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)

Tumor-to-tumor metastases are uncommon. The most frequent donor tumors are the lung, whereas renal cell carcinoma is by far the most common recipient. In this report the authors describe a lung tumor that metastasized to a testicular seminoma. This is the first reported case of tumor-to-tumor metastases in which seminoma of the testis is the recipient. The authors performed mucin and immunohistochemical studies on this case and on ten cases of nonseminomatous germ cell tumors containing embryonal carcinoma and endodermal sinus tumor for comparison. Mucin positivity as well as immunoreactivity for epithelial membrane and carcinoembryonic antigens were confined to metastatic adenocarcinoma in this case, whereas Ki-1 and alpha-fetoprotein immunostaining were restricted to the ten control cases of germ cell tumors. Although the majority of second malignant components found in a seminoma are other nonseminomatous germ cell components, the rare possibility exists that a second malignant component is a metastasis from elsewhere in the body.
 ...
PMID:Lung carcinoma with metastasis to testicular seminoma. 169 19

Tumor metastases to the testes are rare and are usually found incidentally at autopsy or after orchiectomy for prostatic carcinoma. It is even more unusual for testicular metastases to be clinically detected or symptomatic. The authors report two cases of clinically detected testicular metastases from Merkel cell carcinoma of the skin. Merkel cell carcinoma metastatic to the testes has not been reported previously. The two tumors, to some degree, resembled testicular lymphomas and the interstitial type of seminoma.
 ...
PMID:Merkel cell carcinoma metastatic to the testis. 169 5

Lately the role of radiotherapy in stage I seminoma of the testis has been questioned by some authors who reported on a "surveillance" strategy for these patients. Since 1980, 124 patients with seminoma of the testis have been referred to this institution; 97 of 116 patients analysed presented with stage I disease and 10 of these had elevated levels of beta HCG. A total of 64 patients were given radiotherapy after orchiectomy and 33 entered a surveillance protocol. After a median follow-up of 48 months, 3 patients in the surveillance group relapsed after 5, 13 and 49 months and 2 of the irradiated patients did so after 25 and 33 months. Elevation of beta HCG was not significant because none of these patients showed progression. A low rate of progression and excellent survival are associated with standard treatment (orchiectomy and radiotherapy) and good results have been achieved with chemotherapy in cases of relapse. A surveillance policy is not recommended in stage I seminoma because of its slower growth compared with non-seminomatous germ cell tumours (NSGCT), the absence of a specific tumour marker, the 10% risk of occult metastases and the 3-fold higher progression rate compared with irradiated patients. We suggest the use of a reduced dosage and radiation field.
 ...
PMID:Stage I seminoma of the testis. Adjuvant radiotherapy or surveillance? 171 98

The clinical significance of neuron-specific enolase (NSE) as a tumour marker was evaluated in 54 patients with seminoma. Before orchiectomy NSE was elevated in six out of 21 patients with stage I seminoma and 11 out of 16 patients with metastases. After orchiectomy NSE normalised in all evaluated stage I cases, but was still elevated in six out of 12 patients with metastatic disease. NSE monitored the effect of cisplatin-based chemotherapy in patients with metastases. In some patients, increased serum NSE was found together with raised levels of human choriogonadotropin (HCG) and lactate dehydrogenase (LDH), while in others only NSE was elevated. No false positive NSE values were observed. NSE seems to be a clinically worthwhile serum tumour marker for monitoring seminoma patients, with a sensitivity and specificity of the same order as HCG.
 ...
PMID:Neuron-specific enolase--a serum tumour marker in seminoma? 173 33

Recent observations have suggested that a major factor in the development of germ cell tumours may be excessive mitogenic stimulus developed because of failure of feedback suppression of the normal pituitary drive due to atrophic damage to germinal epithelium. With this observation and the increasing recognition that there is a common in situ stage which precedes both seminoma and malignant teratoma/non-seminoma there has been a polarisation of views regarding the relationship between seminoma and malignant teratoma/non-seminoma, with some authors viewing these two entities as separate unrelated transformational events while others hypothesise that seminoma is an interim stage of clonal evolution associated with increased malignant potential towards malignant teratoma/non-seminoma. This chapter reviews the clinical evidence supporting the concept of clonal evolution which arises from the observation that the modal DNA content of seminoma (3.6N) is intermediate between that of in situ carcinoma (4.2N) and malignant teratoma/non-seminoma (2.8N). These observations, taken with the observation that the median age of patients with mixed tumours containing both seminoma and non-seminoma elements (30 years) is intermediate between the slower growing seminoma (35 years) and faster growing malignant teratoma/non-seminoma (25 years), as well as studies of spontaneous regression, tumours in AIDS patients chemo/radio sensitivity and post mortem histology, provide the most convincing evidence supporting clonal evolution. However, these observations cannot explain the fact that some patients have more than one focus of tumour (which can be of different histological type) in a single testis with normal tubules in between, even if they have in situ carcinoma. An extreme manifestation is seen in patients who are treated and cured from metastases arising from one testicle who then die from metastases from a completely different histological type arising from a second transformation event of a germ cell in the contralateral testis. The conclusion from these observations is that it is indeed possible for polyclonal development of tumours to occur, as is seen for bladder and bowel tumours, but they do not detract from the concept that seminoma is an intermediate event in the evolution from in situ carcinoma to malignant teratoma/non-seminoma.
 ...
PMID:Clues from natural history and results of treatment supporting the monoclonal origin of germ cell tumours. 196 26

The records of 40 patients with seminoma of testis were reviewed; nine had cryptorchidism. The incidence of cryptorchidism among the 36 Chinese patients was 22% (8/36). All Stage I and four Stage II patients were treated by orchidectomy followed by radiotherapy of 30 Gy or more to the pelvic and para-aortic lymphatics, while another seven Stage II patients received pelvic and para-aortic lymphatics plus mediastinal irradiation. For patients with normally-descended testis, the 2-year survival for Stage I was 94% and Stage II, with small and clinically unpalpable abdominal nodal metastases, 86%. For patients with Stage I and II seminoma arising from cryptorchid testis, comparable survival can be achieved by giving similar doses of radiation and adjusting the size of the para-aortic and pelvic radiation fields to cover the known extent of the disease. The prognosis of patients with seminoma arising from cryptorchid testis depends more on the stage and extent of disease than the status of cryptorchid testis. Painful groin mass or abdominal pain were the presenting symptoms in more than half of the patients with cryptorchid testes. The changed symptomatology in this group of patients can result in diagnosis delay.
 ...
PMID:Seminoma of normally-descended and cryptorchid testis. 196

In severe combined immunodeficiency (scid) mice which are deficient in T and B cell functions, human yolk sac tumor (YST-2) grew rapidly to enormous sizes in all of the animals after both subcutaneous and intraperitoneal transplantation, while only half of the subcutaneous and none of the intraperitoneal transplants were accepted in usual athymic nude mice. Furthermore, transplanted tumors metastasized spontaneously to distant organs such as lung, liver, kidney, pancreas, and spleen in scid mice, while metastases were not found in athymic nude mice. Similar results were observed in scid mice and scid-nude (streaker) double mutant mice with human classic (typical) seminoma which has been neither transplantable nor metastatic in athymic nude mice. Thus, scid mice provide an invaluable experimental system to investigate the mechanism of metastasis which is the most important and life-threatening problem in cancer patients.
 ...
PMID:SCID (severe combined immunodeficiency) mice as a new system to investigate metastasis of human tumors. 224 54

A case of spermatocytic seminoma intimately associated with rhabdomyosarcoma is reported. The patient, a 51-year-old man, presented with a two-year history of right-sided testicular enlargement. Orchiectomy was performed, and a large testicular tumor was excised. Further investigations during hospitalization revealed lung, liver, and retroperitoneal lymph node metastases. Further therapy was refused, and the patient died at home two months after orchiectomy. Autopsy was not permitted. Although the great majority of spermatocytic seminomas occur in pure form, do not metastasize, and have very good prognosis, in addition to the present case, seven cases of spermatocytic seminoma associated either with rhabdomyosarcoma or undifferentiated sarcoma have been reported. Presence of the sarcomatous element is associated with aggressive behavior, metastatic disease, and very poor prognosis. It is considered that the sarcomatous element develops from the spermatocytic seminoma by anaplastic transformation.
 ...
PMID:Spermatocytic seminoma associated with rhabdomyosarcoma. 225 71

Patients with clinical stage I testicular seminoma usually receive elective para-aortic lymph node radiation after orchiectomy, which is effective in controlling subclinical microscopic disease. However, the majority of patients with clinical stage I seminoma do not harbor occult metastases and, therefore, do not require elective nodal treatment. Vascular space invasion by the primary testis tumor recently has been shown to be an important predictor of metastases in nonseminomatous tumors but no such information exists to date in pure seminoma. Therefore, patients with clinical stage I testicular seminoma were compared to clinical stage II to IV cancer patients with respect to the presence of several features of the primary tumor. Vascular space invasion was identified significantly less frequently in stage I cancer patients (17%, 5 of 29) than in those with stage II or greater disease (39%, 11 of 28, p equals 0.03, 1-tailed t test). Microscopic invasion of the tunica and rete testis, and necrosis also were identified slightly more frequently in the higher stage cancer patients. Of the 12 patients with a maximum tumor dimension of more than 6 cm. 9 (75%) were in the stage II or higher group. Patient age, symptom duration and presenting complaint were similar in the 2 groups. Many higher stage cancer patients did not exhibit aggressive histological characteristics and, therefore, the absence of these features cannot be used to select patients for surveillance. On the other hand, patients with clinical stage I tumors that exhibit vascular space invasion may have an increased rate of occult para-aortic lymph node metastases. Therefore, the presence of vascular space invasion may be a useful criterion for exclusion of patients from surveillance protocols. Confirmatory data are needed before a final recommendation can be made.
 ...
PMID:Testicular seminoma: clinical and pathological features that may predict para-aortic lymph node metastases. 230 64

We present 8 years' experience of primary retroperitoneal lymph node dissection (RLND) in 190 patients with low stage non-seminoma; 154 patients had clinical stage I (CSI) and 36 had clinical stage IIa (CSIIa) disease. Of the 154 patients with CSI tumours, 33 had increased serum AFP and/or HCG before RLND (CSIM+) and 121 had normal tumour markers (CSIM-). Retroperitoneal lymph node metastases (pathological stage II) (PSII) were found in 38 of 121 patients with CSIM-, in 19 of 33 patients with CSIIM+ and in 26 of 36 patients with CSIIa. In a multivariate analysis, the presence of small vessel infiltration (demonstrated in histological sections of the primary tumour) and a prolonged tumour marker half-life were predictive factors for PSII. These 2 factors enabled a group of non-seminoma patients with CSI disease to be identified who had a 15% risk of retroperitoneal tumour growth (low risk group) as compared with a high risk group where 60 to 70% of patients had retroperitoneal lymph node metastases. Relapses occurred in 7 of 107 patients with PSI and in 6 of 83 patients with PSII disease; in the latter group, 5 relapses developed before the start of routine adjuvant chemotherapy; 6% of patients developed major post-operative complications. In addition, "dry ejaculation" was the principal side effect following RLND (unilateral RLND: 20/132 patients; bilateral RLND: 50/54 patients). The comparative cost to the health service during the first year of follow-up was estimated for low risk non-seminoma patients with CSI subjected to RLND and for those in whom a surveillance policy was adopted. The latter approach was preferable. It was concluded that a surveillance policy should be followed in low risk non-seminoma CSI patients provided that frequent follow-up is possible. A more active policy is recommended in high risk patients (e.g. adjuvant chemotherapy without RLND). Nerve-sparing RLND may be considered in patients with CSIIa disease and negative tumour markers.
 ...
PMID:Is routine primary retroperitoneal lymph node dissection still justified in patients with low stage non-seminomatous testicular cancer? 234 Mar 72


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>