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

We report a case of recurrent malignant phyllodes tumor with liposarcomatous transformation metastasizing to the lung. The unusual feature of this case was that the metastases reproduced the primary tumor and contained ductal structures and elements of sarcoma. The origin of the ductal structures in the lung metastases was confirmed to be from the phyllodes tumor, on the basis of their immunophenotype. The epithelial cells were positive for steroid receptors and GCDFP-15, and the myoepithelial cells were positive for anti-smooth-muscle-specific proteins. We also reevaluated by immunohistochemistry a case of phyllodes tumor previously published by West et al., allegedly containing epithelial structures of supposed breast origin within lung metastases. The epithelial component was shown to consist of entrapped alveolar lining cells.
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PMID:Malignant phyllodes tumor of breast with lung metastases mimicking the primary. 977 91

A 5-year review of 50 patients, 28 males, 22 females, with a mean age of 42 years, operated for obstructive jaundice at Ile-Ife, Nigeria was undertaken. Neoplasms of the pancreas, liver, and bile duct were the common causes. Percutaneous Transhepatic Cholangiography (PTC) with hypotonic duodenography was excellent in determining the underlying lesions. Pancreatic carcinoma accounted for 28% of cases, cholelithiasis 24%, hepatoma 22%, metastatic cancer 14%, bile duct carcinoma 10%, and traumatic pancreatic pseudocyst 2%. The patients with malignancies were older than those with biliary calculi. Biochemically, elevated alkaline phosphatase, and conjugated hyperbilirubinaemia, particularly in malignant obstructions, were diagnostic. Benigh bile ductal obstructions were surgically managed without any mortality. Malignant obstructions were surgically managed without any mortality. Malignant obstructions with their advanced presentations were less successfully managed. Biopsy alone or palliative bypass procedure could only be offered and the survival rate was dismal.
West Afr J Med
PMID:Diagnosis, management and prognosis of obstructive jaundice in Ile-Ife, Nigeria. 992 Oct 92

Many patients undergoing surgery for gastric carcinoma will develop peritoneal metastases. A method to identify those patients at risk of peritoneal recurrence would help in the selection of patients for adjuvant therapy. Peritoneal cytology has received little attention in the West, but may prove a useful additional means of evaluating patients with gastric cancer. The aims of this study were to evaluate sampling techniques for peritoneal cytology in patients with gastric cancer, to assess the prognostic significance of free peritoneal malignant cells and to discover the effect of the operative procedure on dissemination of malignant cells. The study is based on 85 consecutive patients undergoing surgical treatment of gastric cancer and followed up for 2 years or until death. Peritoneal cytology samples were collected at laparoscopy, and at operation prior to resection by intraperitoneal lavage and serosal brushings. After resection, samples were taken by peritoneal lavage, imprint cytology of the resected specimen and post-operatively by peritoneal irrigation via a percutaneous catheter. Malignant cells were diagnosed by two independent microscopists. Preoperative peritoneal lavage yielded malignant cells in 16 out of 85 cases (19%). The yield of free malignant cells was increased by using serosal brushings (by four cases) and imprint cytology (by two cases); all of the cases had evidence of serosal penetration. One serosa-negative case exhibited positive cytology in the post-resection peritoneal specimen in which the preresection cytology specimen was negative. Survival was worse in the cytology-positive group (chi2 = 25.1; P< 0.0001). Among serosa-positive patients, survival was significantly reduced if cytology was positive, if cases yielded by brushings and imprint cytology were included (log-rank test = 8.44; 1 df, P = 0.004). In conclusion, free peritoneal malignant cells can be identified in patients with gastric cancer who have a poor prognosis; the yield can be increased with brushings and imprint cytology in addition to conventional peritoneal lavage. Evaluation of peritoneal cytology by these methods may have a role in the selection of patients with the poorest prognosis who may benefit most from adjuvant therapy.
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PMID:Peritoneal cytology in the surgical evaluation of gastric carcinoma. 1002 23

Granulosa-theca cell tumours are ovarian neoplasms of low malignancy with hormone secreting potential, accounting for 2-3% of all ovarian cancers. They have an uncertain clinical course and a potential for late recurrence after surgical removal. Clinical features of a patient presenting with pulmonary metastases 21 years after removal of the primary tumour are described, along with a review of the management options.
West Indian Med J 1999 Mar
PMID:Granulosa-theca cell tumour of the ovaries. A late metastasizing tumour. 1037 91

Gastric cancer is often advanced and unresectable at diagnosis. Even when a curative resection is possible, the 5-year survival rate for patients with T2 or higher tumors is less than 50%. Survival rates are even lower if lymph node metastases are present at surgery. Many phase III trials of adjuvant therapy have been conducted around the world during the past 4 decades, but their interpretation varies in the East and West. In the West, postoperative treatment modalities have not proven to be superior to postsurgical observation alone. Thus, at present, the routine use of postoperative therapy should be discouraged. In the Orient, however, routine use of postoperative chemotherapy and/or immunotherapy is common after a surgical procedure. Further investigations that correlate treatment response with molecular markers are needed. Improved clinical trial designs, including better preoperative staging, standardized surgical techniques, inclusion of adequate numbers of patients, and the continued use of a surgery-alone control group, are essential. In addition, the incorporation of newer active agents, radiotherapy, and new strategies, such as preoperative therapy and selection of patients based on tumor biology, would result in much-needed advances. Less toxic approaches with novel mechanisms of action, such as antiangiogenesis therapy, tumor vaccines, monoclonal antibodies, and matrix metalloproteinase inhibitors, also hold promise.
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PMID:Adjuvant therapy for gastric carcinoma: closing out the century. 1058 99

Since it is still an open debate whether malignant tumors are mainly influenced by environmental factors, the frequency of such malignant tumors in historic populations with different living conditions is of particular interest. In the present study, we investigated the occurrence of malignant tumors affecting bone tissue in a population of mumrnies and skeletons, which had been excavated from the large necropolis of Thebes-West, Upper Egypt. Our study material comprised a series of at least 415 individuals (thereof 325 adults) dating from approx. 1500-500 B.C. All individuals had been mummified, but were severely damaged and partially broken by grave robbers, so that often only parts of the mummies/skeletons were available for investigation. The available specimens were subjected to careful macroscopic examination, while isolated findings were radiologically analyzed. Using this approach, we identified at least 4 cases showing malignant tumors affecting the skeleton. In two cases, multiple mixed osteolytic-osteoblastic lesions suggested multiple metastases from carcinomas. Two further individuals presented with multiple osteolyses (vertebra, pelvis, skull) most suggestive of multiple myeloma. The observation of at least 4 cases of malignant tumors with osseous manifestation in a series of 325 adult individuals provides clear evidence that malignant tumors were not a rare event in the ancient Egyptian study population, particularly when the limitations of a study of tumors manifested only in osseous remnants are taken into consideration. A calculation of the age- and sex-adjusted tumor frequency in our material in comparison with a recent model for such a material by Waldron (1996) indicates that the rate of malignant tumors with bone affection in our series is higher than in an English population from 1901-1905, although lower than in a comparable present day population. This clearly indicates that important factors affecting malignant tumors were effective even in historic populations.
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PMID:Malignant tumors in an ancient Egyptian population. 1062 86

The 5-year overall survival after curative gastrectomy for gastric cancer is markedly different in the West from that in the Far East. Japanese surgeons feel that extended lymphadenectomy contributes to this superior survival, although survival differences may reflect improved staging or less aggressive tumor biology. We analyzed consecutive cases of gastric adenocarcinoma diagnosed and treated at the University of California, Irvine Medical Center from 1989 through 1998 to determine whether patients of Asian descent diagnosed with gastric cancer in Southern California have improved outcome. Fifty-two cases (36%) occurred in patients of Asian descent (39% Vietnamese, 31% Chinese, 13% Korean, 6% Filipino, and 2% Japanese). Only one Asian patient was born in the United States. Non-Asian patients (67% white, 30% Latino, and 3% black) were younger (59 years vs 64 years; P < 0.05) and more likely to have tumors of the gastroesophageal junction (33% vs 4%; P < 0.001). Asian patients were less likely to have distant metastases (24% vs 39%; P = 0.08), were more likely to undergo formal gastrectomy (71% vs 45%; P < 0.01), and were more likely to undergo a curative resection (40% vs 18%; P < 0.01). The overall survival of Asian patients at 3 years was significantly higher than the overall survival of non-Asians (39.4% vs 19.6%, P < 0.05). Asians with regional (node-positive) disease had superior survival (40.2% vs 14.8%, P < 0.05), which can be largely attributed to greater rates of resectability. We conclude that the clinical behavior of gastric cancer in Asians in Southern California differs from that in non-Asians. The increased proportion of resectable disease and improved survival of patients of Asian descent likely reflects less aggressive tumor biology.
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PMID:Asian gastric cancer patients at a southern California comprehensive cancer center are diagnosed with less advanced disease and have superior stage-stratified survival. 1099 8

Treatment results of gastric cancer patients differ considerably between Japan and the West, even at the same stage of disease. This may be partly explained by the varying extent of local control and the "stage-migration" theory. There is an important conceptual difference concerning lymphadenopathy and lymphadenectomy: Japanese surgeons believe that lymph nodes are the governors of metastatic disease and thus that lymphadenectomy will result in cure, while in the West lymph nodes are seen merely as the indicators of systemic metastasis and thus lymphadenectomy serves only for staging. The UICC TNM system has recently abandoned the anatomical N-classification and adopted the numeric N-classification. Although this is a good prognostic indicator, it does not provide surgeons with any information for surgical decision-making. Japanese surgeons will continue to use the Japanese classification that has served as a guideline for standard D2 lymphadenectomy. To establish an international standard for gastric cancer treatment, both sides should make efforts to understand each other and discuss most practical and beneficial treatment modalities for patients in the respective medical environments.
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PMID:[Problems of international standardization of gastric cancer surgery]. 1168 Oct 2

Since 1985, we have observed an increasing number of differentiated thyroid cancer cases in Huntington, West Virginia. We describe tumor incidence, patient and tumor characteristics, treatment modalities, and tumor recurrence and death. One hundred seventeen patients with differentiated thyroid cancer were identified between 1976 and 1999. Data were collected from patient records in our practice and the tumor registries at the three hospitals serving our community. The annual incidence of differentiated thyroid cancer increased significantly from fewer than 3 cases per 100,000 prior to 1996 to 9.4 cases per 100,000 in 1999. The median age at diagnosis was 49 years (range, 16-80). The median tumor size was 2.5 cm (range, 1.2-10). Forty-seven percent of the patients had bilateral disease, 28% had three or more tumors, 44% had thyroid capsular invasion, and 16% had gross extrathyroid invasion at surgery. Twenty-two percent had cervical lymph node involvement and 9% had distant metastases at diagnosis. During 1-month to 23-year follow-up, 11% had recurrence, and 5% died of thyroid cancer. In summary, differentiated thyroid cancer has increased dramatically in our community. The tumors appear to be aggressive at diagnosis as reflected by the high percentage of tumors with bilateral, multicentric, and locally invasive disease.
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PMID:Increasing incidence and characteristics of differentiated thyroid cancer in Huntington, West Virginia. 1176 17

Three hundred and eight-one cases of head and neck cancers were studied over a 10 year period (1988 - 1998) at the Lagos University Teaching Hospital, Lagos. The aim was to assess the various sites of primary lesion, gender and age distribution and histopathological types. The International Classification of Diagnosis Oncology's (ICDO) 9TH version was used to categorize sites of primary lesion. A yearly incidence of 38 cases was noted with an overall male preponderance. Forty-five percent of the patients with head and neck cancers were in their forth and fifth decades of life. The nasopharynx was the commonest site of primary lesion (16.8%) followed by the nose, paranasal sinuses and middle ear (ICDO - 160) with 13.6%. Laryngeal cancer ranked third accounting for 12.1% of the cases. Other common sites of primary lesion were: the skin (9.2%), the salivary glands (7.6%), the mandible (7.3%) and the thyroid gland (7.3%). Metastatic cancer in the neck with unknown primary lesion was seen in 2.9% of the patients. Cancers associated with heavy tobacco use e.g. laryngeal cancers, lip and tongue cancers showed a very high male predilection with M:F ratios of 10.5:1, 8:1 and 6:1 respectively. 91% of the head and neck cancers were of epithelial tissue origin while sarcomas accounted for only 6.6% of the cases. The results show that head and neck cancers affect Nigerians especially males at the prime of their working life. The devastating psychosocial effects on the individual, the family and the society are enormous. Emphasis on cancer prevention is recommended.
West Afr J Med
PMID:Pattern of head and neck cancers among Nigerians in Lagos. 1176 8


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