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

Thirteen cases of primary endocrine carcinoma of the skin (Merkel cell carcinoma) were reviewed with the aim of defining the morphological, immunohistochemical and ultrastructural criteria for diagnosis. The tumour cells were characterized by their scanty cytoplasm, generally small uniform nuclei with finely dispersed chromatin and multiple small nucleoli. Nuclear shapes varied from round to spindle, with larger and pleomorphic forms predominating in 2 tumours. A striking feature seen in 12 tumours was the occurrence of a "ball-in-mitt" pattern represented by 1 or 2 crescentic tumour cells closely wrapped around an oval cell. Staining for neuron-specific enolase was the most consistent marker of the tumour and the characteristic juxtanuclear globular staining for keratin and cytokeratin and the occasional coexpression of neurofilament set this tumour apart from other cutaneous neoplasms, in particular, metastatic carcinoid tumours and oat cell carcinoma from the lung. The fine structural features of note were striking paranuclear or juxtanuclear whorls of intermediate filaments, seen in 7 cases, the presence of variable numbers of membrane-bound dense core granules of 80-150 nm diameter in all cases and cytoplasmic spinous or microvillous projections containing microfilaments in 4 cases. Less consistent characteristics of primary endocrine carcinomas of the skin included cell moulding, argyrophilia and immunohistochemical staining for ACTH, VIP and calcitonin. The high frequency of vessel invasion in this series is in keeping with the high rate of local recurrence, lymph node metastases and visceral dissemination reported. The distinction from other similar appearing tumours in the skin is discussed.
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PMID:Criteria for the diagnosis of primary endocrine carcinoma of the skin (Merkel cell carcinoma). A histological, immunohistochemical and ultrastructural study of 13 cases. 243 4

Between July 1981 and December 1983, 63 patients, with brain metastases were treated with an accelerated split course regimen; irradiation was given to the whole brain in 3 daily fractions of 160 cGy each (with 4-h interval between the fractions), for 5 days a week. The cycle was repeated after 2 weeks to a total dose of 4800 cGy. Male-female ratio was 3:1 (48 males and 15 females). Median age was 58 years (range 24 to 75). The most frequent site of primary tumor was lung (squamous cell carcinoma in 33 patients and oat cell carcinoma in 8 patients), breast in 6 patients, melanoma in 3 patients, other sites in 8 patients and unknown cancer in 5 patients. Thirty-five patients had multiple brain metastases localizations. In 33 patients (52.3%), metastases were present in other sites outside the central nervous system. Two patients failed to complete the scheduled treatment: one because of early death and the other by refusal of therapy during treatment. We obtained complete remission (CR) in 4 patients and partial remission (PR) in 24 patients. The median survival time was 21 weeks. The overall response rate was 42.5%. Toxicity was not considerable. The treatment results were not influenced by the site of primary tumor or by disease spreading; only the neurologic status before radiotherapy and the response to treatment influenced survival. The results we obtained are similar to those reported by other studies; however, with the accelerated split course regimen the treatment time was reduced and a shorter period of hospitalization was required.
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PMID:Accelerated split course regimen in the treatment of brain metastases. 245 31

We describe the case of a young pregnant woman with oat cell carcinoma diagnosed by immunohistochemical reactions and ultrastructural study of a mediastinal biopsy specimen. A neonate was delivered by a cesarean section without evidence of carcinoma, but a thorough pathologic examination of the placenta showed intervillous metastasis of the maternal oat cell carcinoma. This case is interesting, since placental metastases from solid tumors are rare (38 reported cases with pathologic examination of the placenta), and 39% of them arise from maternal melanomas.
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PMID:Placental metastasis from maternal bronchial oat cell carcinoma. 254 Jul 29

From July 1979 to July 1986, 215 patients with non-oat cell carcinoma of the lung were treated by surgery at our institution. Of these, 169 had complete, potentially curative resection of their primary tumor and all accessible mediastinal lymph nodes. The extent of pulmonary resection consisted of pneumonectomy in 70 patients, lobectomy in 78 patients, bilobectomy in 18 patients and wedge resection in 3 patients. All were staged according to the AJG staging system. There were 88 patients without lymph node metastases (N0), 10 patients with peribronchial lymph node metastases (N1) and 60 patients with regional lymph node metastases (N2). All patients with N2 disease received radiation therapy to the mediastinum after surgery. The overall survival rate was 62% at 1 year, 36% at 3 years and 27% at 5 years. Survival in patients with N2 disease was 56% at 1 year, 23% at 3 years and 12.4% at 5 years. We conclude that patients with mediastinal lymph node metastases can be effectively treated by combined resection and radiation therapy, with prolonged survival.
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PMID:[Lung cancer with mediastinal lymph node involvement. Results of the combination of surgery and radiotherapy]. 258 1

We present our experience with 18 bronchial carcinoids, two of those being of atypical histology. Mean age is 44 years, without sex preponderance. Clinical symptoms are poorly specific, with persistent cough and recurrent pneumonia as most frequent features. Carcinoid syndrome was seen in one patient. In 4 patients, the carcinoid tumor was an incidental finding on routine chest X-Ray film. Lack of pathognomonic clinical signs explains the considerable delay in diagnosis, with a mean of 10 months of clinical evAluation. Radiographic patterns are atelectatic lobe consolidation, a solitary coin lesion or a transparent lung field. All patients were submitted to bronchoscopic evaluation and only two endoscopic explorations remained negative, because of their peripheral localizations. In all other cases, there was a typical appearance of "cherry red adenoma". Mediastinal extension was present in 2 cases, while extrathoracic metastases were never found. Whenever possible, surgical resection was performed (16 cases). Two patients got endoscopic extirpation of their tumor. There is one postoperative hospital death. This study was done to gain a better understanding of clinical, diagnostic and pathologic features of bronchial carcinoid tumors, and their implications in terms of therapy and prognosis. The authors discuss clinical, diagnostic and therapeutic aspects of bronchial carcinoids as well as their microscopic appearance and relationship with oat cell carcinoma.
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PMID:[Carcinoid tumors of the bronchi. Our experience of these during the last 10 years, with a review of the literature]. 267 50

A serum assay of CA-50, CA-125, CA-19.9, ENOLASE (NSE) and CEA was performed in 65 patients with primary lung cancer, 63% of whom had visceral metastases, with the following histological distribution: squamous carcinoma (40), adenocarcinoma (9), large cell carcinoma (4), oat cell carcinoma (12). A raised CEA level was detected in 37% of cases, compared with 40.6% for CA-50, 44.6% for CA-19.9 and 40.6% for CA-125 and only 26.6% for NSE. Overall, at least one marker was positive in 83% of cases. Statistical analysis of the different markers (correlation analysis and principal component analysis) demonstrated the existence of a strict correlation between the levels of CA-50, CEA and CA-19.9 (p less than 0.01). ENOLASE was more frequently elevated in oat cell carcinomas (42%) than in non-oat cell carcinomas (30%), but the difference was not significant. In contrast, CA-125 appears to be a good marker for non-oat cell carcinomas (51%) (p less than 0.05). The authors also found a correlation between the presence of a raised level of CA-50 (p less than 0.05), CA-125 (p less than 0.02) and especially CEA (p less than 0.001) and the presence of visceral metastases. The initial survey of disseminated lung cancers should include the assay of at least 4 of these markers in order to obtain a reliable serum tracer in more than 2/3 of cases.
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PMID:[Comparative analysis of serum levels of CA-50, CA-125, CA-19.9, enolase and CEA in bronchopulmonary cancer]. 282 32

Two cases of oat cell carcinoma are described. Both patients presented initially with a lump in the breast. A review of the published reports on breast metastases as a presenting feature of malignant disease was performed and lung cancer was found to be the commonest extramammary tumour to present as a breast mass (80% of cases) and usually as small cell carcinoma.
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PMID:Breast lumps: rare presentation of oat cell carcinoma of lung. 283 51

A 54-year-old man with small cell carcinoma of the esophagus and extensive metastases to the liver and bone is presented herein. Ectopic hormone production and a high level of serum NSE (neuron specific enolase), as revealed by biochemical and radioimmunoassay, suggested that this tumor was derived from the cells of the APUD (amine precursor and dehydroxylation) series. He was treated with a combination chemotherapy, resulting in a prompt remission with significant palliation lasting five months. Small cell carcinoma of the esophagus is as responsive to chemotherapy as small cell carcinoma of the lung. Although this is an uncommon tumor, recognition is important because of its responsiveness to chemotherapy and the potential for significant palliation of symptoms without surgical intervention.
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PMID:Small cell carcinoma of the esophagus: report of a case treated with chemotherapy. 284 21

A fifty-seven-year-old woman with urinary bladder carcinoma with extensive areas resembling oat cell carcinoma of the lung in whom distant metastases developed, died seven months after diagnosis. Argyrophil cells could not be demonstrated, but electron microscopy demonstrated dense-core, membrane-bound intracytoplasmic granules. We reviewed 12 cases of epithelial neoplasms of the bladder from the literature in which there was ultrastructural evidence of neuroendocrine differentiation. Cases with malignant histologic features, like their pulmonary counterparts, have the potential for widespread dissemination and rapid growth. We support the previous suggestion that these neoplasms may be of considerable incidence and their recognition is important to determine prognosis and selection of therapy.
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PMID:Small cell carcinoma of urinary bladder. 284 28

From 1979 to 1987, 907 patients with non-oat cell carcinoma of the lung were subjected to thoracotomy: of these, 685 (75.5%) underwent radical resection of the lung tumour. The 230 stage IIIa patients were studied in this paper. These were divided into three groups. First group: 93 patients with only local parietal or mediastinal spread without involvement of the mediastinal lymph nodes (T3N0-1M0); the 5-year survival of this group was 35% (44.1% when the ribs and muscles were not affected). A second group of 118 patients had tumour spreading to the mediastinal lymph nodes, but without local involvement (T1-2N2M0): this group had a 5-year survival of 22.3%. The 5-year survival was better in patients without metastases in the subcarinal lymph nodes than in patients with them (23.76% versus 12.89%). Skipping of lymphatic levels was frequent: 37% of patients with metastasis to mediastinal lymph nodes did not have metastases in the lymph nodes of the lung; 10% of tumours removed by lobectomy had metastases in the lymph nodes of the residual lobe. The third group with parietal and lymphatic mediastinal invasion (T3N2M0) had a poor survival (13.5% at 5 years). The author concludes that it is possible to achieve an acceptable 5-year survival in selected cases with metastasis to mediastinal lymph nodes: when the CT scan demonstrated mediastinal lymph nodes larger than 1.5 cm, mediastinoscopy was carried out and, if positive, the patient was judged inoperable.
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PMID:Results of radical treatment of stage IIIa non-small-cell carcinoma of the lung. 285 5


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