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

With infrared light and a dye (Indocyanin green) bound to proteins it is possible to study the choroidal circulation much better than with usual fluorescein angiography. For the differential diagnosis of choroidal tumors, this method contributes the following: (1) The diagnosis of choroidal hemangioma can be made with confidence. (2) while it is not yet possible to differentiate between a nevus and a melanoma, choroidal angiography nevertheless represents a second vascular parameter (in addition to the retina) for monitoring the growth of potentially malignant tumors. (3) The value of this method for the diagnosis of choroidal metastases and rare choroidal tumors - such as the case of an osteoma presented here - has yet to be studied.
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PMID:[Significance of infrared angiography in the differential diagnosis of choroid tumors]. 399 1

From 1977 to 1983, 44 cases with nevus cells in the capsule and trabeculae of axillary lymph node specimens from about 7000 mastectomies performed for primary breast cancer were found. This finding was therefore less than 1%. In 3 cases, the nevus cells were present in 2 nodes, whereas in 41 cases solitary nodes were involved. In 13 cases, nevus cells were present in nodes that also contained metastatic carcinoma. Silver impregnation of reticulin fibers is very useful for the differential diagnosis of nodal metastases of breast carcinoma.
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PMID:Nevus cells in axillary lymph nodes from radical mastectomy specimens. 402 39

Two axillary lymph nodes from a patient who underwent modified radical mastectomy for carcinoma of the breast showed benign nevus cells in the fibrous capsule and within afferent lymphatics. Subsequently, an intradermal nevus from the area of drainage of the axillary lymph nodes was excised, which showed groups of nevus cells lying within small lymphatic channels. It is postulated that the nevus cells in the lymph node capsule could represent benign metastases from the intradermal nevus.
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PMID:Nevus cells within lymph nodes. Possible metastases from a benign intradermal nevus. 402 28

Lentigo maligna, a precancerous lesion, is a brown-black irregularly pigmented freckle, usually occurring on the face of the elderly subject. In a series of 99 patients with malignant melanomas, lentigo maligna was the pre-existing lesion in 21. The clinical and histological findings, and previous publications on the subject are reviewed. Lentigo maligna itself is not a superficial malignant melanoma. After the development of malignant melanoma from lentigo maligna, eight of 21 patients developed metastatic disease. This seems to indicate that once malignant melanoma has developed (whether de novo from the junctional portion of a pre-existing nevus, or from a lentigo maligna), the outlook is the same. During the development of malignant melanoma from lentigo maligna there is an indefinite period when it is virtually impossible to determine histologically whether malignant melanoma is present. Naturally, the inclusion of these indefinite cases will greatly influence reported results of treatment.
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PMID:Lentigo maligna and malignant melanoma. 592 2

Sixty two patients with gestational trophoblastic disease were investigated and treated between January 1977-December 1983. The value of pelvic arteriography was examined. The cases included: 45 moles with a simple outcome. 14 cases of invasive trophoblastic neoplasia after evacuation of the mole. 3 choriocarcinomas after full term pregnancy. Pelvic arteriography was performed in 14 patients. 9 of the 14 patients presented with persistent HCG secretion 6 to 8 weeks after evacuation of the mole. Before chemotherapy was begun, we looked for unfavourable prognostic features such as extra-pelvic metastases, multiple pulmonary metastases, high HCG secretion, delay between the initial event and starting chemotherapy of more than six months. The Ishizuka score was calculated. Six arteriography type I readings suggested choriocarcinoma with an Ishizuka score above five. Double chemotherapy (oncovin-methotrexate) was started successfully (with a one year follow up). Only two patients had unfavourable factors. Two arteriography type III suggested persistent moles, with an Ishizuka score below five. Chemotherapy (only methotrexate) was successful). It was not possible to classify the last arteriography, so the patient was treated successfully with double chemotherapy. Three patients failed to recover with chemotherapy. Arteriography was indicated to determine the site of HCG secretion. Three hysterectomies were performed. Tissue choriocarcinoma was found. Two diagnoses of choriocarcinoma were confirmed by arteriography: In one case an unexplained pleurisy appeared six months after full term. HCG was then positive. In the other case, extrauterine pregnancy was first suspected, but the woman had not had intercourse for six months. Arteriography demonstrated tubal choriocarcinoma. So pelvic arteriography is useful for managing complicated gestational trophoblastic disease.
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PMID:[Importance of arteriography in complicated trophoblastic disease]. 609 10

We have embarked upon a pilot study of photoradiation therapy (PRT) in the treatment of persistent or recurrent cancer of the head and neck utilizing the photosensitizing agent hematoporphyrin derivative (HPD). This treatment is based upon selective concentration of HPD within malignant tissue with resultant necrosis upon illumination with light of the appropriate wave length (630 nm). Patients entered in this trial have failed all forms of conventional therapy. Twenty-one patients with local recurrence were treated. Sites of recurrence were: tongue (9), nasopharynx (3), floor of mouth (2), soft palate (2), oropharynx (1), buccal mucosa (1), maxilla (1), larynx (1), basal cell nevus (1). There were six complete responses and twelve partial responses (greater than 50% reduction). These responses are clinically significant with some complete responses lasting over one year after a single course of therapy. Ten patients with cutaneous metastases from head and neck primary tumors were also treated. There were two complete responses and three partial responses. However, these patients rapidly developed new tumors in areas adjacent to those previously treated. Less than complete responses could be augmented by repeated applications of this technique. The success of this pilot study combined with the accessibility of head and neck primaries suggest that HPD-PRT should be given a clinical trial in early mucosal cancer of the head and neck region.
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PMID:Photoradiation therapy of head and neck cancer. 609 73

Flow cytometric analysis of nuclear DNA content is valuable for indicating ploidy- and proliferation abnormalities in surgically removed human malignant melanomas. In 35 primary cutaneous melanomas, 20 metastases of melanoma in skin and lymph nodes, and 16 nevi the DNA distribution was analyzed by flow cytometry and compared with a variety of histological parameters and the subsequent clinical course. Heteroploid DNA distributions with increased polyploid or aneuploid fractions were found in 26 primary melanomas (74%), 14 metastases (70%), and 4 nevi (25%) indicating tumor clones with an abnormal nuclear DNA content. Three or more cell clones in a single biopsy was found in 10 primary melanomas, 2 metastases, and 1 nevus. The frequency of heteroploidy was significantly higher in primary and secondary melanomas than in nevi (p less than 0.001) and was correlated significantly with a high mitotic activity (p less than 0.002), marked nuclear pleomorphism (p less than 0.01), large nucleoli (p less than 0.01) and a thickness of the primary melanoma of more than 2.25 mm (p less than 0.02). Such histologic findings in malignant melanomas have been shown previously to be correlated with a bad prognosis. No significant correlation was found between heteroploidy and the histologic type of melanoma or the level of invasion. A 2-year clinical follow-up showed that more patients died from melanoma if the DNA distribution in the primary or secondary melanoma was heteroploid (6/26; 23% and 8/13; 62% respectively) than if it was diploid (0/9; 0% and 2/5; 40% respectively). However, the differences were not statistically significant. It is concluded that heteroploidy 1) is not an absolute criterion of malignancy, 2) is significantly correlated with histologic features indicating marked cellular anaplasia, and 3) is apparently correlated with a bad prognosis.
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PMID:DNA ploidy-characteristics of human malignant melanoma analysed by flow cytometry and compared with histology and clinical course. 613 88

Using an indirect immunoperoxidase technique, 20 nevocellular nevi, 5 dysplastic nevi, 14 primary cutaneous melanomas, and 24 metastatic melanomas were tested with a panel of monoclonal antibodies to monomorphic determinants of Class I (HLA-A,B,C) and Class II (la-like) major histocompatibility complex antigens. Class I HLA and beta 2-microglobulins were not detected on the majority of nevus cells but were expressed by 3 of 5 dysplastic nevi, by the majority of tumor cells in 12 of 14 primary cutaneous melanomas, and in 13 of 24 metastases. The different expression of Class I HLA and beta 2-microglobulins in primary and metastatic lesions suggests that loss of these antigens may be associated with progression of malignancy. Class II HLA were not detected in common nevi but were locally present in 1 of 5 dysplastic nevi, 7 of 14 cases of primary cutaneous melanoma, and all 24 cases of metastatic lesions tested. These findings suggest that increase in Class II HLA expression may be associated with progression of malignancy. The staining patterns obtained with monoclonal antibodies to distinct determinants of Class I HLA and Class II HLA were superimposable within each type of antigen. Therefore, the discrepancies in the literature about the expression of histocompatibility antigens by lesions of melanocytic origin are not likely to reflect the different specificity of the antibodies used by the various investigators.
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PMID:Immunohistochemical analysis of malignant melanomas and nevocellular nevi with monoclonal antibodies to distinct monomorphic determinants of HLA antigens. 620 49

This paper starts with a short description of the history of the discovery of the hydatidiform mole ( Tulp in 1641) and of the treatment (before 1956, hysterectomy in most cases). After 1961 chemotherapy started to be used even in patients who had cerebral metastases. 72 patients who had attended Professor Hubinont 's department in the University Hospital of Saint-Pierre in Brussels between January 1971 and December 1981 were followed up. Questionnaires were sent to the patients and to their doctors who were treating them in order to try and find out what had happened in subsequent pregnancies and what the maternal and fetal consequences and complications were. The social class and the marital status of the patients was also considered as well as their wish to become pregnant again. Of the 72 cases that were followed up after evacuation 63 (87.5%) recovered while 9(12.5%) had clinical, biological or radiological signs of persistent non-metastatic (3) and metastatic (6 cases) active disease. The department asked patients not to become pregnant in the year following evacuation of the mole. 10% were sterilised, 4 by hysterectomy and 4 by tubal ligation. 42% used the oral contraceptive pill and 34% (24 cases) condoms. Control follow-up of patients who became pregnant was compared with a group of 2 529 pregnancies in Saint-Pierre Hospital during the year 1981. 44 out of the 72 patients who were followed up after hydatidiform mole became pregnant with a total of 52 pregnancies. Ten became pregnant in the first 6 months after attempting it, 11 between 6 and 12 months and 23 after a delay of 12 months. Out of the 52 pregnancies, 34 5%) had a live baby at term. 6 were premature and 31 out of 34 babies delivered at term were delivered vaginally and 3 by Caesarean. There were 9 spontaneous abortions (17%) and 2 terminations of pregnancy (4%). Three patients had repeated non-intentional abortions and one had a still-birth for which the cause could not be found. Only one other had a second mole. When these results are compared with the histories of these patients before they had the hydatidiform mole there did not seem to be any increase in the number of spontaneous abortions or premature labours, nor was there when this group was compared with a control group. Only one of the 38 live-born children showed a major congenital abnormality which was varus equinus. There was no possibility of picking out statistically anything of value as far as congenital malformations was concerned.
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PMID:[The reproductive function following a hydatidiform mole]. 632 1

Six evident lesional steps of tumor progression form the neoplastic system that affects the human epidermal melanocyte: 1) the common acquired melanocytic nevus; 2) a melanocytic nevus with lentiginous melanocytic hyperplasia, i.e., aberrant differentiation; 3) a melanocytic nevus with aberrant differentiation and melanocytic nuclear atypia, i.e., melanocytic dysplasia; 4) the radial growth phase of primary melanoma; 5) the vertical growth phase of primary melanoma; and 6) metastatic melanoma. The common acquired melanocytic nevus is viewed as a focal proliferation of melanocytes, destined in most instances to follow a programmed pathway of differentiation that leads to disappearance of the nevus. If the pathway of differentiation is not followed, characteristic lesions result, and such lesions are regarded as the formal histogenetic precursors of melanoma. Such a developmental flaw is termed aberrant differentiation, and the resultant precursor lesion is designated melanocytic dysplasia. The vast majority of melanocytic nevi showing melanocytic dysplasia are terminal lesions that do not progress to melanoma. If melanoma is to develop via a precursor lesion, however, the nevus with melanocytic dysplasia is that precursor. When melanomas do develop, they develop focally within the precursor. The resultant primary melanoma itself does not follow a pathway of inexorable expansion of a population of melanoma cells in space and time. Rather, primary melanomas, with the exception of nodular melanoma, also evolve in a stepwise fashion. The first step, termed the radial growth phase, is characterized by the net enlargement of the tumor at its periphery, along the radii of an imperfect circle. Tumors in this stage of development show a characteristic pattern of growth within the epidermis and a distinctive form of invasion of the papillary dermis. Such melanomas are not associated with metastasis, and it is hypothesized that such tumors do not have competence for metastasis. For a melanoma to acquire competence for metastasis it must progress to the next step of tumor progression--the vertical growth phase. This lesional step is characterized by the appearance of a new population of cells within the melanoma, not an expansion of the cells forming the pre-existing radial growth phase. The net growth of the cells of the vertical growth phase is perpendicular to the directional growth of the radial growth phase. As a rule, the cells of the vertical growth phase grow in an expansile fashion, expansile as a balloon expands: a growth form characteristic of metastases.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:A study of tumor progression: the precursor lesions of superficial spreading and nodular melanoma. 650 May 48


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