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

The clinical features of 57 autopsied cases of intrahepatic bile duct carcinoma including 28 cases of the peripheral type (cholangiocarcinoma in the narrow sense) and 29 cases of the hilar type are described in comparison with those of hepatocellular carcinoma, with a review of the literature on the clinicopathological aspects of intrahepatic bile duct carcinoma. As compared with hepatocellular carcinoma, the average age of the patients was older; the male predominance was not obvious, chronic parenchymal liver disease was infrequent in the past history, association of primary cirrhosis was seldom, cholestatic features were frequently the early signs and more pronounced during the course, the liver was enlarged to a lesser extent, ascites was less common, signs of portal hypertension were absent or minimal, and extrahepatic metastases were less frequent. In many respects, the hilar type resembled extrahepatic bile duct carcinoma, and the peripheral type was somewhat between it and hepatocellular carcinoma. Although the overall survival was not much different from that for hepatocellular carcinoma, early diagnosis is emphasized; this would make surgical management possible. Differential diagnosis from hepatocellular carcinoma may be possible in the majority with direct cholangiography, liver scan, celiac angiography, determination of alpha-fetoprotein and hepatitis B antigen, and blood chemistry such as SGOT, SLDH, serum bilirubin and alkaline phosphatase. Illustrative cases are given including one patient with a hilar carcinoma who survived for more than 2 years after transhepatic biliary drainage.
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PMID:Clinical aspects of intrahepatic bile duct carcinoma including hilar carcinoma: a study of 57 autopsy-proven cases. 6 93

The study deals with the influence of persistent hepatitis B virus infection on immediate and end results of chemotherapy for breast cancer with bony metastases. The infection was shown to be associated with lower complete and partial remission rates, lower 3-year survival rate and higher rate of combination chemotherapy toxic effects such as nausea, vomiting and increased activity of aminotransferases.
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PMID:[The effect of an infection due to the hepatitis B virus on the treatment results in breast cancer patients with bone metastases]. 130 Jul 39

A Nigerian series of 890 patients with primary liver cell carcinoma, seen during the recent three years, has been examined with a view to establishing the natural history of the tumour in untreated cases. There were 60 males and the mean age of all the patients was 50 years. Hepatitis B surface antigen was positive in 70 pc of tested patients and there were higher pathologic levels of aflatoxins in these patients when compared to normal controls. Liver cirrhosis was associated with 81 pc of patients. Alcohol and smoking were unlikely to be aetiologically important in these patients. The macroscopic type of tumour was mainly diffusely nodular and the commonest microscopic pattern was the characteristic trabecular pattern. Metastases were present in 52 pc of the patients and were mainly to the lungs. Due to late presentation and underlying cirrhosis, most patients were critically ill with high incidence of ascites, jaundice and hepatic precoma. The mean survival time of all patients was six months after onset of the initial symptoms to death and only three weeks after admission to death. The major causes of death were advanced cancer in 78 pc, hepatic failure in 48 pc and rupture of tumour, 39 pc. These observations clearly show that the prognosis of liver cancer is dismal in this environment, as elsewhere. Medical education on earlier presentation in hospital and early operative removal of the tumour should be emphasised. It is suggested that an attempt through immunisation should be employed to reduce the incidence of liver cancer in the population.
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PMID:The natural history of primary liver cell carcinoma: a study of 89 untreated adult Nigerians. 132 87

Hepatic metastasis of colorectal cancer was found in 40 (16%) of 250 patients with colorectal cancer treated in our department during the past 5 years. Liver cirrhosis was not found among the 40 patients with metastases (16%) but was present in 46 (21.9%) of the 210 nonmetastatic patients, with a significant difference between the two groups (p less than 0.001). The rate of patients who were positive for hepatitis B surface antibody was 10% in the metastatic group and 34.3% in the nonmetastatic group, with a significant difference (p less than 0.01). These findings suggest that colorectal cancer does not metastasize to the injured liver, especially the cirrhotic liver.
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PMID:Absence of colorectal cancer metastasis to the cirrhotic liver. 827 67

From June 1981 to June 1989 we diagnosed 174 cases of hepatocellular carcinoma (HCC) at our institution (Piacenza, Northern Italy). Average age was 65.6 years; male to female ratio 3.4. 149 patients were cirrhotic (85.6%); alcohol abuse was present in 88/169 (52.1%); in 53/145 patients all hepatitis B virus markers were negative. Alpha-fetoprotein showed a low diagnostic sensitivity (values above 500 ng only in 49/169 or 29.0%). We used ultrasound (US) examination with a very high identification rate in all cases; pathological diagnosis was achieved by US guided fine-needle aspiration biopsy in 135 patients; in 13, by laparoscopy-histology. Metastases were found in 24/169 cases (14.2%); a second malignancy was diagnosed in 13/169 (7.7%): the most common association was HCC-non-Hodgkin lymphoma. Only 14 patients could be referred to surgery, which significantly improved prognosis.
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PMID:Diagnostic aspects and follow-up of 174 cases of hepatocellular carcinoma. Second report. 170 84

Markers for hepatocellular cancer include the best and worst of cancer detection. Although hepatocellular cancer is relatively infrequent compared to other cancers in the western world, HCC has a very high incidence in parts of Asia and Africa. It is estimated to be one of the most common cancer worldwide. High risk factors for HCC include previous hepatitis B infection, heavy alcohol consumption, cirrhosis, and aflatoxin exposure. Alpha fetoprotein may be the best human cancer marker that appears in the serum, but levels of this marker are often not elevated until the tumor is beyond surgical treatment. No other serum or tissue marker is particularly useful. Screening of high-risk populations in China has detected previously undiagnosed HCC in 1,000 of 5 million individuals tested and has led to an increase in survival from 5.5 to 61.6% with surgical resection over those who are later diagnosed with HCC without screening. Elevations of AFP due to yolk sac tumors may be differentiated from those due to HCC on the basis of Concanavalin A reactivity. Immunodetection using radiolabeled anti-AFP and immunoscintigraphy have given inconsistent results that are not as sensitive as ultrasonography in detecting HCC in the liver. Various enzymes, isoenzymes, and other markers may be useful as adjuncts to diagnosis in selected cases, but are not generally as good as AFP alone. If a patient has an AFP-producing tumor, the serum levels of AFP provide an excellent means of monitoring its progression. If the serum AFP levels drop to normal and stay there, cure is almost certain. If, however, the serum AFP level does not fall at the normal catabolic rate after therapy, or subsequently rises, regrowth of metastases are indicated. Immunotherapy using anti-AFP has not been shown to induce remission, but experimental studies indicate that drug-conjugated anti-AFP is effective in inhibiting growth of AFP-producing tumors. Clinical trials using drug-conjugated anti-AFP are now underway. Monoclonal antibodies have not yet identified the "antigens" useful for the diagnosis or treatment of HCC, but epitopes identified by monoclonal antibodies have been studied experimentally in rats which indicate multiple cellular lineages to HCC in cases of experimental chemically induced hepatocarcinoma.
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PMID:Markers for hepatocellular carcinoma. 171 67

We have reviewed retrospectively the records of 157 patients, less than or equal to 30 years of age with nasopharyngeal carcinoma (NPC) from 218 such cases identified in the tumor registry files of three major teaching hospitals in Taipei, Taiwan. These cases were diagnosed between 1 January 1982 and 31 December 1985, with a minimum follow-up of 2 years. The average age was 25, with a male/female ratio of 1.67. The TNM (tumor size, nodes, metastases) classification of 127 patients showed T1, 22%; T2, 33.1%; T3, 23.6%; T4, 21.3%; N0, 26%; N1, 16.5%; N2, 27.6%; N3, 30%; and M1, 13.4%. Antibody titer to Epstein-Barr virus capsular antigen (EBVCA) were elevated in 45 of 48 patients tested. Of the 29 patients who had hepatitis B (HB) viral survey done 34.5% were positive for HB surface antigen (HBsAg). Of 13 patients with elevated EBVCA antibody who were also tested for HB, six were HBsAg carrier. Actuarial survival rates of 2 and 3 years are 70 and 62%, respectively, among the 90 patients who were followed regularly or to death. HBsAg carriers and patients with M1 disease had a shorter survival time. We concluded that patients less than 30 years of age seemed to have an increased incidence of NPC, compared to that in an earlier report. Our patients frequently presented with advanced stage and poor prognosis. The high rate of HB carrier raises the possibility that HBV may play a role in the carcinogenesis and tumor growth in some NPC patients. Future prospective studies are needed.
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PMID:Nasopharyngeal carcinoma in young patients. 184 56

The Liver Cancer Study Group of Japan analyzed statistically 12,887 cases of primary liver cancer diagnosed from January 1, 1982 to December 31, 1985 in more than 500 institutes throughout the country. The study was based on the answers to 258 questions. There were 4354 cases of hepatocellular carcinoma, 256 cases of cholangiocellular carcinoma, 49 cases of mixed carcinoma, 22 cases of hepatoblastoma, 10 cases of sarcoma, and 74 other cases. The survey and analysis, based mainly on 4765 histologically proved cases, included gross anatomic and histologic features of the tumors, pathology of the noncancerous portion, distant metastases, past medical history, frequency of positive Hepatitis B surface antigen and Hepatitis B surface antibody, age distribution, various diagnostic procedures, surgical procedures, and survival rate in relation to operative curability and tumor stage.
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PMID:Primary liver cancer in Japan. Clinicopathologic features and results of surgical treatment. 215 91

Clinical, laboratory, and ultrasonographic features of 75 patients of primary hepatocellular carcinoma (PHC) living in the Gizan Area of Saudi Arabia and their follow-up, during a 2-year period, were characterized. Eighty-nine percent of the cases were defined histologically, whereas in the rest, ultrasonographic (US) evidence along with an alphafetoprotein (AFP) level exceeding 480 ng/ml were taken as the positive evidence for PHC. Eighty percent of the cases were male patients, with the peak incidence during the seventh decade. The most common clinical presentations were hepatic enlargement (91%), abdominal pain (76%), splenic enlargement (33%), and acites (33%), followed by bruit, fever, metastases, and varices. Alteration in a liver function test was manifest in 97% of the cases, AFP values greater than 480 ng/ml in 57%, and a hepatitis B virus surface antigen (HBsAg) positivity in 65% of the cases. There was no intersex variation in positivity for HBsAg, antibody to HBsAg (anti-HBs), antibody to hepatitis B virus core antigen (anti-HBc) among the 30 PHC cases studied. Positivity for HBsAg or the overall hepatitis B virus exposure in PHC cases was higher than the normal controls (P less than 0.001). In addition to histologic confirmation of PHC in 67 cases, there was histologic evidence of cirrhosis in 25%, or chronic active hepatitis in 19% of the cases. At the time of diagnosis, the average duration of the presenting illness was less than 2 months, while the mortality in the ensuing 2-month period was 73%. The average span of total illness in the vast majority of cases was 4 to 6 months. Two female patients (one with fibrolamellar carcinoma) however, survived for 2 years. Immunization against hepatitis B virus should be considered for all newborns in such hyperendemic communities. A continuous program should be started in such communities to screen and immunize all those yet unexposed to hepatitis B virus. The established HBsAg carriers should be periodically examined ultrasonographically along with an AFP estimation for initiating the chemotherapeutic and other measures against PHC in fairly early stages of malignancy.
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PMID:A profile of primary hepatocellular carcinoma patients in the Gizan Area of Saudi Arabia. 242 66

In a consecutive series of 395 patients with pathologically verified hepatocellular carcinoma, 20 patients (5%) had bone metastasis at initial presentation. Of these, 16 were men and four women ranging from 26 to 64 years of age (median, 50 years). The age, sex, hepatitis B surface antigen seropositivity, alpha-fetoprotein level, and frequency of associated cirrhosis were not statistically different from those in patients without initial bone metastasis. Initial presentation was usually the result of spinal lesion with neurologic compression, and chest wall or scalp mass. Metastasis most commonly involved spine and ribs, and occurred as osteolytic lesions or extrapleural mass. Computed tomography proved best for demonstrating an expansile soft tissue mass with bony destruction. Angiography showed hypervascular appearance over the destructive bone area. Treatment results were poor. The follow-up period ranged from 3 weeks to 14 months with a median survival of 5 months. The data suggested that hepatocellular carcinoma be ruled out in patients with osteolytic lesions.
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PMID:Hepatocellular carcinoma presenting as bone metastasis. 247 34


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