Metastasis

From Anvita Health Wiki

Contents 1 More Specific Terms 2 Introduction 3 Etiology 4 Pathology 5 Genetics 6 Complications 7 Management 8 More General Terms 9 Additional Terms 10 References

More Specific Terms

• bone metastases
• brain metastases
• carcinomatous meningitis (leptomeningeal metastases)
• drop metastases
• liver metastases
• lymph node metastases
• pulmonary metastases

Introduction

• Patterns of metastases of common cancers (see etiology)

Etiology

• metastasis to lymph nodes

• breast cancer(60-80%)
• lung cancer (83% local, 29% distant)
• prostate cancer (68%)
• melanoma (58%)
• ovarian cancer (48% local, 58% distant)
• colorectal carcinoma (53%)

• metastasis to liver

• lung cancer (73%)
• melanoma (63%)
• breast cancer (40-60%)
• ovarian cancer (48%)
• colorectal carcinoma (44%)
• kidney cancer (44%)
• prostate cancer (36%)

• metastasis to lung

• kidney cancer (72%)
• breast cancer (66%)
• melanoma (60%)
• prostate cancer (49%)
• ovarian cancer (34%)
• colorectal carcinoma (16%)
• ipsilateral or contralateral lung cancer (8%)
• thyroid cancer
• head & neck cancer

• metastasis to bone

• prostate cancer (67%)
• breast cancer (62%)
• lung cancer (56%)
• melanoma (48%)
• colorectal carcinoma (27%)
• bladder cancer (26%)
• cervical cancer (21%)
• ovarian cancer (12%)
• kidney cancer (10%)

• metastasis to brain

• lung cancer (37-50%)
• breast cancer (10-23%)
• melanoma (10-48%)
• kidney cancer (19%)
• colorectal carcinoma (11%)
• cervical cancer (9%)
• bladder cancer (7%)
• ovarian cancer (3%)
• prostate cancer (2%)

• metastasis to skin

• melanoma (44%)
• breast cancer (20%)
• colorectal carcinoma (5%)
• bladder cancer (5%)
• kidney cancer (5%)
• ovarian cancer (5%)
• cervical cancer (3%)
• prostate cancer (3%)

• metastasis to adrenal

• melanoma (48%)
• lung cancer (35%)
• bladder cancer (35%)
• colorectal carcinoma (31%)
• breast cancer (31%)
• cervical cancer (31%)
• kidney cancer (20%)
• ovarian cancer (20%)
• prostate cancer (17%)

• metastasis to kidney

• melanoma (27%)
• cervical cancer (26%)
• ipsilateral or contralateral kidney cancer (21%)
• bladder cancer (19%)
• breast cancer (17%)
• lung cancer (16%)
• colorectal carcinoma (13%)
• prostate cancer (11%)
• ovarian cancer (6%)

Pathology

• relatively few malignant cells shed by primary tumors metastasize successfully
• either the malignant cells do not enter distant organs, or they enter but fail to multiply
• only malignant stem cells may successfully metastasize [3]

• malignant stem cells attach to endothelial cells in the target organ's microcirculation, then invade the stroma
• in the stroma, the malignant stem cells induce fibroblasts to produce periostin ( breast cancer metastasis) [3]

Genetics

• abnormalities of alpha-catenin are involved in the process of cancer invasion & metastasis

Complications

• 
  
• disease interaction(s) of cancer with Alzheimer's disease

Management

• brain metastasis

• a single brain metastasis may be amenable to surgical resection
• multiple brain metastases are treated palliatively

More General Terms

• neoplastic process

Additional Terms

• down-regulated in metastasis protein (key-1A6 protein, novel nucleolar protein 73, NNP73, DRIM)
• metastasis-associated protein MTA2 (metastasis-associated 1-like 1, MTA1-L1 protein, p53 target protein in deacetylase complex, MTA2, MTA1L1, PID)

References

1. Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 521
2. Medical Knowledge Self Assessment Program (MKSAP) 15, American College of Physicians, Philadelphia 2009
3. Journal Watch Komaroff AL New Insights into the Biology of Metastasis Journal Watch February 1, 2012 Massachusetts Medical Society
   - Malanchi I et al. Interactions between cancer stem cells and their niche govern metastatic colonization. Nature 2011 Dec 7; 481:85. PMID: [1]
   - Png KJ et al. A microRNA regulon that mediates endothelial recruitment and metastasis by cancer cells. Nature 2011 Dec 14; 481:190. PMID: [2]
4. NCI: Metastatic Cancer; Questions & Answers [3]
5. National Guideline Clearinghouse Follow-up of malignant or aggressive musculoskeletal tumors. ngc-guideline: [4]
   - ACR Appropriateness Criteria for metastatic bone disease ngc-guideline: [5]
   - Screening for pulmonary metastases. American College of Radiology ngc-guideline: [6]
   - Leptomeningeal metastases. Association of Comprehensive Cancer Centres ngc-guideline: [7]
   - Metastatic malignant disease of unknown primary origin. Diagnosis and management of metastatic malignant disease of unknown primary origin. National Collaborating Centre for Cancer ngc-guideline: [8]

metastasis