and MR imaging is used to evaluate vertebral metastasis: in 44 lesions of bone scintigraphy positive for vertebral metastasis, 40/44 lesions (91%) which MR imaging reveal vertebral metastasis.
  • In 24 lesions of negative of bone scintigraphy for vertebral metastasis, the authors found that 14/24 lesions (58%) showed positive of vertebral metastasis from MR imaging.
  • MR imaging demonstrated metastatic cord compression in 16 cases.
  • Extradural extension causes spinal canal narrowing in 30 cases.
  • CONCLUSION: The authors conclude that the MR imaging is more efficient than the bone scintigraphy in detecting vertebral metastasis, especially in the cases that bone scintigraphy are equivocal or negative for vertebral metastasis in high clinical suspicion.
  • Furthermore, MR imaging is important for the further treatment planning such as radiation therapy or systemic chemotherapy.
  • Although MR imaging is useful in the detection of early metastasis that are localized completely in the bone marrow cavity routinely bone scintigraphy remains that most cost-effective method for examination of the entire skeleton.
  • [MeSH-major] Lumbar Vertebrae / pathology. Magnetic Resonance Imaging. Spinal Neoplasms / radionuclide imaging
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Child. Diphosphonates. Female. Humans. Male. Middle Aged. Neoplasm Metastasis / radionuclide imaging. Organotechnetium Compounds. Radionuclide Imaging. Retrospective Studies. Spinal Cord Compression. Young Adult

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  • (PMID = 19530588.001).
  • [ISSN] 0125-2208
  • [Journal-full-title] Journal of the Medical Association of Thailand = Chotmaihet thangphaet
  • [ISO-abbreviation] J Med Assoc Thai
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Thailand
  • [Chemical-registry-number] 0 / Diphosphonates; 0 / Organotechnetium Compounds; 0 / technetium 99m methylene bisphosphonate
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15. Mizuno S, Iida T, Fujita S: Adult-onset adrenal ganglioneuroblastoma - Bone metastasis two years after surgery: report of a case. Surg Today; 2010 May;40(5):482-6
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  • [Title] Adult-onset adrenal ganglioneuroblastoma - Bone metastasis two years after surgery: report of a case.
  • Ganglioneuroblastoma (GNB) is a common type of tumor in children but is rarely seen in adults.
  • This report presents a case of an adrenal GNB in a 53-year-old man with bone metastasis after surgery.
  • The tumor was 11 cm in diameter with no local invasion or distant metastasis, and was completely removed.
  • Histologically, on gross examination the tumor contained a visible neuroblastomatous nodule with ganglioneuromatous component, and was diagnosed as GNB nodular classical type.
  • Two years after surgery, multiple metastatic lesions were found in the patient's lumbar spine.
  • Because the prognosis was not favorable, despite surgery and radiation therapy or chemotherapy, it is necessary to closely follow patients with large GNB tumors.
  • [MeSH-major] Adrenal Gland Neoplasms / pathology. Adrenal Gland Neoplasms / surgery. Ganglioneuroblastoma / pathology. Ganglioneuroblastoma / surgery. Lumbar Vertebrae / pathology. Spinal Neoplasms / secondary

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  • [Cites] Int Urol Nephrol. 2004;36(4):481-3 [15787320.001]
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  • (PMID = 20425556.001).
  • [ISSN] 1436-2813
  • [Journal-full-title] Surgery today
  • [ISO-abbreviation] Surg. Today
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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16. Matsuda Y, Sakayama K, Sugawara Y, Miyawaki J, Kidani T, Miyazaki T, Tanji N, Yamamoto H: Mesenchymal chondrosarcoma treated with total en bloc spondylectomy for 2 consecutive lumbar vertebrae resulted in continuous disease-free survival for more than 5 years: case report. Spine (Phila Pa 1976); 2006 Apr 15;31(8):E231-6
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  • [Title] Mesenchymal chondrosarcoma treated with total en bloc spondylectomy for 2 consecutive lumbar vertebrae resulted in continuous disease-free survival for more than 5 years: case report.
  • STUDY DESIGN: A case report of an extremely rare malignant spinal tumor successfully treated with total en bloc spondylectomy and chemotherapy.
  • OBJECTIVE: To describe points for consideration when an osteogenic lesion in the spine is diagnosed and treated.
  • SUMMARY OF BACKGROUND DATA: Primary mesenchymal chondrosarcoma in the spine is extremely rare.
  • There were no reports of this tumor being treated with spondylectomy to achieve total surgical resection with a wide margin followed by chemotherapy.
  • Magnetic resonance imaging and computerized tomography showed an osteosclerotic tumor of the lumbar vertebrae.
  • RESULTS: To resect the tumor completely, total en bloc spondylectomy for 2 consecutive lumbar vertebrae was performed.
  • Five years after surgery, there have not been any signs of local recurrence or distant metastasis, and the patient has remained continuously disease free.
  • CONCLUSIONS: To our knowledge, we reported the first case of mesenchymal chondrosarcoma occurring from the lumbar spine treated with total en bloc spondylectomy and chemotherapy.
  • Although the effect of chemotherapy on the final results could not be clearly determined, considering that at least continuous disease-free survival was achieved, it is highly likely that chemotherapy contributed to the favorable results.
  • [MeSH-major] Chondrosarcoma, Mesenchymal / surgery. Lumbar Vertebrae / surgery. Spinal Neoplasms / surgery
  • [MeSH-minor] Adult. Antineoplastic Agents / therapeutic use. Disease-Free Survival. Female. Humans

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  • (PMID = 16622368.001).
  • [ISSN] 1528-1159
  • [Journal-full-title] Spine
  • [ISO-abbreviation] Spine
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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17. Akens MK, Hardisty MR, Wilson BC, Schwock J, Whyne CM, Burch S, Yee AJ: Defining the therapeutic window of vertebral photodynamic therapy in a murine pre-clinical model of breast cancer metastasis using the photosensitizer BPD-MA (Verteporfin). Breast Cancer Res Treat; 2010 Jan;119(2):325-33
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Defining the therapeutic window of vertebral photodynamic therapy in a murine pre-clinical model of breast cancer metastasis using the photosensitizer BPD-MA (Verteporfin).
  • Currently, radiation therapy and surgery are the treatment of choice, but the success rate varies and additional adjuncts are desirable.
  • Photodynamic therapy (PDT) has been applied successfully as a non-radiative treatment for numerous cancers.
  • Earlier work has shown that the athymic rat model is suitable to investigate the effect of PDT on bone metastasis and benzoporphyrin-derivative monoacid ring A (BPD-MA; verteporfin) has been shown to be a selective photosensitizer.
  • The aim of this study was to define the therapeutic window of photosensitizer with regard to drug and light dose.
  • At 14 days, the largest vertebral lesion by bioluminescence imaging was targeted for single treatment PDT.
  • A drug escalating-de-escalating scheme was used (starting drug dose and light energy of 0.2 mg/kg and 50 J, respectively).
  • Outcomes included 48 h post-treatment bioluminescence of remaining viable tumour, histomorphometric assessment of tumour burden, and neurologic evaluation.
  • The region of effect by bioluminescence and histology increased with increasing drug dose and light energy.
  • A safe and effective drug-light dose combination in this model appears to be 0.5 mg/kg BPD-MA and applied light energy of less than 50 J for the thoracic spine and 1.0 mg/kg and 75 J for the lumbar spine.
  • Overall, PDT represents an exciting potential new minimally-invasive local, safe and effective therapy in the management of patients with spinal metastases.
  • [MeSH-major] Breast Neoplasms / pathology. Lumbar Vertebrae / drug effects. Photochemotherapy / methods. Photosensitizing Agents / pharmacology. Porphyrins / pharmacology. Spinal Neoplasms / drug therapy. Thoracic Vertebrae / drug effects
  • [MeSH-minor] Animals. Cell Line, Tumor. Dose-Response Relationship, Drug. Dose-Response Relationship, Radiation. Female. Genes, Reporter. Humans. Luciferases / genetics. Mice. Rats. Rats, Nude. Time Factors. Transfection. Xenograft Model Antitumor Assays

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  • (PMID = 19263216.001).
  • [ISSN] 1573-7217
  • [Journal-full-title] Breast cancer research and treatment
  • [ISO-abbreviation] Breast Cancer Res. Treat.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Photosensitizing Agents; 0 / Porphyrins; 129497-78-5 / verteporfin; EC 1.13.12.- / Luciferases
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18. Jalali K, Chautard D, Racineux P, Pabot du Chatelard P: [Spinal cord metastasis from prostate cancer]. Prog Urol; 2004 Sep;14(4):554-7; discussion 557
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  • [Title] [Spinal cord metastasis from prostate cancer].
  • The majority of spinal cord lesions observed in prostate cancer are related to extradural compression.
  • Intradural (extramedullary or intramedullary) metastases are very rare.
  • Despite endocrine therapy initiated immediately after diagnosis, the patient rapidly developed leg pain due to vertebral osteolysis.
  • He developed flaccid paraplegia despite radiotherapy of the lumbar spine combined with corticosteroid therapy and chemotherapy.
  • Spinal cord magnetic resonance imaging (MRI) showed typical features of very probable carcinomatous myelitis in the cervicothoracic zone.
  • Regardless of the primary cancer, intramedullary spinal cord metastases have a very poor prognosis.
  • [MeSH-major] Adenocarcinoma / secondary. Prostatic Neoplasms / pathology. Spinal Neoplasms / secondary

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  • (PMID = 15776912.001).
  • [ISSN] 1166-7087
  • [Journal-full-title] Progrès en urologie : journal de l'Association française d'urologie et de la Société française d'urologie
  • [ISO-abbreviation] Prog. Urol.
  • [Language] fre
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] France
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19. Weis J, Ciray I, Ericsson A, Lindman H, Aström G, Ahlström H, Hemmingsson A: Spectroscopic imaging of bone marrow composition in vertebral bodies. MAGMA; 2001 Aug;13(1):15-8
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  • The proton spectroscopic imaging technique that uses read gradient during acquisition was used for the measurement of the proton spectra in the lumbar and thoracic part of the spine of a patient with breast cancer without known skeletal metastases.
  • The bone marrow fat/water ratios were evaluated in the same location before and after chemotherapy treatment.
  • The fat/water ratios showed a significant increase as a consequence of the bone marrow degradation process due to chemotherapy.
  • [MeSH-major] Bone Marrow / pathology. Bone Neoplasms / diagnosis. Magnetic Resonance Imaging / methods. Protons. Spectrophotometry / methods. Spine / pathology
  • [MeSH-minor] Adipose Tissue / pathology. Breast Neoplasms / pathology. Female. Humans. Middle Aged. Neoplasm Metastasis. Water

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  • (PMID = 11410392.001).
  • [ISSN] 0968-5243
  • [Journal-full-title] Magma (New York, N.Y.)
  • [ISO-abbreviation] MAGMA
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Protons; 059QF0KO0R / Water
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20. Biswas A, Puri T, Goyal S, Gupta R, Eesa M, Julka PK, Rath GK: Spinal intradural primary germ cell tumour--review of literature and case report. Acta Neurochir (Wien); 2009 Mar;151(3):277-84

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Spinal intradural primary germ cell tumour--review of literature and case report.
  • BACKGROUND: Primary spinal cord germ cell tumour is a rare tumour.
  • We herein review the tumour characteristics, associated risk factors, treatment policy, and patterns of failure of primary intradural germ cell tumour.
  • METHOD: We conducted a PUBMED search using a combination of keywords such as "spinal germ cell tumor," "germinoma," "extradural," "intradural," "intramedullary," "extramedullary," and identified 19 cases of primary spinal germ cell tumour.
  • Clinical features, pathologic characteristics, and treatment details of these patients including status at follow-up were noted from respective case reports.
  • We also describe a case of a young Indian patient of intradural extramedullary germ cell tumour treated with a combination of surgery, chemotherapy, and radiotherapy.
  • Most patients were treated with a combination of surgery, radiation therapy, and systemic chemotherapy.
  • Magnetic resonance imaging spine showed an inhomogeneous hyperintense soft tissue mass at L(2)-L(4) spinal level.
  • He was treated with complete surgical excision and four cycles of chemotherapy with BEP regimen following a histological diagnosis of non-seminomatous germ cell tumour.
  • Palliative irradiation to the lumbar spine was given on progression at 3 months.
  • The patient eventually succumbed to his condition, due to compressive transverse myelitis possibly due to cervical cord metastasis.
  • CONCLUSION: Limited surgery followed by upfront radiation therapy and adjuvant chemotherapy is the optimal management of this rare group of tumour.
  • Omission of radiation therapy from the treatment armamentarium might engender local recurrence and spinal dissemination at first failure.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / pathology. Neoplasms, Germ Cell and Embryonal / therapy. Spinal Cord / pathology. Spinal Cord Neoplasms / pathology. Spinal Cord Neoplasms / therapy
  • [MeSH-minor] Adult. Antineoplastic Agents / therapeutic use. Biomarkers, Tumor / analysis. Biomarkers, Tumor / metabolism. Chorionic Gonadotropin, beta Subunit, Human / analysis. Chorionic Gonadotropin, beta Subunit, Human / metabolism. Decompression, Surgical. Disease Progression. Fatal Outcome. Humans. Lumbar Vertebrae. Magnetic Resonance Imaging. Male. Myelitis, Transverse / etiology. Neoplasm Metastasis / pathology. Neoplasm Recurrence, Local / radiotherapy. Neurosurgical Procedures. Radiotherapy. Subarachnoid Space / pathology. Subarachnoid Space / surgery

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  • [CommentIn] Acta Neurochir (Wien). 2009 Aug;151(8):983-4 [19337687.001]
  • (PMID = 19240975.001).
  • [ISSN] 0942-0940
  • [Journal-full-title] Acta neurochirurgica
  • [ISO-abbreviation] Acta Neurochir (Wien)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Austria
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Biomarkers, Tumor; 0 / Chorionic Gonadotropin, beta Subunit, Human
  • [Number-of-references] 41
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21. Morita M, Osawa M, Naruse H, Nakamura H: Primary NK/T-cell lymphoma of the cauda equina: a case report and literature review. Spine (Phila Pa 1976); 2009 Nov 15;34(24):E882-5
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  • This report is the first to describe a case of primary nasal type NK/T-cell lymphoma of the cauda equina.
  • Further investigations including immunohistochemical stains made a diagnosis of primary nasal type NK/T-cell lymphoma of the cauda equina, and the patient received radiotherapy to the lumbosacral area.
  • Brain metastasis was detected 8 months after surgery, and the patient died 14 months after his initial clinical presentation despite additional treatments including whole-brain radiotherapy and oral chemotherapy.
  • Early definitive diagnosis with examination of the cerebrospinal fluid followed by combined treatment with radiotherapy and high-dose methotrexate should be considered.
  • [MeSH-major] Lumbar Vertebrae / pathology. Lymphoma, Extranodal NK-T-Cell / pathology. Polyradiculopathy / pathology. Spinal Canal / pathology. Spinal Cord Neoplasms / pathology. Spinal Nerve Roots / pathology
  • [MeSH-minor] Aged. Brain Neoplasms / secondary. Decompression, Surgical. Fatal Outcome. Humans. Laminectomy. Magnetic Resonance Imaging. Male. Myelography. Neoplasm Metastasis / pathology. Neoplasm Metastasis / physiopathology. Radiotherapy. Sciatica / etiology. Treatment Outcome. Urinary Bladder, Neurogenic / etiology

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  • (PMID = 19910757.001).
  • [ISSN] 1528-1159
  • [Journal-full-title] Spine
  • [ISO-abbreviation] Spine
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 19
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22. Greene S, Hawkins DS, Rutledge JC, Tsuchiya KD, Douglas J, Ellenbogen RG, Avellino AM: Pediatric intradural extramedullary synovial sarcoma: case report. Neurosurgery; 2006 Dec;59(6):E1339; discussion E1339
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  • A magnetic resonance imaging scan of the spine revealed a spinal intradural, extramedullary mass at L2-L4 and four additional nodules of enhancement.
  • Radiation and chemotherapy were administered.
  • Intracranial metastases became evident during treatment.
  • CONCLUSION: The rapid progression of leptomeningeal metastasis despite maximal treatment demonstrates the aggressive nature of the tumor and the need for further study.
  • [MeSH-major] Lumbar Vertebrae / pathology. Sarcoma, Synovial / pathology. Sarcoma, Synovial / therapy

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  • (PMID = 17277671.001).
  • [ISSN] 1524-4040
  • [Journal-full-title] Neurosurgery
  • [ISO-abbreviation] Neurosurgery
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 38
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23. Rickman T, Garmany R, Doherty T, Benson D, Okusa MD: Hypokalemia, metabolic alkalosis, and hypertension: Cushing's syndrome in a patient with metastatic prostate adenocarcinoma. Am J Kidney Dis; 2001 Apr;37(4):838-46
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  • Abdominal CT scan and magnetic resonance imaging showed multiple small liver lesions and multiple thoracic and lumbar intensities consistent with diffuse metastatic disease.
  • Histological analysis of a biopsy specimen from the thoracic spine showed an undifferentiated adenocarcinoma consistent with a prostate primary tumor.
  • In this case report, we describe an unusual tumor associated with ectopic ACTH and CRH production and the pharmacodynamic relationship of plasma cortisol levels and urinary cortisol excretion with ketoconazole treatment.
  • [MeSH-minor] ACTH Syndrome, Ectopic / diagnosis. ACTH Syndrome, Ectopic / drug therapy. ACTH Syndrome, Ectopic / epidemiology. Adrenocorticotropic Hormone / blood. Aged. Comorbidity. Corticotropin-Releasing Hormone / blood. Corticotropin-Releasing Hormone / secretion. Humans. Hydrocortisone / blood. Ketoconazole / therapeutic use. Male. Neoplasm Metastasis / diagnosis. Paraneoplastic Endocrine Syndromes / diagnosis. Paraneoplastic Endocrine Syndromes / epidemiology. Tomography, X-Ray Computed


24. Park IH, Ro J, Lee KS, Kim EA, Kwon Y, Nam BH, Jung SY, Lee S, Kim SW, Kang HS: Phase II parallel group study showing comparable efficacy between premenopausal metastatic breast cancer patients treated with letrozole plus goserelin and postmenopausal patients treated with letrozole alone as first-line hormone therapy. J Clin Oncol; 2010 Jun 1;28(16):2705-11
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Phase II parallel group study showing comparable efficacy between premenopausal metastatic breast cancer patients treated with letrozole plus goserelin and postmenopausal patients treated with letrozole alone as first-line hormone therapy.
  • Of those, 35 premenopausal patients received goserelin (3.6 mg subcutaneously every 28 days) plus letrozole (2.5 mg orally daily), and 38 postmenopausal patients received letrozole alone as their first-line endocrine therapy in a metastatic setting.
  • With the median follow-up of 27.4 months, there was no statistical difference in the median time to progression between the two groups (9.5 months [95% CI, 6.4 to 12.1 months] v 8.9 months [95% CI, 6.4 to 13.3 months]).
  • In patients who did not receive bisphosphonate, letrozole +/- goserelin caused a greater loss of bone mineral density at 6 months compared with that of patients receiving bisphosphonate treatment (premenopausal group, -16.7% v 53.9%; P = .002 and postmenopausal group, -13.3% v 17.4%; P = .04 at the lumbar spine).
  • CONCLUSION: Clinical efficacies in premenopausal MBC patients with combined letrozole and goserelin therapy were comparable to those in postmenopausal patients treated with letrozole alone.
  • Although letrozole +/- goserelin resulted in a modest increase in bone resorption, concurrent treatment with bisphosphonate could prevent bone loss at 6 months.
  • [MeSH-major] Antineoplastic Agents, Hormonal / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Breast Neoplasms / drug therapy. Breast Neoplasms / mortality. Goserelin / administration & dosage. Neoplasm Invasiveness / pathology. Nitriles / administration & dosage. Triazoles / administration & dosage
  • [MeSH-minor] Administration, Oral. Adult. Aged. Biopsy, Needle. Bone Density / drug effects. Disease Progression. Disease-Free Survival. Dose-Response Relationship, Drug. Drug Administration Schedule. Female. Humans. Immunohistochemistry. Injections, Subcutaneous. Kaplan-Meier Estimate. Maximum Tolerated Dose. Middle Aged. Neoplasm Metastasis. Neoplasm Staging. Postmenopause / drug effects. Postmenopause / physiology. Premenopause / drug effects. Premenopause / physiology. Probability. Prognosis. Proportional Hazards Models. Risk Assessment. Statistics, Nonparametric. Survival Analysis. Treatment Outcome

  • Genetic Alliance. consumer health - Breast Cancer.
  • Genetic Alliance. consumer health - Metastatic cancer.
  • MedlinePlus Health Information. consumer health - Breast Cancer.
  • ClinicalTrials.gov. clinical trials - ClinicalTrials.gov .
  • Hazardous Substances Data Bank. LETROZOLE .
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  • (PMID = 20421538.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Nitriles; 0 / Triazoles; 0F65R8P09N / Goserelin; 7LKK855W8I / letrozole
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