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)

Malignant mixed tumor of salivary glands is a rare tumor whose variable behavior and prognosis are related for the most part to the clinical stage and histologic grade of the carcinomatous component. The purpose of this study is to predict prognosis by comparing the histologic grading and subclassification of the carcinomatous component with the immunohistochemical reactivity for E-cadherin, P53 mutation protein, and cellular proliferation (Ki67). Stains were performed on formalin-fixed paraffin-embedded tissue sections from 18 cases of malignant mixed tumor. Clinical follow-up was obtained for each patient. Regional lymph node and distant organ metastases were the criteria for poor prognosis. Of seven cases with lymph nodes metastasis, five were high-grade tumors (with one subsequent death from brain metastasis) and two were low-grade. Of the eight high-grade tumors, positivity for Ki67, p53, and E-cadherin were noted in six, four, and two cases, respectively. In contrast, of the 10 low-grade tumors, two stained with Ki67, five with p53, and none with E-cadherin. Most notably, all seven metastatic cases (as opposed to only one of 11 nonmetastatic tumors) had Ki67 reactivity of more than 10%. We conclude that malignant mixed tumor represents a spectrum of malignancies in which the clinical behavior is closely related to the carcinomatous element. In addition to histologic grading, Ki67 is a useful prognostic marker in the evaluation of malignant mixed tumor while p53 and E-cadherin appear to be of limited value.
 ...
PMID:Prognostic factors in malignant mixed tumors of the salivary gland: correlation of immunohistochemical markers with histologic classification. 1217 Apr 50

Malignant mixed tumor of the parotid is known to have odd sites for metastases. We describe the fine-needle aspiration cytology (FNAC) findings of pleural metastasis from a malignant mixed tumor misdiagnosed as a mesothelioma on cytology at the onset.A 47-year-old man presented to us with breathlessness and a massive pleural effusion with pleural-based nodules. He had been operated 2 years before for a pleomorphic adenoma of the parotid and had a healthy scar at that site. FNAC from the pleural lesions showed myxoid background substance with entrapped cuboidal epithelial cells with atypical nuclei, which were interpreted as mesothelial cells. These cells in contrast to the usual mesothelial cells were not arranged in sheets but rather were huddled in places and formed a pseudoacinar pattern and blended with the myxoid substance.After the diagnosis of a mesothelioma, patient received pemetrexed and cisplatin based chemotherapy with partial response. While on chemotherapy tumor recurred at the primary site in parotid and was confirmed to be a carcinosarcoma on a FNAC and biopsy.To conclude, pleural metastases from a true malignant mixed tumor of the parotid gland can be misdiagnosed as mesothelioma and could occur in the absence of uncontrolled disease at primary site. Both mesotheliomas and pleomorphic adenomas metastatic to the pleura are biphasic tumors, but in a patient with history of pleomorphic adenoma, the latter should be kept as a foremost possibility. Attention to the cytomorphology of tumor cells will also assist in confirming the diagnosis.
 ...
PMID:Fine-needle aspiration biopsy of pleural metastases from a carcinosarcoma or true malignant mixed tumor of the parotid gland mimicking a mesothelioma. 1937 13