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

An analysis of 246 operated patients with 260 carcinomas of the external ears from the periods 1949-57 and 1962-67 is presented. Carcinoma of the external ear occurs in Denmark with a frequency of 1.2 cases per 100 000 inhabitants and constitutes approximately 6% of all skin cancers. In the present material 67% of the tumours were squamous-cell carcinomas and 30% were basal-cell carcinomas. These forms of tumours were most frequent in elderly men who have had outdoor employment. Half of these tumours were sited on the helix and lobe, while one quarter, respectively, were sited medially and laterally. 15% of the squamous-cell carcinomas recurred, 3% of the these with metastases of the regional lymph nodes. Of the basal-cell carcinomas 18% recurred but with no metastases of the regional lymph nodes. The frequency of recurrence did not depend on the site of the tumour on the ear, but it did increase with increasing tumour size. The 5-year survival rate without recurrence was 56% +/- 4% for the squamous-cell carcinomas, and for the basal-cell carcinomas 59% +/- 6.5%. It is concluded that surgical treatment is best suited for these tumours, and the minimum excision distance for basal-cell carcinomas of less than 3 cm in size should be 8 mm, while for squamous-cell carcinomas of the same size the distance should be 10 mm. For both forms of tumour where the greatest extent is more than 3 cm the excision distance should be at least 15 mm.
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PMID:Carcinoma of the external ear. 101 87

Management problems in patients with recurrent squamous cell carcinoma (SCC) of the external ear (pinna) have prompted a review of the management and treatment outcomes of patients who present with localized disease. Forty patients were seen over a 15-year period (1972 to 1991). Thirty-six were men, and 4 were women, with an age range from 43 to 93 years (average age: 71 years). Presenting TNM status was stage 0 in 2 patients, stage I in 15 patients, stage II in 13 patients, stage III in 2 patients, stage IV in 4 patients, and unknown stage in 4 patients. Thirty-six patients had clinically negative nodes at presentation (N0), and 4 had palpable nodes (N+). The primary treatment was local excision in 13 patients, Mohs' micrographic surgery in 16 patients, local excision plus external beam radiotherapy in 4 patients, and radical resection (parotidectomy/neck dissection/mastoidectomy) with or without radiotherapy in 5 patients. Two patients with stage IV disease died after diagnosis and prior to treatment, and two other patients with stage IV disease received palliative chemotherapy. Twenty patients developed recurrence from 2 months to 8 years. It included nine local recurrences, eight regional recurrences (parotid/neck/mastoid), and three distant metastases (lung or brain). After treatment of the recurrences in 20 patients, 8 are alive 15 months to 16 years later, 2 patients died of other diseases, and 10 patients died of SCC. The recurrences were managed by reoperation, radiotherapy, or chemotherapy. From the results of this study, we conclude that localized carcinoma of the external ear has a high propensity for local and regional failure and merits more aggressive treatment of the primary lesion and elective treatment of the regional lymph nodes and parotid gland in high-risk patients.
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PMID:Localized carcinoma of the external ear is an unrecognized aggressive disease with a high propensity for local regional recurrence. 146 2

Management of melanoma of the external ear is controversial. Thirty-one patients treated for this disease were identified at our institution between January 1, 1974 and December 31, 1989. Follow-up was an average of 7.12 years (range 1-15). Local therapy performed included 16 wedge resections, 3 split thickness skin grafts after excision to the perichondrium, 10 partial and 2 total amputations. There were two local recurrences, four metachronous cervical metastases, and four distant metastases. Three elective and five therapeutic neck dissections were performed. Survivors at 1, 5, and 10 years were 93, 77, and 47%, respectively. There was no relationship between DNA ploidy, local surgical therapy, and eventual recurrence. Clinical stage and tumor thickness demonstrated a statistically significant correlation with likelihood of recurrence (P = .02 and .05). There is no evidence that melanoma of the ear has a poorer prognosis or different prognostic factors than melanoma at other cutaneous sites. In selected cases, local disease can be controlled by excision and skin graft rather than the more aggressive current procedures.
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PMID:Melanoma of the external ear. 159 81

Squamous cell carcinoma of the external ear can be a potentially lethal lesion. Although it is the most common cancer involving the pinna, the variables that have the greatest impact on prognosis are still in question. We reviewed 75 cases of squamous cell carcinoma of the external ear to determine patterns of occurrence and treatment failure. Forty patients had adequate follow-up for determination of cancer control rates. Local control was successful with initial treatment in 85% of the cases. The incidence of lymph node metastases was 10%, whereas distant metastasis occurred in only one patient (2.5%). This series differs from others in that most patients were unselected and most of the lesions treated were early (less than 1 cm). The significance of positive margins after surgical excision is also analyzed.
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PMID:Squamous cell carcinoma of the external ear: a review of 75 cases. 311 13

Although only a few of the malignant tumors of the skin develop in the external ear, they are more frequent than one would expect. These tumors recur and develop metastases more often than tumors in other sites. Because of this and because of surrounding vital structures, these tumors have a poor prognosis. Surgical therapy, that is, wide excision, is better than radiotherapy. Many methods for reconstruction of the external ear have been published, and sometimes plastic protheses are acceptable. From 1982 to 1986, 17 patients with malignant tumors of the external ear were treated in our center. There were 15 men and 2 women. The mean age was 73 years. There were 4 basal cell and 12 squamous cell carcinomas, and 1 patient had malignant melanoma of the external ear. Nine of these tumors were on the helix. During the follow-up period, 6 patients had local recurrent disease. In 7 patients, reexcision had to be performed several times after incomplete excision. Six patients are alive without any sign of the disease, and 3 patients died.
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PMID:Malignant tumors of the external ear. 323 32

This report describes an aggressive squamous cell carcinoma of the skin for which we suggest the name acute epithelioma. It is frequently larger than 2 cm and has a characteristic morphology with raised, rolled, vascular but not everted edges. Commonly there is a central crust covering a foul discharge on a papilliferous base. The biopsy is characteristically ambiguous but often that of a well differentiated squamous cell carcinoma. Irrespective of the history, which is usually short, all tumors have a period of rapid growth. Among 193 patients with squamous cell carcinomas of the eyelids or external ear, 24 (12%) of the tumors were designated as being acute epitheliomas. For the eyelids 15/125 (12%) patients were in this group; 10 (67%) had tumors larger than 2 cm, five (33%) developed regional metastases, and three (20%) had tumor related deaths. Irradiation controlled the primary tumor in 15 (100%) patients. Among the 68 ear tumors, nine (13%) were called acute epitheliomas. Eight (89%) were larger than 2 cm, three (33%) developed regional metastases, and two (22%) patients had tumor related deaths. Irradiation controlled the primary tumor in seven (78%) patients. It is postulated that these acute epitheliomas are virus induced tumors that develop in actinicly damaged and immunologically suppressed skin. Following treatment, careful follow-up is recommended because of their metastatic and lethal potential.
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PMID:Acute epithelioma--an aggressive squamous cell carcinoma of the skin. 408 65

The medical records of 486 patients with pathologically proved squamous carcinoma of the skin of the external ear were analyzed. It is a disease of elderly white men, and the helix is the most common site of origin. Well-differentiated squamous carcinoma is the most frequent histologic variant. Ninety-five percent of our patients were treated surgically with above-clavical control in 87 percent and 28 percent survival. The low survival rate was related to the old age of the patients who frequently died of intercurrent disease and second cancers. A 12 percent incidence of nodal metastases is comparable with the incidence reported in other series. Aggressive surgical ablation and the selected use of adjunctive postoperative irradiation appear justified in those patients with locally invasive tumors, multiple nodal metastases, and extracapsular invasion.
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PMID:Squamous carcinoma of the external ear. 662 89

A histological scoring system was created to determine the aggressiveness of basal cell carcinomas of the head and neck and to determine which squamous cell carcinomas of the external ear will develop metastases. Basal cell carcinomas of the external ear were the most aggressive. The parameters depth of growth and mode of invasion were the most valuable in predicting metastases.
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PMID:[Histologic scoring system for various cancers of the external ear]. 670 1

The metastatic properties of the M5076 tumor, a reticulum cell sarcoma of ovarian origin, were examined. This tumor metastasizes preferentially to the peritoneal viscera (liver, ovaries, spleen, and kidneys) regardless of the site or route of tumor cell injection. Subcutaneous tumor growth followed by direct invasion into the peritoneum resulted in extensive generalized peritoneal involvement. However, when tumor cells were injected in the dorsum, external ear, or footpad, fewer and primarily hepatic metastases developed. Hepatic, splenic, ovarian, and renal tumor colonies were formed after i.v. injection of tumor cells. Radiolabeled tumor cells were used to study the arrest, distribution, and survival of tumor cells injected i.v. These tumor cells were rapidly arrested in the lungs and were retained there for 3 to 4 days. They then slowly detached, recirculated, and were arrested in the liver, where they subsequently developed into tumor nodules. These results strongly support the "soil-seed" hypothesis of metastatic growth and demonstrate that long-term retention of tumor cells in an organ need not result in the formation of a clinically obvious tumor nodule.
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PMID:Metastatic behavior of a murine reticulum cell sarcoma exhibiting organ-specific growth. 701 33

All cases of squamous-cell carcinoma of the external ear that were treated at the ENT Clinic, University Hospital, Lund, Sweden, between 1970 and 1977 were analyzed retrospectively to determine parameters for predicting the development of metastases. These cases included 62 males and 3 females, with a mean age of 77 years. The frequency of metastases for these patients was 16.4%. The carcinomas were graded according to four parameters: depth of growth, mode of invasion, cellular differentiation, and cellular plasmolymphocytic response. We concluded that depth of growth and mode of invasion were the most useful of these parameters and that prophylactic lymph node dissection should be performed in cases of tumors larger than 4 cm in diameter, of tumors infiltrating the cartilage, and of smaller tumors with maximum scores for depth of growth and mode of invasion.
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PMID:Guidelines for prophylactic radical lymph node dissection in cases of carcinoma of the external ear. 736 89


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