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)

Fifty-seven thymomas, defined as neoplasms of the epithelial-reticular framework cells of the thymus, were assessed in respect to histologic type, inclusive of there ultrastructural aspects. The median age of the 57 patients was 40.4 years, with a range of 2 1/2--72 years. All neoplasms were located in the anterior mediastinum. The tumours in 40 cases were encapsulated and without invasion of adjacent tissue or implants (equal to non-invasive thymomas). The tumors in 17 cases were invasive of adjacent tissue, particularly mediastinal pleura, pericard and trachea. Six of 57 patients (equal to 10.5%) with thymomas have had a thoracic and supraclavicular lymph node metastasis, and osteolytic metastases in the vertebrae and sternum. Thirty-seven (equal to 64.9%) were so-called lympho-epithelial, 7 (equal to 12.3%) pure epithelial, 4 (equal to 7.0%) atypical (or anaplastic) with granulomatous focuses, 3 (equal to 5.3%) carcinoid and one (equal to 1.8%) seminomatous tumors. One patient have had a thymic cyst as a tumor-like conditions of the thymus, and four patients (equal to 7.0%) have had a thymo-lipoma. The histologic type of thymoma had no proof value in predicting prognosis with the exception of the so-called atypical or anaplastic thymoma. The fine structural aspects of thymomas and the fine structural differential diagnosis of anterior mediastinal tumors are discussed.
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PMID:[A comparative clinical and pathological study on the classification and prognostic features of 57 thymomas. I. Microscopy and ultrastructural pathology (author's transl)]. 14 45

66 patients suffering from tumors of the small intestine were operated upon between 1963 and 1976 in the Surgical Department of the University of Mainz Medical School. In 16 cases benign tumors were found (6 neurinoma, 4 leiomyoma, 4 lipoma, 2 polyps), in 50 cases the tumors were malignant (24 carcinoma, 20 sarcoma, 2 malignant schwannoma, 4 carcinoids). Only in 12 patients surgery was radical and no metastases found. In more than one third of the patients surgery had to be done as an emergency operation because of life threatening complications. The correct diagnosis was established preoperatively only in 57.5% of all cases. Only 5 out of 15 patients still living have survived more than 5 years. Correct interpretation of early clinical symptoms, repeated X-ray studies and additional chemotherapy may improve the prognosis of malignant tumors of the small intestine.
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PMID:[Tumors of the small intestine - clinical signs and symptoms, diagnosis and therapy (author's transl)]. 32 8

Thirty cases formerly diagnosed as Grade I lipogenic liposarcoma (well differentiated liposarcoma) were reviewed. The basic histologic pattern in all was that of adult fat modified by the presence of cells with enlarged, hyperchromatic nuclei; in most cases there was also a component of myxoid and/or fibrous tissue. The length of follow-up ranged from two to 30 years. Nine of the tumors were located in the subcutaneous layer. None of these recurred after excision, not even those which were simply "shelled out," and none metastasized. The term "atypical lipoma" is proposed for this group. Thirteen were located within or between muscles of the limbs, limb girdles, and head and neck. Nine of these recurred at least one, but there were no metastases and no deaths due to tumor. These were designated "atypical intramuscular lipoma." The remaining eight originated in the retroperitoneum. Although none of these patients developed metastases, five suffered inoperable recurrence and three died as a result of the neoplasm. It is suggested that the term "well differentiated retroperitoneal liposarcoma" be retained for cases of this type.
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PMID:Atypical lipoma, atypical intramuscular lipoma, and well differentiated retroperitoneal liposarcoma: a reappraisal of 30 cases formerly classified as well differentiated liposarcoma. 42 Nov 82

24 cases are described in which retroperitoneal processes were operated on for primarily gynecologic reasons in women of at least 60 years of age. They include 6 sarcomas, 3 neurinomas, 1 cyst, 1 fibroma, 1 lipoma, 1 congenital sacciform kidney, 1 hydronephrosis, 3 pancreatic carcinomas, 2 renal carcinomas, 1 ureteral cyst and 4 metastases of various malignomas. These cases were gathered in 18 West Berlin Departments of Obstetrics and Gynecology during a 10-year period. The post-operative mortality rate was 37.5% (9 deaths); this is probably due to the relatively low incidence of symptoms and signs associated with retroperitoneal diseases and their anatomical localization. Finally, new procedures for the diagnosis of retroperitoneal tumors are indicated.
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PMID:[Retroperitoneal diseases and geriatric-gynecologic laparatomy (author's transl)]. 127 61

Ninety-two cases of well-differentiated liposarcoma of deep soft tissue of the extremity, retroperitoneum, and groin with follow-up information of at least 2 years and no evidence of dedifferentiation at the time of diagnosis were studied to determine their long-term behavior. The tumors occurred most commonly in the muscles of the extremity (46 cases), followed by the retroperitoneum (23 cases), groin (14 cases), and miscellaneous sites (nine cases). Tumors in the retroperitoneum recurred in nearly all cases (21 of 23 cases), occasionally caused patient death, and dedifferentiated in four cases (median time to dedifferentiation, 8 years). Tumors in the groin had a similar high recurrence rate (11 of 14 cases), caused death of patients (two of 14 cases), and dedifferentiated (four of 14 cases). In contrast, those in the extremity recurred less frequently (20 of 46 cases) and had no disease-related mortality. Three of 46, however, underwent dedifferentiation (median time to dedifferentiation, 7 years). Of the 11 cases that underwent dedifferentiation, the interval between diagnosis and dedifferentiation ranged from 2 to 18 years (median time, 9 years; average time, 11 years). Six of the 11 patients showed dedifferentiated foci in the first recurrence, and three died of metastatic disease. Our study indicates that the behavior of well-differentiated liposarcomas is strongly influenced by location. Although the prevailing view is that dedifferentiation is restricted to tumors of the retroperitoneum, our study indicates that it is not a site-specific phenomenon, but is more likely a time-dependent phenomenon seen in situations with a high likelihood for clinical persistence of disease for a long period. Dedifferentiation identifies a tumor that is potentially more aggressive; yet the progression of the disease following dedifferentiation may be highly variable and probably depends on a number of factors, including the amount of dedifferentiation and type of therapy. Although atypical lipoma is an acceptable term for well-differentiated liposarcomas of the subcutis, it fails to convey the potentially life-threatening properties of retroperitoneal tumors. For these lesions as well as those in the deep soft tissues of the extremity, retention of the term well-differentiated liposarcoma is advocated.
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PMID:Well-differentiated liposarcoma (atypical lipoma) of deep soft tissue of the extremities, retroperitoneum, and miscellaneous sites. A follow-up study of 92 cases with analysis of the incidence of "dedifferentiation". 147 25

Based on own experience and on the published literature we report about indications and efficiency of endosonography (EUS) in gastric tumors. The following conclusions can be drawn at the present time. Submucous tumors can be clearly differentiated from extragastric compressions. Although the endosonographic aspect does not allow to formulate an etiologic diagnosis, EUS findings can give hints regarding the nature of the submucous tumor (e.g. leiomyoma, lipoma, cyst). In 75% of cases malignant submucous tumors can be visualized and a correct preoperative staging can be performed. EUS is of special importance in the description of gastric carcinoma. The pT stage can be correctly determined preoperatively in about 80% (69-92%) of cases. Accompanying inflammation in early gastric cancer can lead to overstaging. The sensitivity for local lymph node metastases reaches about 77% (50-88%). Gastric non-Hodgkin lymphomas can be excellently visualized with EUS. The sensitivity amounts to 90-100% and in about 90% of cases the extent of the tumor can be correctly determined preoperatively. The response to radio-chemotherapy of gastric non-Hodgkin lymphomas can be monitored easily with the method. At the present time EUS is the most sensitive imaging tool in visualizing and staging of gastric tumors. Its main advantage is the exact demonstration of intramural and paragastric alterations. However, despite the use of high ultrasonic frequencies and the excellent demonstration of even tiny details with EUS, biopsies for histologic evaluation are still mandatory, especially when dealing with gastric ulcer.
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PMID:[Endosonography of stomach tumors]. 147 65

The pathology report on a testicular germ cell tumor should include the following information: Tumor type: The histologic type of tumor present. If the tumor is of mixed type, the components should be listed, in order of relative abundance. The pathologist may endeavor to give a numeric estimate of the percentages of each element. Staging information: The size of the tumor should be listed. Local spread--into rete testis, tunica albuginea, epididymis, and spermatic cord--should be listed. If the cord is involved, possible involvement of its surgical resection margin should be assessed. Vascular/lymphatic invasion should be assessed for its presence or absence. Status of the remainder of the testis: Evidence of cryptorchidism or other dysgenetic features should be mentioned. Such features may imply a greater risk for the development of a contralateral tumor. Also, the presence of normal spermatogenesis elsewhere in the uninvolved testis should be reported. This finding may suggest a relatively decreased risk for contralateral tumor development and is a likely indicator of fertility should the patient consider sperm banking prior to retroperitoneal surgery and chemotherapy. The finding of mature sperm in the epididymis is an easy way to confirm spermatogenesis in the testis. Incidental findings: Lipomas or hydroceles of the cord, adrenal rests, and adnexal cysts may be found. The pathologist plays a crucial role in the diagnosis of germ cell tumors. In addition to elucidating tumor type, the pathologist is relied upon for precise local staging and for the classification of metastases, all of which have important implications in determining optimal therapy. As the clinical management of germ cell tumors evolves, the pathologist will continue to play a role in defining those features that have a bearing on patient outcome.
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PMID:Pathology of testicular germ cell tumors. 166 35

The epithelial membrane antigen (EMA) is expressed by the majority of colorectal cancers but has not previously been investigated as a target for radiation-labeled monoclonal antibodies (MoAb) in the imaging of patients with colorectal cancer. A rat IgG2a MoAb that recognizes EMA, ICR2, was labeled with Indium-111 (100 megabecquerel per milligram [MBq/mg]MoAb) using the bicyclic anhydride of the chelating agent diethylene triamine pentacetic acid (ccDTPA) and was administered intravenously to 22 patients known to have or thought to have colorectal cancer. Daily gamma camera imaging was performed for 3 days during the time between the administration of the radiation-labeled antibody and surgical procedure. At operation, the biopsies were done of the tumors and the normal colon, and the uptake of radiation-labeled MoAb was measured in a gamma well-counter. Immunocytochemistry for EMA expression also was done on resected tumors. Independent unblinded and blinded reporting was done on all scans. The sensitivity of 111In-ICR2 for detecting cancers preoperatively was 80% and 60%, respectively, on unblinded and blinded reporting, and the corresponding specificity 20% and 60%. The low unblinded specificity was attributable to a false-positive localization in severely dysplastic benign tumors (n = 2) and inflammatory tissue (n = 2). Liver metastases present in three patients were cold relative to normal liver. Lymph node metastases were localized in 1 of 6 patients preoperatively. The mean absolute uptake of 111In-ICR2 in tumor tissue was 7.75 +/- 3.77 x 10(-3) percent of injected dose per gram, and the ratio to normal colon was 2.10 +/- 0.92:1. On immunohistochemistry, EMA was expressed by 16 of the 17 primary cancers, both dysplastic adenomas, and all nodal metastatic deposits. EMA-negative tumors (1 cancer + 1 colonic lipoma) had negative antibody scans, and patients whose tumor was negative or only focally positive for EMA expression had lower tumor/normal colon ratios of radioactivity (1.30 +/- 0.26 versus 2.45 +/- 0.65, P = 0.005) on gamma well-counting of excised specimens. These results suggest a possible role for 111In-ICR2 in the detection of colorectal cancer and metastases but not its liver deposits.
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PMID:Preoperative imaging of colorectal cancers. Targeting the epithelial membrane antigen with a radiation-labeled monoclonal antibody. 173 Jan 14

Radiation detectors may allow the intraoperative localization of small cancer deposits following administration of radiolabelled tumour-associated antibodies. This technique was evaluated in 16 patients with colorectal tumours (14 cancers, one adenoma, one lipoma) with the 111In-labelled monoclonal antibody (MAb) ICR2 which recognizes the tumour-associated epithelial membrane antigen (EMA). At operation counting was carried out (3 x 20 s per site) using a hand-held radiation probe over the primary lesions and any palpable lymph nodes in the mesocolon. The tumour to normal colon (T/NC) ratio of counts recorded at operation was more than 1.5:1 in eight of the 14 patients with cancer (mean(s.d.), 1.54(0.41):1) and 0.91:1 and 1.06:1 respectively in the two patients with benign tumours. Node to normal colon ratios were higher in lymph nodes containing metastases. The uptake of radiolabelled antibody (T/NC ratio) was higher in EMA-expressing cancers than in those not expressing the target antigen (mean(s.d.), 2.45(0.65):1 versus 1.40(0.20):1, P = 0.019). An abdominal tumour model was also developed. Radioactively filled containers of 0.5-10 ml representing tumour deposits were suspended in a tank of 111In solution representing the background activity found in normal tissues. The ratio of radioactivity in the 'tumour' to that of background varied from 2:1 to 8:1. The 'tumour' was considered to be detectable if the mean counts recorded over the 'tumour' exceeded the mean of counts recorded over background by three standard deviations. At a ratio of 2:1 only 'tumours' greater than 5 ml could be detected with a sodium iodide probe and those over 10 ml could be detected with a cadmium telluride (CdTe) probe. At a ratio of 8:1, 'tumours' of 0.5 ml could be detected with either probe. At all ratios and counting periods the NaI probe was more sensitive than the CdTe.
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PMID:Intraoperative localization of colorectal cancers using radiolabelled monoclonal antibodies. 207 Feb 29

The computed tomography (CT) appearances of intussusception in 14 patients and the clinical follow-up of this condition in 17 adults with known primary malignant neoplasms were retrospectively reviewed. The ages of the 11 men and six women ranged from 25 to 83 years. Nine patients had been treated for malignant melanoma and the others for various primary neoplasms. Intussusception on CT was characterized by thickening of the affected bowel segment in all 14 patients and by the presence of intraluminal fat density material in 13, a concentric ring or "target" lesion in four, and an intra-luminal soft-tissue mass in nine. Five patients had intussusception, without other evidence of disease, caused by metastases in three patients, lipoma in one and idiopathic in one. Eleven of the other 12 patients had extensive disease, and one had small bowel cytomegalovirus infection. Five of these patients had more than one site of bowel involvement. Ten of the 12 patients had progression of disease on follow-up CT examinations and six died between 26 days and 7 months after diagnosis of intussusception. Intussusception may occur as the first indication of tumour recurrence or metastasis, but is more commonly a manifestation of widespread disease. However, even in patients with malignant neoplasms, it may be idiopathic or a result of benign neoplasm.
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PMID:The computed tomographic appearances and clinical significance of intussusception in adults with malignant neoplasms. 234 64


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