Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A patient with an unresectable well-differentiated bile duct tumor who survived for 15 yr after biopsy diagnosis is presented. Histologic examination of the tumor revealed bland features of bile duct adenoma despite extensive spread within the liver. Over its subsequent course, the tumor progressively replaced the liver, achieving huge size, although there was no evidence of metastases until shortly before the patient's death. This clinical course was very unusual for either bile duct adenoma or cholangiocarcinoma, but would be more characteristic of another tumor of intrahepatic bile duct origin, the biliary cystadenoma. However, this latter diagnosis was excluded with both gross and microscopic pathologic criteria. Evidence is presented to support classification of this tumor as an unusual varient of peripheral cholangiocarcinoma which requires correlation of the clinical and pathologic findings for correst diagnosis.
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PMID:Well-differentiated peripheral cholangiocarcinoma with an unusual clinical course. 22 5

Differential diagnostic problems between gastric carcinomas and precancerous lesions with severe dysplasia have become more perceptible with the increasing number of resected early carcinomas. Although such problems come up for all macroscopic and histologic types of gastric cancer they are particularly marked between early carcinomas of the elevated type and adenomatous polyps. Elevated early carcinomas are usually highly differentiated adenocarcinomas with a morphology which often reminds of of adenomas. But sometimes the carcinomas also demonstrate convincing signs of being developed from adenomas. The criterion of distinction between intramucosal carcinomas and adenomas is invasion through the basal membrane, often difficult to evaluate. The morphological relation between elevated early gastric carcinomas and adenomas and the criterion of distinction between them were studied in 20 early gastric carcinomas of the Japanese types I and IIa, 6 intramucosal and 14 submucosal all highly differentiated adenocarcinomas, and in 42 polyps, of which 5 were of the adenomatous type. All lesions were taken from resection specimens. Among the carcinomas 5 demonstrated convincing signs of being malignant transformed adenomas. In addition, 6 carcinomas had a morphology which more or less reminded of adenomas, but their genetic origin was more uncertain. Nine carcinomas revealed no sign of an adenomatous origin. Among the 5 polyps diagnosed as adenomas 2 revealed an extraordinary degree of severe dysplasia which caused uncertainty on the benign diagnosis. The rest of the polyps were without dysplasia. The significance of invasion through the basal membrane as an indispensable factor of distinction between adenoma and carcinoma in the stomach is discussed. It is concluded that the degree of dysplasia can be so severe and the invasion so difficult to evaluate that the classification of some few tumours depends on the subjectivity of the single pathologist. Four of the tumours, 2 adenomas and 2 intramucosal carcinomas, having a remarkable macroscopic appearance like a large mucosal fold are especially mentioned. Their relation to gastric mucosal prolaps is discussed. Furthermore, a tumour apparently demonstrating only a moderate degree of dysplasia, but even so setting up metastases is mentioned in detail.
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PMID:Elevated early gastric carcinoma. Differential diagnosis as regards adenomatous polyps. 22 35

Angiography was carried out on 28 patients by which a beta cell tumour was verified in 21. One case was excluded as no final diagnosis was established. Angiography correctly localized 14/17 adenomas (82%) and 3/4 carcinomas (75%), in total 17/21 tumours (81%). The adenomas were equally distributed throughout the pancreas. Three false negative diagnoses included an adenoma in the head of pancreas seen in retrospect, a hypovascular adenoma in the head of pancreas and an adenoma in the tail of pancreas which probably was hidden by the spleen. All carcinomas were located in the body and tail of pancreas. Metastases to the liver were demonstrated in two cases, although present in all. One carcinoma was not distinguished from superimposed metastases in the left lobe of the liver. A false positive diagnosis was reported in 3/7 cases (57%). One resulted from accumulation of contrast in the duodenal mucosa, another from a small accessory spleen in the tail of pancreas and the third was probably due to contrast accumulation in the body of pancreas seen 'end-on'. A false positive diagnosis may also derive from contrast accumulation in a hyperplastic lymphnode, a penetrating gatroduodenal ulcer, a pancreatic haemangioma or metastasis. Diagnostic specificity was 0.85, sensitivity 0.43.
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PMID:Angiographic localization of beta cell tumours. 22 82

Tumor-specific immunity to carcinoma of the colon, pancreas and stomach was assayed by tube LAI. Cancers of the colon, pancreas and stomach, were shown to possess organ-type specific neoantigens. In 115 patients with colon cancer, 100%, 75%, 61% with Dukes' A, B and C cancer were LAI positive, respectively. Even a microfocus of in situ cancer in a colon adenoma was sufficient to stimulate measurable tumor-specific immunity in the host. In Dukes' D cancer, 25% of patients with widespread metastasis were positive, whereas 100% with solitary lesions were positive. Reactive leukocytes from patients with colon cancer did not react to extracts of normal bowel mucosa or villous adenoma from LAI-negative patients. Leukocytes from 19% (3 of 16) of patients with colon adenomas reacted to the extract of colon cancer but not normal colon mucosa. Moreover, the LAI-positive response of the patients with colon adenomas or colon cancer is directed to a colon cancer TSA which is linked to beta2-microglobulin. These studies suggest that some colon adenomas express TSA before morphological evidence of cancer. It is not known if the acquisition of a cell surface TSA is an irreversible step toward unrestrained growth and metastasis. In pancreatic cancer, 100% of patients with cancers less than 5 cm and without metastasis were LAI positive, whereas 29% were positive when the cancer was greater than 5 cm or had metastasized. In Patients with stomach cancer, 100% with Stage II and 46% with Stage III and IV cancer were LAI-positive. Leukocytes from patients with other GIT cancers and from patients with inflammatory bowel disease or pancreatitis did not react with extracts of colon, stomach or pancreatic cancer. Leukocytes from patients with metastatic cancer, usually did not react in the tube LAI assay because their surfaces were coated in vivo with TSA. LAI reactivity was present when CEA was not detectable and when CEA levels were elevated LAI activity was often absent. The present study suggests that the automated tube LAI shows sufficient promise to warrant studies to determine its efficacy for the diagnosis of GIT cancers.
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PMID:Tube leukocyte adherence inhibition (LAI) assay in gastrointestinal (GIT) cancer. 37 89

Thirty-two patients with medullary carcinoma of the thyroid (MCT) were studied before and after therapy. Sixteen patients had familial and 16 had the sporadic type of disease. The groups differed in several features: Patients with sporadic disease were older at diagnosis and presented with enlargements in the thyroid or lymph nodes, and one patient had neuromata; in the familial group the disease was more often bilateral and was associated at times with the MEA syndrome (parathyroid adenoma or pheochromocytomas, or both). The immunoreactive serum calcitonin (CT) level was measured before and after some form of therapy in all 32 patients. Our investigations showed: 1) Delaying treatment was clearly detrimental in this progressive disease; 2) The most effective therapy was surgery, while radiotherapy and chemotherapy were less effective; 3) Postoperatively, the CT level usually fell sharply, when the disease was thought extirpated, but the lowest nadir might be reached at from 1 month to 6 years; 4) In all such patients the CT level eventually rose from the postoperative nadir; 5) Patients with no clinical or radiological evidence of disease, had high CT levels for a mean of 3 years of observation; 6) A marked rise of CT levels in three patients preceded metastases and death; 7) Patients with abdominal, particularly liver disease had the highest CT levels; and 8) Patients who died had relatively high CT levels, corresponding in general with the extent of disease.
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PMID:Medullary thyroid carcinoma: importance of serial serum calcitonin measurement. 42 24

Because it is difficult histologically to differentiate between a renal cell carcinoma and a renal adenoma, their differentiation has been based on size. Lesions less than 3 cm. have been called adenomas and those greater than 3 cm. carcinomas. It is a widely accepted concept that adenomas evolve into adenocarcinomas, and it is true that lesions less than 3 cm. rarely metastasize. However, as demonstrated by this case and others, metastasis can occur, therefore, it is suggested that the term renal adenoma no longer be used.
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PMID:Renal adenoma -- a misnomer. 44 31

A case of C cell thyroid adenoma in a 47-year-old female patient is described. The nodule showed progression over 34 years. The adenoma cells showed histochemical and ultrastructural properties characteristic for C cells. Histologic examination revealed no atypical features of nodule cells nor infiltration of capsule by neoplastic cells. In the period of 8 years following the excision there was neither recurrence nor metastases.
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PMID:C cell adenoma of the human thyroid gland. 45 Mar 88

Fourteen case reports have been published in which "hot" nodules have been documented as carcinoma, with or without coexisting adenomas. The diagnosis of these lesions is difficult, since hot nodules usually represent benign disease. These carcinomas are not functional, but represent coexistence of a functional area or a malignant degeneration. Hot nodule carcinomas should be suspected in high-risk patients. A euthyroid, 31-year-old woman who, as a teenager, had radiotherapy for acne is reported. She was followed up with yearly scans for a hot nodule in the right lower lobe of her thyroid. When she was 36, a node was discovered in the right side of her neck, and carcinoma was suspected. Surgical excision revealed a papillary-follicular carcinoma adjacent to an adenoma with metastases to regional lymph nodes.
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PMID:Thyroid carcinoma in a patient with a coexisting functional adenoma. 53 Jun 98

This report deals with a rare case of bilateral cancer of the parotid gland, with lymph node metastases. Histologically, the tumor was a trabecular adenocarcinoma. The first neoplasm was located in the right parotid gland and developed into a pleomorphic adenoma. Both cancers were treated with parotidectomy and bilateral neck dissection. From a comprehensive review of the literature, it appears that the present case is the sixth on record of bilateral parotid tumors. Pathogenetically, it is suggested that a common carcinogenic factor might have acted simultaneously and bilaterally on the parotid gland.
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PMID:Bilateral synchronous trabecular adenocarcinoma of the parotid gland. 57 Jun 88

Over a 25-year period, two carcinomas of the parathyroid were observed in 67 cases of primary hyperparathyroidism. The most important signs and symptoms were bone disease, palpable neck metastases, renal stones, and hypercalceamia with high blood levels of parathyroid hormone. Histology revealed that in principle parathyroid carcinoma can be distinguished from adenoma by a trabecular pattern and thick fibrous bands. The presence of cellular atypia and variation or mitotic figures (regressive polymorphia) was not a useful criteria for carcinoma. Local recurrence occurred in both cases.
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PMID:[Parathyroid neoplasm associated with hyperparathyroidism]. 68 29


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