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)

Nine cases of aggressive angiomyxoma (AAM) of the pelvic soft parts were studied by light and electron microscopy and immunohistochemistry. The tumors were confined to the vulva, vagina, pelvic floor, and perineum in the seven women. The perineum and the para-anal region were involved in the two men. The patients ranged in age from 18 to 63 years. Aggressive angiomyxoma presented as a slowly growing, polypoid or cyst-like tumor. Six of the nine cases were followed up; all of the tumors recurred within nine to 84 months, and one recurred for the second time at 144 months. Recurrences were attributed to incomplete tumor excision. None of the six patients died or had metastases. The aggressive angiomyxomas had infiltrative borders and rubbery, white or soft, gelatinous cut surfaces. Histologically, the lesions were composed of stellate and spindle-shaped neoplastic cells embedded in a collagenous and hyaluronic acid-containing stroma. Nuclear atypia and mitoses were absent. Typically, the lesions had an important vascular component, often displaying medial hypertrophy and vascular grouping. Ultrastructurally, the neoplastic cells resembled fibroblasts rather than myofibroblasts. They showed strong immunoreactivity for actin but were negative for S-100 protein, Factor VIII, carcinoembryonic antigen, and keratin. The morphoimmunocytochemical characteristics of AAM cells favor a fibroblastic origin and differentiation. Aggressive angiomyxoma should be distinguished from the more common benign and malignant myxoid neoplasms or tumor-like conditions of the pelvic soft parts. Recurrence of AAM may be avoided by wide, local excision.
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PMID:Aggressive angiomyxoma of pelvic soft parts: a clinicopathologic study of nine cases. 399 39

No results from therapeutic trials describing the best therapeutic procedure for cervical carcinoma in stages I and IIa are available. Analysis of a series of 242 cases of cervical carcinoma in stages I and IIa, from 1975 to 1980, treated with radical surgery and radiation therapy, yields a therapeutic approach that envisions the most reliable evaluation of subclinical extension, cure of cervical tumor and prevention of pelvic or extra-pelvic metastases with a minimum of post-radiation problems. The choice of combination surgery and radiation therapy is primarily determined by staging and the volume of the central pelvic tumor. For stages I and IIb (upper third of vagina involved) with central pelvic tumor less than 4 cm in diameter, the usual procedure is recommended i.e. radium application, total hysterectomy with pelvic lymphadenectomy followed by external irradiation of pelvic lymphatics in cases with lymphadenopathy. For stages IIb (obvious parametrial involvement) and for stages I or II with central pelvic tumor between 4 and 6 cm in diameter: total dose external and internal pelvic radiation therapy followed by total hysterectomy without pelvic lymphadenectomy but with exploration of obturator, hypogastric, external iliac, common iliac, and aortic nodes. For the rare supravaginal central pelvic tumors greater than 6 cm in diameter, the risk of clinical evaluative error and incomplete sterility by irradiation alone, warrants first an explorative laparotomy using Wertheim's procedure, then pelvic lymphadenectomy and exploration of pelvic and aortic lymph nodes.
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PMID:[Radiation and surgical treatment of cancer of the cervix uteri in proximal stages I and II]. 402 41

Estrogen receptor (estrophilin) has been identified in ovarian carcinomas by a variety of physicochemical methods. Since these methods require disruption of the tissue, they do not provide any anatomic information about the cellular distribution and location of receptor. The authors have used monoclonal estrophilin antibodies and an indirect immunoperoxidase technique to study the immunocytochemical localization of estrogen receptor in 43 tissue samples of ovarian carcinoma from 27 patients. The immunocytochemical findings were compared with the results of conventional estrogen receptor assays of cytosolic and nuclear extracts prepared from adjacent pieces of ovarian carcinoma. Exclusively nuclear localization of estrogen receptor was observed with the immunocytochemical technique in all of the 25 tumor samples which had a cytosolic estrogen receptor content, determined by either the dextran-coated charcoal or hydroxylapatite techniques, greater than 700 fmoles/gm wet weight of tissue. Only 3 of 16 tumor samples with cytosolic estrophilin concentrations of less than 700 fmoles/gm wet weight displayed nuclear staining for estrogen receptor; two of these three were metastases from receptor-rich primaries. Specific cytoplasmic staining for estrogen receptor was not observed. These results indicate that many ovarian carcinomas have estrogen receptor, predominantly localized in the nucleus, which is similar to tissues of the female genital tract (vagina, cervix, endometrium, fallopian tube) and breast carcinoma.
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PMID:Immunocytochemical identification of estrogen receptor in ovarian carcinomas. Localization with monoclonal estrophilin antibodies compared with biochemical assays. 403 69

This editorial consists of summaries of the discussions on incidence, pathogenesis, prognosis and patient follow-up, and transcripts of the discussions on detection and treatment of endometrial carcinoma, from a symposium held in Carefree, Arizona. 75% of the cancers occur in postmenopausal women; average age is 52 years, but is decreasing. Endometrial carcinoma rose from 20.3 to 46.3% of all uterine cancers in Cleveland University Hospitals from 1941-1970. Older patients are often diabetic, overweight, nulliparous, with anovulatory or familial history; young women frequently resemble mild Stein-Levinthal syndrome. Clinically, 20% of patients are assymptomatic, others may have softer or larger uterus, larger ovaries, irregular postmenopausal bleeding, or lengthy onset of menopause. The Gravlee jet wash is indicated for high risk patients and those about to take estrogen. Endometrial carcinoma first affects epithelium, then endometrial stroma, then upper myometrium, lower myometrium, then other organs, perhaps via lymphatics, vagina, tubes, but ascites is uncommon. Generally, U.S. physicians use intrauterine radium followed by surgery, British use surgery first, and Swedish use radiation only. Cases must be treated individually, e.g. surgery only for minimal cancer, radium and surgery for more serious cases, and preoperative external radiation also for advanced disease. Although radiation lessens chance of implantation during surgical trauma, insertion of intrauterine radium enhances spread of tumor cells. Injectable progestins sometimes control metastatic disease, although they require 8 weeks to act. Progestins may help those with late recurrence, squamous metaplasia, or who are under 50 years of age. Estrogens are rarely effective. Prognois for terminal patients often includes subjective improvement, bowel obstruction, lung complications, hemorrhage. Radiation side effects and menopausal symptoms are often problems for cured patients. In young cured patients the endometrium should be suppressed with progestins or oral contraceptives.
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PMID:Endometrial cancer: rising incidence, detection and treatment. 469 33

From January 1960 to June 1974, 71 patients with a postsurgical relapse of endometrial adenocarcinoma have been referred to the Radiology Institute of the University of Florence. Eleven patients showed hematogenous metastases; the remaining 60 cases showed locoregional relapses and were treated with radiotherapy. Forty-eight patients, whose relapse was localized to the pelvis, vagina, inguinal nodes or perineal scar, were treated with a radical aim (4,500-6,000 rad in 5-6 weeks); the treatment was palliative in 12 cases with abdominal extrapelvic relapse. The therapeutic response was not evaluated in 8 patients lost to follow-up shortly after the treatment. In the cases treated with a radical scope, a complete regression was attained in 22 of 43 (51%); a survival rate of 16 of 43 (37%) was attained at 5 years. In 9 cases treated with a palliative aim, only subjective remission was attained, and no patient was alive one year after the therapy. The most favorable therapeutic response was attained in the vaginal relapses (50% survivors at 5 years) and the cases with a late recurrence (more than 3 years) after the initial surgery. No definite correlation was found between the prognosis of the relapse and the histological grading of the primary tumor.
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PMID:Salvage with radiotherapy of postsurgical relapses of endometrial cancer. 615 57

Twelve patients who were primarily irradiated at the Princess Margaret Hospital (PMH) for mucosal melanomas of the head and neck and 6 patients irradiated for mucosal melanomas of the vagina and anorectal region are reported. The PMH results of irradiation of mucosal melanomas of the head and neck are combined with the literature results for this type of melanoma. A total of 24 patients who had 25 areas irradiated are considered. The complete remission rate locally is 72% (18 of 25 areas treated). Seven of the 18 patients who achieved complete local remission subsequently relapsed locally (9 to 144 months post treatment); 11 are in maintained complete local remission (9 to 54 months). Four died of intercurrent disease without melanoma, 5 are alive and well post irradiation, one recurred regionally and was salvaged surgically and one died of distant metastases without local or regional relapse. Only 1 of 7 patients who failed to respond to irradiation was salvaged with subsequent surgery, the others all died very rapidly following unsuccessful irradiation. Analysis of local control versus fraction size revealed that 6 of 7 patients treated with a fraction size of 400 rad or more achieved complete remission as compared to 5 of 18 treated with a fraction size of 399 rad or less. The results of primary irradiation for mucosal melanomas of the head and neck are compared with the literature on radical surgery, it is concluded that in view of the poor results of radical surgery that large dose per fraction irradiation should be seriously considered as the initial treatment of choice for primary mucosal melanomas of the head and neck. Four patients with vaginal melanomas were treated at the PMH, all achieved complete remission locally, 2 recurred at 18 and 28 months, one is alive and well at 3 years and one died of intercurrent disease at 1 1/2 years. Two patients with anorectal melanoma had transient palliative benefit from irradiation. Since the treatment of both vaginal and thick (greater than 2 mm) anorectal melanoma is essentially palliative it is suggested that irradiation should be considered as an alternate treatment to radical treatment in these conditions.
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PMID:Radiotherapy for mucosal melanomas. 618 Oct 42

Four cases of squamous cell carcinoma with sarcoma-like stroma located in the vulva (1), vagina (2) and cervix (1) of postmenopausal women are presented. The gross and microscopic features are very similar to those of similarly named tumors occurring in the upper respiratory and digestive tract and in the skin. Light microscopic, electron microscopic, and immunohistochemical examination provided convincing evidence that these tumors are composed solely of squamous cell carcinoma, which has undergone a spindle cell sarcoma-like transformation in the deeper portions. Follow-up revealed an aggressive clinical course in three of the four patients, who died of their tumor between 2 and 45 months after presentation. At the time of death, two of the patients had widespread metastases and the other had massive local recurrence.
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PMID:Squamous cell carcinoma with sarcoma-like stroma of the female genital tract. Clinicopathologic study of four cases. 619 57

Three hundred fifty-nine patients with gestational trophoblastic disease (choriocarcinoma and invasive mole) received complete treatment at the Brewer Trophoblastic Disease Center of Northwestern University Medical School from 1962 through 1978. Data were gathered as of December 31, 1978, to permit a minimum follow-up of 2 years. An overall remission rate of 92% was achieved: 100% (185/185) for nonmetastatic disease and 83% (144/174) for metastatic disease. All 200 patients with invasive mole and 129 of 159 patients (81%) with choriocarcinoma were cured. Chemotherapy was the main form of treatment, with adjuvant surgery and radiation therapy being used in selected patients. Five factors were determined to significantly influence response to treatment in patients with metastatic disease: 1) clinicopathologic diagnosis of choriocarcinoma versus invasive mole (71 versus 100%, P much less than .0005); 2) pretreatment human chorionic gonadotropin titer greater than 100,000 IU/liter and time greater than 4 months from pregnancy event to treatment (62 versus 93%, P much less than .0005); 3) metastases to sites other than lung and/or vagina (37 versus 92%, P much less than .0005); 4) antecedent term gestation compared with hydatidiform mole, abortion, and ectopic pregnancy (56 versus 79%, P less than .02); and 5) prior unsuccessful chemotherapy compared with no previous treatment (48 versus 83%, P much less than .0005). The value of secondary chemotherapy and adjuvant irradiation was evaluated. Relapse from remission was also studied.
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PMID:Gestational trophoblastic disease: treatment results at the Brewer Trophoblastic Disease Center. 628 7

In order to better define the frequency and patterns of metastasis to the female genital tract, all cases of nonhematopoietic metastases to the adnexa, uterus, vagina, and vulva encountered in patients treated at Barnes Hospital between 1950 and 1981 were reviewed. Three hundred twenty-five metastatic cancers from 269 patients were recovered. One hundred forty-nine cases were from extragenital primaries; the remaining tumors were intragenital metastases. Ovary and vagina were the most frequent metastatic sites for both extragenital and genital primaries. The majority of the extragenital metastases were adenocarcinomas from the gastrointestinal tract, but a variety of other primaries did spread, on occasion, to the genital tract. Twenty-seven percent of the metastases presented as possible primary gynecologic lesions, and 75% of these tumors had an extragenital origin. It is shown that despite certain trends in the distribution of metastases, all sites in the female genital tract are at risk for the occurrence of metastases.
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PMID:Metastases to the female genital tract. Analysis of 325 cases. 632 66

In the treatment of AGS, the pediatric surgeon is faced with the task of correcting the form and appearance of the virilized female genitalia as early as possible. For severe forms, a pull-through operation of the vagina and closure of the urethral fistula is necessary. At the same time, the hypertrophied clitoris should be corrected by a reduction plasty or backward displacement of the crura. The prospects for cure after treatment of adrenal cortical or ovarian tumours are usually poor. The tumours are malignant in over 85% of cases and metastasize early. The secondary sexual characteristics produced by the tumours regress only partially. When bony development is advanced, these patients inevitably remain small after growth ceases. Cortisone substitution under the guidance of the pediatric endocrinologist is essential at all surgical procedures.
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PMID:Virilizing diseases and tumours of childhood. Pediatric surgical aspects. 634 85


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