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

A study of 50 consecutive cases (22 men, 28 women; age range, 39 to 84 years; mean age, 65 years) of cutaneous neuroendocrine Merkel cell carcinoma (CNC), 39 of whom had a mean follow-up of 34 months, revealed that the prognostic significance of the histopathologic subtyping in trabecular, solid, and diffuse variants of CNC was not as important as the pathologic postsurgical staging in localized, regional, and extraregional disease. The overall mortality was 23.5%. None of the 19 patients with localized disease died of CNC, while 11% of the 24 patients with regional disease and all seven patients with extraregional disease at presentation died of CNC. A second primary malignancy was found to be associated with the CNC in 15% of the cases. The clinical course in patients with localized disease was favorable in spite of the high number of local recurrences. Also, the presence of regional metastases was not related to an unfavorable prognosis. In 68% of the cases the disease involved the lower limbs or girdle. In ten cases the overt exophytic presentation of primary CNC was replaced by the presence of tumor masses infiltrating the inguinal soft tissues with or without nodal involvement.
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PMID:Clinicopathologic correlations of cutaneous neuroendocrine Merkel cell carcinoma. 319 69

The records of 13 patients suffering from Merkel cell tumour of the skin have been reviewed and the treatment analysed. Pending further experience of this uncommon tumour, a recommendation is made for wide excision of the primary site with elective postoperative radiation to both the primary site, the in-transit zone where practicable, and regional nodes. If malignant nodes occur, block dissection with postoperative radiotherapy is indicated. If widespread metastases develop, cyclophosphamide, doxorubicin, vincristine and prednisone chemotherapy may give a response. The prognosis is poor.
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PMID:Management of Merkel cell tumour. 320 31

Carcinomas histologically resembling nasopharyngeal lymphoepithelioma have been identified in the salivary gland, thymus, tonsil, and uterine cervix. Five patients with similar tumors primary in the skin are described. The patients ranged in age from 50 to 81 yr. Four neoplasms were situated on the head, and one was located on the shoulder. Microscopically, they were concentrated in the mid- and deep dermis and lacked connections with epidermis. The pattern was of multiple nodules, smaller irregular islands, and cords. The uniform tumor cells had moderate amounts of lightly eosinophilic cytoplasm and vesicular nuclei with one or two prominent nucleoli. A lymphoid infiltrate was intimately associated with each neoplasm and obscured the malignant epithelium in one. Neither squamous nor glandular differentiation was present, but all tumors exhibited intracytoplasmic mucin. Immunohistochemistry was positive for cytokeratin (5 of 5; diffuse) and epithelial membrane antigen (4 of 5; 3 diffuse, 1 focal). Focal reactivity was also noted for carcinoembryonic antigen (1 of 5), neuron-specific enolase (1 of 5), and vimentin (1 of 5). S100 protein, leukocyte common antigen, Factor VIII-related antigen, prostate-specific antigen (males), Leu M1, and salivary amylase reactivity were absent. One patient developed local recurrence and metastases after 39 mo and was dead of disease at 57 mo. The remaining four were free of disease after 46, 27, 25, and 6 mo of follow-up. The diagnosis of lymphoepithelioma-like carcinoma of the skin is based on microscopic findings and exclusion of occult malignancy. The tumor can be confused with a lymphoid infiltrate and is differentiated from Merkel cell carcinoma primarily on cytologic grounds. The neoplasm may be of adnexal origin.
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PMID:Lymphoepithelioma-like carcinoma of the skin. 323 11

Four cases of Merkel cell tumor located in the face or on the trunk are presented. In a literature review 339 cases were found and analysed. The Merkel cell tumor is a neuroendocrine tumor of the skin derived from the Merkel cells. It is located most often in the face and neck area. Typically, it is an exophytic node, has a red-blue color and measures 25 mm in diameter on the average. Since it is metastasizing it is a malignant tumor. Regional node metastases were found in 27%, local recurrences occur in 51%, and distant metastases were seen in 32% of the cases. The best therapy is excision with wide margins as is the rule for a malignant skin tumor. While the tumor reacts to radiotherapy, chemotherapy seems to be of no help.
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PMID:[Clinical aspects and therapy of Merkel cell tumor--report of 4 personal cases and review of the literature]. 328 29

Thirteen patients with regional or distant metastases from Merkel cell carcinoma were treated with combination chemotherapy. Three patients had a complete response to therapy. In two patients with nodal disease the duration of response was 10+ and 4+ years. In addition, three patients had a partial response, and six patients had minor responses. Chemotherapy using a combination of drugs that are active against small cell carcinoma of the lung is recommended in the treatment of unresectable disease in patients with Merkel cell carcinoma; it may produce prolonged responses. While tumor regressions as a result of chemotherapy were often dramatic, once the disease progressed, the course of the disease often moved rapidly downhill and proved to be fatal.
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PMID:Chemotherapy for metastatic Merkel cell carcinoma. Review of the M.D. Anderson Hospital's experience. 329 60

Eleven patients with Merkel cell carcinoma of the skin were reviewed retrospectively. The aggressive nature of this tumour is reflected by the incidence of local recurrence, regional nodal metastases and systemic dissemination, which is 36%, 55%, and 18% respectively. This high frequency of local recurrence and metastases is confirmed in the literature. Management strategies should be planned accordingly, following accurate assessment of the extent of disease. Wide excision, with or without nodal dissection, together with adjuvant wide field irradiation is necessary for loco-regional control of this radiosensitive tumour. Radiotherapy alone may be appropriate treatment for extensive loco-regional tumours or in those that have already metastasized. Although the role of chemotherapy is unclear, there are an increasing number of reports of chemosensitivity and further investigation in this area is required.
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PMID:Merkel cell carcinoma: a review of behaviour patterns and management strategies. 332 66

One case of Merkel cell carcinoma is reported in a 71 years-old woman. Lately treated by surgical excision (14 years after the occurrence of the tumour), this tumour was already associated with inguinal lymph node metastases. Its evolution was lethal within 3 months after local recurrence, cutaneous and visceral (lung, liver) metastases. This tumour, characteristic histologically and ultrastructurally (secretory granules), was accompanied by an infiltrative epidermoid carcinoma. This association and the presence of cytokeratin in tumoral Merkel cells are arguments for the common origin of keratinocytes and neuroendocrine Merkel cells from a common young epithelial cell.
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PMID:[Merkel-cell tumor associated with a spinocelluar epithelioma. Apropos a case report]. 346 5

A neuroendocrine carcinoma of the skin was diagnosed in one male and four female patients. Their case histories were short (five months on the average). In two patients, we found metastases of the regional lymph nodes already at the first physical examination; another patient died of distant metastases after 15 months. Histopathological examination revealed cells fairly uniform in size. The tumors replaced the dermis and subcutaneous tissue without affecting the epidermis. In all cases, the cells were arranged in solid sheets and compact nests with occasional cords and trabeculae in the periphery. The cells and nuclei usually were round and hyperchromatic, and showed many mitoses. Typically, the neuron-specific enolase was positive in all tumor formations, whereas the protein S 100 marking was always negative. Electron microscopic examination of the tumor cells showed cytoplasmatic, neurosecretory granules, which were confined to the membranes, as well as collections of perinuclear intermediate filaments and intercellular junctions. A reliable diagnosis regarding neuroendocrine carcinoma of the skin should consider histological, immunohistochemical, and ultrastructural techniques. Cutaneous metastases of other neuroendocrine carcinomas have to be ruled out.
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PMID:[Neuroendocrine (Merkel cell?) carcinoma of the skin]. 357 91

Two cases of a rare neuroendocrine skin tumour (Merkel cell carcinoma) are reported. The tumour affects mainly old women and men. It has a great tendency to metastasize to lymph nodes and distant sites. The primary treatment is surgical but radiotherapy has an important role to play. Merkel cell tumours are capable of producing NSE and have also been documented to secrete calcitonin and ACTH. Difficulties in histological diagnosis are frequent. The definitive diagnosis can only be made by electron microscopic examination.
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PMID:Merkel cell tumour of the skin. 370 Dec 4

A case of trabecular carcinoma of the skin that resulted in prequarter amputation of the arm for local tumor aggressiveness is presented. The tumor was originally diagnosed as metastatic, most probably neuroblastoma, leading to inadequate local resection that resulted in recurrence with extensive regional nodal metastases. The importance of recognizing trabecular carcinoma as a primary tumor of the skin with a potential for recurrence and metastasis is underscored, primarily since initial total excision with adequate margins of resection has proven in most instances to be curative.
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PMID:Trabecular carcinoma of the skin simulating metastatic disease. 372 97


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