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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 multiple keratoacanthomas association with a well-differentiated squamous cell carcinoma is presented. Incomplete excision of a keratoacanthoma deprives the pathologist of his main criteria in differentiating this lesion from a squamous cell carcinoma. Wide excision appears to be the treatment of choice. Multiple keratoacanthomas can be associated with squamous cell carcinomas, which initially look identical. Persistence with conservative treatment in a growing lesion can fail to deal with an invasive squamous cell carcinoma which will require disfiguring or mutilating operations to cure. Squamous cell carcinoma does develop in keratoacanthomas, but metastases are rare.
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PMID:Giant keratoacanthomas. 54 50

The problem in diagnosis of keratoacanthoma versus squamous cell carcinoma has been reviewed, and 13 patients are presented to illustrate the difficulties in differentiating between these two lesions. If the pathologist is in doubt, the lesion should be called "probable keratoacanthoma, but squamous cell carcinoma cannot be ruled out." We should all be aware that even the most careful pathologist, using all the information and material available, may still erroneously diagnose a lesion as a benign keratoacanthoma--one which, if inadequately treated, may metastasize or recur as a squamous cell carcinoma. Therefore, it is important for the clinician to treat most keratoacanthomas by adequate removal and close follow-up.
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PMID:Metastasizing keratoacanthomas? The difficulties in differentiating keratoacanthomas from squamous cell carcinomas. 67 15

The association of multiple sebaceous neoplasms and visceral malignancies is known as the Muir-Torre syndrome. We describe a patient who had papillary transitional cell carcinoma of the right renal pelvis resected in 1981 and papillary transitional cell carcinoma of the left renal pelvis removed surgically in 1983. Recurrent transitional cell carcinoma necessitated further resection of tumor in the right renal pelvis in 1983, right nephrectomy and partial ureterectomy in 1984, and removal of the right ureteral stump in 1985. History included multiple seborrheic keratoses, a keratoacanthoma and 4 sebaceous carcinomas between 1968 and 1985. In 1971 partial colectomy and jejunectomy were performed for stage D (Duke classification) adenocarcinoma of the transverse colon. Despite this the patient remains alive and well with no evidence of residual or metastatic disease. The Muir-Torre syndrome is a subtype of the cancer family syndrome, with gastrointestinal tract tumors being the most frequent visceral malignancies. Urinary tract carcinomas are present in just more than 10 per cent of the cases. This entity is discussed and the literature is reviewed with emphasis on the urological associations.
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PMID:Transitional cell carcinoma in the Muir-Torre syndrome. 359 63

Controversy continues to exist as to whether or not a keratoacanthoma is a benign lesion and can be accurately differentiated from a squamous cell carcinoma. From a review of the available evidence and clinical experience, we believe an attempt to make this distinction is unwise. It is dangerous to assume these lesions are benign. Many lesions diagnosed as keratoacanthomas have gone on to behave very aggressively and even to metastasize. We believe all lesions suspected of being keratoacanthomas should be managed by surgical excision and not observed in the hope that spontaneous involution will occur.
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PMID:Are keratoacanthomas really squamous cell carcinomas? 714 61

During a 10-year period, 30 patients with lesions of the lower lip, suspected to be cancerous, were operated on by primary resection without a prior biopsy. The patients have been continuously followed to evaluate if the treatment strategy, with avoidance of an incisional biopsy, might influence local recurrence and metastatic rate. One patient developed a second primary lesion, and none of the patients had local recurrences. Local lymph node metastases were detected in two patients. There was full agreement between the initial clinical and histopathological diagnosis among 26 patients with squamous cell carcinomas. In another two patients, the histopathological examination revealed severe epithelial dysplasia, and finally one case was diagnosed histopathologically as a keratoacanthoma. In 29 out of the 30 cases, a pre-treatment biopsy would not have influenced the extent of the surgical procedure.
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PMID:Squamous cell carcinomas of the lower lip. 769 81

Partial regression in cutaneous malignant melanoma has been reported by a number of observers, albeit not all, to be associated with a relatively poor prognosis; in contrast, a keratoacanthoma, which eventually regresses, does not metastasize. The Hammond effect could explain the possibly poor prognosis of the thin regressing melanoma. Hammond(W.G. Hammond et al., Cancer J., 8: 130-138, 1995) showed that the speed of biological progression to less differentiated phenotypes is directly related to the immunocompetences of the tumor hosts. If partial regression is a sign of an unusually strong immune reaction, then the melanoma that partially regresses might have a relatively poor prognosis because of the greater risk of biological progression among the surviving tumor clones. A Hammond effect is not associated with regression of a keratoacanthoma. I postulate that the growth of this tumor is accelerated, rather than restrained, by the immune reaction and that the ultimate regression of the tumor is the result, not of immune cytotoxicity, but of a rapid terminal differentiation (a reverse Hammond effect); alternatively, very rapid growth might lead to an exhaustion of growth potential before progression to clonal immortality could occur.
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PMID:The paradoxical association of regression with a poor prognosis in melanoma contrasted with a good prognosis in keratoacanthoma. 864 Jul 80

Basal cell and squamous cell carcinomas are the most common skin cancers, occurring mainly on sun-damaged skin of old persons. Basal cell carcinoma is a neoplasm of follicular germinative cells which may infiltrate and destroy adjacent tissues, but rarely metastasizes. Five clinico-pathologic types of basal cell carcinomas can be recognized, namely, nodulo-ulcerative, superficial, morpheiform, fibroepithelial, and infundibulo-cystic. Actinic keratosis and Bowen's disease are intrepidermal proliferation of atypical keratinocytes that eventually may progress to become over squamous cell carcinoma. Lesions arising in sites of chronic injury or scarring bear an higher risk of metastases. Keratoacanthoma is a rapidly evolving tumor of keratinocytes that resolves spontaneously. Keratoacanthoma might represent a self-healing type of squamous cell carcinoma.
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PMID:Basal cell and squamous cell carcinomas. Clinico-histological features. 880 83

Keratoacanthoma of the skin and well-differentiated squamous cell carcinoma are two cutaneous neoplasms that most often occur in sun-exposed sites of light-skinned persons. It is often difficult to distinguish these two from each other either clinically or histologically. The view that these two cutaneous neoplasms are part of the same disease entity is not new. We reviewed 150 patients with these two diseases in an effort to see whether any specific criteria for diagnosis and treatment could be achieved. It is our hypothesis that they are not separate diseases but within the spectrum of the same disease. Keratoacanthoma may be some sort of aborted malignancy or hyperplastic premalignant lesion within the squamous cell carcinoma spectrum. The incidence of metastases from squamous cell carcinoma of the skin may be as high as 3%. We do not have the courage to wait 3 months to see if a potentially invasive and metastatic neoplasm is indeed involutional. Incision biopsy may be wrought with significant histopathological inconsistencies. We believe that early, complete excision is the treatment of choice for all skin neoplasms thought to be keratoacanthoma.
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PMID:Keratoacanthoma: is it a real entity? 960 Apr 29

Spontaneous neoplasms in 930 control Wistar rats from five carcinogenicity bioassays conducted between 1990 and 1995 were reviewed and compared with review findings in studies between 1980 and 1990. Mean survival at 104 weeks was 55% for males and 60% for females, similar to that of the previous review. A total of 1599 neoplasms was diagnosed in 361 (78%) male and 415 (89%) female rats; 1293 (81%) of these were benign and 306 (19%) were malignant (11% with metastases). Sixty-eight percent of all neoplasms were in endocrine and integumentary systems, similar to 74% seen in the previous review. Most common neoplasms (affecting > 7% of either sex) were pituitary adenoma (34% of males, 50% of females), benign adrenal pheochromocytoma (10% of males, 1% of females), thyroid C cell adenoma (6% of males, 8% of females), mammary fibroadenoma (3% of males, 36% of females), keratoacanthoma (11% of males, 0.6% of females), testicular interstitial cell tumor (11% of males), uterine stromal polyp (16% of females), pancreatic acinar cell adenoma (13% of males, 0.6% of females), and benign thymoma (3% of males, 8% of females). Seventeen neoplasms affecting 2 to 6.9% of either sex included adrenal cortical adenoma, thyroid follicular adenoma, pancreatic islet cell adenoma, pituitary carcinoma, mammary adenoma, mammary adenocarcinoma, fibroma, fibrosarcoma, dermal papilloma, uterine schwannoma, uterine granular cell tumor, pancreatic acinar cell carcinoma, hepatocellular adenoma, lymphoma, granular cell meningioma, renal mesenchymal tumor, and hemangiosarcoma. Remaining neoplasms occurred in fewer than 2% of animals. Mean tumor incidence did not differ significantly between our two reviews. Ratios of benign to malignant neoplasms were similar in both reviews and percentages of survival at 104 weeks were similar. Between the two reviews, greater than threefold increase in frequency of some neoplasms occurred only in males and included keratoacanthomas, pancreatic acinar cell adenomas/carcinomas, and astrocytomas. Frequencies of remaining neoplasms were within twofold or within 10% of previous frequencies. Some neoplasms diagnosed in this review but not in the previous review included cardiac schwannoma, pilomatrixoma, parathyroid adenoma, and prostatic adenoma but incidence was approximately 1% for any one tumor. Based on these reviews, Wistar rats appear to have a predilection to pituitary neoplasms and mammary fibroadenomas (females).
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PMID:Spontaneous neoplasms in control Wistar rats: a comparison of reviews. 984 5

Keratoacanthomas are distinct skin lesions that occur most often as solitary tumors in sun-exposed areas in elderly, fair-skinned patients. Clinically, these tumors are characterized by a rapid onset and regression within months. Keratoacanthomas display distinct histological features including a keratin-filled crater lined by a proliferating squamous epithelium. Cytologically, there may be overlap with classical well differentiated squamous cell carcinoma. Rarely, otherwise typical keratoacanthomas show intravascular and perineural invasion and lymph node metastases. Keratoacanthomas should, therefore, be considered to be a clinically distinct variant of well differentiated squamous cell carcinoma capable of spontaneous regression. This view is supported by their common etiology, occasional concurrent occurrence, and a multitude of studies revealing no substantial differences between these two lesions. Regression is immunologically mediated and activated by a variety of molecular mechanisms. Considering the common nature of keratoacanthomas and well differentiated squamous cell carcinomas, and the lack of any features predicting prognosis, surgical excision of keratoacanthoma is advisable.
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PMID:Keratoacanthoma: a clinically distinct variant of well differentiated squamous cell carcinoma. 1002 94


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