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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The findings in 28 patients with synchronous lung cancers are reviewed. Mediastinoscopy and systemic staging were performed to exclude the possibilities that one pulmonary lesion was metastatic from the other or that both represented systemic metastases from another tumor. Nineteen patients underwent resection of both tumors. Median survival was 25 months for four patients with definite Stage I synchronous cancers (no nodal involvement; different cell types, bronchoscopically separate endobronchial lesions or arising from separate foci of carcinoma in situ) and was 27 months for seven patients with possible synchronous Stage I cancers (no nodal involvement; similar cell types; located in separate lobes). Median survival was 11 months for 16 patients having Stage II or III lung cancer accompanied by a second synchronous lung cancer. In the absence of hilar or mediastinal nodal involvement and systemic metastases, synchronous tumors should be considered separate primaries when located in different lobes, even if they have similar histologic features. Prognosis of synchronous cancers is related to the presence or absence of nodal metastases. Pneumonectomy is the operation of choice for synchronous unilateral tumors. With bilateral tumors, sequential resection starting with the most advanced lesion is appropriate. Preservation of lung tissue without compromising the cancer operation is critical.
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PMID:Diagnosis and management of synchronous lung cancers. 397 73

Sixty-one patients with clinical low-stage (Jackson Stage I) and 22 patients with clinical high-stage (Jackson Stage II or III or T3-4N0-1M0) carcinoma of the penis who were seen between 1952 and 1979 and followed for at least 3 years or until death were reviewed. The majority of patients with Stage I cancer were treated with partial penectomy, either with or without ilioinguinal lymphadenectomy. The remainder of patients with these early small lesions were treated with local excision or circumcision. Forty-one of the patients with this early penile cancer (Jackson Stage I or Tcis, T1N0M0 or T2N0M0) survived at least 3 years and were considered cured. The other 20 patients died of cancer (12 cases) or unrelated disease (8 cases). If the patients who died of other diseases are excluded, the corrected 5-year survival rate was 77%. Treatment failure was primarily due to metachronous inguinal metastases after initial treatment of the primary tumor and failure of response of metastatic disease to salvage treatment. Four factors probably were associated with a poor prognosis: large primary tumor, moderately to poorly differentiated cancer, younger age at onset, and inadequate initial treatment. In advanced (Jackson Stages II and III) disease, treatment by partial or total penectomy alone or in combination with radiation to inguinal nodes after penectomy produced 3-year or longer survival in only 2 of 9 patients, whereas treatment by early extended excision of both the primary lesion and the ilioinguinal lymph nodes produced 3-year or longer survival in 11 of 13 patients. The results suggest that local excision is appropriate only for carcinoma in situ. Partial penectomy and monthly follow-up for at least 1 year is appropriate for patients with small, well-differentiated primary tumors. Patients who have large or moderately to poorly differentiated primary tumors probably should undergo partial or total penectomy and immediate ilioinguinal lymphadenectomy.
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PMID:Cancer of the penis. Prognosis and treatment plans. 397 57

Two cases of occult invasive carcinoma of the cervix have been reported with emphasis on diagnostic failure and subsequent inappropriate treatments. A prompt replacement with malignant cells simulating dysplasia or carcinoma in situ was observed at the sites of cauterization preoperatively. However, histology of postoperative specimen showed apparent invasiveness in both cases and lymphatic metastases in one of them. These findings have led us to a concept that the present cases may represent a variety of occult carcinomas, which is in between the common and verrucous types of squamous cell carcinomas.
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PMID:Undenuded invasive cervical carcinomas erroneously treated by cauterization. 402 95

Prostatic adenocarcinomas were induced in 5 out of 20 Wistar rats upon a single administration of 50 mg/kg N-nitroso-N-methylurea (NMU). The rats were pretreated with a daily dose of 50 mg/kg cyproterone acetate for 3 weeks followed by 3 daily injections of 100 mg/kg testosterone. All tumours developed in the dorsolateral prostate and were invasively growing. In 2 cases distant metastases were found. Three proliferative lesions classified as carcinomas in situ were also found in the dorsolateral prostate. A total of 7/20 animals (35%) carried an adenocarcinoma and/or a carcinoma in situ. In addition, 6 epithelial hyperplasias were observed in the dorsolateral and 1 in the ventral prostate of non-tumour-bearing rats. The method described may provide a good animal model for cancer of the prostate and lead to a better understanding of prostatic carcinogenesis.
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PMID:Adenocarcinomas of the prostate induced by N-nitroso-N-methylurea in rats pretreated with cyproterone acetate and testosterone. 621 69

For this investigation on growth, p-classification and grading of squamous cell carcinomas of the vocal cord serial sectioning was applied to 108 specimens (58 partially and 50 totally extirpated larynges) of vocal cord cancers that had not previously been treated otherwise. The evaluation of these serial sections showed that frequently recurring patterns of the spread of carcinomas can be recognized which may be subdivided as follows: (1) Carcinoma in situ and early carcinomas of the vocal cord (microinvasive or minimal invasive carcinomas) originate from the strip of squamous cell epithelium covering the vocal cord mostly on its subglottic part. There are circumscribed as well as diffuse types, the latter mostly spreading subglottically, too. (2) Similar to the early vocal cord carcinomas the larger ones mostly expand in the subglottic direction. These glotto-subglottic tumours also follow the metaplastic areas of squamous cell epithelium caudally; they often infiltrate deeply, affect the cricoid and the thyroid cartilage and leave finally the larynx dorsolaterally. They metastasize to the deep cervical and paratracheal lymph nodes. (3) Less frequently larger carcinomas develop in the upper half of the vocal cord epithelium at the floor of the ventricle and extend cranially. These 'ventricle carcinomas' do not spread widely on the surface, but at once infiltrate deeply lateralcaudally into the paraglottic space and - in extreme cases - grow intramurally circularly. They often penetrate the laryngeal framework and metastasize mainly to the deep cervical lymph nodes. (4) Transglottic tumours ('multiregional' vocal cord carcinomas) represent a kind of 'pool' for advanced vocal cord carcinomas having expanded in different directions (sub- and supraglottically). In extensive cancerized fields they can also arise multicentrically. They frequently penetrate the laryngeal framework and metastasize to the deep cervical and paratracheal lymph nodes. The investigation of the growth of vocal cord carcinomas proved different modes of invasion of the various anatomical structures of the larynx. The submucosa or the so-called compartments do not resist the tumour growth, muscles are destroyed with increasing infiltration; tumours quickly spread in the relatively loose tissue and use vessels and nerves as pathways. The ossified parts of the hyaline laryngeal framework are infiltrated comparatively easily whereas non-ossified parts, together with ciliated epithelium, and mucous glands represent a kind of barrier against tumour growth.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Carcinoma of the larynx. Growth, p-classification and grading of squamous cell carcinoma of the vocal cords. 636 47

The clinical and pathologic features of carcinoma arising in Barrett's esophagus were studied in resection specimens from 26 patients. White males predominated (73%). A history of symptomatic gastroesophageal reflux was frequently absent, being elicited in only eight of 14 patients (57%) with a carefully obtained history at the time of presentation with carcinoma. Survival was relatively short with a median survival of 23 +/- 5 months, and only three patients had a disease-free survival longer than 2 years. A pathologic spectrum of carcinoma was found: differentiation ranged from well to poorly differentiated in the 20 patients with a single adenocarcinoma; two separate carcinomas were found in four patients; and a spectrum of differentiation in a single tumor was found in the other two cases, one an adenocarcinoid tumor and the other an adenosquamous carcinoma. The tumors were generally far advanced, with extension through the esophageal wall in 23 of 26 cases (88%) and metastases to lymph nodes in 17 of 24 cases (71%). Epithelial dysplasia, including carcinoma in situ in some cases, was found in Barrett's mucosa adjacent to the tumor in all 26 patients. Our findings suggest that a surveillance program for dysplasia in patients known to have Barrett's esophagus is warranted in an attempt to improve the outcome. However, the impact of surveillance on the incidence of Barrett's carcinoma may be lessened by its frequent occurrence in patients with asymptomatic gastroesophageal reflux.
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PMID:The spectrum of carcinoma arising in Barrett's esophagus. A clinicopathologic study of 26 patients. 646 17

Sebaceous carcinoma of the eyelid is commonly misdiagnosed because it simulates other entities both clinically and pathologically. In a review of all pathologic material removed from the eyelids of patients at the Mayo Clinic between 1905 and 1981, 43 sebaceous carcinomas were discovered. The tumors manifested most frequently on the upper eyelid; the onset of symptoms occurred in 31 women and 12 men at a mean age of 61.5 years (range, 28-82 years). Of the 43 patients, 11 had an associated second malignant tumor or exposure to irradiation. The microscopic diagnosis was based on finding a proliferation of basophilic neoplastic cells with foamy cytoplasm and a positive fat stain. Intraepithelial neoplasia in the form of pagetoid change or carcinoma in situ was found in more than 80% of cases. Histologically, the tumor tended to be moderately differentiated. A high degree of infiltration was frequently observed cases with metastases. When intraepithelial neoplasia is observed microscopically, we recommend a fat stain on a frozen section and a full-thickness eyelid biopsy to exclude sebaceous carcinoma.
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PMID:Sebaceous carcinoma of the eyelid. Errors in clinical and pathologic diagnosis. 646 19

The prognostic characteristics of stage I cutaneous malignant melanoma were evaluated. For this purpose, all patients with malignant melanomas diagnosed between January 1, 1967, and December 31, 1982, at the Department of Pathological Anatomy of the S.S.D.Z. were examined. Of the 187 total cases of malignant melanoma, 169 patients had stage I disease. Of these, 101 were not included in the investigation for the following reasons: carcinoma in situ (2), previous radiation treatment (1), localization in mucous membrane (2), microscopic sections unsuitable for morphometry and measurement of tumor thickness (11), follow-up period shorter than 60 months (61), lost for follow-up (12) and cause of death unrelated to melanoma (12). Of the remaining 68 patients, 46 had been alive without metastases for at least 60 months ("survivors") and 22 had died from metastases within 60 months ("nonsurvivors"). The following parameters were investigated: age, sex, localization, histologic type, level of invasion according to Clark and Breslow, ulceration, mitotic activity index, morphometric parameters (relating to nuclear shape and size) and number, size and localization of nucleoli. Wilcoxon's test and the chi-square test showed significant differences between survivors and nonsurvivors with regard to ulceration (P = 0.005), mitotic activity index (P = 0.006), histologic type (P = 0.03), level of invasion according to Clark (P = 0.004), Breslow tumor thickness (P = 0.003), standard deviation of nuclear contour index (P = 0.04) and nuclear correlation coefficient (P = 0.008). The results showed that tumor thickness of cutaneous malignant melanoma is the most significant prognostic parameter.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Evaluation of prognostic characteristics of stage I cutaneous malignant melanoma. 650 33

Thirty-six cases of vulvar squamous cell carcinoma 5 mm or less in thickness were studied, and potential predictors of lymph node metastases were evaluated. Tumor thickness and depth of stromal invasion were measured. Inguinal lymph node metastases were present in six (17%) cases, all of which had primary neoplasms more than 3 mm thick. The most superficial lesion to have lymph node metastasis was 3.2 mm thick and had 1.6 mm of stromal invasion. Nonetheless, depth of stromal invasion of less than 3 mm was associated with statistically fewer lymph node metastases (7%) than that of neoplasms with 3 mm or more of stromal invasion (50%). Although lymphatic or blood capillary invasion was present in four (11%) cases, this feature had no statistically significant association with lymph node metastasis. There was no relationship between clinical stage, surface diameter, or histological grade of the lesion and lymph node metastasis. A significant percentage of cases had either carcinoma in situ (31%) or atypical hypertrophic dystrophy (19%) in the epithelium adjacent to the infiltrating carcinoma. Koilocytotic atypia suggestive of human papilloma virus infection was present in the adjacent epithelium in 47% of the cases. This study suggests that thickness of the neoplasm is a valid predictor for the presence or absence of lymph node metastasis in vulvar squamous cell carcinoma; it may be more useful than neoplastic depth of invasion in this regard.
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PMID:The pathology of superficially invasive, thin vulvar squamous cell carcinoma. 651 Nov 60

We compared two commercial assays for measurement of serum thyroglobulin [Nuclear Medical Systems (NMS) and "CIS" (Damon Diagnostics)] with each other and with one developed at Stanford (J Clin Endocrinol Metab 49:557-564, 1979). The NMS assay is a competitive-binding RIA, the CIS and Stanford assays are two-site immunoradiometric assays. The kit standards varied in thyroglobulin concentration. The NMS standards differed in immunoreactivity from thyroglobulin in clinical specimens and from the other standards. Also, nonparallelism between standards and patients' sera in the NMS assay suggested a less-specific antiserum. Results by the CIS and Stanford assays correlated well (n = 120, r = 0.964), those by the NMS assay less strongly (n = 101, r = 0.855 vs CIS, r = 0.888 vs Stanford). Clinical evaluation in 50 patients treated for differentiated thyroid carcinoma (10 with metastases and 40 currently disease-free) indicated good agreement for positive results by the three assays. The CIS and the Stanford assay both gave high results (greater than or equal to 25 micrograms/L) in all 10 cases with metastases; the NMS RIA identified eight of these patients (thyroglobulin greater than or equal to 30 micrograms/L), but excluded two with anti-thyroglobulin autoantibodies. In subjects without disease, however, the percentage of undetectable thyroglobulin (negative result), as opposed to low measurable thyroglobulin (inconclusive result) varied considerably: 85% by CIS, 30% by NMS, and 75% by the Stanford assay.
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PMID:Differences in radioimmunoassay results for thyroglobulin that affect management of patients with thyroid cancer. 669 Jan 56


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