Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0007097 (carcinoma)
 152,788 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Four cases are described of a distinctive morphologic variant of thymic carcinoid that was characterized by abundant stromal mucin admixed with the neuroendocrine elements resulting in a histologic picture reminiscent of metastatic mucin-secreting carcinoma. The patients were three men and a woman, aged 22 to 43 years. The tumors presented with symptoms of chest discomfort, cough, and dyspnea and were described as large anterior mediastinal masses on chest radiographs and computerized scans. Histologically, all cases showed nests and strands of tumor cells embedded in an abundant lightly eosinophilic, mucinous stroma with small cellular clusters as well as scattered single tumor cells seen floating in the mucin. The mucinous matrix was negative for periodic acid Schiff's and mucicarmine stains; alcian blue stains at pH 2.5 showed strong positivity of the mucinous material; this reaction was abolished by treatment with hyaluronidase, indicating the presence of nonepithelial stromal mucosubstances. Immunohistochemical stains showed strong positivity of the tumor cells with CAM 5.2, chromogranin, synaptophysin, and neuron-specific enolase, and negative staining with carcinoembyronic antigen and epithelial membrane antigen. Electron microscopy done in one case showed abundant dense-core cytoplasmic neurosecretory granules; there was no evidence of glandular secretory activity by the tumor cells. The tumors in two patients behaved in a highly aggressive fashion, with invasion of the chest wall, recurrence, and metastases to the lungs, pleura, and axillary, retroperitoneal, and mesenteric lymph nodes. Thymic carcinoid should be considered in the differential diagnosis of mediastinal neoplasms displaying prominent mucinous features. Application of immunostains and electron microscopy will be of value for establishing the correct diagnosis in this setting.
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PMID:Thymic carcinoid with prominent mucinous stroma. Report of a distinctive morphologic variant of thymic neuroendocrine neoplasm. 757 90

The caruncle is an ocular adnexal structure composed of both mucosal and epidermal elements. Consequently, a number of benign and malignant lesions of epithelial and supportive tissues may arise in this area. Lesions of the caruncle are rarely reported, and their appropriate diagnosis and management may be uncertain. One such lesion is sebaceous gland hyperplasia. Of all caruncular lesions that undergo excision, sebaceous gland hyperplasia is infrequently encountered. We have observed four cases of sebaceous gland hyperplasia of the caruncle over the last 2 years. Our observations suggest that this lesion has a characteristic onset, progression, and appearance, enabling diagnosis to be made on clinical examination alone. Excision is indicated only if there is an atypical presentation, a carcinoma is suspected, if mass effect causes discomfort or epiphora, or if cosmesis is an issue.
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PMID:Sebaceous gland hyperplasia of the caruncle. 774 20

Six cases of mucoepidermoid carcinoma of the thymus are presented. The patients were two men and four women aged 17 to 66 years (median age, 34.5). Clinically, three patients had symptoms of chest discomfort and three were asymptomatic. Grossly, the tumors in three patients were described as cystic structures varying in size from 7 to 8 cm in greatest dimension, with focal areas of induration within the walls of the cyst that averaged from 1.5 to 3 cm. The other three cases had grossly and radiographically well-circumscribed, homogeneous tumor masses. Histologically, the lesions showed a spectrum of features that ranged from those of well-differentiated, to moderately well-differentiated, to poorly differentiated mucoepidermoid carcinoma, with sheets and solid islands of squamoid cells admixed with mucin-secreting epithelium lining gland-like spaces. In four cases, the tumor was histologically seen in continuity with the epithelial lining of multilocular cystic structures; the nonneoplastic components of the cysts contained abundant inflammation and showed the features of otherwise conventional acquired multilocular thymic cysts. Clinical follow-up showed that the two patients with intermediate and high-grade tumors died within 2 and 7 months after initial diagnosis. One of these patients showed at autopsy residual tumor limited to the mediastinum, whereas the other patient died with metastases to pericardium and myocardium despite postoperative radiation therapy. Two patients with low-grade tumors were alive and well with no residual disease 2 and 3 years after surgery, and the other two were lost to follow-up. Mucoepidermoid carcinoma of the thymus should be included in the differential diagnosis of cystic neoplasms of the thymus. As with their counterparts at other sites, the biologic behavior of these tumors closely correlates with their degree of differentiation and amount of cytologic atypia.
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PMID:Mucoepidermoid carcinomas of the thymus. A clinicopathologic study of six cases. 779 81

We report a very rare case of small cell carcinoma of the stomach. A 69-year-old man, complaining of epigastric discomfort, was admitted to our hospital. Gastric endoscopy showed a Borrmann type 3 tumor at the lesser curvature of the cardia. Multiple liver metastases were observed in CT-scan, and total gastrectomy and cannulation to the hepatic artery were carried out. Macroscopically it was gastric cancer with P0H3N1T3M0, Stage IV b, histologically small cell carcinoma, intermed, INF gamma, ss, ly1, v3, n1(+), ow(-), aw(-). Immunochemotherapy was carried out, but liver metastases developed. The prognosis of this disease is very poor, resulting from rapidly developing metastases and invasion, in spite of treatments such as gastrectomy, chemotherapy and radiotherapy. More effective treatments are needed.
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PMID:[A case of small cell carcinoma of the stomach with multiple liver metastases]. 794 74

A case with primary triple cancers including thyroid cancer is reported. A 57-year old woman complaining of laryngeal discomfort was found to have an firm elastic lump on the right anterior neck. On 123I scan, the nodule in the right thyroid lobe accumulated considerable amounts of radioiodine as a warm nodule, while the remainder of the gland showed decreased uptake. Thyroid hormone levels remained within normal ranges. Cytological findings obtained by fine-needle aspiration biopsy showed papillary carcinoma. Right lobectomy was performed. The histological examinations revealed papillary carcinoma embedded within adenomatous thyroid tissue. It is probable that the surrounding adenomatous tissue accumulated radioiodine, since the warm nodule on 123I scan was larger than the size of the carcinoma. Examinations of the gastrointestinal tract revealed the presence of poorly differentiated adenocarcinoma in the stomach and well differentiated adenocarcinoma (carcinoma in adenoma) in the rectum. Expressions of ras p21 and p53 were examined immunohistochemically in these carcinoma tissues. The ras p21 product was clearly detected in not only the thyroid carcinoma but in a part of the surrounding adenomatous regions as well. Both ras p21 and p53 proteins were observed in the rectal cancer tissue. In contrast, these oncoproteins were not found in the gastric cancer tissue. In this case ras oncogene activation may be an early event in the tumorigenic process of the thyroid and rectum. However, different genetic alterations seem to occur during the development of these three carcinomas.
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PMID:[A case report of primary triple cancers in the thyroid, stomach and rectum with evidence of variable oncoprotein expressions]. 800 92

We reviewed our experience with ultrasound-guided biopsies of masses of the thyroid gland that were either nonpalpable or difficult to localize by palpation to evaluate the technique and correlate the results. Thirty-two biopsies were performed upon 25 patients whose clinical presentations were palpable nodule (six patients), throat discomfort (two patients), postpartial thyroidectomy follow-up evaluation (two patients), incidental discovery of a mass--by ultrasound of the neck (two patients), roentgenogram of the chest (two patients), computed tomography of the chest (one patient) and during tracheostomy placement (one patient). Other presentations were eliminate infection (one patient), odynophagia (one patient), hoarseness (one patient), cold nodule on a nuclear medicine study (one patient), hyperparathyroidism (one patient), rule out metastasis from carcinoma of the colon (one patient), persistent cough (one patient), enlarged thyroid gland (one patient) or family history of carcinoma of the thyroid gland (one patient). Fifteen patients had nuclear medicine studies showing either a cold nodule (ten patients), multinodular goiter (one patient), normal examination (two patients), hot nodule (one patient) or no thyroid gland activity (one patient). The ultrasound examinations showed either a hypoechoic nodule (25 patients), inhomogeneous or mixed echogenic nodule (six patients) or a hyperechoic nodule with hypoechoic rim (one patient). The nodules ranged in size from 3 milliliters to 7 centimeters. Twenty-six lesions were less than 3 centimeters in diameter; of the other six, four were substernal goiters. Six patients had a previous nondiagnostic biopsy directed by palpation only. Biopsy was performed using real-time ultrasound guidance with various needles. One patient had a small hematoma, which was the only complication in the study. The results of the biopsies were diagnostic in 26 of 32 patients. The final diagnosis was benign follicular cells (ten patients), adenomatous nodule (seven patients), follicular neoplasm (three patients), colloid cyst (two patients), aspergillus (two patients), fibrosis (one patient) and papillary carcinoma (one patient). Six of the biopsies yielded unsatisfactory specimens. One of the patients with a diagnosis of benign follicular cells on biopsy had a follicular carcinoma after surgical pathologic factors were obtained; that was the only false-negative result. We conclude that ultrasound-guided biopsy of the thyroid is a safe and useful method of evaluating nonpalpable and difficult to palpate thyroid masses.
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PMID:Ultrasound guided biopsy of nonpalpable and difficult to palpate thyroid masses. 815 14

Surgical treatment of familial adenomatous polyposis (FAP) remains controversial. The arguments in favour of ileal pouch-anal anastomosis (IPAA) are well known. All the premalignant mucosa is removed and the risk of rectal carcinoma is avoided. Recent studies have compared results of IPAA and ileo rectal anastomosis (IRA). Morbidity is higher after IPAA, but it does not seem to influence the functional result, and it has to be compared with discomfort of subsequent rectal fulgurations. Functional result of these two procedures is very similar. The risk of occurrence of desmoid tumor is also similar. But desmoid tumor can interfere with the planned treatment and conversion of IRA to IPAA is not always feasible. Furthermore, it is suggested that desmoid tumour could be promoted by iterative surgical trauma. We conclude that it is preferable to perform directly the best and definitive operation and that IPAA is for us the procedure of choice in FAP, except in case of low rectal cancer or extensive colic cancer.
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PMID:[Ileo-anal anastomosis in familial adenomatous polyposis: procedure of choice?]. 816 Nov 38

Damage to the pelvic bones after radiotherapy for gynecological malignancies is uncommon with megavoltage radiotherapy. It can be misdiagnosed as bony metastases and is a diagnosis of exclusion. We report 12 women, who were treated for endometrial or cervical carcinoma who developed osteitis, femoral head or neck necrosis, or insufficiency fractures of the acetabulum, pubic symphysis or sacroiliac bones after radiotherapy. Many had multiple areas of bone damage. The prescribed external beam dose ranged from 40.0 to 61.2 Gy. All but one patient developed bony discomfort or pain as a symptom. Bony changes of the pelvic girdle appeared between 6 months and 8 years after irradiation. Radiographic studies including plain films, CT or bone scans were performed in these patients and showed correlative changes. Bone scans showed increased radionuclide uptake in affected bones. The subsequent favorable clinical course and outcome with resolution of symptoms confirmed the diagnosis of radiation osteitis. Therapy recommendations are conservative with avoidance of weight-bearing, use of analgesics and physical therapy. Femoral head necrosis/fractures required arthroplasty. Proper shielding, use of multifield technique, treatment of all fields per day, and awareness of tolerance doses are recommended.
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PMID:Radiation osteitis and insufficiency fractures after pelvic irradiation for gynecologic malignancies. 819 13

This is the first North American report describing the use of the holmium:YAG (Ho:YAG) laser to treat patients with superficial bladder carcinoma. Fifteen patients, with a total of 52 recurrent superficial bladder tumors, underwent endoscopic laser photoablation of their lesions. No intraoperative or delayed complications occurred. At follow-up cystoscopy performed 3 months after lasing, four patients (27%) were without disease; eight patients (53%) had out-of-field recurrences; and three patients (20%) were classified as having in-field recurrences. We conclude that using the Ho:YAG for endoscopic treatment of patients with superficial bladder tumors is both feasible and clinically useful and that the lack of perceived pain or discomfort during lasing, as well as the lack of need for an in-dwelling urethral catheter, makes it advantageous for selected patients over conventional electroresection techniques.
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PMID:Use of the holmium:YAG (Ho:YAG) laser for treatment of superficial bladder carcinoma. 820 47

A vaginal or a laparoscopic approach in radical surgery for cervical carcinoma has been proposed. A pilot study of eight cases shows that an oncologic surgeon familiarized with these techniques is able to take advantage of the benefits of both routes in the same patient: laparoscopic surgery is adapted to lymph node dissection, section of the origin of the uterine artery, and dissection of the ureter under direct vision; vaginal surgery allows a precise incision of the vaginal cuff. Both routes may be used for the section of parameters, but we propose the use of the vaginal route. The combination of vaginal and laparoscopic surgery spares the pain and discomfort of both laparotomy and perineotomy.
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PMID:Laparoscopically assisted radical vaginal hysterectomy. 827 2


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